J Rheumatol
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Mast cells have been linked to rheumatoid arthritis (RA) and are essential to the pathogenesis of RA-like disease in a mouse model. We describe a 34-year-old woman who developed Sjögren's syndrome concurrently with telangiectasia macularis eruptiva perstans (TMEP), a rare form of cutaneous mastocytosis. The patient had sicca symptoms with an abnormal minor salivary gland biopsy and decreased salivary flow, peripheral neuropathy, an 80 pound weight loss, and a macular erythematous rash that exhibited superficial perivascular mast cell infiltrates on biopsy of lesional skin. This case further underscores the link between mast cells and the development of autoimmunity.
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To describe the reasons for inter-hospital transfers of patients with systemic lupus erythematosus (SLE), to identify predictors of transfers, and to compare the risk of in-hospital mortality between patients who were transferred and those not transferred. ⋯ Patient and transferring hospital characteristics vary with the reason for transfer. Transfers for continued medical care are associated with higher risks of in-hospital mortality, but these risks may differ with the SLE-related experience of the attending physician at the receiving hospital.
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Enthesitis is defined as inflammation at sites of tendon, ligament, joint capsule, or fascia insertion sites to bone, and is a hallmark feature of psoriatic arthritis. Several outcome measures have been developed to assess enthesitis, but none have been validated in psoriatic arthritis. In this evidence-based review, we assess the limited data on treatments for enthesitis and make recommendations for further studies in psoriatic enthesitis.
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Comparative Study
Quality of life and functional status in systemic sclerosis compared to other rheumatic diseases.
To assess clinical factors associated with disability and physical health in patients with systemic sclerosis (SSc) compared to psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) and healthy controls. ⋯ Physical health relating to quality of life is adversely affected in patients with SSc. Disability is associated with the presence of >or= 11 tender points, a high skin score, and joint and GI involvement. Joint involvement in SSc is more disabling than joint involvement in PsA; and patients with SSc experience more severe pain than patients with RA.
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Review Meta Analysis
Medicinal and injection therapies for mechanical neck disorders: a Cochrane systematic review.
To systematically review randomized trials on medicines and injections used to improve pain, function/disability, and patient satisfaction in adults with mechanical neck disorders (MND) with or without associated headache or radicular findings. ⋯ Intramuscular injection of lidocaine for chronic MND and intravenous injection of methylprednisolone for acute whiplash were effective treatments. There was limited evidence of effectiveness of epidural injection of methylprednisolone and lidocaine for chronic MND with radicular findings. Muscle relaxants and nonsteroidal antiinflammatory drugs have unclear benefits. There was moderate evidence that Botox-A intramuscular injections for chronic MND were not better than saline.