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Query: UMLS:C0684275 (haemophilia)
 10,958 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present review examines the literature regarding the efficacy of cognitive-behavioral and other self-control interventions in helping arthritis patients reduce their pain and functional disabilities. The evidence indicates that self-control interventions have produced significant and positive changes in the pain and functional disabilities of patients with rheumatoid arthritis and arthritis secondary to hemophilia. However, the literature suffers from deficiencies with regard to the use of small subject samples; inadequate control procedures and follow-up assessments; failure to demonstrate that positive outcomes are related to changes in subjects' covert experiences or control of physiological variables; and reliance upon self-report measures of outcome. The review is followed by a description of a multidisciplinary study of the efficacy of a biofeedback-assisted, cognitive-behavioral group therapy program for rheumatoid arthritis patients that features several methodological improvements relative to previous investigations. The preliminary outcome data show that the cognitive-behavioral intervention is associated with reductions in pain behavior and self-reports of pain and disability. It is concluded that, although the self-control interventions have shown promising results, psychologists must demonstrate positive and reliable outcomes among large numbers of arthritis patients over extended periods of time if the interventions are to be viewed as credible by rheumatologists.
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PMID:Psychological approaches to the management of arthritis pain. 653 14

Continuous passive slow motion (CPSM) was used to aid postoperative rehabilitation in seven difficult pediatric knee and elbow problems. Four patients had joint erosion secondary to hemophilic arthropathy and three patients had joint irregularities associated with long-standing limitation of joint movement. CPSM was started soon after surgery at the slow speed of 1 revolution every 12.5 min. The early, slow mobilization did not cause pain and established an arc of joint motion before intraarticular adhesions became a problem. Compared with a similar group not using CPSM, our hemophilia patients did not require postoperative manipulation, had decreased hospitalization time, and gained a greater range of motion. The group with long-standing limited joint mobility exhibited maintenance and in most cases improved motion after surgery. Thus CPSM after surgery enhances the rehabilitation process of difficult pediatric knee and elbow problems.
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PMID:Use of continuous passive slow motion in the postoperative rehabilitation of difficult pediatric knee and elbow problems. 663 Apr 83

The abdominal hemophilic pseudotumor is a rare but frequently disabling and life-threatening complication in patients with severe hemophilia. Our patients were observed for a considerable period of time to document progressive enlargement of the pseudotumor and increasing disability from severe pain, nerve compression, or leg swelling. The decision to operate was made on the basis of incapacitating symptomatology or fear of impending rupture. Although the complications resulting from operation may be major, with the current availability of large amounts of factor VIII and activated prothrombin complex concentrate, excision of this lesion can be performed without concern for the hazard of uncontrollable hemorrhage. Late recurrence of the pseudotumor may necessitate further operative management.
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PMID:Management of abdominal hemophilic pseudotumor. 679 32

Spontaneous splenic rupture in hemophilia A is an uncommon occurrence which is difficult to diagnose. We have reported a case of hemophilic rupture of the spleen unaccompanied by thrombocytosis, which has been emphasized as a diagnostic clue to hemophilic splenic rupture. Hence, splenic rupture should still be considered in any hemophilic patient with pain in the left upper quadrant and a normal platelet count. Splenic rupture in hemophilia must be recognized because its treatment requires not only clotting factor infusion but also surgical intervention.
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PMID:Hemophilic splenic rupture without thrombocytosis. 682 13

The results of total knee replacement in five patients aged between 22 and 37 with severe haemophilia A or B are described. All patients had been managed conservatively without success. Frequent bleeds, severe pain and limitation of movement were the indications for operation. Despite close haematological surveillance, bleeding problems occurred in three of the patients and large quantities of plasma concentrates were required. Review of the patients over a period of 25 to 48 months after operation showed dramatic lessening of pain and maintenance of a satisfactory range of movement. The frequency of haemarthrosis diminished markedly and the requirements for factor concentrate in the years after operation fell substantially. Two patients returned to employment. Total knee replacement led to marked clinical improvement in all the patients, but the long-term results are not yet known.
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PMID:Total knee arthroplasty in haemophilic arthritis. 682 22

