Over the past 30 years, there has been increasing recognition of psoriatic arthritis as a distinct clinical entity. Psoriatic arthritis occurs mostly in patients with psoriasis and may affect up to 1% of the general population. It has many similarities to other forms of spondyloarthritis, and must be differentiated from related conditions. Given that most patients with psoriatic arthritis have skin and musculoskeletal diseases that significantly affect their quality of life and function, patients are ideally managed in a multidisciplinary clinic with rheumatologists, dermatologists and a nurse specialist, physical therapist and occupational therapist. Psoriatic Arthritis covers the epidemiology and diagnostic and classification criteria, describing the clinical features of the disease, including skin and nail involvement, articular, and other extra-articular manifestations. Laboratory features and imaging characteristics are covered in detail, along with co-morbidities and their impact. A comprehensive review of skin disease therapy is also provided, along with the various treatment options for joint disease, including traditional disease modifying therapy and newer biologic agents . This comprehensive yet concise and practical volume is the perfect guide to psoriatic arthritis for the busy practitioner, and will be of interest to trainees and specialists in rheumatology and dermatology.

Of the many special roles played by proteolytic enzymes in immune reactions, this book addresses different aspects of membrane peptidases, signal transduction via ligation of membrane peptidases (especially of dipeptidyl peptidase IV/CD26 and aminopeptidase N/CD13), and regulation of membrane peptidases in vivo and in vitro. A number of newly discovered peptidases (including cathepsin F, W and X, carboxypeptidase X, attractin) are described, with special emphasis given to the role of peptidases in immune and defense reactions and in the pathogenesis of inflammatory and other diseases, including rheumatoid arthritis, pancreatitis, multiple sclerosis, Alzheimer's disease and tumours of various origins. The focus on the involvement of a selection of proteolytic enzymes in immune reactions and diseases is a unique feature of this multifaceted work , which combines biochemical, immunological and clinical research reports with literary reviews of the field.

Six million people in the United States meet the criteria for fibromyalgia. On average, they see about four doctors before they were correctly diagnosed, and many were convinced they had a life-threatening illness such as a body-wide cancer. Fibromyalgia is a combination of pain, fatigue, and systemic symptoms. Ten million patient visits to doctors every year in the United States are for pain; $600 billion is spent annually to diagnose or manage chronic pain, including litigation fees. One group has estimated that patients with fibromyalgia run up $20 billion in medical expenses annually. 10% of US adults have moderate pain and 1% have severe pain. 12% have functional disability due to chronic pain. Additionally, at any visit, 15 percent of all patients tell their doctor they are tired. There is a paucity of reliable, detailed information about the fibromyalgia syndrome that patients can use to help themselves or others. This updated edition of Making Sense of Fibromyalgia is written by well known, widely published experts in the field. It distills complex concepts of amplified pain into a easily readable and understandable narrative. This monograph is aimed at college educated laypersons, allied health professionals, patients and treating physicians. Since it was first published in 1999, Making Sense of Fibromyalgia has sold over 100,000 copies. Now updated and improved, this effort should increase one's knowledge of a very complex subject.

One million people in the United States suffer from systemic lupus erythematosus (SLE or lupus), a chronic autoimmune disease that is potentially debilitating and sometimes fatal as the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage. SLE can affect any part of the body, but most often damages the heart, joints, skin, lungs, blood vessels, liver, kidneys and nervous system. The course of the disease is unpredictable, with periods of illness alternating with remission. It can be treated symptomatically, mainly with corticosteroids and immunosuppressants, though there is currently no cure. The symptoms of lupus vary widely, come and go unpredictably, and often mimic or are mistaken for other illnesses. As a result, patients present with varied symptoms to different practitioners and diagnosis can be elusive, with patients sometimes suffering unexplained symptoms and untreated lupus for years. Hence, a practical guide to the diagnosis and treatment of lupus is a valuable resource to an array of clinicians and may help expedite earlier diagnosis and better patient care. Part of the Oxford American Rheumatology Library, this concise, authoritative pocketbook describes the pathophysiology of lupus, diagnostic strategies and tools, and current and emerging therapeutic options, focusing on direct clinical applications for busy healthcare professionals. With 20 new tables and the most up-to-date information on the diagnosis, treatment and management of the condition, this second edition fulfills a need for a concise, practical guide to Lupus for clinicians that distills the principal features of this complicated, often misunderstood disorder.

