Scandinavian journal of rheumatology
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Scand. J. Rheumatol. · Jan 1996
Randomized Controlled Trial Clinical TrialQuantitative and qualitative assessments of pain in children with juvenile chronic arthritis based on the Norwegian version of the Pediatric Pain Questionnaire.
Quantitative and qualitative aspects of pain were studied using a standardized questionnaire (the Varni/Thompson Pediatric Pain Questionnaire--PPQ). Fifty-seven of 64 consecutive in- and out-patients (6-18 yrs) with juvenile chronic arthritis (pauciart. n = 27, polyart. n = 30) and 52 parents participated. The patients were examined by the same rheumatologist and randomly interviewed by either a disabled or a non-disabled person. ⋯ Forty-two percent of the patients thought it valuable to be interviewed by a disabled physician. The Norwegian Varni/Thompson PPQ is easy to administer to children down to six years and makes it possible to compare results internationally. Lack of agreement on the assessment of pain by a child and his/her parent indicates the need to interview both parties.
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Isolated congenital heart block (CHB) detected in utero is strongly associated with autoantibodies reactive with the intracellular soluble ribonucleoproteins 48 kD SSB/La, 52 kD SSA/Ro, and 60 kD SSA/Ro. An erythematous skin rash with a predilection for the scalp and periorbital area, most often apparent in the first few postnatal months, is also highly associated with these maternal antibodies. The permanent cardiac disease and transient cutaneous disease are the most common manifestations of the neonatal lupus syndromes. ⋯ Numerous anecdotal cases support the use of dexamethasone for treatment of effusions and hydrops and possibly incomplete block. To further efforts both at the bench and bedside, national registries have been established in the U. S. and Canada.
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Scand. J. Rheumatol. · Jan 1995
Randomized Controlled Trial Clinical TrialPain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine.
Pain intensity, muscle strength, static muscle endurance, pressure pain threshold, and pain tolerance at tender points and control points were assessed in 31 patients with fibromyalgia (FM), before and after intravenous administration of morphine (9 patients), lidocaine (11 patients), and ketamine (11 patients). The three different studies were double-blind and placebo-controlled. The patients were classified as placebo-responders, responders (decrease in pain intensity by > 50%) and non-responders. ⋯ Tenderness at tender points decreased and endurance increased significantly, while muscle strength remained unchanged. The present results support the hypothesis that the NMDA receptors are involved in pain mechanisms in fibromyalgia. These findings also suggest that central sensitization is present in FM and that tender points represent secondary hyperalgesia.
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Scand. J. Rheumatol. · Jan 1995
The relative value of spinal and thoracic mobility measurements in ankylosing spondylitis.
The relative value of nine spinal and thoracic mobility measurements was investigated in 73 male patients with ankylosing spondylitis (AS). The value of a test was obtained by the relative ranks of validity, reliability and sensitivity to change. Validity was determined as age-adjusted correlation of the test result with AS-specific radiological changes in the lumbar spine. ⋯ Of these, FFD had high reliability and sensitivity ranks, but poor correlation with AS-specific spinal changes. TR had high validity and sensitivity ranks, and improvement of the measurement technology would probably result in a superior test for the follow-up of AS. Chest expansion and vital capacity had low ranks in all comparisons.
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Scand. J. Rheumatol. · Jan 1995
The reliability and validity of pain threshold measurements in osteoarthritis of the knee.
The purpose of this study was to examine the reliability and validity of measuring pain threshold (PT) of persons with osteoarthritis (OA) of the knee. The PTs of women with and without OA of the knee were measured on 3 occasions at 6 sites at the knee with a pressure dolorimeter. Subjects with OA also recorded their pain on a visual analogue scale (VAS) and on the McGill Pain Questionnaire (MPQ). ⋯ The correlations between PT and measures of pain intensity were poor. It is concluded that the measurement of PT at the knee distinguishes OA from healthy controls, and that it has moderate reliability. However, it cannot substitute for a measure of pain intensity.