J Rheumatol
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Multicenter Study Comparative Study
Development and testing of a systemic lupus-specific risk adjustment index for in-hospital mortality.
Valid comparison of patient outcomes among hospitals requires adjustment for differences in the severity of patients' illness. Disease-specific indexes of severity of illness may permit more accurate risk adjustment than generic indexes. The objective of this study was to develop a systemic lupus-specific risk adjustment index for in-hospital mortality, and to compare its performance to that of the generic Charlson index. ⋯ The SLE-specific risk adjustment index developed from diagnoses recorded in administrative discharge abstracts performed similarly to the generic Charlson index in correctly classifying mortality outcomes, but the SLE-specific index stratified patients by their level of risk of mortality better than the Charlson index. Adjustment for SLE-specific risks of mortality did not alter the association between hospital experience and the risk of in-hospital mortality.
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Comparative Study
Musculoskeletal examination teaching in rheumatoid arthritis education: trained patient educators compared to nonspecialist doctors.
To assess whether students taught by trained patients acquire the same levels of competence in musculoskeletal examination skills as students taught by nonspecialist doctors. ⋯ Patient partners are either equal or superior to doctors not specifically trained in musculoskeletal medicine or orthopedics, in the teaching of musculoskeletal examination techniques and basic communication skills.
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Randomized Controlled Trial Clinical Trial
Double blind randomized clinical trial examining the efficacy of bupivacaine suprascapular nerve blocks in frozen shoulder.
To determine whether the pain, contracture, and disability associated with idiopathic frozen shoulder are diminished by a series of 3 indirect bupivacaine suprascapular nerve blocks delivered in an ambulatory care clinic. ⋯ The use of bupivacaine suprascapular nerve blocks was effective in reducing the pain of frozen shoulder at one month. Clinical studies with a larger number of subjects and a longer study period will help determine the duration and nature of the effect of bupivacaine suprascapular nerve blocks in treating the pain, disability, and glenohumeral joint contracture of frozen shoulder.
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Randomized Controlled Trial Clinical Trial
Randomized double blind trial of an ayurvedic plant derived formulation for treatment of rheumatoid arthritis.
To evaluate RA-1, a standardized plant extract formulation, traditionally considered a safe, effective antiarthritic in the Asian-Indian Ayurvedic medicinal system. ⋯ In a trial with sufficient power, RA-1 revealed efficacy that was not significantly superior to the strong placebo response, except for improvement in joint swelling. Further, the effect on RF and good safety profile led to an open label phase.
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Randomized Controlled Trial Clinical Trial
Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study.
To evaluate the efficacy of intravenous (i.v.) clodronate in patients with reflex sympathetic dystrophy syndrome (RSDS) and to assess the urinary excretion of type I collagen crosslinked N-telopeptide (NTx) before and after the treatment. ⋯ A 10 day i.v. clodronate course is better than placebo and effective in the treatment of RSDS. NTx seems to be a predictive factor for clodronate efficacy.