Clinical rheumatology
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Clinical rheumatology · Jul 2009
Clinical TrialIntravenous lidocaine for fibromyalgia syndrome: an open trial.
Fibromyalgia is a disorder characterized by chronic widespread pain. In this study, we investigated the effect of intravenous infusions of lidocaine in pain and quality of life of patients with fibromyalgia. Twenty-three consecutive patients were included in the study, which consisted on five sequential intravenous 2% lidocaine infusions with rising dosages (2-5 mg/kg, days 1-5). ⋯ A significant improvement was observed in the FIQ scores after the fifth infusion (73.52 +/- 16.56 vs 63.29 +/- 21.21, p = 0.02), which was maintained after 30 days (73.52 +/- 16.56 vs 63.85 +/- 24.59, p = 0.04). Similar results were seen concerning the VAS: 8.19 +/- 1.76 vs 6.84 +/- 2.44, p = 0.01 and 8.19 +/- 1.76 vs 7.17 +/- 2.35, p = 0.05, respectively. Intravenous lidocaine infusions are safe and effective in the management of fibromyalgia.
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Clinical rheumatology · Jun 2009
A comparative study of arterial stiffness, flow-mediated vasodilation of the brachial artery, and the thickness of the carotid artery intima-media in patients with systemic autoimmune diseases.
Patients with autoimmune diseases may have increased vascular risk leading to higher mortality rates. Novel imaging techniques are necessary for the early assessment and management of these patients. In this study, we compared augmentation index (AIx) and pulse wave velocity (PWV), indicators of arterial stiffness, to brachial arterial flow-mediated vasodilation (FMD) and common carotid artery intima-media thickness (ccIMT), standard indicators of endothelial dysfunction and atherosclerosis, respectively. ⋯ AIx, PWV, and ccIMT positively correlated and FMD negatively correlated with the age of the autoimmune patients. Arterial stiffness indicated by increased AIx and PWV may be strongly associated with endothelial dysfunction and overt atherosclerosis in patients with autoimmune diseases. Assessment of arterial stiffness, FMD, and ccIMT are reproducible and reliable noninvasive techniques for the complex assessment of vascular abnormalities in patients at high risk.
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Clinical rheumatology · Jun 2009
Dynamic Doppler evaluation of the hand arteries of the patients with Raynaud's disease.
The aim of this study was the determination of blood flow characteristics and parameters in the hand arteries of patients with primary Raynaud's phenomenon (pRP) and comparison with the results of healthy subjects. The diameter, resistive index and flow volume of the digital, ulnar and radial arteries of the patients with pRP and the control group were measured at rest and after cold provocation. The flow starting time (FST) in the digital artery and the flow normalising time (FNT) of all three arteries were also recorded after cold provocation. ⋯ The mean FST was 3.6 +/- 3.8 min for the patients and 0.9 +/- 1.2 min for the controls. The mean FNT was significantly longer in all the arteries of the patients; FNT cutoff times for the radial, ulnar and digital arteries were 6.5, 5.5 and 6.5 min, respectively. The measurements of the diameter, resistive index and flow volume of all the arteries measured before and after cold provocation as well as FST of the digital artery and FNT of all the arteries may facilitate in providing additional information in pRP patients.
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Clinical rheumatology · May 2009
Translation and validation of the Persian version of the Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF) in patients with rheumatoid arthritis.
Cultural adaptation and validation of the Persian version of the Arthritis Measurement Scales 2-Short Form (AIMS2-SF). The translation and cultural adaptation of the original questionnaire was carried out in accordance with published guidelines. Three hundred and fifty consecutive Persian-speaking patients with rheumatoid arthritis (RA) were asked to complete the AIMS2-SF, the Short Form Health Survey (SF-36), and four visual analog scales (VAS) for pain, joint stiffness, and patient's and physician's global assessment to test convergent validity. ⋯ The Persian AIMS2-SF scales showed excellent test-retest reliability with Intraclass Correlation Coefficient ranging from 0.83-0.93 (p < 0.01). The results of the present study showed that the Persian AIMS2-SF has reasonably good convergent validity, internal consistency, and test-retest reliability in patients with RA. It can now be applied in clinical settings and future outcome studies in Iran.
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Clinical rheumatology · May 2009
Perceived barriers to paracetamol (acetaminophen) prescribing, especially following rofecoxib withdrawal from the market.
Cyclooxygenase-2 inhibitor (COX-2) inhibitors were publicly subsidized in Australia for osteoarthritis. However, guidelines still recommended paracetamol as first choice therapy. When rofecoxib was withdrawn in 2004, paracetamol should have been offered as replacement. ⋯ Consumers did not remember being given the choice to use paracetamol as regular treatment for chronic pain. Pharmacists and doctors did not appear to be discussing options for pain control well with consumers and had mismatched perceptions with consumers about paracetamol. An educational intervention to encourage more rational use of paracetamol is now being planned to provide consumers with more knowledge about paracetamol effective use.