The role of trace metals, especially copper and zinc, in the pathogenesis of rheumatic conditions has continued to receive much interest following the initial upsurge of research activity in the 1970s. Meantime also copper and zinc complexes receive continued attention for their potential anti-inflam matory actions. Since the previous major titles were published in this field some years ago (e. g. 1,2) it was considered timely to consider progress which has been made in the interceding period. Thus in this volume aspects are re viewed of the metabolism and biodisposition of copper and zinc, especially as they may be influenced by inflammatory processes, the mode of action of copper and zinc compounds in inflammatory states, and the actions of some newer copper complexes. While we still understand relatively little about how copper and zinc complexes work in inflammation, and indeed what the fate of the ligands and their complexed ions is in inflammation, it is hoped that this volume will be useful for giving a current view of the "state of art" in the field. Special thanks are given to the valued efforts of the contributors, Dr Peter Clarke (Publishing Director, Kluwer Academic Publishers) and Mrs Veronica Rainsford-Koechli for her help in proof-reading the manuscripts. K D Rainsford Hamilton, Ontario, Canada February 1989 References 1. Rainsford, K. D., Brune, K. and Whitehouse, M. W. (eds) (1981). Elements in the pathogenesis a treatment of inflammation."

In this issue of Rheumatic Disease Clinics, guest editors Drs. Eli Miloslavsky and Anisha Dua bring their considerable expertise to the topic of Vasculitis. Top experts in the field cover key topics such as vasculitis mimics and other related conditions; vasculitis and pregnancy: disease state and medication management; CNS vasculitis: PACNS and CNS manifestations of systemic vasculitis; ENT manifestations of vasculitis; isolated aortitis workup and management; and more. Contains 14 relevant, practice-oriented topics including peds vasculitis: Kawasaki's and COVID MIS-C; emerging therapies EGPA; managing immunosuppression in vasculitis patients in the time of COVID; future of vasculitis: DEI in vasculitis clinical trials, pathway targets, precision medicine, PROs, models for damage/relapse, biomarkers; and more. Provides in-depth clinical reviews on vasculitis, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In recent years there have been a number of significant developments of natural products for the treatment of rheumatic diseases, pain and gastro-intestinal ulcers and inflammation. The volume covers some of these novel developments of natural products which are of current and future interest as therapies for the above-mentioned conditions. Most available volumes cover a wide range of biological and technicological aspects of natural products and their discovery, some involving synthesis and properties of chemical compounds. The difference in this volume is that the natural products have a focus on their therapeutic effects on pain, arthritic and gastrointestinal diseases. Some of the natural products covered are either at the experimental stage of development while others are well-established clinically-used products. Each has its own unique place in therapy.

Autoimmune (IgG4-related) Pancreatitis and Cholangitis reviews the breadth of clinical, imaging, histological, laboratory, and imaging features associated with IgG4-associated systemic disease, especially AIP and IAC. Written by experts in their fields, each chapter includes an overview of existing data as well as the most up-to-date scientific information and emerging data. The book also addresses areas of uncertainty and controversy, briefly highlighting clinical and research needs relative to the respective topic. Comprehensive and easy to use, Autoimmune (IgG4-related) Pancreatitis and Cholangitis is a valuable resource for physicians who deal with or are interested in these complex disease processes, including gastroenterologists, hepatologists, and surgeons.

Integrative Rheumatology offers a new and much-needed perspective in disease and symptom management, blending conventional medicine with alternative approaches not typically included in a Western medical practice. While conventional treatments can provide considerable symptomatic relief and can even slow the progression of many rheumatologic conditions, integrative treatment incorporating lifestyle interventions, mind-body approaches, and practices such as acupuncture and meditation into conventional medical therapies can improve quality of life, reduce medication dosages, and are generally better tolerated. In this book, researchers and clinicians highlight specific gaps in conventional rheumatologic care and examine how alternative approaches may be ideally suited to address these missed opportunities. Here, the authors introduce topics not typically addressed in conventional rheumatology texts, including nutritional therapies, exercise, herbal medicine, mind/body approaches, Ayurveda, and energy medicine. The contributors, all of whom have a background in academic medicine, share the approaches that they have found most effective in their own practices, basing their work on the best scientific evidence available. Ultimately, an understanding of complementary and alternative approaches to healing can help clinicians care for their patients using the best proven therapies to modify disease progress and relieve pain and disability.

