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1.
Ann Rheum Dis ; 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31427438

RESUMO

OBJECTIVES: To describe and explore differences in formal regulations around sick leave and work disability (WD) for patients with rheumatoid arthritis (RA), as well as perceptions by rheumatologists and patients on the system's performance, across European countries. METHODS: We conducted three cross-sectional surveys in 50 European countries: one on work (re-)integration and social security (SS) system arrangements in case of sick leave and long-term WD due to RA (one rheumatologist per country), and two among approximately 15 rheumatologists and 15 patients per country on perceptions regarding SS arrangements on work participation. Differences in regulations and perceptions were compared across categories defined by gross domestic product (GDP), type of social welfare regime, European Union (EU) membership and country RA WD rates. RESULTS: Forty-four (88%) countries provided data on regulations, 33 (75%) on perceptions of rheumatologists (n=539) and 34 (77%) on perceptions of patients (n=719). While large variation was observed across all regulations across countries, no relationship was found between most of regulations or income compensation and GDP, type of SS system or rates of WD. Regarding perceptions, rheumatologists in high GDP and EU-member countries felt less confident in their role in the decision process towards WD (ß=-0.5 (95% CI -0.9 to -0.2) and ß=-0.5 (95% CI -1.0 to -0.1), respectively). The Scandinavian and Bismarckian system scored best on patients' and rheumatologists' perceptions of regulations and system performance. CONCLUSIONS: There is large heterogeneity in rules and regulations of SS systems across Europe in relation to WD of patients with RA, and it cannot be explained by existing welfare regimes, EU membership or country's wealth.

2.
J Rheumatol ; 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30936275

RESUMO

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Worker Productivity Group continues efforts to assess psychometric properties of measures of presenteeism. METHODS: Psychometric properties of single-item and dual answer multiitem scales were assessed, as well as methods to evaluate thresholds of meaning. RESULTS: Test-retest reliability and construct validity of single item global measures was moderate to good. The value of measuring both degree of difficulty and amount of time with difficulty in multiitems questionnaires was confirmed. Thresholds of meaning vary depending on methods and external anchors applied. CONCLUSION: We have advanced our understanding of the performance of presenteeism measures and have developed approaches to describing thresholds of meaning.

3.
Med Ultrason ; 20(3): 328-334, 2018 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-30167586

RESUMO

AIM: Patients describe rheumatoid arthritis (RA) remission as the absence of any symptoms or return to normality. Residual ultrasound (US) synovitis was frequently described in remission cohorts in previous studies. US tenosynovitis evaluation and scoring seems to better follow clinical remission scores compared with synovitis in RA. Our objective was to verify the presence of US findings suggestive of persistent inflammation in a cohort of patients in remission according to their own opinion. MATERIALS AND METHODS: Forty-three RA patients were prospectively enrolled in this pilot study between 2015-2017 according to their positive answer to the question "Are you feeling free of symptoms, just like before your RA symptomsstarted?". Clinical evaluation of tender and swollen joints was performed in the same day with US evaluation of 24 joints and 26 tendon sites and lab C-reactive protein (CRP) evaluation. DAS28-CRP and SDAI were calculated. RESULTS: A total of 72.9% (35 of 43) of patients were in remission per DAS28 criteria. Except for CRP value, no other variables were significantly different in the 35 of 43. PD scoring in tenosynovitis of the ankle and feet was 100% overlapping remission felt by patients. PD tenosynovitis in both upper and lower limbs was found in less than 10% of patients, and only grade 1 (minimal). CONCLUSION:  A combination of patients' opinion and PDUS evaluation could be a starting point for RA treatment tapering.

