RESUMO
The problem of nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal toxicity was reviewed by members of the Asia Pacific League of Associations for Rheumatology (APLAR) in a consensus conference in September 1992. This paper by the participants presents the consensus conclusions incorporating knowledge from recent publications. There had been a high level of concern that much of the toxicity had resulted from extensive and indiscriminate prescribing of NSAIDs. The implementation of evidence-based guidelines was considered likely to be able to effect a substantial reduction in toxicity without significant loss of overall therapeutic benefit. The evidence from which such guidelines could be developed is critically appraised.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Antiulcerosos/farmacologia , Sistema Digestório/efeitos dos fármacos , Misoprostol/farmacologia , Análise Custo-Benefício , Humanos , Úlcera Péptica/induzido quimicamente , Úlcera Péptica/prevenção & controle , Fatores de RiscoRESUMO
Naproxen, a new nonsteroidal anti-inflammatory analgesic drug was found to be better than placebo and as effective as indomethacin in the treatment of rheumatoid arthritis. The drug was well tolerated, and appears to be a useful alternative to more established medication such as aspirin.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Naproxeno/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Indometacina/efeitos adversos , Indometacina/uso terapêutico , Naproxeno/efeitos adversos , Pacientes Desistentes do Tratamento , PlacebosRESUMO
The co-existence of ankylosing spondylitis and rheumatoid arthritis is uncommon and usually occurs in a male with a long history of back pain followed by the appearance of clinical features of ankylosing spondylitis, while features of rheumatoid arthritis develop in the third or fourth decade of life. Recently, histocompatibility (HLA) antigens have partially elucidated the genetic factors predisposing to both diseases. We report a patient with ankylosing spondylitis and rheumatoid arthritis who had the associated HLA genes.
Assuntos
Artrite Reumatoide/genética , Espondilite Anquilosante/genética , Idoso , Artrite Reumatoide/complicações , Antígenos HLA/genética , Humanos , Masculino , Espondilite Anquilosante/complicaçõesAssuntos
Artrite Reativa/imunologia , Antígenos de Histocompatibilidade/análise , Adolescente , Adulto , Idoso , Sedimentação Sanguínea , Testes Imunológicos de Citotoxicidade , Teste de Histocompatibilidade , Humanos , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Polinésia , Fatores de TempoAssuntos
Infarto do Miocárdio/diagnóstico , Doença Aguda , Fatores Etários , Idoso , Cardiomegalia/diagnóstico por imagem , Cardiomegalia/mortalidade , Diabetes Mellitus/mortalidade , Eletrocardiografia , Seguimentos , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/mortalidade , Humanos , Hipertensão/mortalidade , Hipotensão/mortalidade , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Obesidade/complicações , Prognóstico , Radiografia , RecidivaRESUMO
To investigate the importance of body image concerns relating to hand appearance in rheumatoid arthritis, a questionnaire was devised and administered to 80 female out-patients. Subjective judgements of hand attractiveness, feelings about hands, and behaviours relating to hand adornment and concealment were sought. Objective ratings of hand attractiveness were obtained from photographs taken at this time of the women's hands. Factor analysis indicated four principal orthogonal factors describe these body image items. Evaluative and affective elements were found to be independent of each other. The hypothesis that body image, thus rated, is relevant to desire for reparative hand surgery was tested using a two-stage general linear modelling procedure. Body image concerns, particularly negative feelings about hands, emerged as significant predictors of desire for surgery, and remained significant after the removal of variance accounted for by duration of arthritis, age, grip strength and objectively rated hand attractiveness. It is suggested that in rheumatoid arthritis, self-perception of hands and the associated emotional response, may be a covert agenda in women's decision to have surgery, and need specific clinical consideration.
Assuntos
Artrite Reumatoide/psicologia , Imagem Corporal , Deformidades Adquiridas da Mão/psicologia , Papel do Doente , Adulto , Idoso , Artrite Reumatoide/cirurgia , Feminino , Deformidades Adquiridas da Mão/cirurgia , Humanos , Pessoa de Meia-IdadeRESUMO
A patient who presented with reflex sympathetic dystrophy of the foot is described. Biopsy confirmed metastases of the small bones which at postmortem proved to be from carcinoma of the lung.