Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
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Randomized Controlled Trial Multicenter Study
Open-label observation of addition of etanercept versus a conventional disease-modifying antirheumatic drug in subjects with active rheumatoid arthritis despite methotrexate therapy in the Latin American region.
Previous global studies examined etanercept (ETN) + methotrexate (MTX) for treatment of rheumatoid arthritis (RA), but included few subjects from Latin America. ⋯ Consistent with published global data among RA patients with inadequate response to MTX, adding ETN to MTX demonstrated better efficacy than adding one other conventional DMARD to MTX. No new safety issues were observed. ETN + MTX provided favorable benefit-risk profile among RA patients from LA region.
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Knee arthrocentesis is a commonly performed diagnostic and therapeutic procedure in rheumatology and orthopedic surgery. Classic teaching of arthrocentesis skills relies on hands-on practice under supervision. Video-based online teaching is an increasingly utilized educational tool in higher and clinical education. YouTube is a popular video-sharing Web site that can be accessed as a teaching source. ⋯ A discreet number of YouTube videos on knee arthrocentesis appeared to be suitable for application in a Web-based format for medical students, fellows, and residents. The low-average mean global score for overall educational value suggests an improvement of future video-based instructional materials on YouTube would be necessary before regular use for teaching could be recommended.
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Opportunistic infection has been documented in systemic lupus erythematosus with special attention paid to Pneumocystis jirovecii because of the significant morbidity and high mortality. ⋯ We report the rare occurrence but high mortality of PCP infection in this study. A consensus guideline addressing prophylactic antibiotics against Pneumocystis organisms in highest-risk lupus patients on biologics or immunosuppressants could be helpful in guiding their management.
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Case Reports
Total hip arthroplasty in a 17-year-old girl with progressive pseudorheumatoid dysplasia.
Progressive pseudorheumatoid dysplasia is an autosomal recessively inherited skeletal disease. Progressive pseudorheumatoid dysplasia can involve multiple synovial joints, which then develop structural deformity and articular dysfunction. ⋯ Total hip arthroplasty was performed to treat persistent pain and stiffness by reconstructing a functional joint. Although we found arthroplasty to be an effective way of reconstructing a functional joint, treatment of the underlying cause is urgently required for this disease in the future.