eLetters

322 e-Letters

  • Is arterial stiffness increased in rheumatoid arthritis?
    Julio A Chirinos

    Dear Editor

    I read the recent study by Klocke et al. with great interest.[1]

    The authors reported increased arterial stiffness as estimated by the analysis of arterial waveforms with aplanation tonometry in patients with rheumatoid arthritis (RA) when compared to healthy controls. Their findings can yield an important clue to understanding the increased cardiovascular mortality in RA. However, the...

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  • Continuous seeding of degraded products of normal micro-organisms as a causative factor in RA
    Adriaan C. Breebaart

    Dear Editor

    Toivanen [1] put forward the interesting hypothesis that, in contrast to reactive arthritis where temporary lodging of pathogenic micro- organisms is a causative factor, in RA a continuous seeding of degraded bacterial products from normal intestinal flora may induce synovitis. This hypothesis closely resembles the theory published by us one year earlier,[2] in which we also stressed a continuous seeding o...

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  • Reply to Dr Chan et al's comments on oral pilocarpine for ocular symptoms in Sjogren's syndrome
    Alexandros A Drosos

    Dear Editor

    We thank Dr Chan and collaborators for their interest in our study and for their comments.[1] As concerns the patients’ selection, we excluded patients with serious medical problems such as heart, and lung diseases, as well as other ophthalmological disorders including glaucoma. Thus, none of our patients were treated with beta-blockers and none were on hormone replacement therapy which may exacerbate d...

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  • Alternative hypothesis for gold ring effect on arthritis
    Richard J de Lange

    Dear Editor

    I was intrigued when I heard the report of this paper in view of the widely held belief that copper jewellery is also beneficial in the treatment of arthritis.

    In the case of the gold rings it has to be remembered that gold rings are seldom pure gold. Even 22 carat gold rings are 22/24 parts gold, the rest being copper.

    In view of this what evidence is there that the gold and not the...

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  • Comments on oral pilocarpine for ocular symptoms in Sjõgren’s syndrome
    Wai-Man Chan

    Dear Editor

    We read with great interest the study by Tsifetaki et al. on the efficacy and side effects of the use of oral pilocarpine for the treatment of ocular symptoms in Sjõgren’s syndrome.[1] In terms of patient selection, we noted the authors excluded patients with significant medical conditions, but we are not sure about the status of their concomitant medications. For women in their late 50s, suc...

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  • Glucocorticoids in Rh A.
    Tony S Russell

    Dear Editor

    The recent leader was well balanced and comprehensive.[1]

    However, there was no mention of why they are used and by whom. Thus, the mortality data from ARAMIS and other dara-bases showing an increased mortality in rheumatoid patients taking prednisone is acceptable if it's reserved for the more severe patient. The published evidence suggests to me that use is more physician determined than pa...

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  • Author's reply
    Danielle A. van der Windt

    Dear Editor

    In this letter we would like to respond to the comments made by Frank Conijn to our leader.[1]

    Firstly, we are aware of the differences in the content of physiotherapy in the three trials at issue, and briefly mentioned this in our leader. The fact that passive mobilisations were not allowed in the trial by Winters et al.[2] may, indeed, partly explain the differences in effectiveness of...

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  • Author's reply
    Ilse E Hoffman

    Dear Editor

    We thank dr Barta for his comments on our manuscript ‘anti- Saccharomyces cerevisiae IgA antibodies are raised in ankylosing spondylitis and undifferentiated spondyloarthropathy’.[1]

    We are fully aware of the importance of gut inflammation in spondyloarthropathies (SpA).[2] In our view, the finding of ASCA in SpA provides further evidence for the concept that inflammatory bowel disease and SpA...

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  • ASCA and spondyloarthropathy: with or without gut inflammation?
    Zsolt Barta

    Dear Editor

    Anti-Saccharomyces cerevisiae antibodies (ASCA) are known as specific markers in Crohn's disease albeit the clinical relevance of these antibodies to some oligomannose epitope of the Saccharomyces cerevisiae is not clear. Neither the origin and nor the clinicopathological role are clarified.

    Hoffman et al, investigated whether ASCAs are present in spondyloarthropathies (SpA) in comparison w...

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  • The Leader is biased
    Frank J.J. Conijn

    Dear Editor

    The Leader [1] is an insufficiently objective reaction, and one that demonstrates rather little real-life insight from the authors.

    Insufficiently objective, because it strongly highlights the matter of the outcome measures, while it only slightly touches on the question: is the study by Winters et al,[2] one of the two other (Dutch) randomised studies they use for their substantiation, a valid...

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