March 2011 Briefing - Rheumatology

Here are what the editors at HealthDay consider to be the most important developments in Rheumatology for March 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Early Rehabilitation Post-Knee Arthroplasty Beneficial

THURSDAY, March 31 (HealthDay News) -- Starting rehabilitation within 24 hours of total knee arthroplasty for osteoarthritis reduces the average hospital stay and the requisite number of sessions to achieve autonomy and normal gait and balance, according to a study published online March 7 in Clinical Rehabilitation.

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Osteoarthritis Patients Show Increased Pain Sensitivity

THURSDAY, March 31 (HealthDay News) -- Patients suffering from osteoarthritis (OA) are more sensitive to experimental pain at multiple body sites compared to healthy controls, according to a study published in the March issue of Arthritis Care & Research.

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Changes Seen in Incidence of ESRD From Lupus Nephritis

WEDNESDAY, March 30 (HealthDay News) -- For children with lupus nephritis (LN)-associated end-stage renal disease (ESRD), disparities in treatment and mortality exist by several demographic characteristics; also, incidence rates have increased in younger patients and in African-Americans since 1995, according to two articles published online March 28 in Arthritis & Rheumatism.

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Online Health Records Less Used by Minorities, Poor

WEDNESDAY, March 30 (HealthDay News) -- Online personal health records (PHRs) are less frequently used by racial or ethnic minorities and patients with low annual income, according to a study published in the March 28 issue of the Archives of Internal Medicine.

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Depression Tied to Worse Arthritic Knee Pain in Elderly

FRIDAY, March 25 (HealthDay News) -- Older adults who have minimal to moderate radiographic evidence of knee osteoarthritis (OA) have an increased likelihood of having more severe symptoms if they have coexisting depression, according to a study published in the March 16 issue of The Journal of Bone & Joint Surgery.

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Use of Strategies to Reduce Risk of Opioid Misuse Is Low

FRIDAY, March 25 (HealthDay News) -- The use of opioid risk-reduction strategies by primary care physicians is limited, even among patients at particular risk of misuse, according to a study published online Feb. 24 in the Journal of General Internal Medicine.

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Knee Replacement Improves Level of Physical Activity

THURSDAY, March 24 (HealthDay News) -- People who undergo total knee arthroplasty (TKA) for osteoarthritis experience substantial improvements in the level of physical activity within the first year after surgery, but their activity level is not correlated with clinical outcome, according to a study published in the March issue of Arthritis Care & Research.

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Reduced Hours for Trainees Has Had Little Effect in U.S.

THURSDAY, March 24 (HealthDay News) -- Reducing work hours for doctors in training to less than 80 per week has had little impact on patient outcomes or postgraduate training in the United States, according to a literature review published online March 22 in BMJ.

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Rheumatic Disease Patients Require Two Flu Vaccine Doses

WEDNESDAY, March 23 (HealthDay News) -- Patients with inflammatory rheumatic diseases require two doses of flu vaccine to achieve the same antibody response as one dose elicits in controls, which may be due in part to the influence of specific disease-modifying antirheumatic drugs (DMARDs), according to a study published online March 7 in Arthritis & Rheumatism.

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Qigong Comparable to Exercise for Treating Neck Pain

WEDNESDAY, March 23 (HealthDay News) -- In patients with chronic neck pain, Qigong is comparable to exercise therapy and superior to no treatment, according to a study published in the March 15 issue of Spine.

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Chronic Widespread Pain Not Linked to Physical Trauma

MONDAY, March 21 (HealthDay News) -- Physically traumatic events are not associated with the development of chronic widespread pain (CWP), although being involved in a road accident may confer a modestly increased risk, according to a study published online March 21 in Arthritis Care & Research.

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Neck Disability Index Estimates SF-6D Utility Scores

FRIDAY, March 18 (HealthDay News) -- In patients with cervical degenerative disorders, Short Form-6D (SF-6D) utilities can be estimated using a Neck Disability Index (NDI) regression model, according to a study published online March 15 in Spine.

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Once-Daily Sildenafil Reduces Raynaud's Attack Frequency

FRIDAY, March 18 (HealthDay News) -- Modified-release sildenafil reduces frequency of attacks in patients with Raynaud's phenomenon (RP) secondary to limited cutaneous systemic sclerosis (lcSSc), and is generally well tolerated, according to a study published in the March issue of Arthritis & Rheumatism.

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Bunions Impact General Quality of Life

THURSDAY, March 17 (HealthDay News) -- Increasing severity of hallux valgus is associated with a progressive decrease in general and foot-specific health-related quality of life, according to a study published in the March issue of Arthritis Care & Research.

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Professional Values of U.S. and U.K. Doctors Examined

THURSDAY, March 17 (HealthDay News) -- A core of professional values exists among doctors in the United States and the United Kingdom, though significant differences exist in how these values are expressed and prioritized, according to a study published online March 7 in BMJ Quality & Safety.

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Short Nurse Staffing Linked to Higher Patient Mortality

WEDNESDAY, March 16 (HealthDay News) -- Patient mortality appears to be higher when nurse staffing falls eight or more hours below target level and during nursing shifts when patient turnover is high, according to research published in the March 17 issue of the New England Journal of Medicine.

