This issue brilliantly pairs a rheumatologist with a pulmonologist to explore each of the 14 article topics.? Topics include autoantibody testing, ultility of bronchoalveolar lavage in autoimmune disease, and pulmonary manifestations of such conditions as scleroderma, rheumatoid arthritis, lupus erythematosus, Sjogren's Syndrome, Inflammatory Myopathies, and Relapsing Polychondritis.? The pulmonary vasculitities are discussed, as is antiphospholipid antibody syndrome, ankylosing spondylitis, and the impact of osteoporosis on pulmonary fuction.? Toxicity and monitoring of immunosuppressive therapy used in systemic autoimmune diseases is reviewed, as is lung transplantation in autoimmune diseases.

There are numerous monographs devoted to rheumatoid arthritis.? What sets this issue apart is that it keeps an eye to the future.? Topics explored include measurement of RA disease activity today and in the future; epidemiology of RA - implications for prevention and risk assessment; genes that predispose to RA - relevance to current and future therapeutic strategies; multiple kinases - assessment of the best targets in treating RA; assessment, prevention and treatment of cardiovascular morbidity in RA; mechanistic insights and approaches to prevention of bone damage in RA; cell-cell interactions in RA synovium as potential new targets for treatment; alternative strategies for modulating the function of B lymphocytes in RA; innate immunity in RA; ascertainment and management of preclinical RA.

Rheumatic (or systemic autoimmune) diseases disproportionately affect young women: the female-to-male ratio for patients with systemic lupus erythematosus during the reproductive years is approximately 9:1. In the mid- to late-twentieth century, women with rheumatic disease diagnoses were often advised to avoid pregnancy due to fear of disease exacerbation and adverse outcome. In more recent years, many women with rheumatic disease have deferred childbearing until a later age due to active disease or unsafe therapies. However, with advances in rheumatology therapies, obstetric monitoring, and reproductive medicine technologies, increasing numbers of women with rheumatic diseases are pursuing pregnancy. As a result, obstetricians and rheumatologists need to be aware of the current state of knowledge and the recommendations for management of pregnancy in these patients. Contraception and Pregnancy in Patients with Rheumatic Disease explains the basics of contraception, fertility treatment, and pregnancy in rheumatic disease patients and serves as a guide and reference tool for both rheumatologists and OB/GYNs. Most general rheumatologists and OB/GYNs have limited experience in caring for rheumatic disease patients during pregnancy, and many do not have ready access to expert colleagues in this area. This book summarizes the current state of knowledge and presents a general approach for assessment of the rheumatic disease patient considering pregnancy, hormonal contraception or infertility treatment.

Hypermobility of Joints 4th Edition follows the same format as its successful predecessors. The aim of which was to provide an overview of hyperlaxity of joints and this edition follows that aim by describing the most recent research and new developments in biochemistry, as well as providing practical advice on clinical features and management.

Hypermobility of Joints 4th Edition provides illustrative case histories, a review of hypermobility in the performing arts and sports and an outline of heritable hypermobility syndromes. This book is a valuable reference tool for a wide number of specialties, although it will particularly be of interest to rheumatologists, orthopedic surgeons and medical geneticists.

This issue of the Rheumatic Disease Clinics of North America brings the rheumatologist up to date on the latest practices in quantitative assessment of common musculoskeletal conditions. Topics covered include quantitative measures of rheumatic diseases for clinical research versus standard clinical care; monitoring outcomes of arthritis and longitudinal data collection in routine care using a patient questionnaire; electronic and computer-generated patient questionnaires; integrating patient questionnaire data into electronic medical records; the SDI and CDAI; using SPERA for efficient capture of essential data from patients and health professionals; MDHAQ and RAPID scores; a proposed continuous quality improvement approach to assessment and management of patients with rheumatoid arthritis; and DAS28.

This issue of the Rheumatic Disease Clinics of North America brings the rheumatologist up to date on the latest breakthroughs in the assessment and treatment of infections in rheumatic diseases. Lumiary ACR Master, Luis Espinoza Guest Edited this issue, which covers topics including molecular biology of infectious agents ion chronic arthritis; gonococcal and non-gonococcal arthritis; soft tissues (bursitis, tendonitis) infections; clinical and medical management of reactive arthritis; septic complications in pediatric and adult patients with systemic lupus erythematosus; Lyme arthritis; the role of parvovirus B19 in chronic arthritis; hepatitis C-associated rheumatic disorders; hepatitis B-related autoimmune manifestations; HIV-associated rheumatic disorders; assessment of latent tuberculosis in rheumatic disorders; and infectious complications of biologic agents.

