Clinical rheumatology
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Clinical rheumatology · Feb 2012
Randomized Controlled Trial Multicenter Study Comparative StudyThe efficacy of tramadol/acetaminophen combination tablets (Ultracet®) as add-on and maintenance therapy in knee osteoarthritis pain inadequately controlled by nonsteroidal anti-inflammatory drug (NSAID).
The purpose of this study is to compare the efficacy of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (tramadol/APAP) with that of nonsteroidal anti-inflammatory drugs (NSAIDs) as maintenance therapy following tramadol/APAP and NSAID combination therapy in knee osteoarthritis (OA) pain which was inadequately controlled by NSAIDs. Subjects with knee OA for over 1 year and moderate pain (numerical rating scale [NRS] ≥5) despite at least 4 weeks' NSAID therapy (meloxicam 7.5 mg or 15 mg qd or aceclofenac 100 mg bid) received tramadol/APAP add-on (combination with NSAID) for 4 weeks. Thereafter, subjects with significant pain improvement (NRS <4) were randomized to receive either tramadol/APAP or NSAID for 8 weeks. ⋯ Overall adverse event rates were similar in both groups. Tramadol/APAP add-on significantly improved knee OA pain which had been inadequately controlled by NSAIDs. In those subjects who showed favorable response to tramadol/APAP and NSAID combination therapy, both tramadol/APAP and NSAIDs were effective at maintaining the pain-reduced state and there was no significant difference in efficacy between tramadol/APAP and NSAIDs.
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Clinical rheumatology · Feb 2012
Prevalence, co-occurrence, and predictive factors for musculoskeletal pain among shellfish gatherers.
The aims of this study are to determine prevalence and co-occurrence of musculoskeletal pain (MSP) among shellfish gatherers and its consequences for the use of medicine, health care, and sickness leave and to investigate predictive factors (sociodemographic, lifestyle, comorbidity) of MSP in five anatomical areas (neck/shoulder/higher back, lower back, elbow/wrist/hand, hip/knee, and leg/ankle/foot). Nine hundred twenty-nine shellfish gatherers (94% women) voluntarily took part in a physiotherapy workshop. A self-administered questionnaire was used to assess MSP and its consequences. ⋯ Prevalence of MSP and musculoskeletal comorbidity were high. The study shows that the presence of pain reported in one body area is highly dependent on the total number of painful areas. These findings are consistent with those of similar studies.
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Clinical rheumatology · Feb 2012
Health-related quality of life in women with fibromyalgia: clinical and psychological factors associated.
The objective of the study was to analyse the impact of fibromyalgia (FM) on health-related quality of life (HRQOL) and to identify clinical and psychological factors associated with the disease. A cross-sectional study was conducted with adult Portuguese women with FM. Analysed data were demographic, clinical and psychological variables and HRQOL: SF-36 and Fibromyalgia Impact Questionnaire (FIQ). ⋯ These clinical and psychological variables explained an acceptable proportion of variability (R (2)), ranging from 31.3% on Emotional Role Functioning to 70.6% on FIQ, except for Physical Role Functioning (R (2) = 6.1). FM has a negative impact on both general and specific dimensions of HRQOL, especially the physical dimensions. Pain intensity, anxiety and depression symptoms and the emotion-focused coping are the most relevant explanatory variables of the impact of FM on HRQOL.
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Clinical rheumatology · Feb 2012
Gender and disease features in Moroccan patients with ankylosing spondylitis.
This study was conducted to determine differences in ankylosing spondylitis (AS) between men and women in terms of clinical characteristics, biological features, structural severity and quality of life (QoL). A total of 130 consecutive AS patients fulfilling the modified New York criteria were included. Sociodemographic data were collected. ⋯ Men had worse radiographic damage and lower scores in physical and social domains of QoL, but there were no differences in functional impairment scores. In this study, we noticed that AS presents differently according to gender in our patients. More longitudinal studies seem to be necessary to identify gender-related parameters of disease, thing that may help in diagnosis and therapeutic management of our AS patients.
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Clinical rheumatology · Jan 2012
ReviewAn overview of systematic reviews of complementary and alternative medicine for fibromyalgia.
Fibromyalgia (FM) is a chronic pain condition which is difficult to diagnose and to treat. Most individuals suffering from FM use a variety of complementary or alternative medicine (CAM) interventions to treat and manage their symptoms. ⋯ The reviews found some evidence of beneficial effects arising from acupuncture, homoeopathy, hydrotherapy and massage, whilst no evidence for therapeutic effects from chiropractic interventions for the treatment of FM symptoms was found. The implications of these findings and future directions for the application of CAM in chronic pain conditions, as well as for CAM research, are discussed.