4.
RMD Open ; 3(2): e000453, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28912960

RESUMO

OBJECTIVE: To assess the influence of disease activity of patients with rheumatoid arthritis on treatment choices of rheumatologists in countries with restricted access to expensive, innovative drugs. METHODS: Rheumatologists from Hungary, Romania and UK were invited to complete two consecutive discrete choice experiments with hypothetical drug treatments for two different patient profiles: high and moderate disease activity. Rheumatologists were asked to choose repeatedly between two unlabelled treatment options that differed in five attributes: efficacy (expected improvement and achieved disease activity state), safety (probability of serious adverse events), patient's preference (level of agreement), total medication costs and cost-effectiveness. A heteroscedastic discrete choice model using interaction terms between attribute levels and patient profiles (binary variable) was used to assess the preferences of rheumatologists towards each attribute and the influence of the patient profile. RESULTS: Overall, 148 rheumatologists completed the survey (46% females, mean age 49 years, 49% academic). For both patient profiles, efficacy dominated the treatment choice over patient's preference, safety and economic aspects. However, for patients with high compared with moderate disease activity, the importance of drug efficacy significantly increased (from 48% for moderate to 57% for high disease activity), whereas the importance of patient's preference significantly decreased (from 15% to 11%). No significant differences were observed for economic and safety considerations. CONCLUSION: Rheumatologists were willing to give up some efficacy to account for patient's preference when choosing treatments for patients with moderate compared to high disease activity. Disease activity however did not influence importance of economic aspects in treatment choices.

5.
Med Ultrason ; 19(3): 282-287, 2017 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-28845494

RESUMO

AIMS: Doppler ultrasonography assessment is mandatory nowadays for the complete description of rheumatic disease activity. Initially it was performed in semi quantitative way but recently the (fully) quantitative assessment is gaining more interest. In quantitative assessment, the ratio between total colorized and total pixels (CTR) is computed for the whole image or just for the region of interest (ROI). The frame with the highest amount of Doppler signal (also called worst case scenario image - WCSI) is usually the only one analyzed. The technique requires a very precise identification of WCSI from a certain number of consecutive frames, captured from the same position of the US probe, (and in most cases this is done manually). Our study examined the ability of both experienced and in-training sonographers to identify WCSI using a computerized analytical system as the gold standard. MATERIALS AND METHODS: The study analyzed 480 frame selections done in two distinct exercises. The WCSI and other 3 images with a 5%, 10% and respectively 20% lower level of CTR compared with WCSI were packed in one selection. All frames emerging from the same video clip were randomly presented to six experienced and six in training sonographers; the request was to select the frame with the highest CTR (WCSI) from each package (twenty packages in total). A similar exercise was performed with CTRs decreasing in steps of 2%. RESULTS: In the first exercise the WCSI was correctly identified in 79.1% cases and in 67% of cases in the 2nd exercise. The interobserver agreement between experienced and in-trainer evaluators for the 1st exercise was 0.78 and 0.4 in the 2nd exercise. CONCLUSION: Using computerized analysis as the gold standard, we demonstrated a large heterogeneity across sonographers regarding their ability to identify the best Doppler image even from a small group of frames.


Assuntos
Competência Clínica/estatística & dados numéricos , Sistema Musculoesquelético/diagnóstico por imagem , Doenças Reumáticas/diagnóstico por imagem , Ultrassom/educação , Ultrassonografia Doppler/métodos , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes
6.
Med Ultrason ; 18(4): 457-462, 2016 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-27981278

RESUMO

OBJECTIVE: To identify and analyse existing data regarding knee ultrasound (US) feasibility in clinical practice. Material and methods: A systematic literature review was performed using the terms: ("knee") AND ("ultrasound" OR "ultrasonography") AND ("feasibility" OR "pilot" OR "proof of concept"). Feasibility studies regarding knee US or US aided maneuver involving knee joint, published during 2005-2015, were selected and evaluated against a complex framework constructed around mandatory key areas for feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration and expansion. RESULTS: One hundred and fifty-nine publications were identified, of which 9 were included in the final analysis: 6 dealt with the development and implementation of novel US scores, while the rest focused on implementing MSUS in clinical practice, evaluating the usefulness of articular cartilage US assessment and the feasibility of sonography for intra-articular knee injections, respectively. Six studies quantified feasibility as time spent for the evaluation, with only two addressing areassuch as acceptability, implementation and practicality, although none of these systematically assessed all feasibility domains. CONCLUSION: Knee US feasibility is still poorly addressed; the time required for US assessment is the main area addressed. This information gap should be properly addressed in future works, in order to ensure the right place for this technique.