This comprehensive volume provides current state of the art of the use of corticosteroids in the pediatric patient. It consists of 14 chapters written by leading authors from different countries. The first chapters cover historical notes, general concepts on treatment with corticosteroids with regard to indications and side effects, and basic pharmacologic properties of these compounds. The rest of the book is devoted to the specific use of steroids in the different pediatric subspecialties. Despite advances with newer effective immunosuppressive and anti-inflammatory drugs, corticosteroids still remain the mainstay of therapy for many disorders. Leading authors in their field have summarized these concepts to provide an authoritative, comprehensive guide to help clinicians safely and effectively use corticosteroids in their pediatric patients.

This next volume in our established series proposes to systematically review the basic science and clinical knowledge of the role of free radicals and antioxidants, collectively known as "oxidative stress", in the pathology of arthritis and other joint diseases. It will describe the most current diagnostic tools , laboratory methods and technology, to suggest ways of prevention and treatment and to emphasize the concept of the bench-to-bedside approach. The book will also provide specific coverage on emerging technology and medical applications including discussions of biomarkers and antioxidants as therapeutic agents and several more relevant aspects. In addition, the book will promote the concept of using biomarkers representative of oxidative stress reactions and free radical damage , as well as describe the effect of antioxidants in treating disease in clinical trials. The content will be valuable to researchers studying the development of arthritis/joint disease, and clinicians treating patients with these diagnoses.

In this issue of Rheumatic Disease Clinics, guest editors Drs. M. Elaine Husni and George A. Karpouzas bring their considerable expertise to the topic of Cardiovascular Complications of Chronic Rheumatic Diseases. Top experts in the field cover key topics such as primary and secondary atherosclerotic cardiovascular (ASCVD) risk prevention in the rheumatic disease, pro-thrombotic and pro-atherogenic anti-phospholipid antibodies, recommendations for the use of NSAIDs and CVD risk, and more. Contains 9 relevant, practice-oriented topics including atherosclerotic cardiovascular risk stratification in the rheumatic diseases; subclinical atherosclerosis evaluation across various vascular territories; lessons from heart and large vessel biopsies in patients with and without autoimmune rheumatic disease; the role of lipoprotein levels and function in atherosclerosis associated with autoimmune rheumatic diseases; and more. Provides in-depth clinical reviews on cardiovascular complications of chronic rheumatic diseases, 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.

1 Introduction.- 2 Osteoarthritis.- 3 Rheumatoid arthritis.- 4 Juvenile arthritis.- 5 Crystal-associated arthropathies.- 6 Ankylosing spondylitis.- 7 Psoriatic arthritis.- 8 Reiter's syndrome.- 9 Systemic lupus erythematosus.- 10 Systemic sclerosis (scleroderma).- 11 Polymyositis-dermatomyositis.- 12 Vasculitis.- 13 Polymyalgia rheumatica and giant cell arteritis.- 14 Arthritis in pregnancy.- 15 Fibromyalgia.- 16 Low back pain.- 17 Prediction of the clinical efficacy of and intolerance to antirheumatic drug therapy.- 18 Prediction of organ system toxicity with anti-rheumatic drug therapy.- 19 New concepts in prognosis of rheumatic diseases for the 1990s.

This volume focuses on IgG4-related disease (IgG4-RD), a novel clinical entity involving multiple organs and of unknown origin, associated with the abundant infiltration of IgG4-positive cells. It consists of nine chapters written by prominent experts in the field and discusses the disease concept, diagnosis and treatment, as well as recent findings on its pathogenesis and pathophysiology. As such, it offers an invaluable source of information for researchers and clinicians alike.

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.

This book provides the reader with a comprehensive overview of the Antiphospholipid syndrome. One of the most important advances in rheumatology and connective tissue diseases of the last decade. It provides an explanation for many previously undefined conditions with no clear pathogenesis encompassing all subspeculations in internal medicine as well as obstetrics. Clotting problems leading to strokes and myocardial infarctions (in younger people) as well as a large variety of other syndromes such as chorea, hyproadrenalism, pulmonary problems are now being understood.

This text represents the proceedings of a conference, Rheumaderm, that was held in December 1997. The meeting was a dialogue between the specialties of Rheumatology and Dermatology, exploring and discussing areas of common interest. The aim was to present problems common to both specialties, thereby emphasizing the team approach to such problems and helping to combine various skills.

