Comparison of efficacy and safety of complementary and alternative therapies for scapulohumeral periarthritis: A protocol for Bayesian network meta-analysis.

BACKGROUND: Scapulohumeral periarthritis is a disease with high incidence and great pain. The current western treatments with many side effects, poor efficacy cannot fundamentally solve the problem. Complementary and alternative therapies have played an excellent role in the treatment of scapulohumeral periarthritis. However, it is not clear which complementary and alternative therapy is more effective. Therefore, we propose a protocol to compare the efficacy and safety of various complementary and alternative therapies through network meta-analysis (NMA) to provide choice guidance for the therapy. METHODS: A comprehensive search will be conducted for randomized controlled trials of complementary and alternative therapy for scapulohumeral periarthritis as well as ongoing trials. The time limit is from the establishment of the database until January 2021. Literature and data extraction were completed independently by two researchers. Through pairwise comparison and meta-analysis of Bayesian NMA, all the evidences are evaluated comprehensively. STATA16.0 and WinBUGS1.4.3 software will be used for data processing and analysis, and recommendation evaluation will be used to develop and assess grades to classify the quality of NMA evidence. RESULTS: Through the analysis, we will obtain the ranking of the efficacy and safety of different complementary and alternative therapies in the treatment of scapulohumeral periarthritis, in order to provide reference for clinical selection of treatment methods. CONCLUSION: Complementary and alternative therapies of scapulohumeral periarthritis plays a positive role in improving the symptoms of scapulohumeral periarthritis. This study can provide evidence support for clinicians and patients.International Platform of Registered Systematic Review and Meta-Analysis Protocols registration number: INPLASY202140044.

[Periarthritis of the shoulder joint: variants of the course and treatment with artrofoon].

AIM: To compare efficacy of shoulder joint periarthritis (SJP) treatment with artrofoon vs non-steroid anti-inflammatory drugs (NSAID). MATERIAL AND METHODS: SJP patients of the study group (12 males, 18 females, mean age 59.4 +/- 8.9 years, the disease duration 6.5 +/- 3.8 years) received artrofoon (1 tablet 8 times a day for 3 months, in improvement of the condition the dose was reduced to 4 tablets a day). Patients of the control group (11 males, 19 females, mean age 58.3 +/- 9.6 years, the disease duration 5.1 +/- 4.1 years) were given NSAID (primarily diclofenac in a dose 100 mg/day with subsequent dose reduction in improvement). All the patients were examined on the day of the treatment start, 2 weeks, 1 and 3 months later. The examination protocol included general examination, measurement of blood pressure, body mass, height, pain at rest and exercise, motility of the shoulder joint, subjective and objective efficacy and tolerance of the drugs. Total blood count, biochemical blood analysis, urine test, ECG, x-ray, ultrasound investigation of the joint were performed before and after therapy. RESULTS: The majority of the patients from both groups experienced nocturnal pain relief, artrofoon relived also pain at the joint movement. Significant objective and subjective responses were registered in 15 and 14, partial response--in 10 and 12 patients of the study group, respectively, no response--in 5 and 4 patients, respectively. In the controls, the above degree of the response was in 9 and 12, 18 and 16, 3 and 2 patients, respectively. Negative effects of the treatments were not seen. CONCLUSION: SJP treatment with artrofoon is effective. It relieves pain, improves motility of the joint, normalizes mental and somatic status of the patients.

Pseudotumoral articular amyloidosis.

We present a 71-year-old man with primary amyloidosis characterized by several outstanding clinical features, namely hip involvement of a pseudotumoral appearance, periarticular osteolytic lesions and a pathological fracture. Kappa light chains in the synovial fluid were observed. The patient survived for 90 months without developing plasma cell dyscrasia, and with preservation of vital functions despite parenchymal involvement of multiple organs.

HLA antigens in diabetics with calcified shoulder periarthritis (CSP).

The distribution frequencies of HLA-A and B antigens was determined in 94 maturity onset diabetics (40 with CSP and 54 without CSP), as well as in 400 unrelated age- and sex-matched Greek controls. The standard NIH technique was used for tissue typing. There was an increased prevalence of the antigen B27 only in diabetics with CSP (35%) when compared either to the controls (6.8%) or to diabetics without CSP (9.2%). The calculated p-corrected values were Pc = 0.00027 and Pc greater than 0.005 respectively. These findings indicate that the MHC in man may control the genetic susceptibility of a subgroup of insulin-independent diabetics to develop CSP.

Hydroxyapatite rheumatism and HLA markers.

