Clinical rheumatology
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Clinical rheumatology · May 2008
Clinical TrialTransdermal fentanyl improves pain control and functionality in patients with osteoarthritis: an open-label Canadian trial.
Current treatment guidelines advocate opioids for arthritis when standard analgesics produce inadequate relief. Efficacy, adverse effects (AEs), dosing regimens, physician expertise and patient preference influence treatment selection. This study assessed transdermal fentanyl (TDF) as a treatment option for osteoarthritis (OA) patients. ⋯ Most treatment-related AEs were mild to moderate in intensity. TDF improved pain control, functionality and health-related quality of life in these patients. The findings support current recommendations for use of opioids such as TDF as a treatment option for a sub-population of patients with OA pain.
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Clinical rheumatology · May 2008
Clinical TrialAcupuncture for symptom management of rheumatoid arthritis: a pilot study.
We investigated the feasibility of a future acupuncture trial in the symptom management of rheumatoid arthritis (RA). Twenty-five patients meeting the American College of Rheumatology (ACR) criteria were recruited and given 14 sessions of individualised acupuncture treatment for 6 weeks. Improvement in symptoms was assessed using ACR 20, 50 and 70; disease activity score (DAS28); tender joint count; swollen joint count; morning stiffness and health-related quality of life using the Korean Health Assessment Questionnaire and the SF-36 at baseline and after 6 weeks. ⋯ No major acupuncture-related adverse events were reported. Acupuncture treatment as used in this pilot study was safe and well-tolerated. The use of acupuncture for symptom management in RA warrants further investigation.
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Clinical rheumatology · Apr 2008
ReviewBone marrow edema syndromes of the hip: MRI features in different hip disorders.
The objectives of this study were to describe the essential magnetic resonance imaging (MRI) features of bone marrow edema syndromes affecting the hip joint. In addition, to evaluate the role of MRI in the assessment of hip joint involvement in different clinical settings that may share similar clinical findings. Thirty-four patients who complained of hip pain were studied consecutively. ⋯ MR imaging is the modality of choice when clinical examination is suspect for hip disease and plain radiographs are normal or equivocal. Early diagnosis and treatment is important in many of the disorders. The literature is reviewed regarding bone marrow edema of the hip.
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Clinical rheumatology · Apr 2008
The clinical significance of serum N-terminal pro-brain natriuretic peptide in systemic sclerosis patients.
We evaluated the clinical significance of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in systemic sclerosis (SSc). We studied 45 SSc patients (30 with limited and 15 with diffuse cutaneous SSc) of mean age +/- SD 47.1 +/- 12.9 years, mean duration of disease 10.2 +/- 6.0 years, and 45 age- and sex-matched healthy controls. Pulmonary artery pressure was measured by echocardiography. ⋯ Fifty-seven percent of the variation in log (proBNP) can be explained by the multivariate model (R (2) = 0.57). Serum NT-proBNP levels were higher in SSc patients (particularly the diffuse subset) than in healthy controls and were found to be correlated with skin thickness and %DLco. We conclude that serum NT-proBNP may be a biologic marker of skin fibrosis and pulmonary vascular involvement in SSc.
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Clinical rheumatology · Mar 2008
The assessment of cardiac functions by tissue Doppler-derived myocardial performance index in patients with Behcet's disease.
Vascular involvement is one of the major characteristics of Behcet's disease (BD). However, there are controversial findings regarding cardiac involvement in BD. Although early reports demonstrated that there is diastolic dysfunction in BD, conflicting results were found in the following trials. ⋯ There was statistically significant difference between the two groups regarding left ventricular MPI (0.458 +/- 0.072 vs 0.416 +/- 0.068%, p = 0.016), which were calculated from tissue Doppler systolic time intervals. There was also significant correlation between the disease duration and MPI (r = 0.38, p = 0.017). We have demonstrated that tissue Doppler-derived myocardial left ventricular relaxation time and MPI were impaired in BD patients, although systolic and diastolic function parameters were comparable in the patients and controls.