This book is a practical and evidence-based guide to performing clinical musculoskeletal ultrasound for patients suffering from various rheumatic diseases. It represents the best current thinking on the role of ultrasonography in the assessment of pathology, diagnosis and treatment of these disorders. Following introductory chapters covering fundamental techniques and pitfalls of musculoskeletal ultrasound, the book discusses the uses of ultrasound to identify and monitor different rheumatic conditions, including rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, pediatric musculoskeletal disorders, carpal tunnel syndrome and inflammatory conditions. It concludes with a chapter dedicated to ultrasound-guided interventional procedures, with illustrations depicting patients and probe positioning. Featuring contributions from a large international group of leaders in musculoskeletal ultrasonography, Musculoskeletal Ultrasonography in Rheumatic Diseases is an authoritative reference for rheumatologists, sonographers, radiologists and orthopedic specialists.

The result of modern pathological research, this book offers quickly accessible and clearly arranged information on the 29 most important diseases that belong to the complex of rheumatic diseases: It includes clinical features, helpful marginal notes, an extensive subject index, a comprehensive bibliography, and approximately 300 illustrations, most of which are light, electron, or scanning electron micrographs. The reader is presented with a useful basis for diagnostic considerations and therapeutic decisions. By intensively analysing disease processes and their stuctures and by integrating modern immunological and molecular biological knowledge, the author has succeeded in providing the different pathological entities with a more distinct profile. New results have been achieved, particularly in the fields of Rheumatoid Arthritis, Seronegative Spondarthritides, and Osteoarthritis.

Bones and joints are always under mechanical loading a key concept in understanding bone metabolism. Among the most common diseases of bones and joints in the elderly are osteoporosis and joint osteoarthritis. Dynamic changes in mechanical loading give rise to problems resulting in stenosis of the spinal column at the cervical, thoracic, and lumbar levels. Mechanical loading also accelerates joint destruction caused by inflammation from such conditions as chronic rheumatoid arthritis. An understanding of mechanical loading is essential therefore to clinicians, basic researchers, and engineers working with bones and joints. Providing up-to-date research and clinical findings, the contents of this volume are from the papers, symposia, and special lectures presented at the 12th Annual Meeting of the Orthopaedic Research Meeting of the Japanese Orthopaedic Association in Niigata, in October 1997.

Providing clinicians with a comprehensive, evidence-based summary of musculoskeletal health in pregnancy and postpartum, this is the first book of its kind to describe the physiologic changes, prevalence, etiology, diagnostic strategies, and effective treatments for the most common musculoskeletal clinical conditions encountered during this phase of life. Lumbopelvic pain, upper and lower extremity diagnoses, labor and delivery considerations, including the impact on the pelvic floor, and medical therapeutics will be discussed. Additionally, the importance and influence of exercise in pregnancy, the long-term implications of musculoskeletal health in pregnancy and current and future directions for research will be addressed. The childbearing period is a time of remarkable reproductive and musculoskeletal change, predisposing women to potential injury, pain, and resultant disability. Musculoskeletal Health in Pregnancy and Postpartum offers musculoskeletal medicine specialists, obstetricians and any clinicians involved in the care of pregnant or postpartum women the tools necessary to prepare for, treat and prevent these concurrent injuries during an already challenging time.

This book, written by very well known opinion leaders in the field, covers all aspects of familial Mediterranean fever, the most common monogenic autoinflammatory disease. The opening chapters explain the genetic basis of the disease and provide insights into the pathogenesis derived from recent experimental studies. A large part of the book is then devoted to a detailed description of the typical and atypical clinical presentations, the disease course, and potential complications in both pediatric and adult patients. Guidance is provided on the measurement of disease severity and the management of patients in daily practice. The advice regarding treatment is based on the best currently available evidence and attention is also paid to important emerging treatments. The book is part of Springer's series Rare Diseases of the Immune System, which presents recently acquired knowledge on pathogenesis, diagnosis, and therapy with the aim of promoting a more holistic approach to these conditions. Monogenic autoinflammatory diseases are hereditary disorders that are caused by single-gene defects in innate immune regulatory pathways and are characterized by a clinical and biological inflammatory syndrome in which there is limited, if any, evidence of autoimmunity. Familial Mediterranean fever itself is due to a mutation in the MEFV gene, which codes for the protein pyrin; it is characterized by periodic fever and episodes of painful inflammation in the abdomen, chest, and joints. Familial Mediterranean Fever will be an invaluable source of up-to-date information for all practitioners involved in the care of patients with the disease.

