Strategies for the management of rheumatoid arthritis.

Rheumatoid arthritis is a chronic, systemic inflammatory autoimmune disease that, untreated, can lead to permanent joint damage, decrease in quality of life, and disability. Health care professionals play a vital role in caring for patients with rheumatoid arthritis. The therapeutic possibilities in the management of rheumatoid arthritis have changed, with newer biologic therapies that target the inflammatory cascade seen in rheumatoid arthritis. As new treatments become increasingly available, it is important for health care professionals to stay informed. This article provides physicians with a review of biologic therapies currently used for the treatment of rheumatoid arthritis and describe how those therapies are used to manage rheumatoid arthritis.

Acute respiratory responses of the mouse to chlorine.

In human subjects 15-min exposure to 0.5-1.0 ppm chlorine gas causes a nasal obstructive response in the absence of a marked sensation of irritation. The current investigation was designed to assess the response of the mouse for comparative purposes. Respiratory physiological responses were measured in female C57Bl/6J mice exposed to 0.8 to 4.0 ppm chlorine gas. Chlorine was a potent sensory irritant with an RD50 of 2.3 ppm. The gas produced airway obstruction as indicated by a concentration-dependent increase in specific airways resistance (sRaw) during the 15-min exposure. At 0.8 ppm, chlorine produced only mild sensory irritation (<20% change in breathing frequency) and a 65% increase in sRaw. Pretreatment with atropine was without effect on the obstructive response, suggesting a lack of involvement of muscarinic cholinergic pathways. Pretreatment with the sensory nerve toxin, capsaicin, dramatically reduced both the sensory irritation and obstructive responses to chlorine, suggesting the involvement of sensory nerves. Studies were also performed using the surgically isolated upper respiratory tract of the anesthetized mouse. Chlorine was efficiently scrubbed from the airstream (>97%) in that site and produced an obstructive response that was of sufficient magnitude to account for the entire response observed in the intact animal. In summary, chlorine gas produces an immediate nasal obstructive response in the mouse that appears to be similar to that in the human.

Long-term outcome of gonadectomy performed at an early age or traditional age in cats.

OBJECTIVE: To determine long-term results and complications of gonadectomy performed at an early age (prepubertal) or at the traditional age in cats. DESIGN: Cohort study. ANIMALS: 263 cats from animal shelters. PROCEDURE: Cats that underwent gonadectomy were allotted to 2 groups on the basis of estimated age at surgery (traditional age, > or = 24 weeks old; prepubertal, < 24 weeks old). Adoptive owner information was obtained from shelter records, and telephone interviews were conducted with owners to determine physical or behavioral problems observed in the cats after adoption. Follow-up information was obtained from attending veterinarians for cats with complex problems or when owners were uncertain regarding the exact nature of their cat's problem. RESULTS: Compared with traditional-age gonadectomy, prepubertal gonadectomy did not result in an increased incidence of infectious disease, behavioral problems, or problems associated with any body system during a median follow-up period of 37 months. Additionally, the rate of retention in the original adoptive household was the same for cats that underwent prepubertal gonadectomy as those that underwent traditional-age gonadectomy. CONCLUSIONS AND CLINICAL RELEVANCE: Prepubertal gonadectomy may be performed safely in cats without concern for increased incidence of physical or behavioral problems for at least a 3-year period after gonadectomy.