Arthritis and rheumatism
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Arthritis and rheumatism · Apr 2007
Randomized Controlled TrialPhysical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai Chi classes.
To determine whether Tai Chi or hydrotherapy classes for individuals with chronic symptomatic hip or knee osteoarthritis (OA) result in measurable clinical benefits. ⋯ Access to either hydrotherapy or Tai Chi classes can provide large and sustained improvements in physical function for many older, sedentary individuals with chronic hip or knee OA.
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Arthritis and rheumatism · Apr 2007
Full-limb and knee radiography assessments of varus-valgus alignment and their relationship to osteoarthritis disease features by magnetic resonance imaging.
To examine the correlation between hip-knee-ankle and femur-tibia radiograph angles, calculate the offset of the femur-tibia angle with respect to the hip-knee-ankle angle, calculate the sensitivity and specificity and area under the receiver operating characteristic (ROC) curve of the femur-tibia angle, and examine the relationship of malalignment by each approach with osteoarthritis (OA) tissue pathology in the mechanically stressed compartment using magnetic resonance imaging (MRI). ⋯ In knee OA, the knee radiograph femur-tibia and full-limb radiograph hip-knee-ankle angles were correlated. The femur-tibia angle, corrected for mean offset, was sensitive, specific, and had excellent discriminative ability for identifying varus and valgus alignment evidenced by area under the ROC curve. The relationship between alignment and specific OA MRI features was comparable with the 2 approaches. Use of the femur-tibia angle, corrected for offset, should be considered in research and clinical settings.
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Arthritis and rheumatism · Apr 2007
Randomized Controlled TrialA brief pain management program compared with physical therapy for low back pain: results from an economic analysis alongside a randomized clinical trial.
Guidelines for the management of acute low back pain in primary care recommend early intervention to address psychosocial risk factors associated with long-term disability. We assessed the cost utility and cost effectiveness of a brief pain management program (BPM) targeting psychosocial factors compared with physical therapy (PT) for primary care patients with low back pain of <12 weeks' duration. ⋯ PT is a cost-effective primary care management strategy for low back pain. However, the absence of a clinically superior treatment program raises the possibility that BPM could provide an additional primary care approach, administered in fewer sessions, allowing patient and doctor preferences to be considered.
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Arthritis and rheumatism · Apr 2007
Therapy of patients with rheumatoid arthritis: outcome of infliximab failures switched to etanercept.
The role of alternative tumor necrosis factor (TNF) antagonist therapies in the context of failure of initial TNF antagonist therapy in patients with rheumatoid arthritis (RA) has yet to be clearly defined. The goal of this study was to determine the efficacy of etanercept in patients who failed to respond to infliximab. ⋯ This study confirms that etanercept is effective in patients who fail to respond to infliximab and suggests a higher response in patients who have never had a response to infliximab.
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Arthritis and rheumatism · Apr 2007
Risk of congestive heart failure with nonsteroidal antiinflammatory drugs and selective Cyclooxygenase 2 inhibitors: a class effect?
Nonsteroidal antiinflammatory drugs (NSAIDs) as a class have been shown to increase the risk of congestive heart failure (CHF) compared with celecoxib. The magnitude of the risk for individual NSAIDs is not known. ⋯ In elderly patients with known CHF, indomethacin and rofecoxib are associated with a greater risk of recurrent CHF compared with celecoxib. Alternatives should be considered for patients with CHF who require antiinflammatory drugs.