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pain control in arthritis

Bennet A Butler, David W Fitz, Cort D Lawton, Daniel D Li, Earvin S Balderama, Michael D Stover
OBJECTIVES: Septic arthritis results in rapid joint destruction if not properly diagnosed and treated. A work up for septic arthritis includes a peripheral white blood cell count, inflammatory markers, and a joint aspiration. In the general population, the interpretation of these labs has been well-defined by prior studies. To this point, no study has determined how immunosuppressive states affect this work up. METHODS: Patients with immunosuppressive conditions who received a joint aspiration for a painful joint were retrospectively identified...
March 5, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Daniel Mønsted Shabanzadeh
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by pain, swelling and progressive destruction of the joints leading to loss of function and invalidity. The bone destruction in RA is characterised by two distinct features: structural joint damage and hand bone loss, and their prevention is an important treatment goal. Inhibitors of tumour necrosis factor alpha (TNF-inhibitors) have markedly improved the treatment options in RA patients who fail treatment with conventional synthetic Disease Modifying Anti Rheumatic Drugs (sDMARDS), but their effectiveness with regards to structural joint damage and hand bone loss, predictors thereof and the association with disease activity during treatment have mainly been investigated in randomized controlled trials (RCTs) with limited generalizability due to strict in- and exclusion criteria...
March 2018: Danish Medical Journal
Jude K A des Bordes, Elsa Gonzalez, Maria A Lopez-Olivo, Maithili Shethia, Pratibha Nayak, Maria E Suarez-Almazor
To explore the information needs of patients with rheumatoid arthritis (RA) and their acceptance of online resources and Facebook in particular, as a source of information, interaction, and support among peers. Participants were adults with RA of ≤ 10 years duration, had ongoing or prior treatment with disease-modifying anti-rheumatic drugs or biologic agents, and internet access. We conducted 20 in-depth interviews using semi-structured interview guide to explore: (1) RA information needs, (2) use of self-management health behaviors, (3) use of internet resources for disease management, (4) role of peer support in health self-management, and (5) use of social networking sites (SNS) such as Facebook in disease management...
March 2, 2018: Clinical Rheumatology
Peter Cnudde, Ola Rolfson, A John Timperley, Anne Garland, Johan Kärrholm, Göran Garellick, Szilard Nemes
BACKGROUND: Hip replacements are successful in restoring mobility, reducing pain, and improving quality of life. However, the association between THA and the potential for increased life expectancy (as expressed by mortality rate) is less clear, and any such association could well be influenced by diagnosis and patient-related, socioeconomic, and surgical factors, which have not been well studied. QUESTIONS/PURPOSES: (1) After controlling for birth year and sex, are Swedish patients who underwent THA likely to survive longer than individuals in the general population? (2) After controlling for relevant patient-related, socioeconomic/demographic factors and surgical factors, does relative survival differ across the various diagnoses for which THAs were performed in Sweden? METHODS: Data from the Swedish Hip Arthroplasty Register, linked to administrative health databases, were used for this study...
February 28, 2018: Clinical Orthopaedics and related Research
Swati Jagdale, Gokul Deore, Anuruddha Chabukswar
Background Nabumetone is biopharmaceutics classification system (BCS) class II drug, widely used in the treatment of osteoarthritis and rheumatoid arthritis. The most frequently reported adverse reactions for the drug involve disturbance in gastrointestinal tract , diarrhea, dyspepsia and abdominal pain. Microemulgel has advantages of microemulsion for improving solubility for hydrophobic drug. Patent literature had shown that the work for drug has been carried on spray chilling, enteric coated tablet, and topical formulation which gave idea for present research work for development of transdermal delivery...
February 26, 2018: Recent Patents on Drug Delivery & Formulation
Sawsan O Khoja, Yasser El-Miedany, Archana P Iyer, Sami M Bahlas, Khadijah S Balamash, Mohamed F Elshal
BACKGROUND: The aim of this study is to evaluate the prevalence of vitamin-D insufficiency and vitamin-D receptor (VDR) polymorphisms in rheumatoid arthritis (RA) patients and its association with disease activity and patient reported outcomes (PROs). METHODS: Eighty-two individuals were included in a cross-sectional study (41 RA patients, 41 controls). Prior to assessment, each patient completed a PRO questionnaire. Serum vitamin-D levels and genotyping for VDR were assessed...
