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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Late synovectomy of the knee joint in rheumatoid arthritis is considered by many authors as a positive influencing factor with regard to the local development of the disease at that particular site. Since this assumption is based on evaluation criteria which are by no means uniform, it has so far not been possible to compare the individual results achieved by different authors. For this reason, we conducted follow-up examinations of 57 knee joints in 44 patients with rheumatoid arthritis in whom the synovectomy had occurred at least five years ago, using the standardised follow-up scheme devised by Gschwent et al. Most of these cases represented a late synovectomy, as was evident from the duration of the disease and from Steinbrocker's stages. An analysis of the results showed that in our patients, pain and swelling were most impressively improved, in accordance with the reports made by other authors. Less impressive was the improvement of mobility following synovectomy. Despite increasing instability, it was usually possible to improve the ability of the patients to walk, especially in cases where this ability had been severely restricted. X-ray films showed in almost one-half of the cases that the objective finding had deteriorated, whereas in the other half of the patients the status was largely unchanged or even improved. We can sum up these results by stating that, taking into consideration the comparable results published in the literature regarding late synovectomy of the knee joint in rheumatoid arthritis, a positive influence exercised by late synovectomy on the local pathology can be assumed.
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PMID:[Long-term results following synovectomy of the knee joint in rheumatoid arthritis (author's transl)]. 42 22

Ibuprofen (ibu) is a racemic 2-arylpropionic acid non-steroidal anti-inflammatory drug whose activity is due mainly to the S-enantiomer. So far only the racemic compound is in clinical use. A double-blind randomized trial was carried out for a 2-week period in 50 patients with classical rheumatoid arthritis (RA) (Steinbrocker II-III) to compare the effectiveness and tolerance of S-ibu (400 mg T.I.D.) with that of the racemic compound (600 mg T.I.D.). Ritchie-index, limitation of movement, joint pain on pressure and pain at night decreased significantly in both groups. Due to lack of effectiveness, the dose had to be increased in 3 patients from the S-ibu group as well as in 6 patients from the racemic group resulting in mean daily doses of 1220 mg S-ibuprofen and 1870 mg racemic ibu. No statistically significant difference could be found between both groups concerning efficacy and unwanted effects. Therefore, S-ibu given alone may be advantageous because the metabolic load to the human body is reduced and patients are more likely to comply with drug doses of 1.2 g/day as compared to 1.8 g/day.
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PMID:S-ibuprofen versus ibuprofen-racemate. A randomized double-blind study in patients with rheumatoid arthritis. 178 88

256 individuals with inflammatory rheumatic diseases and 117 individuals of two control groups returned their questionnaires in a survey of subjective symptoms of the masticatory system. Subjective symptoms of the temporomandibular joint (tmj) were reported by 41% of the patients with rheumatoid arthritis, 29% of the patients with psoriatic arthritis, 20% of the patients with ankylosing spondylitis and 23% of the patients with other rheumatic diseases (such as Reiter's syndrome). Statistically significant differences (p less than 0.05) regarding the occurrence of "difficulties in opening the mouth wide" and "crepitus from the tmj" were found between the various types of rheumatic arthritis. In 40 patients with rheumatic diseases and tmj-symptoms the tmj was examined clinically, by orthopantomography and lateral tomography. Radiographic abnormalities were found in 68% of the patients and classified by a new radiographic index, according to the index of Steinbrocker. There were no indications for a relationship between a loss of posterior support and extensive radiographic changes of the tmj. The most common objective symptoms were pain on chewing, crepitus in the tmj and tenderness to palpation of the masticatory muscles and neck.
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PMID:[Clinical study on rheumatoid arthritis of the TMJ]. 226 60

A total locomotion score suited for clinical evaluation of patients with rheumatoid arthritis was developed and fulfilled the 1980 criteria of WHO. The grading system distinguished a subjective score for pain and ability from an objective score for physical signs, and it assessed the upper and lower extremities separately. The total locomotion score consisted of the total subjective and total objective scores combined. The three total assessments each showed a linear relationship to Steinbrocker's four functional classes when tested in 106 rheumatoid patients with ARA criteria 5-8. The interobserver reliability was good. The multifactorial assessment data were monitored by a computer.
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PMID:Locomotion score in rheumatoid arthritis. 275 Apr 99

Seventy-five patients with Steinbrocker stage III et IV rheumatoid wrists underwent arthroplasty with Swanson implant. Sixty-two implants were reviewed at 5 years postoperatively. Functional criteria, namely pain, mobility and grip proved satisfactory in 66% of cases. Radiological examination revealed 23% radial implant fractures, 50% dislocated or fractured ulnar implants and 29% foreign body synovitis. This high rate of complication is disappointing given the encouraging initial results, and leads us to reconsider the appropriateness of such surgery in severe cases of rheumatoid wrist.
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PMID:Arthroplasty of the rheumatoid wrist with Swanson implant. Long-term results and complications. 280 39

