11/315. Simultaneous bilateral painful ophthalmoplegia and exudative retinal detachment in rheumatoid arthritis.A 47-year-old woman who suffered from chronic rheumatoid arthritis presented with bilateral painful ophthalmoplegia with proptosis and exudativeretinal detachment. The painful ophthalmoplegia with proptosis might have been caused by pachymeningitis involving the cavernous sinus bilaterally, or bilateral posterior scleritis spreading to the extraocular muscles and tendons. The exudative retinal detachment might have been a result of bilateral posterior scleritis which had spread to the choroid. These two unusual complications of rheumatoid arthritis occurred simultaneously in this case. Both complications responded to corticosteroid treatment.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/315. Prayer and spirituality.Many patients with arthritis are strongly influenced by religious beliefs and often participate in religious healing activities such as prayer and worship attendance. Scientific studies demonstrate, and most patients confirm, that faith and involvement in religious healing activities can be helpful in preventing and treating illness, recovering from surgery, reducing pain, and improving quality of life. To improve the care of patients, clinicians should develop a patient-centered, spiritually sensitive form of medical practice in which religious issues are addressed gently and appropriately with dignity, respect, and integrity.- - - - - - - - - - ranking = 0.16666666666667keywords = pain (Clic here for more details about this article) |
13/315. Rheumatoid arthritis accompanied by colonic lesions.A 69-year-old woman with a 6-year history of rheumatoid arthritis treated solely with an orally administered NSAID had slowly progressing persistent mild abdominal pain and diarrhea, accompanied with marked sing of inflammation as well as hypoproteinemia due to protein-losing gastroenteropathy. Examinations of the large intestine revealed variously shaped ulcerative lesions, centered around the left hemicolon, as well as luminal narrowing. The course of the disease and the shape of the lesions strongly suggested involvement of rheumatoid vasculitis; oral administration of prednisolone was effective.- - - - - - - - - - ranking = 0.19754342467844keywords = pain, abdominal pain (Clic here for more details about this article) |
14/315. Esophageal varices in Felty's syndrome: A case report and review of the literature.A case of upper gastrointestinal tract hemorrhage secondary to esophageal varices in a patient with Felty's syndrome prompted a review of the pathogenesis and treatment of this condition. Six previously reported cases of this association were found. The clinical picture is that of long-standing rheumatoid arthritis with severe articular and extraarticular manifestations including splenomegaly, depression of the blood elements, mild liver function abnormalities, portal hypertension without cirrhosis or portal vein obstruction, an elevated splenic blood flow, and a reduction in portal hypertension by simple splenectomy. The presence of portal hypertension with varices may be another indication of splenectomy in patients with Felty's syndrome.- - - - - - - - - - ranking = 0.014919061024242keywords = upper (Clic here for more details about this article) |
15/315. Bifocal pubic stress fracture after ipsilateral total knee arthroplasty in rheumatoid arthritis. A case report.We present the case of a 78-year-old rheumatoid patient with a bifocal stress fracture of the pubic rami after ipsilateral total knee arthroplasty. Many risk factors that may cause insufficiency fractures are combined in rheumatoid arthritis. These patients are used to chronic pain, and therefore the diagnosis is often made late. When a patient suffering from rheumatoid arthritis presents with recent pain in the pelvic or hip region after hip or knee arthroplasty, a stress fracture should always be suspected. A standard pelvic radiograph and skeletal scintigraphy establish the diagnosis. CT-scan may be useful in the differential diagnosis with less benign pathology. rest and analgesic drugs are sufficient to let the fracture heal. Nonunion has never been reported for these fractures.- - - - - - - - - - ranking = 0.33333333333333keywords = pain (Clic here for more details about this article) |
16/315. Clinical quality management in rheumatoid arthritis: putting theory into practice. Swiss Clinical Quality Management in Rheumatoid arthritis.Clinical quality management (CQM) in rheumatoid arthritis (RA) aims to reduce inflammatory activity and pain in the short term, and damage, and consequently disability, in the long term. Within CQM as used in switzerland rheumatologists are provided with a measurement feedback system with which they can regularly follow their patients. Inflammatory activity is measured with the disease Activity Score (DAS28) and the Rheumatoid arthritis disease Activity Index questionnaire (RADAI), damage with an X-ray score and disability with the Stanford health Assessment Questionnaire (HAQ). feedback is used to optimize therapy, which in the short term allows the activity of the inflammatory process to be adjusted or 'titrated'. In the long term, the therapy result for the individual patient is monitored by the course of disability and damage. In this paper we present a series of cases to illustrate the usefulness of the CQM system in the management of individual RA patients. CQM in RA may be helpful when making decisions about adjustment of treatment, and to document and communicate these decisions based on quantitative data.- - - - - - - - - - ranking = 0.18208031459281keywords = pain, back (Clic here for more details about this article) |
