Inflammatory arthritis and arthropathy

2021 ◽  
pp. 225-238
Author(s):  
Peter Chira ◽  
Laura E. Schanberg
Keyword(s):  
Inflammatory Arthritis ◽  
Holistic Approach ◽  
Routine Clinical Practice ◽  
Childhood Onset ◽  
Treatment Interventions ◽  
Childhood Arthritis ◽  
Rheumatologic Diseases ◽  
Pain Symptoms ◽  
New Treatments ◽  
Active Inflammation

Musculoskeletal pain from childhood-onset rheumatologic conditions such as juvenile idiopathic arthritis is variable in severity and impact. Advancements in understanding the mechanisms of inflammation causing arthritis and its associated pain have led to new treatments and guidelines for improved control of arthritis disease activity when implemented in a timely manner. In spite of these new treatments, pain often persists in childhood arthritis, even when little-to-no active inflammation is detected, highlighting the need to use a biopsychosocial model to address all factors contributing to pain symptoms. Using this holistic approach, we can better manage the pain of children with rheumatologic diseases in routine clinical practice, as well as in settings such as clinical trials and other treatment interventions.

Pediatric Stroke Caregiver Well-Being: A Holistic Wellness Perspective

2019 ◽  
Vol 63 (4) ◽  
pp. 245-255
Author(s):  
Daniel B. Kissinger ◽  
Kenda S. Grover ◽  
Ronna C. Turner
Keyword(s):  
Holistic Approach ◽  
Well Being ◽  
Evidence Based ◽  
Pediatric Stroke ◽  
Social Self ◽  
Holistic Wellness ◽  
Treatment Interventions ◽  
Five Factor Wellness Inventory ◽  
Current Sample ◽  
Creative Self

Evidence-based models are critical for understanding caregiver well-being and treatment interventions from a holistic perspective. This study introduces the Indivisible Self: An Evidence-Based Model of Wellness (IS-WEL) as a means for examining the holistic wellness of pediatric stroke caregivers. In this exploratory study, 161 participants completed a demographic survey and the Five-Factor Wellness Inventory (FF-WEL). Results indicate significant wellness score differences between the current sample of pediatric stroke caregivers and the FF-WEL norming sample on the higher order Total Wellness factor, the second-order wellness factors of Creative Self and Social Self, and the third-order wellness factors of thinking, emotions, control, positive humor, and love. These results support the veracity of the IS-WEL as an additional empirically sound holistic approach for understanding and addressing the well-being of stroke caregivers. The authors discuss practical clinical and research implications for utilizing the IS-WEL with pediatric stroke caregivers.

Aetiological risk factors for personality disorders

1999 ◽  
Vol 174 (6) ◽  
pp. 530-538 ◽  
Author(s):  
Jeremy Coid
Keyword(s):  
Risk Factors ◽  
Personality Disorders ◽  
Treatment Interventions ◽  
Early Environment ◽  
Axis Ii ◽  
Maximum Security ◽  
Case Files ◽  
Axis I ◽  
Dsm Iv ◽  
New Treatments

BackgroundElucidation of aetiological processes leading to development of Axis II disorders is important in category validation and could lead to new treatments.AimsTo establish aetiological associations between Axis II disorders and specific risk factors.MethodMale and female subjects (n=260) in maximum security hospitals and prisons were interviewed to determine DSM-III Axis II and lifetime Axis I diagnoses. Aetiological risk factors were obtained at interview and from case files. Independent statistical associations were established by logistic regression.ResultsAxis II categories were divided into four groups: (a) disorders of character development, secondary to an adverse early environment: antisocial, self-defeating and paranoid; (b) disorders of temperament, secondary to constitutional aetiology: avoidant, dependent, schizoid and schizotypal; (c) a ‘mixed’ disorder of constitutional and environmental aetiology: borderline; and (d) aetiological associations not established: narcissistic, histrionic, compulsive and passive-aggressive.ConclusionsThe study validates several Axis II categories but challenges the inclusion of others within Axis II of DSM-IV, in particular schizoid, schizotypal, avoidant and borderline personality disorders. The findings have implications for future treatment interventions.

Symptoms of Depression Predict the Trajectory of Pain Among Patients with Early Inflammatory Arthritis: A Path Analysis Approach to Assessing Change

2009 ◽  
Vol 36 (2) ◽  
pp. 231-239 ◽  
Author(s):  
ORIT SCHIEIR ◽  
BRETT D. THOMBS ◽  
MARIE HUDSON ◽  
SUZANNE TAILLEFER ◽  
RUSSELL STEELE ◽  
...  
Keyword(s):  
Disease Activity ◽  
Path Analysis ◽  
Inflammatory Arthritis ◽  
Depression Scale ◽  
Mcgill Pain Questionnaire ◽  
Symptoms Of Depression ◽  
Early Inflammatory Arthritis ◽  
Pain Symptoms ◽  
Longitudinal Relationships ◽  
Over Time

