%PDF-1.4
%
51 0 obj
<>
endobj
48 0 obj
<>
endobj
104 0 obj
<>stream
Acrobat Distiller 4.05 for Macintosh
2003-07-30T09:02:55Z
2024-03-18T22:28:07-07:00
QuarkXPressª 4.11: AdobePS 8.8.0 (301)
2024-03-18T22:28:07-07:00
application/pdf
Heather
2002-898.sept
uuid:59a06e4c-1dd2-11b2-0a00-a809271d5700
uuid:59a06e4e-1dd2-11b2-0a00-bf0000000000
endstream
endobj
37 0 obj
<>
endobj
38 0 obj
<>
endobj
52 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 23 0 R/Type/Page>>
endobj
1 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 25 0 R/Type/Page>>
endobj
4 0 obj
<>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/Thumb 27 0 R/Type/Page>>
endobj
17 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 29 0 R/Type/Page>>
endobj
20 0 obj
<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Thumb 31 0 R/Type/Page>>
endobj
122 0 obj
[126 0 R]
endobj
123 0 obj
<>stream
1 g
/GS0 gs
0 792 m
0 792 l
f
q
-1 793 614 -794 re
W n
q
0 792.03 612 -792 re
W n
BT
0 0 0 1 k
/GS1 gs
/T1_0 1 Tf
-0.00011 Tc 0.069 Tw 10 0 0 10 54 713.1616 Tm
(the damage in both early and late SLE can be attributed to)Tj
0.0199 Tc 0.55409 Tw 0 -1.2 TD
[(corticosteroid therapy directly)64.9 (. Corticosteroid-related)]TJ
-0.00011 Tc 0.2832 Tw T*
(damage tended to accumulate over a prolonged disease)Tj
0.0139 Tw T*
[(course. )17.7 (Thus the contribution of damage related to corticos-)]TJ
0.226 Tw T*
(teroid was lower in the early course of the disease, but)Tj
0.27251 Tw T*
(constituted most of the damage at 15 years of disease.)Tj
0 Tw T*
(Zonana-Nacach, )Tj
/T1_1 1 Tf
0.01849 Tw 6.8471 0 Td
(et al)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.5 0 0 6.5 140.152 644.4615 Tm
(14)Tj
-0.00011 Tc 0.01849 Tw 10 0 0 10 149.3374 641.1616 Tm
(reported that cumulative prednisone)Tj
-0.03529 Tw -9.5337 -1.2 Td
(dose was significantly associated with osteoporotic fractures)Tj
0.03349 Tw T*
(and symptomatic coronary artery disease and cataracts, and)Tj
0.0289 Tw T*
(longer duration of exposure to high dose corticosteroid was)Tj
0.2234 Tw T*
(associated with osteonecrosis and stroke. Our study was)Tj
0.2198 Tw T*
(descriptive of damage in patients with SLE and did not)Tj
-0.0118 Tw T*
[(address associated factors. )17.7 (The number of inception patients)]TJ
-0.0127 Tw T*
(followed at least 15 years was small \(73\), precluding a case-)Tj
0.02499 Tw T*
(control study of associated risk factors.)Tj
0.1037 Tw 1.2 -1.2 Td
[(Patients with SLE are more ef)17.7 (fectively treated for their)]TJ
0.00639 Tw -1.2 -1.2 Td
[(inflammatory disease in the modern era. However)39.7 (, the price)]TJ
0.03081 Tw T*
[(paid for this more ef)17.7 (fective disease control is the accrual of)]TJ
0.3239 Tw T*
(manifestations of damage in these patients, due to the)Tj
