Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
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Tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS) is a rare systemic autoinflammatory disorder characterized by recurrent episodes of fever and localized inflammation of different organs. The disease is dominantly inherited, with an onset usually in early childhood. ⋯ The patient responded well to anti-tumor necrosis factor α therapy. Although periodic fever syndromes, including TRAPS, mainly begin in early childhood, it is important to consider periodic fever syndrome also in patient presenting at an age older than the average reported case for TRAPS.
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Controlled Clinical Trial
The effect of intra-articular triamcinolone preparations on blood glucose levels in diabetic patients: a controlled study.
The objective of the study was to evaluate the effect of intra-articular (IA) triamcinolone hexacetonide (TAH) and triamcinolone acetonide (TA) on blood glucose levels in patients with controlled diabetes with symptomatic osteoarthritis of the knee (OAK). ⋯ Intra-articular injection of either TAH or TA is associated with significantly increased blood glucose levels in patients with controlled diabetes with OAK. This increase is quite solely due to the injected steroids.
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Randomized Controlled Trial
Nerve blocks at the wrist for painful injections of the palm.
Injections into the palmar hand for trigger finger, palmar flexor tenosynovitis, and Dupuytren contracture can be very painful. This randomized, controlled study evaluated nerve block anesthesia at the wrist for prevention of procedural pain associated with painful injection of the palmar hand. ⋯ Nerve block anesthesia at the wrist before palmar injection is preferred by patients and is highly effective in preventing pain associated with injection of the palmar hand for trigger finger and other painful hand procedures.
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Case Reports
A case of levamisole-induced systemic vasculitis and cocaine-induced midline destructive lesion: a case report.
We describe a case of antineutrophil cytoplasmic antibody-positive vasculitis from levamisole-tainted cocaine with concomitant cocaine-induced midline destructive lesions of the palate and nasal septum. The diagnosis was confirmed after extensive clinical, laboratory, pathologic, and radiographic testing. Timely recognition of this clinical entity is critical to avoid misdiagnosis and unnecessary treatment with potentially harmful cytotoxic agents. Given the high rate of levamisole contamination within the nation's cocaine supply, clinicians should be alerted to this emerging health threat.