Rheumatology international
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Observational Study
An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.
The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. ⋯ Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.
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Behçet's disease represents a multisystemic inflammatory disease characterized by recurrent oral ulcers, genital ulcers, and uveitis. Although vascular attack and thrombosis are not major complications in Behçet's disease, they can still pose risks that must not be overlooked. ⋯ Currently, data about the treatment and the prophylaxis of thrombotic events in Behçet's disease are lacking. In this case report, we hope to discuss the future direction of such studies, how we understand the mechanism of Behçet's disease hypercoagulability, and which treatments can improve thrombotic tendencies in Behçet's disease.
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Bone-marrow oedema (BME) represents a reversible but mostly painful increase in interstitial fluid. The exact pathogenetic processes still remain unknown. Treatment options are mainly symptomatic with core decompression as golden standard leading to immediate pain relieve. ⋯ Concerning the MRI scans in both groups, we found a distinct reduction of BME in 47 % and a complete regression in 40 %. Comparing both groups, the improvement of the scores was greater in the prostacyclin group than in the bisphosphonate group; the difference, however, was not significant. Intravenous bisphosphonates as well as prostacyclin are of efficient therapeutic benefit in treatment of BME with a quicker and greater effect of prostacyclin.
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The impact of fibromyalgia on the course of pregnancy is not clearly defined. We evaluate the frequency of FMS symptoms among full-term healthy pregnant women and the impact on the course of delivery. The 2011 modification of the ACR 2010 criteria for FMS diagnosis was used as well as the FIQ, SF-36 and AIMS questionnaires. ⋯ FMS symptoms were highly prevalent among healthy pregnant women at term. The presence of such symptoms may impact on the course of delivery and the need for anesthesia. Evaluating for features of centrally mediated pain may be of clinical relevance for physicians involved in the treatment of pregnant women.
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Multicenter Study
Sexuality of men with fibromyalgia: what are the factors that cause sexual dysfunction?
The purpose of the present study is to compare male patients with the fibromyalgia syndrome (FMS) with healthy individuals in terms of the sexual function. For the purposes of this study, 37 sexually active male FMS patients and 30 healthy controls were enrolled. The demographic data of the patients were recorded, and the widespread pain observed in FMS was graded with the help of the visual analogue scale (VAS 0-100 mm). ⋯ The SF-36 scores (physical functioning, role limitations due to physical problems, pain and general health perception) were observed to be positively correlated with the IIEF scores (p < 0.05). No significant relationship has been observed between the scores obtained from the domains of IIEF and the psychological status (p > 0.05). FMS leads to an impairment in the sexual function in male patients, which is especially strongly associated with the age, widespread pain and the quality of life.