January 1, 2018: Clinical Laboratory
Anna Lina Rahlf, Klaus-Michael Braumann, Astrid Zech
CONTEXT: Although increasingly used for therapeutic treatment only limited evidence exists regarding the effects of kinesio taping on patients with knee osteoarthritis. OBJECTIVE: To determine the effects of kinesio taping on pain, function, gait and neuromuscular control concerning patients with knee osteoarthritis (OA). DESIGN: Randomized sham-controlled trial. SETTING: University laboratory. PARTICIPANTS: 141 Patients (65...
February 21, 2018: Journal of Sport Rehabilitation
Pernille Juhl, Christian S Thudium, Natasja S Gudmann, Morten A Karsdal, Anne-Christine Bay-Jensen, Anne Sofie Siebuhr
OBJECTIVES: The objective of this study was to examine the tissue degradation in response to anti-IL6 receptor treatment in rheumatoid arthritis (RA) patients which are anti-TNF-α inadequate responders. METHODS: RADIATE was a randomised, double-blinded, placebo-controlled, parallel-group, phase III trial. RA patients with previous inadequate response to anti-TNFα therapy (n=299) were randomly assigned to tocilizumab 4 or 8 mg/kg with methotrexate (10-25 mg weekly) or placebo with methotrexate...
January 31, 2018: Clinical and Experimental Rheumatology
Elizabeth M Badley, Dov B Millstone, Anthony V Perruccio
STUDY DESIGN: Cross-sectional population-level health survey. OBJECTIVE: To describe the frequency of co-occurring conditions with back pain; to identify risk factors for back pain controlling for co-occurring conditions; and to examine the association between back pain and individual co-occurring conditions. SUMMARY OF BACKGROUND DATA: Back pain shares risk factors with a range of other conditions. Most studies have considered risk factors for back pain without taking into account the potential influence of co-occurring conditions...
February 16, 2018: Spine
Sarah R Kingsbury, Puvan Tharmanathan, Ada Keding, Sarah J Ronaldson, Andrew Grainger, Richard J Wakefield, Catherine Arundel, Fraser Birrell, Michael Doherty, Tonia Vincent, Fiona E Watt, Krysia Dziedzic, Terence W O'Neill, Nigel K Arden, David L Scott, John Dickson, Toby Garrood, Michael Green, Ajit Menon, Tom Sheeran, David Torgerson, Philip G Conaghan
Background: Synovitis is believed to play a role in producing symptoms in persons with hand osteoarthritis, but data on slow-acting anti-inflammatory treatments are sparse. Objective: To determine the effectiveness of hydroxychloroquine versus placebo as an analgesic treatment of hand osteoarthritis. Design: Randomized, double-blind, placebo-controlled clinical trial with 12-month follow-up. (ISRCTN registry number: ISRCTN91859104). Setting: 13 primary and secondary care centers in England...
February 20, 2018: Annals of Internal Medicine
Shannon Stark Taylor, Eugene Z Oddone, Cynthia J Coffman, Amy S Jeffreys, Hayden B Bosworth, Kelli D Allen
PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-efficacy, perceived pain control, and pain catastrophizing mediated changes in physical functioning following an osteoarthritis intervention involving weight management, physical activity, and cognitive-behavioral pain management. METHOD: Three hundred Veteran patients of 30 primary care providers with knee and/or hip OA were cluster randomized to an OA intervention group or usual care...
February 16, 2018: International Journal of Behavioral Medicine
Thomas Reygaerts, Stéphane Mitrovic, Bruno Fautrel, Laure Gossec
OBJECTIVES: Fatigue is a significant issue in psoriatic arthritis. The objective was to assess the effect of biological disease modifying antirheumatic drugs and apremilast on fatigue in psoriatic arthritis randomised controlled trials and to compare this effect with the effect in the same trials, on pain, through a systematic literature review and meta-analysis. METHODS: A systematic literature review was performed up to January 2017 in PubMed, Embase and Cochrane databases...
February 13, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Antonino Lo Giudice, Idona Brewer, Rosalia Leonardi, Neal Roberts, Gianluca Bagnato
The aim of the study was to evaluate whether a reduced pain threshold is associated with increased temporomandibular dysfunction in systemic sclerosis (SSc) compared to psoriatic arthritis (PsA) and healthy controls. Ninety subjects participated in the study (30 SSc, 30 PsA, and 30 healthy controls). The Helkimo index was used to evaluate temporomandibular dysfunction. Digital palpation was performed at the temporomandibular joint (TMJ) surface and at the superficial masseter muscle (SMM) and pain intensity was recorded on a visual analog scale (VAS), while pain pressure threshold (PPT) was measured at the same sites through a pressure algometer...
