Clinical rheumatology
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The aim of the study was to investigate the effect of osteoarthritis (OA) on hand function in elderly patients. One hundred elderly patients with a mean age of 68.50 +/- 6.37 years (87 women, 13 men) were enrolled to the study. Radiological hand OA was defined as the presence of Kellgren-Lawrence (K-L) grade > or = 2. ⋯ Our results suggest that there is a lack of association between radiological hand OA and Jebsen test and objective hand functions like grip and pinch strength, but the patients with radiological hand OA have restrictions in the self-reported functional limitation test. The presence of tenderness, pain, and Heberden's and Bouchard's nodules had a negative effect on hand functions. Dreiser's functional index and the hand disability index of HAQ were found as related parameters with the radiological grade of OA.
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Clinical rheumatology · Sep 2007
ReviewTranslating evidence into practice for people with osteoarthritis of the hip and knee.
There is an international focus on improving the quality of care for people with chronic conditions, including those with chronic rheumatic conditions such as osteoarthritis (OA). A number of evidence-based clinical practice guidelines exist to guide clinician management of OA of the hip and knee. ⋯ This paper reviews the role of clinical practice guidelines within the contemporary discourse and practice of information translation. This discussion paper uses an OA quality improvement case study to illustrate how evidence for effective implementation strategies can be used in conjunction with a practical implementation model to plan and implement quality improvement projects.
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Tumor-induced osteomalacia, also known as oncogenic osteomalacia, is a rare paraneoplastic syndrome in which vitamin D resistant osteomalacia occurs due to the presence of a tumor. The following case report describes a young woman who seeks a second opinion from a rheumatologist and is found to have oncogenic osteomalacia. Not often discussed in the rheumatology literature, oncogenic osteomalacia is a rare and interesting disease entity in which diagnosis is often more challenging than treatment.
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Clinical rheumatology · Aug 2007
Case ReportsLow-dose intra-venous cyclophosphamide therapy in a patient with neurological complications of Behçet's disease.
Behçet's disease (BD) is a chronic relapsing-remitting inflammatory disorder of unknown origin, affecting multiple organs. Neurological involvement is one of the most devastating manifestations of BD and may be fatal. We report a 36-year-old woman with neuro-Behçet who was treated with low-dose pulse cyclophosphamide (St. Thomas' protocol) and methylprednisolone, with almost complete clinical remission.
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Clinical rheumatology · Aug 2007
Case ReportsSuccessful treatment of life-threatening intestinal ulcer in Behçet's disease with infliximab: rapid healing of Behçet's ulcer with infliximab.
Behçet's disease is a chronic, relapsing, multisystem inflammatory disorder characterized predominantly by recurrent orogenital ulcers, skin involvement, and uveitis. Recurrent mucocutaneous lesions may be the only symptom in mild cases, but ocular, gastrointestinal, and central nervous system involvement may occur in severe cases. ⋯ Antitumor necrosis factor (TNF) therapy could be an emergency therapeutic option in patients with massively bleeding Behçet's disease and unstable patients or those with acute bleeding with other TNF-alpha-mediated autoimmune diseases. Another option for anti-TNF therapy could be as bridging management between conservative and surgical treatment.