Zeitschrift für Rheumatologie
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Review Multicenter Study Clinical Trial
Primary fibromyalgia syndrome: a critical evaluation of recent criteria developments.
Although nonspecific musculoskeletal aching of nonarticular origin has been described in European literature since the 17th century under such names as muscular rheumatism, the fibrositis syndrome with generalized musculoskeletal aches or stiffness, fatigue, poor sleep, and multiple tender points as a characteristic rheumatologic entity was not described until the 1960s. Smythe first suggested criteria for this condition based on clinical experience in the 1970s. ⋯ Since then other criteria have been published, and in 1989 criteria studies on fibromyalgia with appropriate design and controls were reported. This article critically evaluates current criteria developments in fibromyalgia.
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Randomized Controlled Trial Clinical Trial
[Cognitive behavior therapy in patients with ankylosing spondylitis].
As an adjunctive treatment, a cognitive-behavioral program for pain management was administered to 25 patients with spondylitis ankylosans organized in self-help groups of the German Rheumatism-League. Another 20 patients with the same disorder served as a waiting-for-treatment control-group. ⋯ In a six-month follow-up, significant reductions in pain intensity, in impairments due to pain, in anxiety, and in sleep disorders could be confirmed by analyses of variance. Besides in improvement in pain control, our results indicate a long-term effect on wellbeing as a consequence of our program.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Shortening diclofenac therapy by B vitamins. Results of a randomized double-blind study, diclofenac 50 mg versus diclofenac 50 mg plus B vitamins, in painful spinal diseases with degenerative changes].
The use of nonsteroidal anti-inflammatory drugs (NSAID) such as diclofenac for treatment of degenerative rheumatic disorders of the lumbar spine is of great significance in orthopedic practice. Clinical studies have shown that concomitant treatment with vitamins B1, B6, B12 and diclofenac provides more efficient pain relief than treatment using diclofenac alone. This study was undertaken in order to determine whether the duration of treatment with diclofenac for lower back pain can be shortened by adding B-vitamins to the therapeutic regimen. ⋯ Undesirable side-effects were documented with 39 patients, 14 of them having discontinued therapy for this reason. No statistically significant difference could be determined within this group with regard to therapy. The study results document the positive influence of B-vitamins on painful symptoms and indicate that less NSAID is needed for pain relief when combined with B-vitamins.
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The relative and absolute blood contents in the knee joint after intraarticular injections were determined using a biochemical joint function test. Normally, only minimal amounts of blood leak into the joint cavity, but in a few cases greater quantities were found, unnoticed at the time of injection. Intraarticular injections should be done only by a specialist.
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Comparative Study
[Therapy of seronegative oligoarthritis with salazopyrine].
In an open, controlled study we treated 55 patients suffering of psoriatic arthritis (PsA), 29 patients suffering of Bechterew's disease (MB) and 16 patients with Reiter's syndrome with Salazopyrin at a daily dosage of 2000 mg. We monitored the following criteria of activity: duration of morning stiffness, joint index, global well being scored by the patient and erythrocyte sedimentation rate. ⋯ The effect of the drug appeared between week 5 and 15 of treatment. 21% of all patients had to discontinue the treatment because of severe side effects; this figure correlates with the percentages given in the literature. Most of these side effects appeared from week 3 to week 7 of treatment; after week 15 none of the patients had to discontinue the medication of because of severe side effects.