0.0018 Tc 0.37309 Tw T*
(disease itself \(primarily early\) and from corticosteroid)Tj
-0.00011 Tc 0.02499 Tw T*
(therapy \(primarily late\).)Tj
/T1_2 1 Tf
0 Tw 0 -2.4 TD
(REFERENCES)Tj
/T1_0 1 Tf
0.02499 Tw 8 0 0 8 61 439.1616 Tm
[(1.)-875.1 (Gladman DD, Urowitz MB. Prognostic subsets and mortality in)]TJ
1.675 -1.25 Td
[(systemic lupus erythematosus. In: )17.7 (W)79.9 (allace D, Hahn B, editors.)]TJ
0 -1.25 TD
[(Dubois\325)-201.1 (lupus erythematosus. 6th ed. Baltimore: )17.6 (W)39.8 (illiams &)]TJ
T*
[(W)39.8 (ilkins; 2001:1213-327.)]TJ
-1.675 -1.25 Td
[(2.)-875.1 (Urowitz MB, Gladman DD. )54.8 (Assessment of disease activity and)]TJ
1.675 -1.25 Td
[(damage in SLE. In: Gladman DD, Hochber)17.7 (g MC, editors.)]TJ
T*
[(Bailli\217re\325)54.8 (s clinical rheumatology)64.8 (. International practice and)]TJ
T*
[(research. London: Bailli\217re )17.7 (T)35 (indall; 1998:405-13.)]TJ
-1.675 -1.25 Td
[(3.)-875.1 (Gladman DD, Ginzler E, Goldsmith C, et al. )17.7 (The development and)]TJ
1.675 -1.25 Td
(initial validation of the SLICC/ACR damage index for SLE.)Tj
T*
(Arthritis Rheum 1996;39:363-9.)Tj
-1.675 -1.25 Td
[(4.)-875.1 (Gladman DD, Urowitz MB, Goldsmith CH, et al. )17.7 (The reliability of)]TJ
1.675 -1.25 Td
(the Systemic Lupus International Collaborating Clinics/American)Tj
33 49.421 Td
(College of Rheumatology Damage Index in patients with systemic)Tj
T*
[(lupus erythematosus. )54.8 (Arthritis Rheum 1997;40:809-13. )]TJ
-1.675 -1.25 Td
[(5.)-875.1 (Petri M. Musculoskeletal complications of systemic lupus )]TJ
1.675 -1.25 Td
[(erythematosus in the Hopkins Lupus Cohort: an update. )54.8 (Arthritis)]TJ
T*
(Care Res 1995;8:137-45. )Tj
-1.675 -1.25 Td
[(6.)-875.1 (Stoll )17.7 (T)74 (, Seifert B, Isenber)17.7 (g DA. SLICC/ACR Damage Index is)]TJ
1.675 -1.25 Td
[(valid, and renal and pulmonary or)17.7 (gan scores are predictors of)]TJ
T*
(severe outcome in patients with systemic lupus erythematosus. Br )Tj
T*
(J Rheumatol 1996;35:248-54.)Tj
-1.675 -1.25 Td
[(7.)-875.1 (Nossent JC. SLICC/ACR Damage Index in )54.8 (Afro-Caribbean patients)]TJ
1.675 -1.25 Td
(with systemic lupus erythematosus: changes in and relationship to)Tj
T*
[(disease activity)64.8 (, corticosteroid therapy)64.8 (, and prognosis. J Rheumatol)]TJ
0 Tc 0 Tw T*
(1998;25:654-9.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(8.)-875.1 (Zonana-Nacach )54.8 (A, Camar)17.7 (go-Coronel )54.8 (A, )36.8 (Y)99.8 (anez P)110.7 (, et al.)]TJ
1.675 -1.25 Td
(Measurement of damage in 210 Mexican patients with systemic)Tj
T*
(lupus erythematosus: relationship with disease duration. Lupus)Tj
0 Tc 0 Tw T*
[(1998;7:1)36.9 (19-23.)]TJ
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(9.)-875.1 (Gladman DD, Urowitz MB. )17.7 (The SLICC/ACR damage index:)]TJ