The authors studied a series of 25 rheumatoid wrists, stages II and III according to Steinbrocker or Larsen, treated between 1981 and 1983 by realignment-stabilization synovectomy. The mean follow-up period was 2 1/2 years. The different steps of the operation--articular and tenosynovectomy, tendon transfers associated with dorsal ligamentoplasty--have an additive effect in achieving relief of pain, with preservation of the pre-existing mobility and long-term stability in both the frontal and sagittal planes. In other studies, resection of the ulnar head results in a 40 p. cent increment in instability with notably aggravation of ulnar sliding. Preservation of the distal radioulnar articulation according to Sauve-Kapandji's operation constitutes a new approach to rheumatoid arthritis and, in our opinion, appears to be simple and is very efficient in stabilizing the wrist immediately, thus allowing early rehabilitation of these patients. Long-term stability is affirmed by clinical and roentgenologic follow-up.
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PMID:Realignment stabilization synovectomy in the rheumatoid wrist. A study of twenty-five cases. 409 7

In this pilot study carried out in two centres, six male and two female patients with severe active rheumatoid arthritis (RA) (average duration over 10 years) were treated with thymopentin 50 mg in the form of prolonged i.v. injection (over 10 min), 3 times weekly for 3 to 20 weeks. Two of these patients were subsequently treated with different s.c. doses of thymopentin in a crossover fashion for more than two years, including periods without any treatment or treatment with placebo. The overall clinical efficacy was judged by assessing pain patterns and joint status and the functional stage of the patients according to Steinbrocker; in addition, the sedimentation rate was measured before and after the therapy. Seven out of eight patients showed definite improvement in their clinical status as assessed by the Steinbrocker scale. Most of the symptoms, particularly pain, capsular swelling, tenderness and morning stiffness, were remarkably reduced within 3 weeks of thymopentin treatment. Sedimentation rate decreased in five out of eight patients. Prolonged i.v. injections seemed to have somewhat better effects than s.c. administration; in the latter group the highest dose (3 X 100 mg/week or higher) produced the best results. During placebo treatment and during the medication-free intervals both groups of patients got worse. No side-effects occurred during the study.
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PMID:First observations on high-dosed and long-term thymopentin treatment in active rheumatoid arthritis. 639 13

During a controlled open long-term study, Lonazolac-Ca, a new nonsteroidal antiphlogistic substance, has been tested in 35 patients with rheumatoid arthritis (stage I-III, according to Steinbrocker). The patients took 600 mg Lonazolac-Ca daily in three equal doses. The observation period was one year. Clinical and laboratory controls were carried out in monthly intervals. In more than 50% of the patients the tested parameters pain, swelling and active mobility improved significantly. Because of acute deterioration of the basic disease which necessitated the application of steroids, therapy with Lonazolac-Ca was discontinued in some cases. Lonazolac-Ca is well tolerated. But also as with other non-steroidal antiphlogistics, administration of the substance may be restricted in individual cases due to gastric symptoms. No adverse effect on blood count, liver and kidney function was seen.
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PMID:[Lonazolac-Ca-a non-steroidal antirheumatic agent. Long-term clinical study in chronic polyarthritis]. 702 81

Between 1970 and 1979, 123 synovectomies of the ankle joint were performed on 99 patients. Sixty two of these patients (81 ankles) were followed up for an average period of four years. Using Steinbrocker's classification 10 ankles had Stage I disease, 34 had Stage II, 33 had Stage III and 4 had Stage IV. In more than 80% of the joints pain and swelling significantly decreased after operation, with improvement in the range of motion and of the gait pattern. However the procedure did not change the walking distance or dependency upon walking aids, probably because the ankle joint was rarely the only joint of the lower extremity affected by rheumatoid arthritis.
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PMID:Synovectomy of the ankle joint. 715 44

The efficacy and safety of auranofin, an oral gold compound, were investigated for the treatment of patients with active early rheumatoid arthritis (RA). The 48 patients enrolled in the study had RA that satisfied the diagnostic standards set in 1987 by the American College of Rheumatology, was of less than 5 years' duration, and was of stage I or II and class 1 or 2 according to the Steinbrocker system. Auranofin 3 mg was administered orally twice daily for 12 months. All patients also received nonsteroidal anti-inflammatory drugs as a basic therapy. Some patients also received steroids, although the dose was limited to < 5 mg/d prednisolone equivalent. No other disease-modifying antirheumatic drug (DMARD) was administered. On the first day of the trial and after 3, 6, and 12 months of treatment, clinical symptoms, modified Lansbury index, C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, and the patients' assessments of severity of pain, judged using a visual analog scale, were evaluated. All of these measurements had improved significantly after 12 months of treatment. Moreover, no adverse events were observed during the treatment period. Therefore, the results confirm that auranofin is an effective and safe DMARD and is useful as a first-line therapy in the treatment of patients with RA.
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PMID:Efficacy and safety of auranofin in patients with active early rheumatoid arthritis. 775 62


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