In this issue of Rheumatic Disease Clinics, Guest Editors Laura E. Schanberg MD and Yukiko Kimura MD brings his considerable expertise to the topic of pediatric rheumatology. Top experts in the field cover key topics such as CARRA, Mental health, Social media and JIA, CV disease in PRD, and more. Provides in-depth, clinical reviews on pediatric rheumatology, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 20 relevant, practice-oriented topics, such as Pharmacosurveillance of biologics in pediatric rheumatic disease (or JIA); cSLE in developing countries: impact of access to care, ethnic differences?; Biomarkers and Outcome Measures in cSLE; Role of environment on PRD; and more.

This edition of the companion volumes Muscle Pain: Understanding the Mech- isms and Muscle Pain: Diagnosis and Treatment is essential reading for those interested in clinical approaches to acute and chronic pain conditions involving muscle tissues and in the mechanisms underlying these conditions. The volumes cover a very important topic in pain medicine, since muscle pain is very common and can often be dif?cult to diagnose and treat effectively. Furthermore, chronic pain involving muscle and other components of the musculoskeletal system increases with age, such that it is a common complaint of those of us who are middle-aged or older. Indeed, as changing population demographics in "west- nized" countries result in higher proportions of the population living longer and being middle-aged and elderly, chronic muscle pain will likely become even more of a health problem. In the case of acute muscle pain, this can often be very intense, and in the short term can limit or modify the use of components of the musculoskeletal system associated with the sensitive muscle. Chronic muscle pain can also be intense, as well as unpleasant and disabling, and it is in many cases the over-riding symptom of most musculoskeletal disorders that are associated with long-term deleterious changes in musculoskeletal function.

Guest edited by Dr. Brian Mandell, this issue of Medical Clinics of North America will cover several key areas of interest related to Rheumatology. This issue is one of six selected each year by our series Consulting Editor, Dr. Jack Ende. Articles in this issue include but are not limited to: Vaccinations in Patients with Rheumatic Disease: Consider Disease and Therapy, Rheumatic Complications of Immune Checkpoint Inhibitors, Managing the Cardiovascular Risk in Patients with Rheumatic Disease, Statin associated myalgias and muscle injury - recognizing and managing both while still lowering the low-density lipoprotein, Perioperative Management of Rheumatic Disease and Therapies, Fibromyalgia: Recognition and Management in the Primary Care Office, Management and Cure of Gouty Arthritis, Update on the Treatment of Giant Cell Arteritis and Polymyalgia Rheumatica, Suspecting and Diagnosing the Patient with Spondyloarthritis and What to Expect from Therapy, Pregnancy and Management in Women with Rheumatoid Arthritis, Systemic Lupus Erythematosus and Obstetrical Antiphospholipid Syndrome, Rheumatoid Arthritis: Early Diagnosis and Treatment, Management of Knee Osteoarthritis: What Internists Need to Know, Antinuclear antibody (ANA) testing for the diagnosis of Systemic Lupus Erythematosus (SLE), and more.

In 1928, it was discovered that copper was essential for normal human metabolism. A decade later, in 1938, it was observed that patients with rheu matoid arthritis exhibited a higher than normal serum copper concentration that returned to normal with remission of this disease. Thirteen years later, it was found that copper complexes were effective in treating arthritic dis eases. The first report that copper complexes had antiinflammatory activity in an animal model of inflammation appeared twenty-two years after the dis covery of essentiality. In 1976, it was suggested that the active forms of the antiarthritic drugs are their copper complexes formed in vivo. This sugges tion has been confirmed and extended in the interim in over 200 recent publications. Individual biomedical scientists from many countries who have published in these areas recently saw a need for a meeting to exchange current re supporting new hypotheses. We search results and discuss the evidence met on the University of Arkansas Medical Sciences campus in Little Rock, Arkansas, August 10-13, 1981. Participants came from Australia, England, France, Germany, Israel, Italy, The Netherlands, Norway, Poland, Scotland, Sweden, Switzerland, Wales, Zimbabwe, and over twenty of the United States."

