British journal of rheumatology
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Clinical Trial Controlled Clinical Trial
Outpatient lumbar epidural corticosteroid injection in the management of sciatica.
The value of epidural injections of corticosteroid as an outpatient treatment of sciatica has been hitherto uncertain. An epidural injection of 80 mg methylprednisolone in 10 ml physiological saline was compared with an interspinous injection of 2 ml physiological saline in a double blind fashion amongst 39 outpatients. ⋯ Outpatient epidural injections of corticosteroid are thus a useful short-term means of relieving pain in sciatica but probably have little effect on the long-term natural history of symptoms. Factors associated with a failure to respond to epidural steroid injections are discussed.
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Case Reports
Lymphoreticular malignancy and monoclonal gammopathy presenting as polymyalgia rheumatica.
Five patients presenting with polymyalgia rheumatica-like symptoms were found to have a monoclonal gammopathy. In addition one of these patients had acute myeloblastic leukaemia, two had early myeloma and one patient had probable Waldenström's macroglobulinaemia. The association of polymyalgia rheumatica-like symptoms, monoclonal gammopathy and lymphoreticular malignancies is discussed.
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Clinical Trial Controlled Clinical Trial
A double-blind study of the simple analgesic nefopam in rheumatoid arthritis.
The role of pure analgesics in the management of rheumatoid arthritis (RA) remains uncertain. In a double-blind cross-over study of 27 patients, nefopam was a more effective analgesic than placebo when given as a supplement to anti-inflammatory drugs. ⋯ Side-effects occurred in 9 (35%) on nefopam and none on placebo. The results suggest a valuable supplementary role for analgesics such as nefopam in the treatment of RA.
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A unique kindred with an unusual high incidence of serological markers of past or present hepatitis B infection was studied. None of eight relatives had clinical or chemical evidence of hepatitis and all were negative for IgM anti-hepatitis A, but four sisters, each with at least one hepatitis B marker, had features of rheumatic disorders. ⋯ There was no segregation of HLA-A, -B and -C alleles with hepatitis B infection. The intrafamilial occurrence of B virus infection and multiple vasculopathies suggests a wider role of this virus in inflammatory vessel diseases.
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Case Reports
Sjögren's syndrome presenting as a severe sensory neuropathy including involvement of the trigeminal nerve.
Primary Sjögren's syndrome (SS) can be associated and may present with neurological complications. We describe a 32-year-old woman with a debilitating sensory neuropathy, including trigeminal nerve involvement which was the initial manifestation of this disease.