ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Epidemiologic studies confirm the jigh prevalence and incidence of osteoarthitis,including low back pain. The medical management of low back pain is provided primarily by physicians and chiroprators. The debate continuies regarding the comparative effecacy of these types of health care.The role of surgery in degenarative back disease is controversial. In particular,lumber fusion may be associated with poor outcomes. Studies suggest that genetic facotrs mwy be more important than environmental risk factors in determining susceptiblity to degenerative disk disease. Lifestyle modification may have a significant impact on osteoporotic hip fracture rates. Radiologic progression in patients with newly diagnosed rheumatoid arthritis is greater in seropositive patients who have baseline dameage and continued joint inflammation. Approdimately 10% of the excess mortality observed in rheumatoid arthrits may be attriutable to medication use,in particular nonsteroidal anti-inflammatory drugs and corticosteroids. Work characteristics may be less important in predicting work disability in rheumatoid arthrits than severity of disease and desire to be at home.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This paper reviews clinical trials that have been published during the course of the past year on the rheumatologic diseases. The greatest number of clinical trials were done in rheumatoid arthrits. These trials show promising results for combination therapy with disease-modifying antirheumatic drugs,whereas results of studies with monoclonal antilymphocyte antibidies have been disappointing. The role of oral collgen remains to be defined. Nonsteroidal anti-inflammatory drugs with selective cyclooxygenas-2(Cox-2)inhibition may have a more favorable toxicity profile and are likely to find wide usee. As adjuvant therapy appaeard artritis, Intravenous immunoglobulin therapy appeard ineffective in the disease specific.The inclusion of the more standardized and disease specific outcome measures has enhanced the quality of clinical trials in rheumatology and their applicability to rheumatologic practice.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Universally, health care systems are currently undergoing tremendous change. It is not sufficient to demonstrate that specific medical interventions and services are effective, as third party payers have become increasingly interested in financial outcomes. Managed care has accelerated this movement and rheumatology is facing new challenges to position itself in a changing health care environment. Studies dealing with the economic burden of musculoskeletal diseases and the economic evaluation of particular services and interventions are reviewed. As the health care system shifts toward managed care, rheumatology is facing tremendous challenges to position itself in new markets.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Patient education programs in rheumatology are emerging as important therapeutic interventions. The current evidence for their efficacy, economic benefits, and underlying causal mechanisms is discussed. Current meta-analytic studies suggest that patient education can affect knowledge, pain, joint counts, depression, exercise, and coping behaviors. Evidence is presented suggesting that self-efficacy and social support are strong underlying causal mechanisms. Although studies of the economic impact of patient education are still scant, most that exist indicate that the programs evaluated tended to reduce health care service utilization. An example of a complex costeffectiveness study is discussed.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The current literature is reviewed related to three disease processes commonly encountered by the physiatrist, rheumatologist, and internist in clinical practice, including osteoarthritis, rheumatoid arthritis, and osteoporosis. These diseases often have effects beyond the pathology that has an impact on the individual's function and integration into society. Emphasis is on the specific rehabilitative approach to the individual.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Advances in rheumatologic arthritis health services research continue to be of interest to clinical rheumatologists and arthritis researchers interested in healthcare delivery and policy. Recent studies have shown that a higher incidence of osteoarthritis and functional disability among rural inhabitants influences delivery of arthritis care to rural areas and urban-rural variations in specialist distribution. In the United States, managed care organizations are increasingly dictating who delivers and who receives health care for arthritis. Provision of arthritis care by rheumatologists has become more discretionary and is strongly influenced by a patient's health insurance coverage. Coinciding with this trend, a higher percentage of arthritis care is being shifted to primary care providers. Based on prominent practice pattern variations, generalists have divergent knowledge and beliefs about the value of various arthritis treatments. New therapeutic programs have been proposed to better coordinate efforts between generalists and specialists. Many arthritis patients also seek alterative therapies. Of these, chiropractic care is one of the most common nontraditional therapies. Chiropractic management appears to be as cost-effective as traditional back care in certain settings.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The recent literature on behavioral and social research in rheumatology covers the descriptive epidemiology of the behavioral, psychologic, and social impact of rheumatic diseases, the identification of risk factors and predictors of psychosocial outcomes, and cognitive and behavioral interventions used in the management of rheumatic disease. Past studies focused primarily on behavioral and social outcomes in rheumatoid arthritis and osteoarthritis. Recent work has continued to explore these issues in rheumatoid arthritis and osteoarthritis, but a number of studies are examining psychosocial impact and interventions in other rheumatic conditions, such as fibromyalgia and systemic sclerosis. The continued understanding of these consequences of rheumatic disease will enhance the quality of life in individuals who have these conditions.

ISSN:1040-8711    

出版商:OVID    

年代:1997

数据来源: OVID