HLA typing of 38 patients suffering from calcific periarthritis (hydroxyapatite rheumatism) showed an increased prevalence of HLA A2 (66 per cent) and HLA BW35 (34 per cent) vs 44 per cent and 19 per cent in 591 controls (p less than 0.01 and p less than 0.03 respectively). These preliminary results suggest a possible association between factors controlling susceptibility to the disease and some HLA markers. Larger series of patients and family studies are required to confirm this hypothesis.

[Analgesic and anti-inflammatory effects of balance acupuncture on experimental scapulohumeral periarthritis in rabbits].

OBJECTIVE: To investigate therapeutic effects of balance acupuncture on scapulohumeral periarthritis (SP)and the mechanisms. METHODS: Thirty male New Zealand rabbits were randomly divided into a blank group (group B), a model group (group M) and a balance acupuncture group (group BA) with 10 rabbits in each group. SP model was established by using persistent mechanical strain and ice compress. Balance acupuncture at "Jiantong" point was applied in the animals in group BA, but not in the rabbits of the other two groups. Joint movement and pathological changes in tissues around the affected shoulder joint were observed, and interleukin-1beta (IL-1beta), 5-hydroxytryptamine (5-HT) in plasma and the affected surrounding tissues, and DNA contents in tendon of supraspinatus muscle were measured. RESULTS: The content of plasma 5-HT in group BA [(18.16 +/- 4.44) ng/mL] was significantly lower than that in group M [(23.28 +/- 5.89) ng/mL] (P < 0.05), but without obvious difference in IL-1beta content between the two groups (P > 0.05). Compared with group M, the contents of IL-1beta, 5-HT in affected surrounding tissues, and DNA expression in tendon of supraspinatus muscle were significantly lowered to va rious extent in group BA (P < 0.01, P < 0.05). CONCLUSION: Balance acupuncture can effectively improve local and systemic pathological situation induced by SP by way of reducing pain-producing factors, inflammatory factors and DNA expression to alleviate local organization and adhesions in rabbits with experimental SP.

[Lack of correlation between frozen shoulder and HLA-B27 (author's transl)]. / Absence d'association entre HLA-B27 et la rétraction capsulaire de l'épaule.

HLA-B27 antigen is strongly correlated with ankylosing spondylitis and several other rheumatic diseases. However, data concerning frozen shoulder are contradictory. Bulgen reported an increased frequency of HLA-B27 which was not observed by Noy. We performed HLA typing of 46 French patients with frozen shoulder. We agree with Noy: frozen shoulder is not correlated with HLA-B27.

Palindromic rheumatism. Clinical and serum complement study.

A review of 39 patients diagnosed as suffering from palindromic rheumatism showed that 17 cases had evolved into typical rheumatoid arthritis (RA), while 22 had remained palindromic. The pattern of palindromic attacks in the two groups gave no grounds for regarding palindromic rheumatism as a separate condition from RA with palindromic onset. At the first attendance minor clinical or radiological changes, raised erythrocyte sedimentation rate, and positive serology were more common along those patients who were about to develop the picture of RA. Rheumatoid disease developing in patients with a palindromic onset was at least as severe as that among other patients with RA. 5 patients gave a history suggestive of fluid retention during the palindromic episodes, suggesting that attacks might be related to circulating immune complexes and altered vascular permeability. However, samples of blood obtained from 6 patients both during and between attacks showed no reduction in any of a variety of complement components tested.

HLA-B27 and frozen shoulder.

Histocompatibility antigens were determined in 38 patients with frozen shoulder and 216 normal blood-donors. HLA-B27 was significantly more common in patients with frozen shoulder (42%) than in the controls (10%). The distribution of the other 19 histocompatibility antigens was similar in the patient and control groups. This result may be associated with the suggested immunological pathogenesis of the condition.

6-Sulfanilamidoindazole arthritis of the rat: complement activity and sulfhydryl group concentration of the serum in three different phases of inflammation.

In 6-sulfanilamidoindazole (6-SAI) arthritis the total haemolytic complement activity of the serum was significantly increased by 69% in developing arthritis at day 4, and by 42% in fully developed arthritis at day 8. In declining arthritis at day 12, 5 days after the last administration of the prophlogistic agent 6-SAI, no difference of the serum complement activity between arthritic rats and non-arthritic controls could be determined. The serum SH group concentration was significantly decreased by 31% at day 4 and by 54% at day 8, but it was nearly normalized at day 12. There was no close correlation between increase of paw diameter and serum complement activity in 6-SAI-arthritic rats. It is suggested that investigations on the role that complement components might play in 6-SAI arthritis could be interest.