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(not at or for diagnosis, but already during the disease course.)Tj
0.1371 Tw 0 -1.2 TD
(Indeed, in our study a delay in attending the tertiary care)Tj
0.0603 Tw T*
(center seemed to worsen the outcome, since remission was)Tj
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(presumably due to selection of cases with refractory disease,)Tj
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[(We)-79.9 ( )]TJ
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(\(22.4%\), i.e., they did not come to followup for at least 2 years.)Tj
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[(We)-79.8 ( )]TJ
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[(followup: this can reflect a dif)17.6 (ferent disease duration in the 2)]TJ
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(groups, and/or the fact that patients with milder disease are less)Tj
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(likely to seek medical care and keep followup appointments.)Tj
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(Overall, we observed that the remission rate increases)Tj
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(with followup time up to 5 years from disease onset, after)Tj
0.1062 Tw T*
(which it reaches its peak \(5\32010 years from disease onset\),)Tj
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[(and then slowly declines. )17.7 (This is probably because patients)]TJ
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(with active disease tend to seek medical advice more)Tj
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[(frequently)64.8 (, and therefore would stay in the followed group)]TJ
0.1629 Tw T*
[(for a longer period. Moreover)39.7 (, we observed that in some)]TJ
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(patients the disease can reactivate even after a long period)Tj
0.02499 Tw T*
(\(> 15 years in a few cases\) of remission.)Tj
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(Classification of childhood arthritis is a work in progress,)Tj
0.0918 Tw -1.2 -1.2 Td
(and new criteria for classification of the so-called juvenile)Tj
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(idiopathic arthritides have been proposed by ILAR)Tj
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(18)Tj
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(. For)Tj
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[(the purpose of this study)64.8 (, we decided to categorize our)]TJ
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(patients according to the EULAR and ESSG classification,)Tj
0.00819 Tw T*
(although we acknowledge the importance of the new classi-)Tj
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(fication system)Tj
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(19)Tj
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[(. )17.8 (This is mainly because roughly 23% of)]TJ
0.0705 Tw -6.8718 -1.2 Td
(our patients would fall into the nonspecific ILAR category)Tj
0.01421 Tw T*
[(of \322other arthritis\323 and therefore we would have lost a lar)17.7 (ge)]TJ
0.02499 Tw T*
(part of our data.)Tj
-0.0314 Tw 1.2 -1.2 Td
(Our study has shown that remission depends mostly upon)Tj
0.2894 Tw -1.2 -1.2 Td
(clinical diagnosis, and is scarcely influenced by age at)Tj
-0.0345 Tw T*
[(disease onset. )54.8 (As expected, RF positive polyarticular disease)]TJ
0.2135 Tw T*
[(had the worst prognosis. In the juvenile SpA)-408.7 (group, the)]TJ
0.0199 Tc 0.6162 Tw T*
(group less frequently studied, juvenile ankylosing)Tj
-0.00011 Tc -0.0338 Tw T*
(spondylitis had a worse prognosis than psoriatic arthritis and)Tj
0.02499 Tw T*
[(undif)17.7 (ferentiated spondyloarthropathy)64.8 (.)]TJ
-0.0159 Tw 1.2 -1.2 Td
(Our hospital based study suggests that childhood arthritis)Tj
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(goes into remission in about a third of cases. In our series,)Tj
0.3186 Tw T*
(58.3% of patients never achieved remission during the)Tj
0.33521 Tw T*
(disease course. Patients who were referred and treated)Tj
-0.0202 Tw T*
(before one year of disease had a better prognosis concerning)Tj
0.04601 Tw T*
[(remission at last visit. )17.7 (These findings need to be confirmed)]TJ
0.0029 Tc 0.37199 Tw T*
(in other series and with prospective population based)Tj
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[(studies. )17.7 (These findings could also be important from a ther-)]TJ
0.0701 Tw T*
[(apeutic point of view)64.8 (, as more aggressive treatment can be)]TJ
0.02499 Tw T*
(warranted in selected cases.)Tj
/T1_2 1 Tf
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(REFERENCES)Tj
/T1_0 1 Tf
0.02499 Tw 8 0 0 8 325 703.1616 Tm
[(1.)-875.1 (Minden K, Kiessling U, Listing J, et al. Prognosis of patients with)]TJ
1.675 -1.25 Td