The Nature and Functions of Dreaming presents a comprehensive theory of dreaming based on many years of psychological and biological research by Ernest Hartmann and others. Critical to this theory is the concept of a Central Image; in this volume, Hartmann describes his repeated finding that dreams of being swept away by a tidal wave are common among people who have recently experienced a trauma of some kind - a fire, an attack, or a rape. Dreams with these Central Images are not dreams of the traumatic experience itself, but rather the Central Image reveals the emotional response to the experience. Dreams with a potent Central Image, like the tidal wave, vary in intensity along with the severity of the trauma; this pattern was shown quite powerfully in a systematic study of dreams occuring before and after the September 11 attacks in New York. Hartmann's theory comprises three fundamental elements: dreaming is simply one form of mental functioning, occurring along a continuum from focused waking thought to reverie, daydreaming, and fantasy. Second, dreaming is hyperconnective, linking material more fluidly and making connections that aren't made as readily in waking thought. Finally, the connections that are made are not random, but rather are guided by the dreamer's emotions or emotional concerns - and the more powerful the emotion, the more intense the Central Image.

Arthritis Research: Methods and Protocols, Second Edition expands upon the first edition to present new and current techniques for the research of arthritis and related conditions. A compendium of leaders in the field contribute chapters that cover practical research methods such as the intravital multiphoton microscopy technique, techniques for evaluating exhausted CD8 T cell and for studying nucleic acid sensors and their effects, methods for in vivo tetracycline-controlled transgenic mice and T cell receptor transgenic mice, protocols to detect V(D)J recombination products and microRNA, and the technique to make bleomycin-induced dermal fibrosis. Written in the successful Methods in Molecular Biology series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible protocols, and notes on troubleshooting and avoiding known pitfalls. Authoritative and easily accessible, Arthritis Research: Methods and Protocols, Second Edition will serve both professionals and novices with state-of-the-art techniques pertaining to this fascinating research field.

Leading clinical experts survey the latest information available on the key rheumatic and allergic issues that physicians face in treating the HIV-infected patient. The physicians focus on the rheumatologic and dermatologic manifestations of HIV-1 infection, which include arthritis, myopathies, vasculitis, sicca syndrome, other autoimmune phenomena, and psoriasis. They also examine the question of allergic reactions in HIV patients, including drug hypersensitivity, with special attention given to adverse reactions to trimethoprim-sulfamethoxazole, the most frequently prescribed anti-infective. Practical advice for the diagnosis and treatment of these problems is given in full.

Gene therapy for inflammatory diseases is a new , burgeoning field of medicine. Edited by the undisputed pioneers of this area of research, this volume is the first devoted to its topic. It contains thirteen chapters, each written by leaders in their respective fields, that summarize the state of the art in developing novel, gene based treatments for inflammatory diseases. As well as providing an introduction to the basic concepts of gene therapy and the use of naked DNA approaches, the book describes the advances that have been made in applying them to arthritis, lupus, multiple sclerosis, diabetes, Sjogren`s syndrome and transplantation.One chapter is devoted to discussing the first human clinical trials that apply gene therapy to the treatment of an inflammatory disease. As well as providing novel therapeutic approaches, gene therapy facilitates the development of new and improved animal models of disease; a chapter describing these advances is also included. As an up-to-date, timely book written by th

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 of adverse 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.

The contents of this book represent papers which were presented at the Third International Meeting on "Side-Effects of Anti-Inflammatory and Analgesic Drugs" which was held under the auspices of the University of Verona, Institute of Pharmacology in Verona on 8-11 May 1991. This meeting was held in conjunction with the 13th European Workshop on Inflammation and although publications from this part of the meeting are not published here (they appear in Agents and Actions), we were fortunate in having a group of people interested in inflammation from varying backgrounds. The success of the third meeting followed previous meetings held in Cambridge and Verona respectively and continue a tradition which has now become well established. The meeting brought together physicians, scientists and those concerned with the production and use of anti-inflammatory drugs to a very stimulating conference to discuss basic issues affecting all aspects of side-effects of anti-inflammatory and analgesic drugs as well as their detection and treatment. The meeting was held in the Auditorium of Glaxo Italy and we are very grateful to that company for use of their facilities as well as to the University of Verona, Institute of Pharmacology, for valuable secretarial and administrative help. The success of the conference would not have been possible without valuable financial assistance of the companies listed separately (under Acknowledgements) as well as to the organizers of the 13th European Workshop on Inflammation who collaborated with us.