Assuntos
Injeções Intra-Articulares/estatística & dados numéricos , Artropatias/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Pesquisa Médica Translacional/estatística & dados numéricos , Ultrassonografia/estatística & dados numéricos , Estudos de Viabilidade , Humanos , Injeções Intra-Articulares/métodos , Traumatismos do Joelho/epidemiologia , Prevalência
7.
Eur J Rheumatol ; 3(2): 50-55, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27708971

RESUMO

OBJECTIVE: Vitamin D has pleiotropic effects including immunomodulatory, cardioprotective, and antifibrotic properties and is thus able to modulate the three main links in scleroderma pathogenesis. The aim of the study was to evaluate the level of vitamin D in patients with systemic sclerosis and to analyze the associations between the concentration of vitamin D and the features of systemic sclerosis. MATERIAL AND METHODS: Fifty-one consecutive patients were evaluated for visceral involvement, immunological profile, activity, severity scores, and quality of life. The vitamin D status was evaluated by measuring the 25hydroxy-hydroxyvitamin D serum levels. RESULTS: The mean vitamin D level was 17.06±9.13 ng/dL. Only 9.8% of the patients had optimal vitamin D levels; 66.66% of them had insufficient 25(OH)D levels, while 23.52% had deficient levels. No correlation was found between vitamin D concentration and age, sex, autoantibody profile, extent of skin involvement, or vitamin D supplementation. Vitamin D levels were correlated with the diffusing capacity of the lung for carbon monoxide (p=0.019, r=0.353), diastolic dysfunction (p=0.033, r=-0.318), digital contractures (p=0.036, r=-0.298), and muscle weakness (p=0.015, r=-0.377) and had a trend for negative correlation with pulmonary hypertension (p=0.053, r=-0.29). CONCLUSION: Low levels of vitamin D are very common in systemic sclerosis. Poor vitamin status seems to be related with a more aggressive disease with multivisceral and severe organ involvement, especially pulmonary and cardiac involvement.

8.
Med Ultrason ; 18(3): 370-7, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27622415

RESUMO

In the last years, important advancements have been made in implementing high resolution imaging related information inside the global management algorithm in RA patients. Musculoskeletal ultrasound has already proven its utility in visualizing directly the joint synovial tissue, the synovial vascularization and in monitoring the response to therapy. Recently, much attention has been given to the presence of tenosynovitis, as a constant, complementary but different facet of the inflammatory involvement in RA. Tenosynovitis identification in early RA stages may allow adequate treatment adjustment in early and established disease in order to prevent and/ or slow down the development of structural damage at tendon and joint level.


Assuntos
Artrite Reumatoide/complicações , Tenossinovite/complicações , Tenossinovite/diagnóstico por imagem , Ultrassonografia/métodos , Humanos , Índice de Gravidade de Doença , Tendinopatia/complicações , Tendinopatia/diagnóstico por imagem , Tendões/diagnóstico por imagem
9.
Maedica (Buchar) ; 11(1): 26-31, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28465747

RESUMO

OBJECTIVE: To identify the particularities of the clinical phenotype of endothelial dysfunction in a lot of Romanian patients from a reference center and compare it to data reported by international registries. MATERIAL AND METHODS: 51 patients were included in a cross-sectional study. The patients were evaluated for the pattern of disease, main visceral involvement, serum markers of disease. RESULTS: 41.2% patients had history of digital ulcers, 27.45% had pulmonary arterial hypertension; cardiovascular involvement also included: diastolic dysfunction in 31.1% of the patients, global systolic dysfunction in 9.8%, rhythm and conduction disturbances in 19.6%, peripheral vascular disease in 19.6%. Scleroderma renal crisis was identified in 2 patients. CONCLUSION: Vascular complications are a major cause of morbidity and mortality in systemic sclerosis. Earlier therapeutic intervention demands improved screening and diagnosis in all cases.

