Zeitschrift für Rheumatologie
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Spinal epidural lipomatosis is a pathological accommodation of fat tissue in the spinal canal. It seems to be a disease entity, which, though rare, has recently been diagnosed more frequently and can be accompanied by neurological deficits. The thoracic spinal canal is the preferred localization. ⋯ Two patients had a "satisfactory" result. Lumbar epidural lipomatosis can be treated conservatively in cases with only mild neurological dysfunctions and known cause (e.g. obesity, steroid therapy). The surgical removal of associated disk herniation proved to be sufficient in cases described in this paper.
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Within the governmental funding program of rheumatological centers a uniform patient registration is performed. It provides information of the proportion of patients with inflammatory rheumatic diseases who are seen in specialized care, how early they are seen and which forms of treatment are provided. In 1993 in the 20 participating centers almost 26,000 patients have been recorded. ⋯ Deficits exist in the areas of ergotherapy, psychological support and patient education. One reason for the small proportion of people with the diseases who are seen in specialized care is the lack of rheumatologists in outpatient care. More rheumatologists in private practices as well as the participation of clinical rheumatologists in outpatient care including reasonable forms of payment are needed.
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Intensity, sensory-discriminative and affective-motivational quality of pain were assessed over a period of 14 days by means of the Bonn Pain Diary in 16 fibromyalgia (FM) patients and 18 rheumatoid arthritis (RA) patients. Additionally, patients reported pain and sleep duration, daily iratations, and pain-reducing interventions. FM patients differed from RA-patients by higher scores in the sensoric-discriminative component of pain. ⋯ Furthermore, the groups differ statistically significantly with respect to interactions of scaled pain with the preferred interventions in order to reduce pain. Conclusions concerning pain-referring cognitions are drawn. In general, the evaluation of self-reports about pain by behavioral parameters is recommended.
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To reduce the risk of cervical myelopathy, 32 patients suffering from rheumatoid arthritis (RA) and atlanto-axial dislocation (AAD) underwent a suboccipital fusion. All patients were interviewed with a pain questionnaire after a mean postoperative follow-up of 21 months (range 2-46). The results indicate a significant postoperative pain reduction as assessed by a visual numeric analogue scale, as well as a reduction of analgesic consumption.
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The recognition of a newly acquired immunodeficiency syndrome (AIDS) in 1981 has had dramatic social and economic implications. Eventually, an epidemic of the viral infection developed with a potential to spread globally. The extraordinary breadth of AIDS research lead to the early identification of the causative agent: The human immunodeficiency virus (HIV) is a member of the lentivirus family and is characterized by its ability to remain latent within the genome of the infected host. ⋯ Recent reports have stressed a new mechanism of disease induction in HIV infected patients. Inappropriate induction of potentially destructive cytokines appears to be initiated by the viral infection and the expression of the viral genome seems to be effectively modulated by cytokines. In summary, HIV infection may provide important insights in the pathogenesis of rheumatic diseases co-occurring with HIV infections.(ABSTRACT TRUNCATED AT 400 WORDS)