Clinical rheumatology
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Clinical rheumatology · Oct 2011
Case ReportsA novel cutaneous vasculitis syndrome induced by levamisole-contaminated cocaine.
In order to describe the clinical and serologic features of a cutaneous vasculitis due to cocaine contaminated with the adulterant levamisole, we report four new cases of this syndrome along with 12 previously reported cases identified through a PubMed Literature search (1964 to March 2011). Of the 16 patients described, the average age was 43, with a female predominance (81% of patients). Over half of patients had involvement of the earlobes, and the rash frequently affected the extremities in a "retiform" pattern. ⋯ Treatment in these patients varied widely, with several patients showing improvement or resolution of the rash without specific therapy following cessation of illicit drug use. This new cutaneous vasculitis syndrome can be recognized by its characteristic rash and skin pathology, together with leukopenia and autoantibody production. Certain clinical features can be attributed to the adulterant levamisole, though cocaine as well may play a role in its pathogenesis.
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Clinical rheumatology · Sep 2011
ReviewYoga for low back pain: a systematic review of randomized clinical trials.
It has been suggested that yoga has a positive effect on low back pain and function. The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for low back pain. Seven databases were searched from their inception to March 2011. ⋯ Two RCTs showed no between-group differences. It is concluded that yoga has the potential to alleviate low back pain. However, any definitive claims should be treated with caution.
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Clinical rheumatology · Sep 2011
Spontaneous skin regression and predictors of skin regression in Thai scleroderma patients.
Skin tightness is a major clinical manifestation of systemic sclerosis (SSc). Importantly for both clinicians and patients, spontaneous regression of the fibrosis process has been documented. The purpose of this study is to identify the incidence and related clinical characteristics of spontaneous regression among Thai SSc patients. ⋯ After regression analysis, only Raynaud's phenomenon at onset and diffuse cutaneous type had a significantly negative correlation to regression. A spontaneous regression of the skin fibrosis process was not uncommon among Thai SSc patients. The factors suggesting a poor predictor for cutaneous manifestation were Raynaud's phenomenon, diffuse cutaneous type while early cyclophosphamide therapy might be related to a better skin outcome.
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Clinical rheumatology · Sep 2011
Coping style as a predictor of compliance with referral to active rehabilitation in whiplash patients.
The objective of the study was to determine the odds ratio for compliance with referral to an active treatment program according to coping style in a cohort of acute whiplash-injured subjects. Sixty whiplash patients were assessed within 1 week of their collision for their coping styles and were then questioned 3 weeks later to determine if they had complied with a referral for an active treatment program. Coping style was assessed with the Vanderbilt Pain Management Inventory. ⋯ As a secondary outcome, the odds ratio for reporting prescription medication use for subjects who had a low active/high passive coping style was 6.7 (P=0.038) (95% CI, 1.1-40.4). Those whiplash patients who have a low active/high passive coping style are less likely to attend an active exercise-based rehabilitation program and more likely to use prescription medications in the first 3 weeks following injury. Coping style may affect recovery from whiplash injury through issues of compliance with active therapy and increased reliance on prescription medications.
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Clinical rheumatology · Sep 2011
Comparative StudyAn examination of coping styles and expectations for whiplash injury in Germany: comparison with Canadian data.
Cross-sectional cohort study: to examine concurrent expectations and coping style for whiplash injury in injury-naive subjects in Germany. Studies suggest the recovery rate from whiplash injury may be faster in Germany than in Canada. Canadians have a high expectation for chronic pain following whiplash injury and Germans do not. ⋯ Coping style scores and patterns were not different from those previously observed in Canadian studies, but there was no correlation between expectations and coping style among German subjects, a finding that differs from Canadian studies. Although expectations and coping styles may interact or be co-modifiers in the outcomes of whiplash injury in Canadian whiplash victims, in Germany, despite having similar coping styles to Canadians, the lack of expectation for chronic pain may be protective from the effect of passive coping styles. Further studies of coping style as an aetiologic factor in the chronic whiplash syndrome are needed.