Like all specialized areas of medicine, that of joint disease informative. The techniques, practical and interpretive, has become surrounded by a practical mystique and are highly reproducible and simple, allowing them to be applied in any laboratory. jargon specific to itself. The number of clinicians working Although we see this volume as being of value to all in the field is large but the number of pathologists small. interested in joint disease it is specifically aimed at It follows that the majority of pathologists are at somewhat laboratory staff wishing to offer a synovial fluid analytical of an immediate disadvantage when discussing and ana service. Like most cytology we believe much of the cell lysing articular problems with their rheumatological and and non-cell identification and quantitation can, and orthopaedic colleagues. should, be undertaken by trained technical staff. The book In the specific area of synovial fluid examination the is therefore aimed primarily at two groups: pathologists difficulties for the pathologist are compounded because who do not specialize in joint disease and technical staff to date there have been no basic texts that detail the who will be generating the data on which interpretation methods, findings and interpretation of the macroscopic will be based. It is therefore both a text book and a bench and microscopic characteristics of the fluid in the common reference manual. arthropathies. In this book we hope to go some way We do not believe our data or methodology represent towards rectifying this omission."

Progress in Basic and Clinical Immunology is a result of the 14th European Immunology Meeting - EFIS 2000, held in Poznan, Poland, on 23-27 September 2000. EFIS 2000 gathered over 1400 immunologists from all over the world. It was an exceptionally memorable meeting for a number of reasons: 1) it was held in the last year of the century and the millennium, thus provoking conclusions of past achievements of immunology and projections for the future; 2) it was held in Poland, a country that is a symbol of struggle for freedom for a large number of scientists originating from the 'Eastern Bloc' countries; and 3) EFIS celebrated its 25th anniversary at this occasion. This comprehensive volume contains 62 chapters grouped into 11 sections: T-cells, Immune Receptors, Antigen Presentation/Dendritic Cells, Cytokines, Immunodeficiencies, Autoimmunity, Allergy/Inflammation, Immunotherapy, Vaccines, Tumor Immunology, and Cancer Immunotherapy.

The disciplines of rheumatology and dermatology are involved in the care of several diseases that share cutaneous and locomotor as well as, quite often, systemic involvement. While traditionally remaining separate, it has long been recognized that there are several areas of common interest in these two specialties. Indeed, this had been realized by sev- eral far-sighted physicians, both rheumatologists and dermatologists, such asG. Rodnan and 1. Gilliam. A number of books have been published over the past few years specifi- cally dealing with skin involvement in the connective tissue diseases, both inherited and acquired. These include The Skin in Rheumatic Disease, by C. R. Lovell, P. 1. Maddison, and G. V. Campion (Chapman and Hall Medical, 1990), Connective Tissue Diseases o(the Skin, edited by C. M. Lapiere and T. Krieg (Marcel Dekker, Inc. 1993), and Cutaneous Manifestations of Rheumatic Diseases, edited by R. D. Sontheimer and T. T. Provost (Wil- liams and Wilkins, 1996). However, despite this shared interest, meetings combining the two specialties were generally limited to small interest groups. It had long been felt that a workshop should be organized that could bring together the views of specialists from the two areas and focus on the challenges that this common ground brings to these two disciplines.

Dr. Heinonen reviews and critically evaluates the scientific literature on the biological role of inorganic pyrophosphate (PPi ) published from 1940 to the end of 1999. He describes and classifies all known biochemical reactions that produce Ppi; describes and evaluates all published methods used in biological Ppi; and compiles and critically evaluates information on the concentration of PPi (with the conclusion that, contrary to common belief, PPi exists throughout the living world in rather high concentrations). Many reactions in which PPi is used as a biochemical energy source instead of ATP have been described in recent decades, especially in bacteria, protists, and plants. These reactions are evaluated from the bioenergetic and regulatory points of view. Also considered is the possible role of PPi as a source of biochemical energy in the primitive phases of life, before ATP. Data is presented on the regulatory role of PPi in living systems, such as activities of enzymes, fidelity of syntheses of macromolecules, and proliferation of cells. PPi may also regulate the formation and dissolution of bone as well as pathologic calcification of soft tissues and the formation of urinary stones. The formation of calcium pyrophosphate dihydrate crystals in the extracellular fluids of joints cause the disease called pseudogout. Biological Role of Inorganic Pyrophosphate book is a unique and invaluable source of references (about 1120) and summarized data for professionals who study or plan to study the role of PPi in living systems. Many different branches of science (biochemistry, microbiology, bioenergetics, plant physiology, parasitology, evolution, orthopedics, rheumatology) have involvement with PPi. This book sums up available knowledge in one place and will help scientists cross disciplinary boundaries.

The purpose of this volume in the Progress in Inflammation Research series is to provide the biomedical and clinical researcher with a state-of-the-art insight in the role of cytokines in joint inflammation and joint destruction. This is of relevance for better understanding of key processes in diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). Apart from the impact of old and novel cytokines on joint tissues, the various chapters address the issue of targeted therapy with biological response modifiers and future interventions with carefully designed inhibitors. Spe cial attention is given to elements of synovial cell activation, cell-cell interaction, cytokine interplay as well as mechanisms of cartilage destruction and bone erosion. In addition to an outline of the role of established cytokines, such as TNF, IL-l and IL-6, new information is given on the novel cytokines IL-15, IL-17 and IL-18 and their positioning in the complex cytokine interplay. Cytokine regulation of destructive enzymes, RANKL, the endogenous inhibitor OPG and their crucial roles as central players in joint erosion are highlighted. Together, the chapters provide a complete and balanced view on pivotal cytokines and joint pathology.

This book provides a complete overview of all modalities used for hand and wrist imaging, along with a complete over- view of the various disease entities that can be diagnosed. As a state-of-the-art overview of hand and wrist imaging it is a reference work for radiologists, hand surgeons, ortho- pedists, traumatologists, rheumatologists and internists and their residents in training. The chapters are written by ex- perts in musculoskeletal radiology from various European countries and the USA.

Heat shock proteins (HSP) have received ample interest by immunologists over recent years. Initially they were found to be dominantly immunogenic microbial antigens. The connection with inflammation was established when it was uncovered that T cells specific for these antigens have a crucial role in the induction and regulation of experimental arthritis. Since then, the raised presence of immunity to HSPs in virtually all conditions of inflammation, including autoimmune diseases, transplant rejection and atherosclerosis, has emphasised the critical significance of immunity to HSPs in inflammatory diseases.

Over the past decade significant advances in technology have opened up the field of glycobiology. In particular, improved methods for carbohydrate analysis have led to important biochemical observations demonstrating that sugars play crucial roles in human physiology. It is clear that many diseases are associated with characteristic changes in glycosylation and furthermore, the possibility of modulating glycan processing to treat disease is beginning to be realised. This volume summarises some of the important recent developments in "glycobiology and medicine. " We highlighted some of the numerous areas in which there are glycosylation dependant pathological mechanisms causing common diseases. The next decade will undoubtedly see novel diagnostic and therapeutic techniques originating from these observations. This will significantly enhance our ability to combat infection and diseases such as bacterial and viral infections, some cancers, glycolipid storage disorders, systemic autoimmune disease and disorders that involve cytokine related inflammatory mechanisms. These topics were discussed at the 6th Jenner Glycobiology and Medicine meeting. This meeting received a European Commission Education grant (No. HPCF-2002-00250). CONTENTS Glycosylation Dependent Bacterial Infections 1. A Sweet Coating-How Bacteria Deal with Sugars ...3 Anthony P. Corfield, Rebecca Wiggins, Cathryn Edwards, Neil Myerscough, Bryan F. Warren, Peter Soothill, Michael R. Millar, and Patrick Horner 2. The Glycosylation of Airway Mucins in Cystic Fibrosis and Its Relationship with Lung Infection by Pseudomonas aeruginosa ...17 . Philippe Roussel and Genevieve Lamblin 3. Structural Basis for Bacterial Adhesion in the Urinary Tract...33 . . Jenny Berglund and Stefan D.

One of the founders of the field of pediatric rheumatology, Dr. Jerry C. Jacobs, comprehensively discusses the care of children with rheumatic diseases and musculoskeletal disorders in this clinical reference. The author has completely revised and updated the text and references. A significant portion of the book is devoted to differential diagnosis; in fact, one of the book's strongest points is the detailed, illustrated description of the physical examination of joints in children. From the reviews of the first edition: "The section on the differential diagnosis of arthritis is the most comprehensive treatise of the subject that I have seen." #New England Journal of Medicine#1 "This is a book that one can pick up and read sections of and go back to again and again, and as such should be readily available wherever people are caring for children with joint complaints." #British Medical Journal#2 "Photographs, both clinical and pathological, radiographs, tables and graphs appear on almost every page and the layout is good so that the text is attractive as well as readable." #British Journal of Rheumatology#3 "...deals with all the facets of rheumatism or arthritis likely to be met with in the clinic. ...Above all the book is user friendly: very comprehensive index sections facilitate access to material, and the provision of many lists and summary tables helps in the location and clarification of information. ...The whole results in a book that is pleasant and surprisingly easy to read ...it would form an ideal library copy, both for selective reading and reference, and should be read by all paediatric rheumatologists." #The Lancet#4

