J Rheumatol
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Rheumatology training is essential for family practice residents, but major inadequacies have been described in current programs. In an effort to guide the design of our own rheumatology curriculum, all patient visits to a family health center over a 15-week period were surveyed. ⋯ Osteoarthritis and regional joint pain were the 2 most frequent problems noted, whereas systemic and inflammatory rheumatic diseases were unusual. Rheumatology curricula for family physicians should stress evaluation, management and prevention of problems in those defined areas.
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Case Reports
Mixed connective tissue disease with pulmonary hypertension: a clinical and pathological study.
Clinical and autopsy findings of 2 cases with mixed connective tissue disease (MCTD) associated with severe pulmonary hypertension are reported. Both cases showed marked intimal and medial thickening in small and medium sized pulmonary arteries. In one of the cases plexiform lesions, endarteritis obliterans, and fibrous intimal thickening of the pulmonary veins were recognized. In some cases with MCTD, pulmonary hypertension develops due to pulmonary vascular lesions which are similar to those of primary pulmonary hypertension.
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Clinical Trial Controlled Clinical Trial
Nicardipine for the treatment of Raynaud's phenomena: a double blind crossover trial of a new calcium entry blocker.
Fifteen patients with Raynaud's phenomenon [systemic lupus erythematosus (6), progressive systemic sclerosis (8) and rheumatoid arthritis (1)] and 12 patients with Raynaud's disease participated in a parallel, 4-week/arm, double blind, crossover study of nicardipine, an experimental calcium channel blocker. Nicardipine significantly improved pain (p = 0.03), decreased number of Raynaud's attacks (p less than 0.03), and was preferred over placebo (p less than 0.05) in the patients with Raynaud's disease, but showed an effect only in the number of attacks (p = 0.049) among the group with Raynaud's phenomenon. ⋯ Nonlimiting toxicity occurred more commonly with drug than placebo (15 vs 9 times, p less than 0.05). Our study demonstrated that nicardipine improves symptoms in Raynaud's disease, but is not effective in Raynaud's phenomenon.
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Clinical Trial Controlled Clinical Trial
Psoriatic arthritis treated with oral colchicine.
We investigated the use of colchicine in psoriatic arthritis to determine if we could confirm the good results obtained in an earlier, uncontrolled study. Twelve of 15 patients with psoriatic skin lesions and arthritis completed a 16-week placebo controlled double blind crossover study. ⋯ The few side effects observed were related to gastrointestinal intolerance, which were usually controlled by temporarily reducing the dose of the drug. Our results indicate that 1.5 mg colchicine daily is an effective treatment for psoriatic arthritis.