11.
Med Ultrason ; 17(3): 352-60, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26343085

RESUMO

AIMS: To investigate by ultrasonography (US) in a cohort of active RA patients starting biologic therapy the responsiveness of tenosynovitis of wrist and hands compared to the responsiveness of synovitis in a 6 month period follow-up, to compare the responsiveness of finger flexor tenosynovitis with the responsiveness of wrist extensor tenosynovitis and to describe the subclinical synovitis and tenosynovitis in RA patients in clinical remission. MATERIAL AND METHODS: Fifty seven patients with active RA starting biologic therapy were included. Clinical, laboratory, and US evaluations were performed at baseline, 1, and 6 months. US evaluation included wrist and MCPs 2-5 joints, bilaterally for synovitis and extensor tendons compartments 2, 4, and 6 and finger flexors 2-5 for tenosynovitis. Eighteen US scores based on semiquantitative or binary grades were calculated at each visit. Responsiveness of synovitis and tenosynovitis scores was calculated using the standardized response mean (SRM). RESULTS: The responsiveness of US tenosynovitis was lower comparing with the responsiveness of US synovitis but both showed large effect of therapy. Furthermore, tenosynovitis responsiveness was similar to CRP responsiveness (SRM -0.90). Finger flexors tenosynovitis showed a higher responsiveness than extensor tenosynovitis on GS (-0.94 compared to -0.63) and a lower SRM on PD (-0.56 compared to -0.85). Tenosynovitis scores remission was overlapping clinical remission according to CDAI and SDAI in 100% of cases. Overall there was less subclinical tenosynovitis than subclinical synovitis at final visit according to clinical activity indices. CONCLUSION: Tenosynovitis US scoring in RA may be as good as synovitis scoring for characterization of disease activity and responsiveness.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Terapia Biológica , Tenossinovite/diagnóstico por imagem , Tenossinovite/tratamento farmacológico , Adulto , Idoso , Feminino , Mãos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Romênia , Índice de Gravidade de Doença , Sinovite/diagnóstico por imagem , Sinovite/tratamento farmacológico , Resultado do Tratamento , Ultrassonografia Doppler
12.
Ann Rheum Dis ; 74(6): 1145-9, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25416720

RESUMO

OBJECTIVE: The eumusc.net project is an initiative founded by the European Community and the European League Against Rheumatism. One aim of the project was to facilitate equal standards for musculoskeletal health across Europe. The aim of this work-package was to develop patient-centred and consensus based standards of care (SOC) for osteoarthritis (OA), which should be available in a professional and a patient version. METHODS: A systematic review concerning guidelines dealing with OA was conducted. Furthermore, experts in musculoskeletal diseases were contacted to ensure that 'grey' literature was not excluded. Documents that fulfilled predefined inclusion/exclusion criteria were included and all interventions for OA were extracted and categorised. Based on this list of interventions, a three round Delphi exercise with an international and multidisciplinary expert panel, including patient research partners, was performed to achieve expert consensus. RESULTS: Six documents were included and used for further analysis. Out of them, 46 interventions have been extracted and 10 consensus based SOC were formulated. In addition, a patient version, written in a lay-understandable wording and in the format of checklist questions was developed. An example is SOC 5: "People with OA should achieve optimal pain control using pharmacological and non-pharmacological means." The matching patient-centred checklist question reads: "Do I know how to control pain associated with OA?" CONCLUSIONS: The SOC for OA will be available in the 23 languages of the European Union to enhance unified information to patients and professionals and to further harmonise the treatment/care of OA within Europe.


Assuntos
Osteoartrite/terapia , Manejo da Dor/métodos , Assistência Centrada no Paciente/normas , Padrão de Cuidado/normas , Técnica Delfos , Europa (Continente) , Medicina Baseada em Evidências , Humanos
13.
Maedica (Buchar) ; 10(2): 91-96, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28275397