The most accessible, current coverage of rheumatologic disorders Offers assessment and management solutions for rheumatologic diseases, ranging from soft-tissue problems such as bursitis to complex, multi-organ conditions such as ANCA-associated vasculitis Provides expert guidance on the medications used in the treatment of rheumatic disease, including the latest biologic therapies Delivers concise, practical guidance for internists, family physicians, rheumatologists, trainees, and medical students Updated to reflect the latest research and findings NEW chapters on genetics and musculoskeletal ultrasound Expanded chapter on laboratory diagnosis

Through 10 outstanding editions, Kelley & Firestein's Textbook of Rheumatology has provided authoritative, in-depth guidance in rheumatology with an ideal balance of basic science and clinical application. The 11th Edition of this classic text continues this tradition of excellence, while keeping you abreast of recent advances in genetics and the microbiome, new therapies such as biologics and biosimilars, and other rapid changes in the field. It provides comprehensive, global coverage of all aspects of diagnosis, screening, and treatment in both adults and children, in a user-friendly, full color reference. Covers everything from basic science, immunology, anatomy, and physiology to diagnostic tests, procedures, and specific disease processes-including key data on therapeutic outcomes to better inform clinical decision making. Includes new chapters on Innate Lymphoid Cells and Natural Killer Cells, Pathogenesis of Inflammasome Mediated Diseases, Bisphosphonates, Ultrasound Evaluation of the Musculoskeletal System, and Evaluation of Monoarticular and Polyarticular Arthritis. Features 1,200 high-quality illustrations, including superb line art, quick-reference tables, and full-color clinical photographs. Shares the knowledge and expertise of internationally renowned scientists and clinicians, including new editor Dr. Gary Koretzky, specialist in immunology and rheumatology. Demonstrates the complete musculoskeletal exam in online videos, including abnormal findings and the arthroscopic presentation of diseased joints. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

The book summarizes recent advances in the elucidation of the mechanisms involved in senile osteoporosis as well as its potential treatment, bringing an integrated approach from the bench to the clinical practice. A unique aspect of this book is its emphasis on the application of translational research in the field of osteoporosis and falls which make it useful not only to biologists but also to clinicians and epidemiologists. The chapters are complemented with color figures showing the basics of bone biology, bone phenotypes and falls prevention interventions and also include tables and flowcharts. Written by investigators (clinicians and basic scientists) in the field of aging bone research, this is a reference guide to geriatricians, gerontologists, endocrinologists, rheumatologists and bone biologists, medical trainees as well as other health professionals (pharmacists, physiotherapists, etc).

Musculoskeletal Imaging Volume 1 provides a comprehensive review of the subject matter commonly encountered by practicing radiologists and radiology residents in training. This volume includes succinct overviews of trauma, arthritis, and tumor and tumor-like conditions. Part of the Rotations in Radiology series, this book offers a guided approach to imaging diagnosis with examples of all imaging modalities complimented by the basics of interpretation and technique and the nuances necessary to arrive at the best diagnosis. Each pathology is covered with a targeted discussion that reviews the definition, clinical features, anatomy and physiology, imaging techniques, differential diagnosis, clinical issues, key points, and further reading. This organization is ideal for trainees' use during specific rotations, for exam review, or as a quick refresher for the established musculoskeletal imager. It is a must-read for residents and practicing radiologists seeking a foundation for the essential knowledge base in musculoskeletal imaging. Musculoskeletal Imaging Volume 2 reviews metabolic, infectious, and congenital diseases; internal derangement of joints; and arthography, and ultrasound.

Orthopedics and rheumatology, while separate specialties, have become close conceptually because advances in bone and joint biology enable practitioners to approach clinical problems comprehensively. This is especially true for the bench and translational scientists. Recently, there has been renewed interest in the role played by bone in the development of osteoarthritis, including targeting bone as a potential therapeutic approach.

The molecular and cellular approaches toward the relationship of joint and bone problems distinguish this from other books on osteoarthritis or skeletal medicine. Emphasis on genetics and on newer viewpoints and approaches, exemplified by the possible effect of subchondral bone on osteoarthritis, gives a wider viewpoint to the reader and may make possible novel approaches to solving a clinical problem. The book will therefore also interest experienced specialists, thereby broadening readership. Authors are internationally recognized experts in their field.

Topics discussed include the role of bone in osteoarthritis, ranging from basic cell and molecular biology to genetics and biomechanics. How this information may be used for new treatment approaches will also be covered.

This book, intended for students, researchers and clinicians, provides information that enables the novice to become oriented and the practitioner to update knowledge. No other book combines information on the relationship of bone to the development of osteoarthritis, or treats the pathophysiology of joints in the same way. This volume, like the others in Topics in Bone Biology series, encompasses aspects of many specialties, including rheumatology, orthopedics, endocrinology, oncology, dentistry, geriatrics, nursing and chiropractic medicine.

