Seminars in arthritis and rheumatism
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Semin. Arthritis Rheum. · Jun 2009
Discordance between hip and spine bone mineral density measurement using DXA: prevalence and risk factors.
Diagnostic discordance for osteoporosis is the presence of different categories of T-scores in 2 skeletal sites of an individual patient, falling into 2 different diagnostic categories identified by the World Health Organization classification system. ⋯ Densitometrists and clinicians should expect that at least 4 of every 10 patients tested by DXA to demonstrate T-score discordance between spine and total hip measurement sites. T-score discordance can occur for a variety of reasons related to physiologic and pathologic patient factors as well as the performance or analysis of DXA itself.
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Semin. Arthritis Rheum. · Feb 2009
Multimorbidity: prevalence, effect on quality of life and daily functioning, and variation of this effect when one condition is a rheumatic disease.
To examine the prevalence and effect of multimorbidity on health-related quality of life (HRQoL) and daily functioning in the general population, and to analyze the influence on HRQoL and daily functioning of multimorbidity including a rheumatic disease. ⋯ Multimorbidity is frequent in the general population and can considerably impair daily functioning and HRQoL. Having a rheumatic disease worsens these outcomes.
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Semin. Arthritis Rheum. · Aug 2008
Restless legs syndrome: a common disorder in patients with rheumatologic conditions.
To review the symptoms, differential diagnosis, and treatment of the restless legs syndrome (RLS), and its relevance within rheumatologic practice. ⋯ The clinical diagnosis of RLS is based on 4 essential diagnostic criteria related to the urge to move that characterizes this disorder. Beyond good sleep hygiene and behavioral measures, dopaminergic agents are first-line treatments for primary RLS. Anticonvulsants, opioids, and sedative/hypnotics may also have a role in management.
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Semin. Arthritis Rheum. · Jun 2008
ReviewTreatment strategy in fibromyalgia syndrome: where are we now?
The treatment of the fibromyalgia syndrome (FMS) is not standardized and often ineffective, and the course of disease progression is unpredictable. ⋯ It is difficult to draw definite conclusions concerning the most appropriate approach to managing FMS because of the methodological limitations of the available studies and the fact that the heterogeneity and nonstandardized nature of their therapeutic programs make them difficult to compare. An individually tailored multidisciplinary pharmacologic, rehabilitative, and cognitive-behavioral approach currently seems to be the most effective.
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Semin. Arthritis Rheum. · Jun 2008
Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.
To discuss the current terminologies used for fibromyalgia syndrome (FMS) and related overlapping conditions, to examine if central sensitivity syndromes (CSS) is the appropriate nosology for these disorders, and to explore the issue of disease versus illness. ⋯ CSS seems to be a useful paradigm and an appropriate terminology for FMS and related conditions. The disease-illness, as well as organic/non-organic dichotomy, should be rejected.