Seminars in arthritis and rheumatism
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Semin. Arthritis Rheum. · Oct 2013
ReviewHeart rate variability in patients with fibromyalgia and patients with chronic fatigue syndrome: a systematic review.
The goal of this systematic literature review is to determine whether there are differences and similarities in heart rate variability (HRV) between adult patients with fibromyalgia (FM), chronic fatigue syndrome (CFS), and healthy pain-free control subjects. ⋯ FM patients show more HRV aberrances and indices of increased sympathetic activity. Increased sympathetic activity is only present in CFS patients at night. Since direct comparisons are lacking and some confounders have to be taken into account, further research is warranted. The role of pain and causality can be subject of further research, as well as therapy studies directed to reduced HRV.
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Semin. Arthritis Rheum. · Aug 2013
Review Case ReportsSystemic adverse events following intraarticular corticosteroid injections for the treatment of juvenile idiopathic arthritis: two patients with dermatologic adverse events and review of the literature.
Intraarticular corticosteroid injections are an important part of the treatment for juvenile idiopathic arthritis due to the ability to achieve high concentration of the medication in the affected joint, while minimizing potential systemic adverse effects. There may be some systemic absorption of corticosteroids resulting in systemic adverse events. Our aim was to demonstrate the potential of adverse events due to the systemic absorption of intraarticular corticosteroids through presentation of 2 case reports, a review of our practices and a systematic review of the literature. ⋯ It is important to recognize the potential of rare adverse events that are attributable to the systemic absorption of intraarticular corticosteroids in children.
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Semin. Arthritis Rheum. · Apr 2013
ReviewOphthalmologic manifestations of systemic necrotizing vasculitides at diagnosis: a retrospective study of 1286 patients and review of the literature.
To determine the frequencies and types of ophthalmologic manifestations in patients with systemic necrotizing vasculitides (SNV), including polyarteritis nodosa (PAN) and ANCA-associated vasculitides (granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA); Churg-Strauss syndrome (CSS)) and review the literature on eye involvement in these diseases. ⋯ Eye manifestations were more common in GPA than MPA, PAN and EGPA, but can be sight-threatening in any SNV. Given the heterogeneity of ophthalmologic involvement in SNV, close collaboration between the ophthalmologists and internists is critical.
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Semin. Arthritis Rheum. · Apr 2013
ReviewIntra-articular corticosteroid injection in osteoarthritis of the knee and hip: factors predicting pain relief--a systematic review.
Variations in the degree of pain relief reported by patients with osteoarthritis following intra-articular corticosteroid injections are well recognized but the reasons for this are not widely understood and factors which might predict variations in response have not been subjected to systematic review. We set out to review systematically the literature relating to predictors of pain reduction following intra-articular corticosteroid injections in patients with knee and hip osteoarthritis. ⋯ Previous research has not identified reliable predictors of response to IA corticosteroid injections, a widely practised intervention in knee and hip OA. Further studies are required if this question is to be answered.
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Semin. Arthritis Rheum. · Feb 2013
ReviewTherapeutic inhibition of tyrosine kinases in systemic sclerosis: a review of published experience on the first 108 patients treated with imatinib.
Experimental and clinical evidence suggest a therapeutic role for the tyrosine kinase inhibitor imatinib in fibrosing conditions. We evaluated published data on the safety and efficacy of imatinib for patients with systemic sclerosis (SSc), a severe autoimmune disease with significant morbidity and mortality. ⋯ The limited available experience suggests that imatinib could be considered as an individualized treatment approach in severe SSc and underscores the need to identify markers for selecting particular patients, who will safely respond to therapeutic inhibition of tyrosine kinases.