Osteoarthritis is the most common joint pathology which primarily affects the older population. The disease is characterized by unique pathological changes in some synovial joints, predominantly affecting the articular cartilage, but also entire joints, including the synovial tissue and subchondral bone. The remarkable growth of research on normal and abnormal biology of tissues in the articulating joint, including the application of novel molecular biological approaches and new imaging techniques, is reflected in this volume. It describes the current state of knowledge and helps to further understand the etiopathology of osteoarthritis, hopefully leading to early detection of the disease and novel treatment modalities. The volume contains contributions and discussions from a select group of investigators, all experts in this field, who met at the conference "The Many Faces of Osteoarthritis", held in June 2001 at Lake Tahoe, to acknowledge Klaus E. Kuettner and his contributions to osteoarthritis...

Seer, forecaster, prophet, geomancer, or tout - all predict future events as physicians must. The medical activity is prognosis from the Greek pro (forward) and gnosis (special knowledgeL thus foreknowledge, and the practitioner is the prognosticator, a sobriquet which falls unhappily upon the ear. Like it or not, there is nothing more critical in the management of chronic rheumatic conditions than a reasonably clear picture of what time and disease will bring. The knowledge is so much a part of ordinary medical thinking that we rarely grace it with the label prognosis. But, like so much of "ordinary medical thinking" (an oxymoron, perhaps), quantitative data are very thin and the chestnuts of personal observation and authority figure assertion loom large. Unlike several books I have seen or written, this one on prognosis needs no justification. The entirety of a person's life contributes to and confounds what the future holds. The ingredients include education levet income, support structures such as family, housing, occupation, availability of medical services, diagnosis, treatment, rate of disease progression, age, gender, race, marital status, and others too numerous to mention or too arcane to be recognized. One would think the task of estimating prognosis impossible. And yet there is light on the horizon -we do know a few things such as the effect of high rheumatoid factor titers on the prognosis of RA or the likely outcome of certain kidney lesions in SLE.

Antibodies are crucial to the fine specificity of the immune system. An effective functioning of these molecules requires interaction with immune cells. Receptors for antibodies, Fc receptors, provide this critical link between the humoral and cellular branches of the immune system. This book presents a comprehensive overview of the different Fc receptors currently recognized. The first part of the book contains state-of-the-art overviews on the biological role of FcR. The latest information on FcR heterogeneity, FcR physiology, FcR-ligand recognition, their crucial coordinating role in immunity, interactions with other immunoreceptors, and the role of FcR in immunoglobulin transport and catabolism are discussed. The clinical importance of FcR is developed in the second part of the book. The well-recognized roles of FcR in allergy, inflammation, infectious diseases, autoimmune disorders, and immunotherapeutic importance are reviewed. The information in this book is easily accessible and should be helpful for researchers and clinical specialists as a convenient overview of the field, as well as a comprehensive introduction for students starting in this area of research.

Meniscal transplantation has become an attractive option in selected patients with incapacitating knee pain. This book discusses all aspects of meniscal transplantation, covering the use of both allografts and meniscal substitutes, including collagen and polyurethane implants. Acknowledged experts in the field review the basic science, explain indications, and describe surgical techniques and the results achieved to date. All the material is up to date, with information on new implants, new techniques, and new surgical approaches. Future trends in the treatment of meniscal lesions are also discussed as we move towards the application of regenerative strategies to restore meniscus function. "

In this monograph about gene therapy of autoimmune and inflammatory d- orders we have gathered international experts and leaders from different fields to review the state of the art advances on topics ranging from disease entities to vectors and engineered cells. The different approaches described in each chapter take into consideration the biomedical knowledge of these diseases and address the complexities of delivering long-term genetic interventions. Gene therapy also serves as a testing ground for new therapeutic entities and helps provide proof of principle for their potential therapeutic role in animal models of disease. Scaling up from mice to men still remains an important h- dle not only from the quantitative point of view, but also for currently unknown and unexpected secondary effects of the vector or the transgene. Some of these approaches have already been tested in the clinic, but much more needs to be done to understand the human conditions treated and the n- ural history of their pathology. We are indebted to the secretarial assistance of Ms. Lin Wells (Bone and Joint Research Unit, London, UK) and the help of Hans Detlef Kluber for his help in getting this book published. We hope this book will be of interest to c- nicians and scientists and inspiring to students of the subject who will use their own ingenuity and knowledge to further forward this discipline into clinical use.