February 14, 2018: Clinical Rheumatology
Paulette Guitard, Lucie Brosseau, George A Wells, Nicole Paquet, Gail Paterson, Karine Toupin-April, Sabrina Cavallo, Sibel Z Aydin, Guillaume Léonard, Gino De Angelis
BACKGROUND: The prevalence of hand osteoarthritis (HOA) has been reported to be higher amongst women over 50 years old (66%) compared to men of the same age (34%). Although exercise therapy has been shown effective in reducing symptoms and disability associated with HOA, adherence to treatment programs remains low. The primary objective of this RCT is to examine the effectiveness of a 12-week knitting program for morning stiffness (primary outcome) and pain relief (secondary outcome) 2 h post-wakening in females (aged 50 to 85 years old) with mild to moderate hand osteoarthritis (HOA)...
February 14, 2018: BMC Musculoskeletal Disorders
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
Neil Basu, Chelsea M Kaplan, Eric Ichesco, Tony Larkin, Richard E Harris, Alison Murray, Gordon Waiter, Daniel J Clauw
OBJECTIVES: Many rheumatoid arthritis (RA) patients report pain despite excellent control of inflammation with immunotherapies. Variable degrees of co-existing fibromyalgia (FM) may explain this disparity. FM has been characterised by aberrant brain functional connectivity, especially between the Default Mode Network (DMN) and insula. We hypothesised that RA patients reporting the highest 2011 ACR FM survey criteria scores- a continuous measure of FM degree also known as fibromyalgianess (FMness)- would demonstrate functional connectivity abnormalities similar to FM...
February 13, 2018: Arthritis & Rheumatology
Sun-Young Jung, Eun Jin Jang, Seoung Wan Nam, Hyuk Hee Kwon, Seul Gi Im, Dam Kim, Soo-Kyung Cho, Dalho Kim, Yoon-Kyoung Sung
OBJECTIVES: To explore the relative efficacy of oral pharmacologic interventions in the treatment of knee OA. METHODS: A systematic literature review was conducted using the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases to identify trials conducted in patients with knee OA with a minimum 6 weeks of follow-up. The standardized mean differences of the change from baseline to week 6 in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain between the treatment groups were estimated using Bayesian random-effects network meta-analyses...
February 12, 2018: Modern Rheumatology
Soraya Shadmanfar, Narges Labibzadeh, Mohsen Emadedin, Neda Jaroughi, Vajiheh Azimian, Soura Mardpour, Fatemeh Abbasi Kakroodi, Tina Bolurieh, Seyyedeh Esmat Hosseini, Mohammad Chehrazi, Maryam Niknejadi, Hossein Baharvand, Farhad Gharibdoost, Nasser Aghdami
BACKGROUND: In this study, we intend to assess the safety and tolerability of intra-articular knee implantation of autologous bone marrow-derived mesenchymal stromal cells (MSCs) in patients with rheumatoid arthritis (RA) and to determine the preliminary clinical efficacy data in this population. The trial registration numbers are as follows: Royan Institute Ethics Committee: AC/91/1133; NCT01873625. METHODS: This single-center, randomized, triple-blind, placebo-controlled phase 1/2 clinical trial randomized RA patients with knee involvement to receive either an intra-articular knee implantation of 40 million autologous bone marrow-derived MSCs per joint or normal saline (placebo)...
February 7, 2018: Cytotherapy
Mahnaz Kalati, Maryam Kashanian, Fereshteh Jahdi, Mohsen Naseri, Hamid Haghani, Narges Sheikhansari
The purpose of the present study was to evaluate the effects of evening primrose oil (EvPO) on the duration of pregnancy and labour. The study was performed as a triple blind placebo controlled randomised clinical trial on nulliparous low-risk women with a certain gestational age of 40 weeks of pregnancy and a Bishop score of less than 4. In the case group (EvPO group), EvPO capsules were administered, 1000 mg, twice daily, for 7 days, and in the control group, placebo was administered similarly. The women of the two groups were followed up to delivery...
February 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Xin Wang, Qin Zhao, Zhao-da Deng, Xiao-Yuan Wang, Si-Gong Zhang, Hai-Li Shen
During choosing non-steroidal anti-inflammatory drugs(NSAIDs), risk factors should be evaluated in elder patients with rheumatoid arthritis. The present study focused on biological therapies, and elderly patients should be more concerned about the risk of infection when used it. Traditional Chinese medicine has advantages of obvious curative effect, especially for tripterygium wilfordii, large clinical trial on western and Chinese medical accurate drug strategies for old patients with rheumatoid arthritis. Old patients are easier to suffer from cardiac diseases and interstitial lung disease, rheumatoid arthritis could be controlled along with the treatment for coexistent disease...
June 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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