Influence of multidisciplinary therapeutic approach on fibromyalgia patients.

There is no specific cure for fibromyalgia (FM), but combined non-pharmacologic and pharmacologic treatments may mitigate symptoms and improve quality of life in patients. The aim of the present study was to monitor patient response to several types of therapy, including cognitive-behavioral and occupational therapy, and kinetic therapy, as compared to a control group that was not subjected to any form of therapy. The study included 98 FM patients, all women, out of which 32 received cognitive-behavioral therapy and occupational therapy (CBT+OT), 34 kinetic therapy (KT) and 32 participated as controls. The evaluation protocol comprised two questionnaires developed in order to assess the patient's condition as fully as possible: Fibromyalgia Impact Questionnaire (FIQ) and Fibro Fatigue (FF) scale. At the pre-evaluation there were no significant inter-group differences. At post-evaluation significant differences were observed between the control sample and the group subjected to kinetic therapy (P<0.05). FIQ scores decreased in the CBT+OT group too, but less than that in the KT group. The FF scale registered notable evolutions in time for the group subjected to kinetic therapy. In order to control and improve most of the FM symptoms, besides proper medication, we suggest an interdisciplinary intervention mainly focusing on long-term individualized kinetic therapy. The simultaneous integration of a cognitive-behavioural and occupational therapy intervention could be the element that completes the complex treatment of FM patients.

A nontraumatic myositis ossificans case of the forearm: Case report and literature review.

Myositis ossificans (MO) is a rare, benign ossifying lesion characterized by focal formation of heterotopic bone and cartilage in extraskeletal soft-tissue that most commonly occurs in young adults. In most cases, no causative factor can be identified. The diagnosis of MO is usually based on the patient's history of trauma, clinical signs, on imaging appearance and histological examination. We present a non-traumatic MO case of the forearm in a 40-year-old man with weakness in left finger motion, a decrease in prehension for more than three weeks, without any weight loss, malaise, anorexia or fever. The clinical symptoms and radiological findings can be easily confused with malignant lesions. Treatment is usually conservative but, due to the limited strength and range of motion of the left hand, the tumor was extirpated and the diagnosis of MO was made by biopsy. The patient had no neurological deficits after surgical treatment and was discharged on the fifth day after the surgery in good condition with the recommendation to begin a rehabilitation program.

A case of giant cell tumor of the tendon sheath in an elderly patient: diagnostic difficulties and therapeutic options.

Giant cell tumor of the tendon sheath (GCTTS) is a benign tumor with a high recurrence rate of up to 50%. The lesion may appear anywhere in the synovium; the nature of this tumor is still controversial, however recent data shows that tenosynovial giant cell tumors (TGCTs) could be clonal neoplastic tumors. Most lesions of GCTTS produce one or more discrete nodules, while the radiological features can include soft-tissue masses with or without bone destruction. In an effort to advance in the understanding of GCTTS pathogenesis, we decided broadly investigate the immunophenotypic profile, of a TGCT in a 69-year-old female patient.

Remission of Walking Parameters in Peripheral Arterial Disease through Association of Galvanic Baths and Kinesytherapy.

Chronic peripheral obstructive arteriopathies (CPOA), together with their determinations, play an important role in the elderly pathology and represent one of the most frequent causes of disability, thus having a negative impact on the patient's quality of life. Therefore, in this clinical randomized trial we proposed to study the efficiency of several treatment methods based on physical exercise together with other therapeutical approaches specific to physical medicine such as galvanic baths. We formed a group of 111 patients diagnosed with peripheral arterial disease in inferior limbs randomized into three groups: the control group (drug treatment and hygiene-dietary), the exercise group (12 weeks supervised exercises program, followed by another 12 weeks home unsupervised exercises) and the exercise and procedure group (kinesitherapy and galvanic baths). All the subjects performed the exercise treadmill test, according to the Gardner protocol, at the beginning of the study, after 12 weeks and after 24 weeks, at the end of the study and were measured: the time to pain onset (TDC) and the time to maximum pain onset (maximum walking time=TDD). We observed quite high TDC differences in the two groups that performed physical exercises compared to the control group, while the amelioration of walking periods was recorded after the first 12 weeks, and after 24 weeks they reached walking periods 2.5 times higher than at the beginning of the study. Adding hydrotherapy to the physical exercise led to even higher TDC values. After 12 weeks, we obtained a 54% TDD remission in the exercise group (p<0.005) and a 65% remission in the exercise and hydrotherapy group (p<0.005) and at the end of period, the TDD remission was 90% in the exercise group (p<0.005) and 100% in the exercise and hydrotherapy group (p<0.05). The kinetic-physical modalities show its efficiency in ameliorating the walking parameters in the patients with claudication and may offer low risks compared to the revascularization methods, high addressability, diminished costs.