RESUMO

INTRODUCTION: Leukotriene C4 synthase (LTC4S) gene -444A/C polymorphism has been implicated in susceptibility to asthma, but a large number of studies have reported inconclusive results. The aim of this study was to investigate the association between the -444A/C polymorphism of LTC4S gene and asthma, asthma phenotypes (aspirin intolerant/tolerant asthma) and different characteristics of the patients. MATERIAL AND METHODS: We included 106 patients with asthma (60 with aspirin tolerant asthma - ATA, 46 with aspirin intolerant asthma - AIA) and 103 controls. All the subjects were genotyped for LTC4S-444 A/C by Real-Time PCR. We assessed the association of LTC4S promoter polymorphism with asthma and its phenotypes and with clinical and biological characteristics of asthmatic patients. RESULTS: We did not find a significant association between the studied polymorphism and asthma, but the minor allele tended to be more frequent in AIA patients. We found a significant association between the minor allele C and lower levels of serum total immunoglobulin E and eosinophils, suggesting a possible role of -444A/C LTC4S polymorphism as modulating factor of allergic inflammation in asthma. CONCLUSION: The results show that LTC4S -444A/C SNP is not associated with susceptibility to asthma in Romanian patients, but could influence asthma phenotype, namely aspirin intolerant asthma.

14.
Maedica (Buchar) ; 10(4): 336-341, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28465735

RESUMO

OBJECTIVES: to identify the particularities of the clinical phenotype of endothelial dysfunction in a lot of Romanian patients from a reference center and compare it to data reported by international registries. MATERIALS AND METHODS: 51 patients were included in a cross sectional study. The patients were evaluated for the pattern of disease, main visceral involvement, serum markers of disease. RESULTS: 41.2% patients had history of digital ulcers, 27.45% had pulmonary arterial hypertension; cardiovascular involvement also included: diastolic dysfunction in 31.1% of the patients, global systolic dysfunction in 9.8%, rhythm and conduction disturbances in 19.6%, peripheral vascular disease in 19.6%. Scleroderma renal crisis was identified in 2 patients. CONCLUSION: Vascular complications are a major cause of morbidity and mortality in systemic sclerosis. Earlier therapeutic intervention demands improved screening and diagnosis in all cases.

15.
Autoimmunity ; 44(5): 427-36, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21244334

RESUMO

It was suggested that the immune system plays an important role at least in the amplification of the main elements in systemic sclerosis (SSc), an autoimmune disease with an incompletely elucidated pathogenesis. Elucidation of the mechanisms involved in the interaction between T and B cells, major players of the immune system, could contribute to a better understanding of some of clinical and pathological manifestations of SSc. Recently, abnormalities in Semaphorin 4D (Sema4D/CD100) or CD72, two contrareceptors involved in T and B cells cooperation, were associated with autoimmunity. Therefore, we investigated CD100 and CD72 expression level on T and B cells in attempting to establish their role in SSc pathogenesis. The results revealed augmented percentages of CD100(high) T and B cells, significantly increased expression of CD100 on CD4(+) T cells and frequently detectable levels of soluble CD100 in SSc patient sera compared to healthy donors. In SSc, CD100 dysregulations were associated with anti-Scl70 antibodies production, disease type, thickening of skin, disease duration, or with active inflammation processes. In consequence, dysregulations in CD100 expression and release could play a role in SSc development and/or maintenance.


Assuntos
Antígenos CD/imunologia , Antígenos CD/metabolismo , Linfócitos/imunologia , Linfócitos/metabolismo , Escleroderma Sistêmico/imunologia , Escleroderma Sistêmico/fisiopatologia , Semaforinas/imunologia , Semaforinas/metabolismo , Adulto , Antígenos CD/sangue , Antígenos CD/genética , Linfócitos B/imunologia , Linfócitos B/metabolismo , Relação CD4-CD8 , Feminino , Regulação da Expressão Gênica/imunologia , Humanos , Imunofenotipagem , Pessoa de Meia-Idade , Escleroderma Sistêmico/sangue , Escleroderma Sistêmico/genética , Semaforinas/sangue , Semaforinas/genética
16.
J Med Life ; 2(1): 36-41, 2009 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20108489

