International journal of rheumatic diseases
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Randomized Controlled Trial
Supplementation of 1,25 dihydroxy vitamin D3 in patients with treatment naive early rheumatoid arthritis: a randomised controlled trial.
1,25 dihydroxy vitamin D3 has immunomodulatory functions in rheumatoid arthritis (RA) and is an anti-osteoporotic agent. No studies exist to assess its pain-relieving action in RA. ⋯ Supplementation of 500 IU of 1,25 dihydroxy vitamin D3 daily to previously DMARD-naïve patients with early RA along with triple DMARD therapy results in a significantly higher pain relief at the end of 3 months. The number needed to treat for this additional pain relief was 5. The prevalence of vitamin D deficiency in the study population was 68.1%.
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To evaluate the benefits of knee joint aspiration and injection in knee osteoarthritis (OA). ⋯ This pilot study appears to show a beneficial trend in giving corticosteroid injections and to aspirate the knee in OA patients. Further studies are needed to address the mechanical benefits, quadriceps strengthening and pain reduction with knee aspiration, as well as the effects that different volumes of fluid may have on knee mechanics and symptoms.
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Pulmonary arterial hypertension (PAH) is a major complication and cause of death in systemic sclerosis (SSc). Our objective was to identify the predictive factors of mortality and the 2-year survival rate among Thai sufferers of PAH-SSc. ⋯ Up to one-third of Thai sufferers of PAH-SSc died within 2 years of PAH diagnosis, without any specific treatment being given. Increased mortality risk was found in SSc patients who had FCIII and visceral organ involvement.
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Vitamin D deficiency is associated with numerous chronic diseases including cancer, heart disease and diabetes type 1 and 2. It is currently estimated that one billion people suffer from vitamin D deficiency worldwide. A major cause is lack of sun exposure, and this is evident even in countries at mid and low latitudes. Although a high prevalence has been found in Saudi Arabia, little is known to date about the reasons for this and, consequently about, reduction methodologies. The study's aim was to investigate the knowledge, attitude and practice (KAP) towards vitamin D deficiency, sun exposure, supplementation and fortification in a sample of female Saudi Arabian students. ⋯ Important barriers for the prevention of vitamin D deficiency in Saudi Arabia were highlighted. Recommendations for more research in specific areas including the prevalence of vitamin D deficiency and recommended daily allowances of supplementation are made. Governmental actions including increasing awareness of the importance of vitamin D and guidelines on how to obtain it are necessary. Creating areas where women, particularly those of lower socio-economic status, can enjoy sun exposure as well as fortifying more foods would go some way towards tackling this problem.
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There is strong rationale for improving care for people with chronic conditions, including osteoarthritis (OA). Successful implementation of healthcare reform requires new concepts and directions that are strongly supported by policy, new models of care (service redesign) and changes in day-to-day practice (healthcare provider and patient practice). In this paper we discuss the extent to which policy about management of OA of the hip and knee has been translated into new service models in Australia. ⋯ Primarily focused within acute care public hospital settings, these have been shown to be feasible and acceptable but have limited data on clinical impact and cost-effectiveness. While policy is extant, implementation has not been systematic and comprehensive. Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently.