Reumatizam
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Treatinent of systemic lupus erythematosus is very difficult because of heterogeneous clinical manifestations. Standard therapy includes non-steroidal anti-inflammatory drugs, glucocorticoids, anitimalarials and cytotoxic agents. ⋯ They are directed to B and T cell depletion, blockade of co-stimulatory molecules, inhibition of cytokines and complement modulation. Sirolimus, tacrolimus, autologous hematopoietic stem cell transplantation and allogenic mesenchymal stem cells transplantation have been also investigated for treatment of systemic lupus erythematosus.
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Spine surgery is a matter of interest of several specialities. The development of new instrumentations brought a number of new operative techniques. Minimally invasive surgery, endoscopy, offers superior results, but first disapontiments appear as well. What to operate, when and how? A schematic presentation of pathology, operative procedures and indications are presented.
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Rheumatic diseases are the leading cause of chronic disability. Physical therapy and rehabilitation are an integral part of the strategy of treatment of rheumatic diseases in order to maintain the function of the musculoskeletal system. Early detection of disability provides a more efficient implementation of all measures of physiotherapy treatment. ⋯ Long-term effect of exercise is possible only if patients achieve adherence to the program. Questionnaires activities of daily living asses functional status of patients, can be a guide for planning the rehabilitation program and indicator of the effectiveness of therapeutic intervention as well. Methods of physical therapy and rehabilitation are part of all published guidelines for the management of rheumatoid arthritis, spondyloarthritides, osteoarthritis, osteoporosis, chronic back pain, chronic non-malignant pain and fibromyalgia.
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Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1%. Rheumatoid arthritis is characterized with synovitis, often evolve erosions of the joints, pain and functional deficit. Etiology is unknown, but the development of such autoimmune disease is due to genetic and environmental factors. ⋯ With the use of biologic agents we wish to evolve the goal of therapy from that of symptomatiic relief to clinical remission. Biologic drugs have documented, fast and continuous efficacy with generaly well accepted safety profile. On behalf of Croatian Society for Rheumatology we propose recommendations for the biologic therapy in rheumatoid arthritis.
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Diagnostic ultrasound (US) is noninvasive, non-ionisating and cost-effective imaging diagnostic technique. It has emerged as a useful imaging modality for the diagnosis of joint and soft tissue pathology. The shoulder is probably the most frequently analyzed joint. ⋯ Power Doppler sonography is used for detection of sinovial vascularisation. In this paper standardized techinque for the US examination of the shoulder is described. Pictures of normal and sam basic phathological findings are presented.