RESUMO

BACKGROUND: Immunological abnormalities in rheumatoid arthritis (RA) imply several antibodies, among which anti-cyclic cytrullinated peptide antibodies (anti-CCP) have the highest sensitivity and specificity. Their diagnostic and prognostic value in RA is well known, although their value as markers of the disease activity has not been established yet. OBJECTIVES: The aim of this study is to evaluate the correlation between anti-CCP antibodies and RA activity which eventually leads to the best treatment of choice. PATIENTS AND METHODS: 217 consecutive patients hospitalized in the Department of Internal Medicine and Rheumatology, "Sf Maria" Clinical Hospital between 01.01-31.06 2007 were retrospectively studied. They were divided into two groups: group A-111 patients with RA (ACR criteria fulfilled) and group B-106 patients with other rheumatic diseases. The following parameters taken out of the patients files were studied: parameters of the clinical activity of disease (C reactive protein, fibrinogen), rheumatoid factor (RF) and anti-CCP antibodies. Disease activity score (DAS) using 4 variables (number of tender joints, number of swollen joints, erythrocyte sedimentation rate and assessement of the disease activity) was also studied. Data were processed with SPSS program using linear functions, Pearson correlation coefficient and Hi2 test of interdependency. RESULTS: The sensitivity of anti-CCP antibodies in patients with RA was 56.75%. The specificity of anti-CCP antibodies in patients with RA was 90.56%. Low seric levels of anti-CCP antibodies were also found in patients without RA, but with other conditions like: osteoarthritis, viral polyarthritis, infectious myositis and Still disease; moderate to high seric levels were found in patients with psoriatic arthritis. Significant correlations were found between anti-CCP antibodies and DAS (r = 0.437), between anti-CCP and fibrinogen (r = 0.32) between anti-CCP antibodies and C reactive protein (r = 0.237) as well as between anti-CCP and RF (r = 0.38). CONCLUSIONS: Anti-CCP antibodies are highly specific but moderately sensitive for RA, their highest frequencies and seric levels being found in seropositive RA. Anti-CCP can be used in patients with RA not only as a diagnostic marker but also as a reliable test for assessing the activity of the disease.


Assuntos
Artrite Reumatoide/imunologia , Autoanticorpos/sangue , Peptídeos Cíclicos/imunologia , Adulto , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças Reumáticas/imunologia , Fator Reumatoide/sangue , Romênia
17.
Zhongguo Zhen Jiu ; 28(6): 459-62, 2008 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-18630549

RESUMO

OBJECTIVE: To compare the efficacy, safety and tolerability of different therapies in Caucasian patients with osteoarthritis (QA) of the knee. METHODS: Seventy-five cases (90 knee joints) of osteoarthritis were randomly divided into 3 groups, western medicine group, traditional Chinese medicine (TCM) group, integrated Chinese and western medicine group. The western medicine group were treated with oral administration of Glucosamine Sulfate, oral administration and external application of non-steroid anti-inflammatory agent, ultrasound physiotherapy, etc. The TCM group were treated with oral administration of J uanbi Decoction, acupuncture and moxibustion, cupping, massage of acupoint and ear acupuncture. The integrated Chinese and western medicine group were treated with oral administration of Glucosamine Sulfate, oral administration and external application of non-steroid anti-inflammatory agent, acupuncture and moxibustion, cupping, massage of acupoint and ear acupuncture. The intensity of knee joint pain on walking, resting and standing, the nocturnal pain, stiffness, the maximum walking distance and the daily living ability were monitored after 30 days, 60 days and 90 days of treatment. RESULTS: After 90 days of treatment, the integrated Chinese and western medicine group was better than other two groups in improvement of percentages in self pain assessment with visual analog scale (VAS), pain and stiffness measured by WOMAC scale, pain and maximum walking distance measured by Lequesne scale (P < 0.05 or P < 0.01). There were no significant differences in the therapeutic effects between the TCM group and the western medicine group. All of these three treatments were well tolerated, and no severe adverse events were found. CONCLUSION: Combined TCM and western medicine treatment has rapid and definite therapeutic effect in reducing pain and improving mobility of knee joints and daily living ability in Caucasian patients of knee osteoarthritis.


Assuntos
Medicina Tradicional do Leste Asiático , Osteoartrite do Joelho/terapia , Terapia por Acupuntura , Grupo com Ancestrais do Continente Europeu , Humanos , Medição da Dor
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