Arthritis and rheumatism
-
Arthritis and rheumatism · Jun 1999
Comparative Study Clinical Trial Controlled Clinical TrialReduced utilization and cost of primary care clinic visits resulting from self-care education for patients with osteoarthritis of the knee.
To determine the extent to which the cost of an effective self-care intervention for primary care patients with knee osteoarthritis (OA) was offset by savings resulting from reduced utilization of ambulatory medical services. ⋯ Eighty percent of the cost of delivering effective self-care education to the knee OA patients in this study was offset within 1 year by the reduced frequency and costs of primary care visits. For >50% of patients receiving the intervention, the savings associated with fewer primary care visits exceeded the cost of self-care education.
-
Arthritis and rheumatism · Mar 1999
Diacerhein treatment reduces the severity of osteoarthritis in the canine cruciate-deficiency model of osteoarthritis.
To determine if diacerhein protects against the early stages of joint damage in a canine model of osteoarthritis (OA). ⋯ Diacerhein treatment significantly reduced the severity of morphologic changes of OA compared with placebo. These findings support the view that diacerhein may be a disease-modifying drug for OA.
-
Arthritis and rheumatism · Jan 1999
Grip strength and the risk of developing radiographic hand osteoarthritis: results from the Framingham Study.
In knees, quadriceps strength may protect against osteoarthritis (OA). Muscle activity is a major determinant of forces at the hand joints, and grip is a common task during which high muscle forces are sustained, especially at the proximal hand joints (metacarpophalangeal [MCP] joints and thumb base). This longitudinal study of radiographic hand OA examined the association between incident OA at different hand joints and maximal grip strength. ⋯ Men with high maximal grip strength are at increased risk for the development of OA in the PIP, MCP, and thumb base joints, and women, in the MCP joints. No association was found between maximal grip strength and incident OA in the DIP joints of men or women.
-
Arthritis and rheumatism · Sep 1998
Codeine and oxycodone use in patients with chronic rheumatic disease pain.
Opioid treatment of chronic rheumatic disease pain is controversial because of concerns regarding efficacy, toxicity, tolerance, dependence, and abuse. This study examined opioid use in a cohort of patients with pain due to defined rheumatic diseases. ⋯ Prolonged treatment of rheumatic disease pain with codeine or oxycodone was effective in reducing pain severity and was associated with only mild toxicity. Doses were stable for prolonged periods of time, with escalations of the opioid dose almost always related to worsening of the painful condition or a complication thereof, rather than the development of tolerance to opioids. Doubts or concerns about opioid efficacy, toxicity, tolerance, and abuse or addiction should no longer be used to justify withholding opioids from patients with well-defined rheumatic disease pain.