In 1928, it was discovered that copper was essential for normal human metabolism. Ten years later, 1938, it was observed that patients with rheumatoid arthritis had a higher than normal serum copper concentration, which returned to normal wi th remission of this disease. Thirteen years later, it was found that copper complexes were effective in treating arthritic diseaseS. The first report that copper complexes had antiinflammatory activity in an animal model of in flammation appeared twenty-two years after the discovery of essen tiality. In 1976, it was suggested that the active forms of the anti arthritic drugs are their copper complexes formed in vivo. This suggestion was confirmed and extended in the interim with over 1000 recent publications, and many of these were addressed in the proceed ings of our first symposium, published in 1982. The present symposium was organized to present new normal physiological, nutritional, and biochemical aspects of essential metal loelement metabolism as well as variations in metabolism associated with disease states. In addition new data concerning antimicrobial, antiinflammatory, antiulcer, anticancer, anticarcinogenic, analgesic, and radioprotectant activities of copper complexes were presented. These activities are consistent with the notion that they represent the facilitation of normal copper-dependent metabolic processes in dis ease states. The presentations and interactive discussions that fol lowed are contained in these proceedings. John R. J. Sorenson Dedication These proceedings are dedicated to those who made this truly memorable scientific and social Arkansas experience possible."

Bringing together the most up-to-date research on post-traumatic arthritis (PTA) and its management, this book is a comprehensive presentation of the current thinking on all aspects of the mechanisms of joint injury and subsequent development of PTA. Divided into thematic sections, it includes discussions of the incidence and burden of PTA, both in society at large and in the military population specifically; the relevant experimental work on PTA, from basic science to animal models; peri-articular tissue responses to of joint injury and potential mechanisms of PTA; the current clinical assessment and treatment of common joint injuries leading to PTA; and emerging technologies and treatments for PTA, including biomarkers and stem cell therapies. Taken together, it will be an invaluable resource for orthopedic surgeons, rheumatologists and other joint injury researchers and clinicians.

This book provides a detailed overview of B-cell directed therapies in patients with rheumatic and systemic autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, Sjoegren syndrome, ANCA-associated vasculitis and cryoglobulinemia. Organ-specific autoimmune diseases are discussed with respect to the use of B-cell directed therapies in neurological autoimmune diseases and autoimmune cytopenias. Situations in which B-cell targeted therapy may be indicated are identified, thereby offering comprehensive support for therapeutic decisions on the basis of the latest published evidence. The book also offers a valuable reference tool for rheumatologists, internists, nephrologists, immunologists, and all specialists involved in the multidisciplinary care of patients with rheumatic and systemic autoimmune diseases.

Recent concern about the adverse effects and relative risks of anti- inflammatory therapies has been such that another meeting was organized in the highly successful series of meetings on this topic. Adverse effects of anti-rheumatic and anti-inflammatory drugs are of major concern to all involved in the prescription, care and management of rheumatic and other patients receiving these important drugs. The IVth International Meeting on Side-Effects of Anti-Inflammatory Drugs, held in Sheffield, UK, 7-9 August 1995, afforded a unique opportunity to hear the latest information and views on issues concerning the development of adverse effects from these drugs, the management of these effects, and the development of safer therapies. In addition to discussions on the safety relative to efficacy of established non-steroidal and steroidal anti-inflammatory drugs and disease-modifying agents, there was detailed consideration of the novel cyclo-oxygenase-2 selective NSAIDs which have recently been developed and introduced to the clinic. Also, the side effects from therapy with biologics, notably monoclonal antibodies and oral tolerance therapies, were considered. Among the other highlights in the programme were: Clinico-epidemiological studies on the adverse effects relative to use/efficacy of established and new anti-rheumatic drugs. Procedures for reducing the gastrointestinal adverse effects. Mechanisms and clinical significance of adverse effects in the gastrointestinal tract, liver, kidney, articular joints, skin and other organs from NSAIDs. Clinical status and mechanisms of action of the newer (third generation) of NSAIDs (e.g. etodolac, nabumetone, meloxicam). Medico-legal aspects ofadverse effects from anti-rheumatic drugs. The concept of conditional pharmacology' or the disease-dependence of the toxicological and pharmacological activity of the anti-inflammatory drugs. The papers in this book were selected from those presented at the meeting.