17/315. Persistent pneumomediastinum in interstitial fibrosis associated with rheumatoid arthritis: treatment with high-concentration oxygen.We present a case of persistent spontaneous pneumomediastinum precipitated by an upper respiratory infection in a patient with interstitial fibrosis associated with rheumatoid arthritis who was receiving chronic corticosteroid treatment. The persistent nature of the mediastinal emphysema over 2 months eventually required treatment with high concentrations of inhaled oxygen that resulted in rapid resolution of the pneumomediastinum without recurrence over 6 months of follow-up. This case, along with others in the medical literature, emphasizes the need for early use of high-concentration inhaled oxygen in the treatment of pneumomediastinum in high-risk patients, such as those with connective tissue disorders.- - - - - - - - - - ranking = 0.014919061024242keywords = upper (Clic here for more details about this article) |
18/315. Results of a longer than 10-year follow-Up of patients with rheumatoid arthritis treated by occipitocervical fusion.STUDY DESIGN: Evaluation of results a longer than 10-year follow-up of patients with upper cervical lesions due to rheumatoid arthritis who underwent occipitocervical fusion. OBJECTIVE: To determine the final outcome of patients with upper cervical lesions due to rheumatoid arthritis treated by occipitocervical fusion. SUMMARY OF BACKGROUND DATA: There are few studies reporting the final outcome of patients with rheumatoid arthritis treated by occipitocervical fusion and observed for longer than 10 years. methods: The subjects were 16 patients with rheumatoid arthritis with myelopathy who underwent occipitocervical fusion with a rectangular rod more than 10 years ago. All 16 patients had irreducible atlantoaxial dislocation, and 11 also had vertical dislocation of the axis. All patients had preoperative nuchal pain, and were classified into Class II (two patients), Class IIIA (nine patients), and class IIIB (five patients) according to Ranawat's preoperative neurologic classification. RESULTS: The atlas-dens interval remained the same as immediately after surgery. Vertical dislocation returned to the preoperative condition, despite successful surgical correction. Preoperative occipital pain disappeared or was reduced in all cases. Myelopathy improved in 12 of the 16 patients (75%) by more than one class in the Ranawat preoperative neurologic classification. survival rate at 10 years after surgery was 38%; mean age at death was 70.7 years. The postoperative periods during which patients could walk by themselves ranged from 6 months to 13 years (mean, 7.5 years). CONCLUSIONS: Occipitocervical fusion for patients with rheumatoid arthritis is useful for decreasing nuchal pain, reducing myelopathy, and improving prognosis.- - - - - - - - - - ranking = 0.52983812204848keywords = pain, upper (Clic here for more details about this article) |
19/315. Case report. Primary cutaneous histoplasmosis in an immunosuppressed patient.A case of cutaneous histoplasmosis is reported in an 80-year-old man with rheumatoid arthritis who had been treated with steroid therapy for 15 years. The patient developed a large ulcerative lesion on the back of the left hand and on the distal third of the left dorsal forearm after a slight trauma. diagnosis was based on histological and mycological examination. Systemic involvement was not found. The lesions healed after 2 months of therapy with 100 mg day-1 fluconazole, confirmed at follow-up 1 year later.- - - - - - - - - - ranking = 0.0077068239630741keywords = back (Clic here for more details about this article) |
20/315. Thoracoscopic resection of the pulmonary aspergilloma: report of two cases.Pulmonary aspergillomas causing hemoptysis were successfully resected through videothoracoscopy in two cases. We removed an aspergilloma located in the right lower lobe of the lung in a 48-year-old woman with a bronchial cyst and rheumatoid arthritis. We also removed an aspergilloma located in the left upper lobe of the lung in a 59-year-old man with emphysematous bullae and diabetes mellitus. In both cases, the aspergillomas were removed by pulmonary wedge resection through scheduled thoracoscopy.- - - - - - - - - - ranking = 0.014919061024242keywords = upper (Clic here for more details about this article) |
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