Objective.To assess the longitudinal relationships, including directionality, among chronic pain, symptoms of depression, and disease activity in patients with early inflammatory arthritis (EIA).Methods.One hundred eighty patients with EIA completed an examination, including swollen joint count, and were administered the Center for Epidemiological Studies Depression Scale (CES-D) and the McGill Pain Questionnaire (MPQ) at 2 timepoints 6 months apart. Cross-lagged panel path analysis was used to simultaneously assess concurrent and longitudinal relationships among pain, symptoms of depression, and number of swollen joints.Results.Pain, symptoms of depression, and number of swollen joints decreased over time (p < 0.001) and were prospectively linked to pain, symptoms of depression, and number of swollen joints, respectively, at 6 months. Symptoms of depression and pain were correlated with each other at baseline (0.47) and at 6-month followup assessments (0.28). Baseline symptoms of depression significantly predicted pain symptoms at 6 months (standardized regression coefficient = 0.28, p = 0.001), whereas pain and disease activity did not predict the course of any other variable after controlling for baseline values.Conclusion.Symptoms of depression predicted the trajectory of pain from baseline to 6 months. In addition, there were reciprocal/bidirectional associations between pain and symptoms of depression over time. More research is needed to better understand the relationship between pain and depressive symptoms and how to best manage patients with EIA who have high levels of both.

Cystic changes in the mammary gland structure in different age periods

2017 ◽  
pp. 37-43
Author(s):  
M.L. Travina ◽  
◽  
A.G. Popov ◽  
S.A. Popov ◽  
E.V. Kulikova ◽  
...  
Keyword(s):  
Breast Disease ◽  
Breast Ultrasound ◽  
Federal State ◽  
Treatment Interventions ◽  
Cystic Changes ◽  
Cystic Cavity ◽  
Pain Symptoms ◽  
Autonomous Institution ◽  
To Receive

The article is devoted to problems of diagnosis of cystic disease of breast at different ages including children and teens. Analyzed various options for classification of cystic changes. The main method of detecting liquid formation is breast ultrasound, then, as a final verification is possible after thorough laboratory studies education (cytological, biochemical and histological method). Therapeutic and diagnostic puncture cysts do not affect the continued operation of the glandular tissue and can be used at any age. Active sonirovanie cysts in children due to the high probability of occurrence of inflammation on the available background cystic cavity. In the adult diagnostic and treatment interventions have a diagnostic character and for reducing local pain symptoms associated with overexertion cysts. Analysis of the results carried out on the basis of examination and treatment of 22 381 patients aged 8 to 72 years, who applied to receive a specialized mammography department of the Federal State Autonomous Institution «National Health Research and Practical Center for Children» of the Ministry of Health of the Russian Federation for the period from 2008 to 2015. Key words: mammalogy, breast cysts, fibrocystic breast disease, breast ultrasound, puncture the cyst.

Predictors of disability in a childhood-onset systemic lupus erythematosus cohort: results from the CARRA Legacy Registry

Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 494-500 ◽  
Author(s):  
A O Hersh ◽  
S M Case ◽  
M B Son ◽  
Keyword(s):  
Logistic Regression ◽  
Lupus Erythematosus ◽  
Health Assessment ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Childhood Onset ◽  
Chi Square ◽  
Childhood Arthritis ◽  
Pain Scores ◽  
Mild Disability

Objective Few descriptions of physical disability in childhood-onset SLE (cSLE) exist. We sought to describe disability in a large North American cohort of patients with cSLE and identify predictors of disability. Methods Sociodemographic and clinical data were obtained from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry for patients with cSLE enrolled between May 2010 and October 2014. The Childhood Health Assessment Questionnaire (CHAQ) was used to assess disability and physical functioning. Chi-square tests were used for univariate analyses, and multivariate logistic regression was used to assess predictors of disability. Results We analyzed data for 939 patients with cSLE. The median and mean CHAQ scores were 0 and 0.25, respectively, and 41% of the cohort had at least mild disability. Arthritis and higher pain scores were significantly associated with disability as compared to those without disability ( p < 0.001). In multivariate logistic regression analysis, low annual income, arthritis, and higher pain scores were associated with disability at baseline. Conclusions Disability as measured by baseline CHAQ was fairly common in cSLE patients in the CARRA Legacy Registry, and was associated with low household income, arthritis, and higher pain scores. In addition to optimal disease control, ensuring psychosocial supports and addressing pain may reduce disability in cSLE. Further study is needed of disability in cSLE.

Ultrasound of the Rheumatologic Diseases

2019 ◽  
pp. 387-391
Author(s):  
Robert Lopez-Ben
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Arthritis ◽  
Calcium Pyrophosphate ◽  
Diagnostic Evaluation ◽  
Disease Course ◽  
Erosive Disease ◽  
Rheumatologic Diseases ◽  
Calcium Pyrophosphate Deposition Disease ◽  
The Us ◽  
Us Findings

Chapter 127 discusses US scanning for rheumatologic diseases. US is increasingly being used in patients with rheumatologic diseases for initial diagnostic evaluation and to objectively monitor disease course and treatment response. US findings of synovitis and erosive disease can help identify and monitor inflammatory arthritis, in particular rheumatoid arthritis (RA), with greater sensitivity and specificity than radiography. Evaluation of target joints for the different rheumatologic diseases helps expedite the examinations. US findings of enthesopathy may help differentiate psoriatic and reactive arthritis from RA. The US findings associated with gout and calcium pyrophosphate deposition disease (CPPD) arthropathy can also help in differentiating these entities from other inflammatory arthritides.

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