Clinical rheumatology
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Clinical rheumatology · Jan 2014
Review Comparative StudyEfficacy of surgery for rotator cuff tendinopathy: a systematic review.
The objective of this study is to review randomized controlled trials evaluating the efficacy of surgery for the treatment of rotator cuff (RC) tendinopathy. Studies up to August 2013 were located in the PubMed, Embase, CINAHL, and PEDro databases using relevant keywords. Studies were included if: (1) participants had rotator cuff tendinopathy, (2) the trials were conducted on an adult population (≥18 years old), (3) at least one of the interventions studied was a surgical procedure, (4) study design was a randomized controlled trial (RCT), and (5) the article was written in English or French. ⋯ Based on low- to moderate-quality evidence, acromioplasty, be it open or arthroscopic, is no more effective than exercises for the treatment of RC tendinopathy. Low-grade evidence also suggests that arthroscopic acromioplasty may yield better results in the short-term for shoulder range of motion in flexion compared to open acromioplasty, but long-term results are comparable between the two types of surgery. More high-quality RCTs are required in order to provide comprehensive treatment guidelines to healthcare providers.
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Clinical rheumatology · Jan 2014
Randomized Controlled TrialThe effectiveness of balneotherapy in chronic low back pain.
The aim of this study is to determine the effectiveness of balneotherapy plus physical therapy versus only physical therapy in patients with chronic low back pain. In this trial, 81 patients with low back pain were followed up in two groups. Patients in group I (n = 44) were treated with physical therapy alone. ⋯ All of the measured parameters improved in both groups. However, improvements in pain, functionality, and quality of life scores were found to be superior in the balneotherapy plus physical therapy group. For the patients with chronic low back pain, balneotherapy plus physical therapy is more effective, compared to physical therapy alone.
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Clinical rheumatology · Jan 2014
Randomized Controlled TrialIntra-articular methylprednisolone acetate injection at the knee joint and the hypothalamic-pituitary-adrenal axis: a randomized controlled study.
The objective of this study was to evaluate the effect of intra-articular corticosteroid injection (IACI) of methylprednisolone acetate (MPA) on the hypothalamic-pituitary-adrenal (HPA) axis in patients with osteoarthritis of the knee. Patients with symptomatic osteoarthritis of the knee who failed to respond to nonsteroidal anti-inflammatory medications and physical therapy were randomized between group 1 and group 2. Group 1 patients had an IACI of 80 mg of MPA at the knee joint and group 2 patients had an intra-articular injection (IAI) of 6 ml (60 mg) of sodium hyaluronate (control group). ⋯ SAI was observed at one time point, two consecutive time points, or two separate time points in the same patient. There was no correlation between SAI and any of the demographic, clinical, or laboratory variables. An IACI of 80 mg MPA at the knee joint induced a transient SAI in 25 % of the patients, an effect that was observed between week 2 and week 4 following the IACI.
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Clinical rheumatology · Jan 2014
Comparative StudyPerceived injustice in fibromyalgia and rheumatoid arthritis.
This is a pilot study to compare levels of perceived injustice via the Injustice Experience Questionnaire in patients with fibromyalgia or rheumatoid arthritis. Two cohorts of patients, one with fibromyalgia (FM), one with rheumatoid arthritis (RA), completed the Injustice Experience Questionnaire, a visual analogue pain scale, and the Hospital Anxiety and Depression Scale (HADS). Inferential statistics were then used to determine whether participants in the two diagnostic groups had significantly different scores on the Perceived Injustice Questionnaire. ⋯ Fibromyalgia is associated with a higher level of perceived injustice than is seen with rheumatoid arthritis. This difference appears to be associated with higher levels of pain reported by fibromyalgia patients, and therefore may not be specific to the diagnosis. Prospective studies may help to resolve this issue.
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Clinical rheumatology · Jan 2014
Serum endothelin-1 and NT-proBNP, but not ADMA, endoglin and TIMP-1 levels, reflect impaired right ventricular function in patients with systemic sclerosis.
Heart and pulmonary involvement is a leading cause of systemic sclerosis (SSc)-related deaths. ⋯ Serum ET-1 and NT-proBNP, but not endoglin, ADMA and TIMP-1 levels correlating with the echocardiographic parameters of RV overload, can be considered as noninvasive indicators of RV dysfunction in SSc patients.