Annals of the rheumatic diseases
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Randomized Controlled Trial Clinical Trial
Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery.
To determine whether continued methotrexate treatment increases the risk of postoperative infections or of surgical complications in patients with rheumatoid arthritis (RA) within one year of elective orthopaedic surgery. ⋯ Continuation of methotrexate treatment does not increase the risk of either infections or of surgical complications occurring in patients with RA within one year of elective orthopaedic surgery. Thus methotrexate treatment should not be stopped in patients whose disease is controlled by the drug before elective orthopaedic surgery.
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To investigate whether patients with severe radiographic osteoarthritis (OA) have a different outcome at one year after total hip replacement than patients with moderate radiographic OA. To investigate sex related differences in preoperative radiographic and self reported status and in postoperative outcome. ⋯ The severity of radiographic changes indicating OA often weighs heavily in the surgeon's decision to perform a total hip replacement. Yet, the findings of this study emphasise that the preoperative radiographic stage of OA has no correlation with the postoperative outcome after one year. Furthermore, this study failed to detect any sex related differences in preoperative radiographic and self reported status or in postoperative outcome of hip replacement.
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To elucidate the real impact in the medical literature of the different denominations for reflex sympathetic dystrophy (RSD). ⋯ The new CRPS terminology has not effectively replaced the old one. RSD and causalgia are the most used denominations.
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Practice Guideline Guideline
EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT).
Osteoarthritis (OA) is the most common joint disease encountered throughout Europe. A task force for the EULAR Standing Committee for Clinical Trials met in 1998 to determine the methodological and logistical approach required for the development of evidence based guidelines for treatment of knee OA. The guidelines were restricted to cover all currently available treatments for knee OA diagnosed either clinically and/or radiographically affecting any compartment of the knee. ⋯ These are the first clinical guidelines on knee OA to combine an evidence based approach and a consensus approach across a wide range of treatment modalities. It is apparent that certain clinical propositions are supported by substantial research based evidence, while others are not. There is thus an urgent need for future well designed trials to consider key clinical questions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the caudal and lumbar approaches to the epidural space.
To investigate the accuracy of placement of epidural injections using the lumbar and caudal approaches. To identify which factors, if any, predicted successful placement. ⋯ The weight of the patient and intended approach need to be considered when deciding the method used to enter the epidural space. In the non-obese patient, lumbar epidural injections can be accurately placed without x ray screening, but caudal epidural injections, to be placed accurately, require x ray screening no matter what the weight of the patient.