Clinical rheumatology
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Clinical rheumatology · Oct 2009
Randomized Controlled TrialEfficacy and safety of diacerein in early knee osteoarthritis: a randomized placebo-controlled trial.
The objective of this study was to evaluate the efficacy and safety of diacerein in early, symptomatic knee osteoarthritis in Indian population. Sixty-four patients of knee osteoarthritis fulfilling American College of Rheumatology Criteria were randomized to receive either diacerein or placebo for 8 weeks, followed by 4 weeks "treatment-free" follow-up in this single-blind, parallel group, post-marketing trial. Primary efficacy variable was visual analogue scale (VAS) assessment of pain on movement; secondary efficacy variables included Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC) subscores for stiffness and physical function, rescue medication use and physician's clinical global impression (CGI). ⋯ Incidence of adverse events were significantly (p < 0.01) higher in diacerein arm with urine discoloration and soft stool being the most common ones. However, most events were of mild to moderate intensity. In Indian patients with knee osteoarthritis, diacerein effectively reduces pain and improves physical function, and despite frequent adverse events, overall tolerability seemed to be good.
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Clinical rheumatology · Oct 2009
ReviewChiropractic treatment for fibromyalgia: a systematic review.
Many patients use chiropractic as a treatment of fibromyalgia, and many chiropractors seem to be convinced that it is effective for that condition. The aim of the study was to conduct a systematic review of randomised clinical trials testing the effectiveness of chiropractic care for fibromyalgia. Six electronic literature searches were conducted. ⋯ Their methodological quality was poor. They generated no evidence to suggest that chiropractic care is effective for fibromyalgia. Currently, there is insufficient evidence to conclude that chiropractic is an effective treatment for fibromyalgia.
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Clinical rheumatology · Oct 2009
Case ReportsSyndrome of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) in siblings.
PFAPA syndrome is characterized by episodes of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. PFAPA syndrome usually begins in children under 5 years old and normally has self-resolution. ⋯ In this paper, we report the cases of two different families with siblings with PFAPA syndrome: two sisters and two brothers. To our knowledge, this is the first report of siblings with PFAPA syndrome.
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Clinical rheumatology · Oct 2009
Efficacy of connective tissue massage and Mc Mennell joint manipulation in the rehabilitative treatment of the hands in systemic sclerosis.
Rehabilitation may contribute to the management of systemic sclerosis (SSc) dealing with disabilities due to hand involvement. The aim of this study is to evaluate the efficacy of a rehabilitation programme based on the combination of connective tissue massage and Mc Mennell joint manipulation specifically conceived for SSc patients' hands. Forty SSc patients were enrolled: 20 (interventional group) were treated for a 9-week period (twice a week, 1 h per session) with a combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme, and 20 (control group) were assigned only to home exercise programme. ⋯ In the control group, the programme of home daily exercises improved only fist closure at the end of the treatment (p < 0.0001). The combination of connective tissue massage, Mc Mennell joint manipulation and home exercise programme is effective in the rehabilitative treatment of SSc hands. This combined treatment may lead to an improvement of hand function and quality of life.