American Rheumatism Association 1958 and 1987 revised criteria for rheumatoid arthritis--how useful to the clinician.

The American Rheumatism Association (ARA) criteria for rheumatoid arthritis (RA) were evaluated in 52 newly referred consecutive, clinically diagnosed cases of RA. The 1958 and 1987 criteria were highly correlated (r = 0.795). By the 1958 criteria, 48 cases (92.3%) had classical/definite RA while 40 cases (76.9%) satisfied the 1987 criteria traditional format. By the 1987 classification tree 50 cases (96.2%) belonged to the first three RA subsets while 2 cases (3.8%) belonged to the non-RA subsets. Comparing the clinicians opinion of the outcome with the statistical modelling of variables based on ARA criteria, we conclude that the clinicians opinion of the outcome is reflected by a combination of morning stiffness duration, number of swollen joints, erosion score on hand radiographs and erythrocyte sedimentation rate. We conclude that evaluation of ARA 1958 and 1987 criteria in individual cases has both diagnostic and prognostic significance. We propose a short questionnaire based on ARA criteria, for use in hospital out patient clinic for diagnosis of RA.

Platelet adhesiveness in coronary heart disease.

A simple reproducible method of determination of whole blood platelet adhesiveness, on columns of unsiliconised glass microbeads, was developed and validated. Platelet adhesiveness was determined in 180 subjects who were classified into four groups. The subjects of Groups I and II had negative cardiac stress and were free from coronary heart disease (CHD). While the 42 subjects of Group I had none of the conventional coronary risk factors, the 46 subjects of Group II had one or more coronary risk factors. Group III consisted of 68 subjects who had positive cardiac stress test. They were patients with myocardial ischemia. Group IV consisted of 24 survivors of myocardial infarction. The percent of subjects with platelet retention values exceeding 50.5% were, 9.5% in Group I, 26.1% in Group II, 32.4% in Group III and 37.5% in Group IV (p < 0.05). Although Group II consisted of subjects free from CHD, its difference from Group I, and closeness to Groups III and IV probably indicate that asymptomatic subjects with coronary risk factors and with increased platelet adhesiveness may be on the threshold of the symptomatic phase of CHD. Increased platelet adhesiveness may thus be a predictive marker of CHD.