Six patients with severe haemophilic arthropathy of the elbow have been treated by limited excision arthroplasty using a sheet of silicone rubber as an interposition membrane. There were no complications. The symptoms and signs before and after operation have been assessed using the grading system advocated recently by the World Federation of Haemophilia. In all cases there was relief of pain and increased movement. Moreover, the subsequent incidence of spontaneous haemorrhage into the elbow has been reduced with considerable cost benefit.
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PMID:Interposition arthroplasty in the management of advanced haemophilic arthropathy of the elbow. 687 15

The use of 1 deamino-8-D-arginine vasopressin (DDVAP), is reported in seven patients with von Willebrand's disease and mild haemophilia undergoing elective surgery. There were no haemorrhagic complications, and both the quality of the clot formed and the rate of healing appeared entirely normal in all patients. No patient received blood products. Local burning pain due to paravenous leakage at the infusion site in a single patient, and transient facial flushing in another were the only side effects encountered. In addition to the anticipated rise in F.VIII:C and F.VIIIR:Ag, shortening of the bleeding time was observed in all five patients with von Willebrand's disease receiving DDAVP. Three additional patients who received intranasal DDAVP showed an inconsistent response in the laboratory parameters measured.
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PMID:Clinical experience with arginine vasopressin (DDAVP) in von Willebrand's disease and mild haemophilia. 697 Sep 7

The incidence of peptic ulceration and gastrointestinal blood loss in patients treated with benoxaprofen is low. Haemophiliac patients frequently suffer recurrent bleeding into their joints with resulting severe arthritis. Their choice of drugs for pain relief and with anti-inflammatory action is limited because of the risk of gastro-intestinal bleeding. Accordingly, four patients with haemophilia had 20 ml of their blood labelled with Chromium51 and 10 ml were reinjected. They were given placebo tablets orally for one week, with a carmine marker at tne end of the placebo period, followed by 300 mg of benoxaprofen daily for a further two weeks. Gastrointestinal blood loss was estimated by daily faecal collections measured for radiochromium. No significant gastrointestinal blood loss was noted in either the placebo or benoxaprofen periods of the trial. This drug can reasonably be regarded as safe to use in haemophiliac patient with arthritis.
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PMID:Gastric microbleeding studies in patients with haemophilia taking benoxaprofen. 697 79

Hemophilia represents a congenital hereditary disorder of blood coagulation characterized by recurrent unpredictable bleeding episodes affecting any body part, especially the joints and extremities. Repeated hemarthrosis eventually results in degenerative arthritis accompanied by severe chronic pain. As contrast to acute bleeding pain, which serves as a functional signal, chronic arthritic pain is a debilitating condition often resulting in analgesic abuse and/or addiction. Two adult hemophiliacs with severe chronic arthritis received training in progressive muscle relaxation exercise, meditative breathing, and imagery associated with past experiences of pain reduction. Imagery training resulted in clinically significant reductions in arthritic pain perception for both patients, maintained over an 8-month follow-up period. Concomitant Measures also demonstrated significant therapeutic gains. Thermal biofeedback assessment of the arthritic joint provided a biophysiological measure of learned temperature control through the imagery techniques. The findings are discussed in relationship to medical observations on the therapeutic value of warming and heat application in the management of arthritic joints, as well as other potential mechanisms which might have contributed in the reduction of arthritic pain perception. Finally, the importance of differentiating between acute bleeding pain management and chronic arthritic pain is emphasized, as well as the necessity of the application of the techniques within an interdisciplinary team setting.
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PMID:Behavioral medicine in hemophilia arthritic pain management: two case studies. 701 64

Haemophilia is characterized by recurrent internal bleeding episodes, with repeated haemorrhages into the joint areas eventually resulting in a chronic condition similar to osteoarthritis. A 31-year-old haemophiliac, with a nine-year history of narcotic analgesic dependence secondary to chronic arthritis pain, learned self-regulation techniques consisting of progressive muscle relaxation exercises, meditative breathing, and guided imagery. Long-term follow-up evidenced clinically significant decreases in arthritic pain intensity and analgesic intake subsequent to self-regulation training.
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PMID:Self-regulation of chronic arthritic pain and long-term analgesic dependence in a haemophiliac. 710 Jul 73


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