1.675 -1.25 Td
(progress report and experience in the field. Lupus 1999;8:632-7.)Tj
-2.175 -1.25 Td
[(10.)-875.1 (Nived O, Jonsen )54.8 (A, Bengtsson )54.8 (AA, Bengtsson C, Sturfelt G. High)]TJ
2.175 -1.25 Td
(predictive value of the Systemic Lupus International Collaborating)Tj
T*
(Clinics/American College of Rheumatology damage index for)Tj
T*
(survival in systemic lupus erythematosus. J Rheumatol)Tj
0 Tc 0 Tw T*
(2002;29:1398-400.)Tj
-0.00011 Tc 0.02499 Tw -2.1381 -1.25 Td
[(1)36.8 (1)-0.1 (.)-875.1 (Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH,)]TJ
2.1381 -1.25 Td
[(and )17.7 (The Committee on Prognosis Studies in SLE. )17.7 (The development)]TJ
T*
[(and validation of the SLE Disease )54.8 (Activity Index \(SLEDAI\).)]TJ
T*
(Arthritis Rheum 1992;35:630-40.)Tj
-2.175 -1.25 Td
[(12.)-875.1 (Gladman DD, Urowitz MB. Systemic lupus erythematous: clinical)]TJ
2.175 -1.25 Td
[(features. In: Klippel JH, Dieppe P)91.7 (A, editors. Rheumatology)64.8 (. 2nd ed.)]TJ
0 Tc T*
(St. Louis: Mosby; 1998:1.1-1.18.)Tj
-0.00011 Tc -2.175 -1.25 Td
[(13.)-875.1 (Reveille JD, Bartolucci )54.8 (A, )54.8 (Alarcon GS. Prognosis in systemic lupus)]TJ
2.175 -1.25 Td
(erythematosus. Negative impact of increasing age at onset, Black)Tj
T*
[(race, and thrombocytopenia, as well as causes of death. )54.8 (Arthritis)]TJ
0 Tc T*
(Rheum 1990;33:37-48.)Tj
-0.00011 Tc -2.175 -1.25 Td
[(14.)-875.1 (Zonana-Nacach )54.8 (A, Barr SG, Magder LS, Petri M. Damage in)]TJ
2.175 -1.25 Td
(systemic lupus erythematosus and its association with )Tj
T*
[(corticosteroids. )54.8 (Arthritis Rheum 2000;43:1801-8.)]TJ
ET
0 0 0 1 K
54 54 m
558 54 l
S
BT
/T1_1 1 Tf
8 0 0 8 54.5 35.9844 Tm
[(Gladman, et al: Or)36.8 (gan damage in SLE)]TJ
0 Tc 0 Tw 60.9375 -0.0313 Td
(1959)Tj
ET
0 0 0 0 k
/GS0 gs
109.22 59.09 396.48 -10.84 re
f*
0.5 w
109.22 59.09 396.48 -10.84 re
S
Q
Q
q
0 0 612 792 re
W n
BT
0 0 0 rg
/GS2 gs
/T1_3 8 Tf
117.48 51 Td
(Personal, non-commercial use only. The Journal of Rheumatology Copyrig\
ht \251 2003. All rights reserved.)Tj
ET
Q
BT
0 g
/GS2 gs
/T1_4 1 Tf
10 0 0 10 540 17 Tm
( )Tj
0 0.48627 0.77255 rg
/GS2 gs
-7.22298 0 Td
(www.jrheum.org)Tj
0 g
/GS2 gs
-16.72996 0 Td
(Downloaded on March 18, 2024 from )Tj
ET
endstream
endobj
31 0 obj
<>stream
8;Z\7Mf&VO#ikr7OPcJ/$",B(mTO<;m[C7mi\Le%N&d$q=.h!Q$=A9h^TNWiGBn>A
fFORS/hWs.,cFrr\-VG7g5OFYqRf4$b;J7:`%_dcC!WQ:+Bp@g)'^QLm;Y-,Ae_E.
Y5]E`ik)3"MI`ZdUN,]t+@bok4TQ/P4f;Js[ic3o8!>4'a"akW1J)e+a+"C_7F(cn
f;DSGdu(W30VL!J*g'$p:"#R?BZEZEF>/@,OITjkoD
@9q.+hj/gY,4RQXUIs>t(@sX!X"cqP*:'d_aJ]H1Mu:JcbQ^#;jeI@PFLMkZ8bIq-
,EdE!\mcJi@Pn`9fkj8N2mJ?nimAEF/\c\MtDbmO1dTn
fl/.F<M$PUA9ph2k)11A
80eh)6m@cg/a+1XO=V5UMiQcR`PVrBSMl5;!