[(juvenile chronic arthritis and juvenile spondyloarthropathy)64.8 (. J)]TJ
0 -1.25 TD
(Rheumatol 2000;27:2256-63.)Tj
-1.675 -1.25 Td
[(2.)-875.1 (W)79.9 (ood PHN. Special meeting on nomenclature and classification of)]TJ
1.675 -1.25 Td
[(arthritis in children. In: Munthe E, editor)54.8 (. )17.7 (The care of rheumatic)]TJ
T*
(children. Basel: EULAR Publishers; 1978:47-50.)Tj
-1.675 -1.25 Td
[(3.)-875.1 (Dougados M, van der Linden S, Juhlin R, et al. )17.7 (The European)]TJ
1.675 -1.25 Td
(Spondylarthropathy Study Group. Preliminary criteria for the )Tj
T*
[(classification of spondylarthropathies. )54.8 (Arthritis Rheum)]TJ
0 Tc 0 Tw T*
(1991;34:1218-27.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(4.)-875.1 (Hanson )17.7 (V)128.9 (, Kornreich H, Bernstein B, King KK, Singsen B.)]TJ
1.675 -1.25 Td
[(Prognosis of juvenile rheumatoid arthritis. )54.8 (Arthritis Rheum 1977;20)]TJ
0 Tc T*
(Suppl 2:279-84.)Tj
-0.00011 Tc -1.675 -1.25 Td
[(5.)-875.1 (Stoeber E. Prognosis in juvenile chronic arthritis. Eur J Pediatr)]TJ
0 Tc 0 Tw 1.675 -1.25 Td
(1981;135:225-8.)Tj
-0.00011 Tc 0.02499 Tw -1.675 -1.25 Td
[(6.)-875.1 (David J, Cooper C, Hickey L, et al. )17.7 (The functional and )]TJ
1.675 -1.25 Td
(psychological outcomes of juvenile chronic arthritis in young )Tj
T*
(adulthood. Br J Rheumatol 1994;33:876-81.)Tj
-1.675 -1.25 Td
[(7.)-875.1 (Ruperto N, Levinson JE, Ravelli )54.8 (A, et al. Longterm health)]TJ
1.675 -1.25 Td
[(outcomes and quality of life in )54.8 (American and Italian inception)]TJ
T*
(cohorts of patients with juvenile rheumatoid arthritis. I. Outcome)Tj
T*
(status. J Rheumatol 1997;24:945-51.)Tj
-1.675 -1.25 Td
[(8.)-875.1 (Graham )17.7 (TB, Lovell DJ. Outcome in pediatric rheumatic disease.)]TJ
1.675 -1.25 Td
(Curr Opin Rheumatol 1997;9:434-9.)Tj
-1.675 -1.25 Td
[(9.)-875.1 (Hull RG. Outcome in juvenile arthritis. Br J Rheumatol)]TJ
0 Tc 0 Tw 1.675 -1.25 Td
(1998;27:66-71.)Tj
-0.00011 Tc 0.02499 Tw -2.175 -1.25 Td
[(10.)-875.1 (Koivuniemi R, Leirisalo-Repo M. Juvenile chronic arthritis in adult)]TJ
2.175 -1.25 Td
(life: a study of longterm outcome in patients with juvenile chronic)Tj
T*
(arthritis or adult rheumatoid arthritis. Clin Rheumatol 1999;)Tj
0 Tc 0 Tw T*
(18:220-6.)Tj
-0.0369 Tc -2.1381 -1.25 Td
[(11)-36.9 (.)]TJ
-0.00011 Tc 0.02499 Tw 2.0881 0 Td
(Spiegel LR, Schneider R, Lang BA, et al. Early predictors of poor)Tj
0.05 -1.25 Td
(functional outcome in systemic-onset juvenile rheumatoid arthritis.)Tj
0 Tc 0 Tw T*
(A)Tj
-0.00011 Tc 0.02499 Tw 0.942 0 Td
[(multicenter cohort study)64.8 (. )54.8 (Arthritis Rheum 2000;43:2402-9.)]TJ
-3.117 -1.25 Td
[(12.)-875.1 (Foster H, Marshall N. JCA)-220.2 (in adult life: a study of long-term)]TJ
2.175 -1.25 Td
[(outcome in patients with JCA)-220.2 (or adult RA)-220.2 ([letter]. Koivuniemi R,)]TJ
T*
(Leirisalo-Repo M [reply]. Clin Rheumatol 2000;19:326-9.)Tj
-2.175 -1.25 Td
[(13.)-875.1 (Guillaume S, Prieur )54.8 (AM, Coste J, Job-Deslandre C. Long-term)]TJ
2.175 -1.25 Td
[(outcome and prognosis in oligoarticular)19.7 (-onset juvenile idiopathic)]TJ
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[(arthritis. )54.8 (Arthritis Rheum 2000;43:1858-65.)]TJ
-2.175 -1.25 Td
[(14.)-875.1 (W)79.9 (allace CA, Levinson JE. Juvenile rheumatoid arthritis: outcome)]TJ
2.175 -1.25 Td
[(and treatment for the 1990s. Rheum Dis Clin North )54.8 (Am)]TJ
0 Tc 0 Tw T*
(1991;17:891-905.)Tj
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[(15.)-875.1 (Andersson G\212re B, Fasth )54.8 (A. )17.7 (The natural history of juvenile chronic)]TJ
2.175 -1.25 Td
[(arthritis: a population based cohort study)64.8 (. II. Outcome. J Rheumatol)]TJ
0 Tc 0 Tw T*
(1995;22:308-19.)Tj
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[(16.)-875.1 (Flato B, )54.8 (Aasland )54.8 (A, )17.7 (V)59.8 (inje O, F\277rre \257. Outcome and predictive)]TJ
2.175 -1.25 Td
(factors in juvenile rheumatoid arthritis and juvenile)Tj
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[(spondyloarthropathy)64.9 (. J Rheumatol 1998;25:366-75.)]TJ
-2.175 -1.25 Td
[(17.)-875.1 (Zak M, Pedersen FK. Juvenile chronic arthritis into adulthood: a)]TJ
0 Tc 2.175 -1.25 Td
[(long-term follow-up study)64.9 (. Rheumatology 2000;39:198-204.)]TJ
-0.00011 Tc -2.175 -1.25 Td
[(18.)-875.1 (Petty R, Southwood )17.7 (TR, Baum J, et al. Revision of the proposed)]TJ
2.175 -1.25 Td
(classification criteria for juvenile idiopathic arthritis: Durban, 1997.\
)Tj
T*
(J Rheumatol 1998;25:1991-4.)Tj
-2.175 -1.25 Td
[(19.)-875.1 (Fantini F)79.7 (. Classification of chronic arthritides of childhood )]TJ
2.175 -1.25 Td
(\(juvenile idiopathic arthritis\): criticisms and suggestions to improve\
)Tj
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[(the ef)17.7 (ficacy of the Santiago-Durban criteria [letter]. J Rheumatol)]TJ
0 Tc 0 Tw T*
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