This book, part of the series Rare Diseases of the Immune System, offers comprehensive, up-to-date coverage of the pathophysiology and management of the antiphospholipid syndrome (APS). Immunologic and genetic aspects are discussed and the pathogenic mechanisms responsible for such phenomena as APS-mediated thrombosis and pregnancy loss/complications are explained. The main clinical manifestations, classification criteria and diagnostic tools are identified, and close attention is paid to the nature of the involvement of various organs or organ systems in APS. Specific chapters describe the treatment of the different symptoms, therapies of value in avoiding recurrences, and innovative treatment approaches. The authors are senior experts in the field who are aided by younger fellows, ensuring that the book is also educationally oriented. This handy volume will be a valuable tool for postgraduates in training and professionals wishing to extend their knowledge of this specific syndrome.

Autoimmunity, characterized by autoreactive lymphocytes and autoantibodies, is the consequence of a failure to discriminate between self and non-self, and autoimmune diseases are an increasing threat to people living in the industrialized countries. Autoimmune disorders are treatable, but not curable, and patients can face disability at later stages of the disease. Thus, there is a medical and economic need for new concepts and treatments in autoimmune disorders. New concepts and treatments can only be achieved by an interdisciplinary approach bringing together expertise, technologies, and clinical experience. The workshop focused on multiple sclerosis, rheumatoid arthritis and type I diabetes, and discussed conventional drug therapies, gene therapy, cell and tissue transplantation therapies, and first treatments using blood stem cells for reprogramming the patients' immune system.

The first section of this volume provides well structured protocols for autoantibody detection. Step-by-step procedures are accompanied by explanatory notes and comments, clear diagrams, line illustrations and excellent photo illustrations. Extensive literature references lead the way to further background information. The methods presented were validated by more than 40 leading laboratories active in sera analysis, which indicates that these methods have been found to be practically useful and lead to consistent inter-laboratory results: consensus in autoantibody detection. The second section contains the a compilation of full, detailed information on autoantigens related to important autoimmune diseases. The chapters are all structured according to an easy-reference fixed template structure: specific detection methods, cellular localization, biochemical characteristics, function, cDNA and derived amino acid sequence, gene structure, B- and T-cell epitopes and lists of published monoclonal antibodies. The text is enhanced by many schematic figures and photo illustrations. As in Section A, extensive literature references are provided. The information for this section was brought together by leading experts in their fields. This Manual is intended as a reference book for bench scientists working in the field of autoimmunity, but also for rheumatologists, general (internal medicine) physicians or clinical immunologists caring for patients with autoimmune disorders.

Recent research, which Bone- Metabolic Function and Modulators expands on, has added new support to the idea that bone not only serves as a support system, but also functions as an integrating organ, with a significant regulatory role for lipid and energy metabolism. Links between physical activity and the skeleton are also becoming increasingly clear. This fully illustrated volume contains up-to-date information on the metabolic role of the skeleton and what this can mean for the treatment of metabolic as well as skeletal and auditory diseases. Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development Bone- Metabolic Function and Modulators is of particular interest to clinician scientists, clinical and basic bone researchers, orthopedists, endocrinologists, internists, dentists, nurse practitioners, medical and dental residents and physiotherapists as well as students of the musculoskeletal system. Bone- Metabolic Function and Modulators is the seventh volume in the series Topics in Bone Biology, edited by Felix Bronner and Mary C. Farach-Carson. Other titles in this series:- Bone Formation Bone Resorption Engineering of Functional Skeletal Tissues Bone and Osteoarthritis Bone and Cancer Bone and Development

George Tsokos and a panel of authoritative clinicians and researchers synthesize the latest findings from across cell and molecular biology with the basic principles of rheumatology to create the first textbook of molecular rheumatology. These established experts describe the biochemical mechanisms by which apoptosis, cell signaling, complement, lipids, and viruses contribute to disease expression, and detail both immune and nonimmune cell function in rheumatic diseases. Their review of the major rheumatic diseases integrates the cellular, biochemical, and molecular biological mechanisms that are important in rheumatic disease pathogenesis. Path-breaking and illuminating, Principles of Molecular Rheumatology expands the envelope of clinical understanding to reveal the biological roots underlying rheumatologic disease, as well as the nature and roles of the powerful new therapeutics now emerging for its optimal treatment.