endstream
endobj
35 0 obj
[/Indexed/DeviceRGB 255 34 0 R]
endobj
34 0 obj
<>stream
J,g]g+e/h_!_gCtO=0f)$P%cIi8Zdfc5&3j_8$7g.@L`YKUJNGBP\poR=_;Dl'P(T
(7Boo^^S:71(MN]ZQX/+Cbu.lK"p74pe1T%s.DY%&\1TdJhr54.M9au6>79n6`Q:4
PbLSZTLEE(8E@'*1mg_*eTnN*;*'V3+gm-EEetX%;Bo$ur2ss*N`.-!.kG_q6GDD'
dKoL!8Ka#EV,@V!\j8ZFbp6EE<9cn=N6j0nf;(&;QU6bUD')c@\
9-d\DA=cZ0Q>gIM$$;cd2O@&a;X,Nn_aP(]I1aRc(K1^ue>
gF/(+GaKo$qneLWDrQ#;5\S(\$q'4Q,85`-8;S(=Z"WSBOV*FM)4,?B],R
endstream
endobj
58 0 obj
<>
endobj
55 0 obj
<>
endobj
62 0 obj
<>
endobj
93 0 obj
<>
endobj
109 0 obj
<>
endobj
63 0 obj
<>
endobj
83 0 obj
<>stream
HLPw9v_lEY=I1WCi$"*
qĜpwX&zܝTQXQS$:ĤjǴ+ٝgvޙ|]#HZfݪ-fGlZ&FBCsdN'Yx=~⎒Y12"(8$8ha\\
{Yhy\x FXVd& imfaC\2mv.ͅ!jr!0!rTh.5%HȲUef!d+|.
bRh1绚'_O&H!^ y:"$bub1CN D:ae:uJT:*֫_3NrLdH;ߟ|'۞X
Xrwa,ٖs'8KzطDwy=5L%/B aaRjru١ _4(@,DO$HgͳS8baa^_":ewPӖ1Vɟ+!
[ūqw[Mjn$hTBBdآ>_&r5Voc%::Y_u5P|\g4pw;]oھ.0~&TzA姀v{(BHB85Zғ隥+@`2Y:Ƶ1Z?B[""ܐS!QVvAND⦆qvCοQUMɺڼ=o%/, 7ށ8{+2W`lt'p^ހo'ҟնּƆh嚿Jjj `6ICP~HButͻV3{TW3-)iG&Xy^ 1.y}u\MkدKDtZ_!_9o-]♁
eG])Ȁ C'V
+q7ޅSpv݁Ӱ7x<p`RE`0j끏&a507%7t78f4Z~n//
ZkxRÇ'Y pqcoeO/
e8VGrWBSM
8&ZT3lwԩ.'j YwFvv"WmmumKR#9α9xHI?)Z؝/H@=t6[ZvXe1@\S>ױaȉ?/F1hxɏ{NUo<HG+O=%]}ڋ.X2p>"Ԏtm
һ.*DÍ~^I22id
Zñ-Zf蒻×;\;G?3hH#wQM4}/TD5rx9dG#LO㎮zq4+E3m0 Y/kq
endstream
endobj
54 0 obj
<>
endobj
86 0 obj
<>stream
HT{PSg˽F!\ZuWATjAByX IG !yI yA@E|,Z7UJm]fsӏݨgg?v|s;s~1k+qǵk>];?D"=6(%_pBs87a6eg5ߎ8gg͉J$];tkU\x3
79`$U-=^^<ʒT)x;oE|>Zeo,FnSbݰo,%Izob"+gSrqJ%cV"gYEJtXa%d
Ug.OKb%)[o!-jbӰakh,i0!XĂ+qjUaK#}K7WIzzFgsoöllvv_Nj>˯f;}h^a?pDSݱYpmN3tp~겋XX߽$ k{Y%Uv^Q}LQ)Of32tA. !+AϠ Hl`xȌʶ6MiɔJ?dv5M1d#kV!d4C~QmuW[:Ng4f]UYPFdws2+?D)9_tY=kg\]#$&3yu::m]Bx1Ce"~#~#8wpgT:LxÒ}\?r\ݝa,̖nEVRmYnpUI#ِ-ȀN85p%}8>% il>rp8HT*>ΑkK4u@d]*E%ÓsU#/ MEnyBEIXͣ~XqQfˏҥW+_7'8OJfR4T
