Clinical rheumatology
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Clinical rheumatology · Mar 2013
Review Case ReportsScrotal involvement in an adult with Henoch-Schönlein purpura.
Henoch-Schönlein purpura is a systemic vasculitis of unknown etiology usually affecting the pediatric age group and characterized by the clinical triad of non-thrombocytopenic palpable purpura, abdominal pain, and arthritis. There also may be varying degrees of renal involvement. The findings of scrotal involvement are not as well recognized. We describe a case of acute scrotal swelling as part of a 37-year-old male's presentation of Henoch-Schönlein purpura, a presentation that has not been reported in this age group.
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Clinical rheumatology · Mar 2013
Review Case ReportsTakayasu's arteritis and posterior reversible encephalopathy syndrome: a case-based review.
Autoimmune vasculitides can have diverse neurological manifestations, including posterior reversible encephalopathy syndrome (PRES). Takayasu's arteritis (TA) is an uncommon vasculitis rarely associated with PRES. Common clinical features of TA include hypertension, audible arterial bruits, absence of peripheral pulses, claudication of the extremities, reduced blood pressure in one or both arms, and angiographic abnormalities. ⋯ We found ten additional cases of TA and PRES in the literature. All patients were females under the age of 40, had renovascular hypertension, and presented with headaches and seizures. Current literature relevant to this rare association is presented and discussed.
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Clinical rheumatology · Feb 2013
Pain and psychological health status in chronic pain patients with migration background--the Zurich study.
The objective of this paper is to investigate whether there were differences in pain and psychological health status in chronic pain patients with and without migration background before and after an 8-week interdisciplinary outpatient pain programme (IOPP). One hundred eighteen consecutively assessed patients were included. Pain and psychological health were recorded prior to and after the intervention, and at the 3-, 6- and 12-month follow-up. ⋯ The results show differences in outcome for chronic pain patients with and without migration background. High pain intensity, high levels of depression, anxiety and catastrophizing at baseline appear to be major barriers for improvement in a sample of migrant patients when participating in an IOPP. Treatments may have to be tailored to the specific needs of this patient group to better address their poor psychological health status and to improve the course of the pain disorder.
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Clinical rheumatology · Jan 2013
Cross-cultural adaptation and validation of the Spanish version of the Cumberland Ankle Instability Tool (CAIT): an instrument to assess unilateral chronic ankle instability.
The Cumberland Ankle Instability Tool (CAIT) is a valid instrument to determine the presence of chronic ankle instability (CAI) and to assess its severity. Self-report test is very useful for researchers and clinical practice, and CAI is a widespread tool. Nevertheless, there is lack of measurement instruments validated into Spanish, which represents a major difficulty for research dealing with a Spanish-speaking population. ⋯ Correlation with the 36-item Short-Form Health Survey (SF-36) physical component summary score (rho = 0.241, p = 0.012) was greater than the SF-36 mental component summary score (rho = -0.162, p = 0.094). The construct validity shows three different factors in the questionnaire and good responsiveness with a mean change of -2.43 (95 % CI = -3.12 to 1.73, p < 0.0001) and a size effect of Cohen's d = 1.07. The Spanish version of the CAIT has been shown to be a valid and reliable instrument for measuring chronic ankle instability and constitutes a useful instrument for the measurement of CAI in the clinical setting in Spain.
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Clinical rheumatology · Jan 2013
Review Case ReportsProgressive disseminated histoplasmosis in systemic lupus erythematosus-an unusual presentation of acute tenosynovitis and a literature review.
Progressive disseminated histoplasmosis is a disease where Histoplasma capsulatum affects multiple organs due to the inability of host cellular immunity to control the infection. Progressive disseminated histoplasmosis mainly involves the bone marrow, liver, and lungs. ⋯ This report highlights the point that H. capsulatum may present as focal lesions and a high level of suspicion is needed to make the diagnosis, especially in SLE patients. We specifically reviewed reported cases of progressive disseminated histoplasmosis in SLE patients, and a review of the literature is presented.