Revista brasileira de reumatologia
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Randomized Controlled Trial
Impact of exercise on the functional capacity and pain of patients with knee osteoarthritis: a randomized clinical trial.
Muscle weakness, especially of the quadriceps muscle, is one of the major musculoskeletal effects of knee osteoarthritis. Exercises are considered one of the main interventions in the conservative treatment of those patients. ⋯ Quadriceps strengthening exercises for eight weeks are effective to improve pain, function, and stiffness in patients with knee osteoarthritis.
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Practice Guideline
Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis.
Glucocorticoids (GC) are used in almost all medical specialties, and approximately 0.5% of the general population of the United Kingdom receives those medications. With the increased survival of patients with rheumatological diseases, morbidity secondary to the use of those medications represents an important aspect of the management of our patients. The incidences of vertebral and non-vertebral fractures are elevated, ranging from 30% to 50% of the individuals on GC for over three months. Thus, osteoporosis and frailty fractures should be prevented and treated in all patients initiating or already on GC. There are several recommendations on this topic elaborated by several international societies, but consensus still lacks. Recently, the American College of Rheumatology has published new recommendations, but they are based on the WHO Fracture Risk Assessment Tool (FRAX®) to evaluate the risk for each individual, and, thus, cannot be completely used for the Brazilian population. Thus, the Committee for Osteoporosis and Bone Metabolic Disorders of the Brazilian Society of Rheumatology, along with the Brazilian Medical Association and the Brazilian Association of Physical Medicine and Rehabilitation, has elaborated the Brazilian Guidelines for Glucocorticoid-Induced Osteoporosis (GIO), based on the better available scientific evidence and/or expert experience. ⋯ To establish guidelines for the prevention and treatment of GIO.
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The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), often used in research in Brazil, although translated and adapted to the Portuguese language, had not had its validity and reliability tested yet. ⋯ The validity and reliability study of the ASES-PT supports its use for assessing shoulder dysfunction.
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Antiphospholipid syndrome (APS), more common in females, manifests clinically as thrombosis and/or recurrent fetal loss. Hemolytic autoimmune anemia and neurological, cardiac and cutaneous manifestations are common. This is the case report of a male patient whose first manifestation of the disease was gangrene of the auricle. ⋯ This is one of the two major criteria, which, along with a minor criterion, establishes the diagnosis of APS. Possible differential diagnoses are discussed. The importance of the biopsy in the APS diagnosis of this male patient is emphasized.
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Comparative Study
Incidence of infectious complications in hip and knee arthroplasties in rheumatoid arthritis and osteoarthritis patients.
Rheumatoid arthritis (RA) is one of the major indications of total hip (THA) or knee (TKA) arthroplasty. International studies have suggested that RA is a risk factor for prosthesis infections. ⋯ RA was not identified as a risk factor for perioperative infections in THA and TKA in this case series of the Hospital SARAH-Brasília, as compared with the group of patients with primary OA or OA secondary to non-inflammatory diseases. The low incidence of infections in both groups may explain our findings.