2W>CɇYXOHO
h.D!RR0I~ wm.ɠJ} nIF\4f%iFYT+WQѝթErV!*h:3Q&n P4⦯8NA|YgUW_ga]q@ꋫT%q#jdB40g@RYޚR ѱQC5r. YfG$'%oRYXA7g8#WK
՟0%ol0νJjomڧwn_{7=w?uQZ*jL_D+Iw>r|hs_tGtE-hCCء-[¶|/g׃{j35<w!yW `ǡ.Qb~ 5i'#/=Qus[ĩT3P=pͮǃ/@^YxX"Izŕ^;E'&^-`+r80xY`Y h0jY9pDpfof#WU4e
gCjBsziK.KH;x:_4{I w42(z[f7[&HL`oǨxY"$,!TIeRKvl`(lhGDź3Ȅ6=Vר).\yޘs/a Akj0n%0O7{1=Ue#"}lBќ(
AݥꯌOV5y>V-4B1 6<8zQ:BU@H8%`8/McCW+^=!¶1#eࣼkQhIْ9EvRGJqYuNࠆO }ܮvj4ȐE T6GպZKu(wRJP^aXIRuO?A3],9~>Mh5ugaӘںLn֪K];>VQ<@ ^&
"*.Z]n\8{-o|;wCL49O|y
l?i_RDA^@+1ɉ+hqϛ-Qo>`R|Ȯu$A1ܓy!hCZp|jD"~ bt p 8}p|K~8OEQE:[rGqh5F+Fi:#
ad]"~%8vEJ*uQˆkӠ8B}mafkgm4&eKnӜ.#>-Re.l#TvMBy^O1=R$[CEbL襦QZL ιJng>8"&;cL 儶.-
byh X6kL?c_Y5K!Q''C3|)7iž`χ%LHq{pnEP#*%Irɵ!0 o)8lQ[ w&3oV_xWF"̋
{ۯ^"X#1P>۞MNjP3*|}֙'97
%ҾR5uʦ㹦Dc_/\CM\j2ʵBl1d۞4-6X*
6Tk$-ifQl-q@#f`]Huj9!{>B/9Hwi-!/>'pM%Jnӿ|lU@gmR
F&Bǻ"w,]"qG}(sW6tL^Fm|ɜ
2mdeU= hh]*=FMƯuD6h:<aT;TJV\aCXeJ%y^3=H_XQ)r$mE(_"NtL.,).;S@b``d䙷dGn}I(c裘V@A-τY( Zqw29Ql,-,}b7"Zw%YǢ*.8/Շ\ Y
`;oikcaLZ3Vh_2ah_sNJ5ۆGmSY+J
2Dm/v_ ٽ:MynO\w+54abv S҄ʔ
"i#m')w.vT?WXՅt:5gJo/pd(Uµ!.AKS;DMئ3pܚ9E-֎GTVJB0q"`cƱ}Hlv}mlN$Z
IQڪJ[M[~ٴVC^{twV1Z1Uڥ+4m+G̍wNźBĄ樵wXb5ZɂM"S s9{g/Ĕ()@稄)Ф(ȇo8fYLxՄ
Q%$ZSq}%f҂N ?7kb! J^qmgg^6J>n81B= /l~#c;Y +l!K*ࣥHɂߙ|(Bߒ+!wyhh'"9h-ްۜ5M%OxJ"*kʾpmOOL^{;G&&
Z8˦X5n+H.tnXZb@MH94
*rq]FW$+P&_~VMȿ"5:Ԑ]
haqb!y$ٸRZgU#l[Ơ'îx5OX.
4]bƞⱒSѩEzQw` 7w<1uU&6?@ǣpTva6z 1Y+ޙ
P{١o8@WM{IsX[SBU=D<T0=D();B
_BDxo%7xu=c~yhH_Su<.EUZ慧"EYHTrTbߵu TQ8BF ߋ%\jwiV5
H&ƽpQIPDLL>ӯR{95NV]c$.Q?e軸d\7BlpL¹V!l4|%]Az-[vajk<hZ)uAJ[G`I
Ϊv[șHNSUVYjUS_o`QM.W`$Ҿ/ժh)/? `g',JsauHrcSh}kv~V0L3,5]FKAwډHmLz%zd^?囊
mxmw
a2tlBEIAQ9Zdq
VLEѓ' n}ٛTmʶ4kr QK23ʞ5Fa_{lB&t