ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We conducted an uncontrolled pilot study to determine the effects of a weight loss and walking program on knee pain and physical function in overweight and obese (body mass index; BMI [kg/m2] 25–29.9 and BMI ≥ 30, respectively) postmenopausal women with knee osteoarthritis (OA). Forty-eight such women completed self-report (Western Ontario and McMaster University Osteoarthritis Index (WOMAC)) and performance-based measures of physical function (“up & go” test, 6-min walk) and enrolled in a 6-month intervention that included weekly nutrition classes and an exercise-walking program.The intervention produced an average weight loss of 5.6 ± 4.0 kg in the 30 women who completed the program. There also were significant improvements in the 6-min walk and on VO2max. Improvements in the timed up & go test and on the WOMAC pain and function scores, however, were restricted only to women who were classified as obese at baseline. These findings suggest that a 6-month weight loss and walking program improves measures of physical functioning and pain in overweight and obese postmenopausal women with knee OA. Among obese women, functional improvement correlated with weight loss, encouraging continued emphasis on weight loss for managing knee OA.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The use of methotrexate in the treatment of psoriatic arthritis is associated with risk of hepatotoxicity. However, monitoring of liver-associated enzymes often lacks sensitivity, and guidelines for serial liver biopsies in psoriatic arthritis are not yet well established. We performed a retrospective review of all patients with psoriatic arthritis receiving methotrexate who were enrolled in the disease-modifying anti-rheumatic drug clinics (DMARD clinics) at the Air Force and Army hospitals in San Antonio, Texas. Information was obtained regarding methotrexate regimen, liver-associated enzyme results, and liver biopsy results. Thirty psoriatic arthritis patients were taking methotrexate in the DMARD clinics. Seventeen patients had a total of 21 biopsies. Biopsies were performed for surveillance dictated by cumulative dose. Liver biopsies were graded on Roenigk scale of I-IV where I is mild steatosis, II is moderate steatosis, IIIa is mild fibrosis, IIIb is severe fibrosis, and IV is cirrhosis. Ten biopsies were grade I, 5 were grade II, 5 were grade IIIa, 1 was grade IIIb, and none were grade IV.In this very small retrospective study, regular monitoring of liver-associated enzymes did not correlate with histologic deterioration in our patients. Until prospective studies are performed, we suggest that routine liver biopsies are necessary to monitor for methotrexate hepatotoxicity in psoriatic arthritis.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This study was conducted to further characterize the nature of leprosy-related bone alterations, to develop a hypothesis of their pathophysiology, and to define the impact of treatment on bone damage. Radiographs of 60 patients under care at the Carville, Louisiana leprosy hospital were compared with 50 from the early (before availability of effective treatment) part of this century and with 27 from the Toronto (Ontario, Canada) leprosy clinic.Two-thirds of lesions were so severe that distal digital tufts had been lost to whittling, resorption, or fragmentation. Fifty percent were felt to be pathognomonic for the changes of leprosy.Resorption, fragmentation, and malaligned fractures are highly suggestive of leprosy, while diaphyseal whittling appears specific when medullary sclerosis or wavy diaphyseal borders are present. Medicinal intervention appeared to be of limited benefit for bone damage; perhaps greater attention to joint/bone protection (as recommended in diabetes management) will prove helpful. Environmental adjustment to minimize injury risk and daily limb examination for injury are recommended.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We report a case of vasculitis after Prosorba treatment in a patient with rheumatoid arthritis. The patient is a 66-year-old white male with long standing rheumatoid arthritis and hepatitis B. He was treated with the standard regimen for Prosorba treatment. He improved and met criteria for an American College of Rheumatology (ACR) 20% response. While on therapy he developed a nonhealing ulcer. Approximately 2 weeks after treatment was completed, he developed palpable purpura and mononeuritis multiplex. Deep dermal biopsy confirmed the presence of both small and medium vessel vasculitis. Nerve conductions studies were consistent with neuropathic conduction delays. He was treated with 1mg/kg/day of oral prednisone.Prosorba has been reported to cause leukocytoclastic vasculitis during treatment, but has not been noted to involve medium sized vessels. This patient’s history and presentation are most consistent with rheumatoid arthritis associated vasculitis, though the Prosorba treatment cannot be ruled out as a cause or a contributing factor. Importantly, although Prosorba treated his synovitis, it did not prevent concomitant vasculitis.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We describe a case of septic arthritis and bacteremia caused byBurkholderia pseudomallei, a bacterium that is endemic in East Asia and northern Australia. We believe that dissemination occurred in our patient after surgical excision of a pulmonary nodule. Bacteremic melioidosis can present with musculoskeletal involvement in 2–10% of patients, but septic arthritis is uncommon. A review of the literature shows a total of 66 patients reported with septic arthritis caused by this organism. Patients with septic arthritis caused byBurkholderia pseudomalleiwere likely to have diabetes mellitus, and the knee is the joint most frequently affected by this organism.Recommended initial treatment consists of ceftazidime, alone or in combination with trimethoprim/sulfamethoxazole, high dose imipenem/cilastatin, or high dose cefoperazone/sulbactam. This is followed by a 12–20 week course of oral therapy (based on susceptibilities) to eradicate the organism. Most patients with subacute or latent disease do well after full antibiotic treatment, but relapses are common if full treatment is not given. Awareness of this disease is important even in areas outside of Asia given the increasing frequency of international travel and the growing likelihood of imported cases, along with an aging population of Vietnam veterans and immigrants.

ISSN:1076-1608    

出版商:OVID    

年代:2001

数据来源: OVID