This volume reviews the current state of research on the IgM antibody and its multiple receptors and binding proteins. Interactions of the IgM ligands with these molecules are important for protection against infections as a first line of defense, as well as for regulation of immune responses to pathogens and self-antigens. The book includes up-to-date information on: (i) the phylogeny of three IgM-binding receptors [polymeric Ig receptor (pIgR), Fc receptor for both IgA and IgM (Fc /R), and Fc receptor for IgM only (FcR)]; (ii) the lymphocyte-restricted distribution and unique ligand-binding activity of FcR; (iii) the definition and potential function of Fc receptor-like molecule A (FCRLA) as a resident endoplasmic reticulum protein that binds IgM, but also IgG and IgA; (iv) IgM antibody-mediated enhancement of humoral immune responses, highlighting the importance of complement and its receptors, (v) the numerous important roles of IgM natural antibodies in regulation of inflammation. It is an invaluable resource for researchers and clinicians alike.

This issue of Rheumatic Disease Clinics, guest edited by Dr. Candace Feldman, is Part II of a two-part issue covering Health Disparities in Rheumatic Diseases. This issue is one of four selected each year by series Consulting Editor, Dr. Michael Weisman. Topics discussed in this issue include, but are not limited to: Disparities in Lupus Care and Outcomes among U.S. Medicaid Beneficiaries, Understanding Risk Factors for Poor Outcomes in a Multiethnic Longitudinal Cohort, Impact of Psychosocial Factors on RA and Lupus Health Disparities, Racial/ethnic and geographic disparities in knee and hip osteoarthritis, Racial/ethnic Disparities in Osteoarthritis Management, Challenges and Strategies to Achieve Equitable Rheumatologic Care Across the World, Strategies to Reduce Disparities, Understanding and Addressing the Provider Biases and the Lack of Diversity in Lupus Clinical Trials, Community-engaged Research: Lupus Conversations, Leveraging Telemedicine as an Approach to Address Rheumatic Disease Health Disparities, and Understanding the Role and Challenges of Patient Preferences in Disparities in Rheumatic Disease Care.

This issue of Rheumatic Disease Clinics, guest edited by Dr. Maripat Corr, will discuss Pain in Rheumatic Diseases. This issue is one of four selected each year by series Consulting Editor, Dr. Michael Weisman. Topics discussed in this issue include, but are not limited to: Pain mechanisms in patients with rheumatic diseases, The back-pain assessment and treatment in clinical practice, Basic mechanisms of pain in osteoarthritis - experimental observations, NGF promise for management of pain in OA - clinical and experimental aspects, Pivotal role of pain in the lupus patient - cause or effect of poor outcomes, Cannabinoids-hope or hype for pain, Sex differences in Models of pain, Neuropathic pain in AS, and Relationship between inflammation and pain - RA as a model.

It is with great pleasure that I write this Foreword to the Proceedings of the International Conference on Behcet's Disease which was held in Berlin in June 2002. This was the first International Conference held under the auspices of the International Society for Behcet's Disease which was founded in 2000 in Seoul. First, I congratulate our colleagues in Berlin, led by Professor Christos Zouboulis of the Department of Dermatology at the Free University of Berlin, for having organised a most successful conference and for having compiled these proceedings so rapidly. It will be realised immediately on scanning the contents of this book that the conference was truly international with 210 participants from 26 countries, as Professor Zouboulis has noted in his preface. These included basic scientists, epidemiologists, pathologists, clinicians and, importantly, representatives from patient organisations. The latter held their own conference alongside the scientific-medical conference to mutual benefit. The combined session of patients and doctors (abstracts on pp 601 - 626) gave the opportunity for an exchange of information and fruitful discussion. The wide ranging scope of the communications is evident from the index and it was most encouraging to see their origin - from all parts of the world, from senior and junior colleagues and, from many different disciplines. Many communications may be regarded as preliminary reports of research in progress and we look forward to seeing the definitive publications in appropriate journals in due course."

Behcet s Syndrome has seen great strides over the last two decades in the availability of new treatments and the understanding of underlying pathogenesis. Only 30 years ago the majority of particularly young men with Behcet s lost total eye sight, now only a minority do. This book covers the most recent developments in the basic and clinical aspects of Behcet s Syndrome. International authorities have collaborated to offer their diverse expert knowledge on the multiple affected organs and systems, including the skin, the eye, the brain, the lungs and not the least the gastrointestinal and the locomotor systems. A special chapter is devoted to juvenile disease. The definitive resource on Behcet s Syndrome, this book is well suited for rheumatologists, dermatologists, ophthalmologists, neurologists, and health professionals caring for Behcet s patients."