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U.S. Death Rate Reaches All-Time Low

WEDNESDAY, March 16 (HealthDay News) -- The age-adjusted death rate for the United States has fallen for 10 straight years and has reached an all-time low of 741 per 100,000, or 2,436,682 deaths, in 2009, down 2.3 percent from 2008, according to a new report issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Outcomes Differ Among Hepatitis C-Related Vasculitides

WEDNESDAY, March 16 (HealthDay News) -- Among patients with hepatitis C virus (HCV)-related vasculitis, those with polyarteritis nodosa (PAN) have a more severe and acute clinical presentation and a higher rate of clinical remission, according to a study published online Feb. 25 in Arthritis Care & Research.

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Weight Loss Counseling Rate Rises for Adults With Arthritis

TUESDAY, March 15 (HealthDay News) -- In the United States, significant national progress has been made toward achieving the Healthy People 2010 (HP2010) target for weight counseling in adults with doctor-diagnosed arthritis, according to a study published in the March/April issue of the Annals of Family Medicine.

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Nonadherence to Medications Common in Lupus Patients

MONDAY, March 14 (HealthDay News) -- In patients with systemic lupus erythematosus (SLE), intentional and unintentional nonadherence are commonly reported, according to a study published in the March issue of Arthritis Care & Research.

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Risk of Infection, Malignancy With Anti-TNF Therapy Unclear

FRIDAY, March 11 (HealthDay News) -- Patients with early rheumatoid arthritis taking anti-tumor necrosis factor (TNF) therapy without prior use of disease-modifying anti-rheumatic drugs (DMARD)/methotrexate do not have an increased risk of serious infections or malignancies, according to a meta-analysis published online Feb. 25 in Arthritis & Rheumatism.

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Pulsed Electrical Stimulation As Effective As Placebo

THURSDAY, March 10 (HealthDay News) -- For patients with moderate to severe osteoarthritis of the knee who suffer from mild to moderate symptoms, 26 weeks of pulsed electrical stimulation (PES) therapy is no more effective than placebo, according to a study published online Feb. 10 in Arthritis & Rheumatism.

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Benlysta Approved for Lupus

THURSDAY, March 10 (HealthDay News) -- Benlysta (belimumab) has been approved by the U.S. Food and Drug Administration to treat lupus, the first medication sanctioned for the condition in the United States since 1955.

Lupus Foundation of America

HealthGrades Finds Rates of Patient Safety Events Vary

WEDNESDAY, March 9 (HealthDay News) -- Patients treated at hospitals rated with a HealthGrades Patient Safety Excellence Award have, on average, a 46 percent lower risk of experiencing a patient safety incident compared to those treated at the lowest-ranked hospitals, according to the eighth annual HealthGrades Patient Safety in American Hospitals Study published online March 9.

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Ethnic Differences Seen in Academic Measures for U.K. Docs

WEDNESDAY, March 9 (HealthDay News) -- United Kingdom-trained physicians and medical students with ethnic minority backgrounds tend to underperform academically compared to their white peers, according to a meta-analysis published online March 8 in BMJ.

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Cyclophosphamide Treatment Tied to Urinary Tract Cancer

WEDNESDAY, March 9 (HealthDay News) -- Patients with systemic necrotizing vasculitides (SNV) treated with cyclophosphamide (CYC) have a five-fold higher risk of developing urinary tract cancer (UTC), according to a study published online Feb. 17 in Arthritis & Rheumatism.

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Pharmacological Meta-Analyses Rarely Report Disclosures

TUESDAY, March 8 (HealthDay News) -- Meta-analyses of pharmacological treatments rarely include information addressing primary study funding and conflicts of interest (COIs) of the authors for the included randomized control trials (RCTs), according to a study published in the March 9 issue of the Journal of the American Medical Association.

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Improvement in Fibromyalgia Pain Scale Quantified

TUESDAY, March 8 (HealthDay News) -- A two-point improvement on the Brief Pain Inventory (BPI) represents the minimum clinically important difference (MCID) for patients with fibromyalgia pain, corresponding to a 30 to 35 percent improvement from baseline, according to a study published online Feb. 10 in Arthritis Care & Research.

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Cancer Risk Up in Taiwanese With Rheumatoid Arthritis

MONDAY, March 7 (HealthDay News) -- Taiwanese patients diagnosed with rheumatoid arthritis (RA) have an increased cancer risk, particularly for hematological, kidney, and vagina/vulva cancers, according to a study published in the February issue of Arthritis & Rheumatism.

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Remission Tied to Earlier Rheumatoid Arthritis Treatment

MONDAY, March 7 (HealthDay News) -- For patients with rheumatoid arthritis (RA), earlier treatment is associated with an increased likelihood of achieving remission, according to a study published online Feb. 18 in Arthritis Care & Research.

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Ankle Replacement Provides Pain Relief in Gouty Arthritis

MONDAY, March 7 (HealthDay News) -- Total ankle replacement provides significant pain relief and good functional results in patients with painful gouty ankle arthritis, and it is associated with a low risk of complications, according to a study published in the Feb. 16 issue of The Journal of Bone & Joint Surgery.

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Psoriatic Arthritis Responds to Anti-Tumor Necrosis Factor-α

FRIDAY, March 4 (HealthDay News) -- Patients with psoriatic arthritis (PsA) undergoing first treatment series with a tumor necrosis factor-α (TNF-α) inhibitor have high drug adherence and a good response, according to a study published in the February issue of Arthritis & Rheumatism.

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Exposure to Insecticides May Up Autoimmune Disease Risk

THURSDAY, March 3 (HealthDay News) -- Women who are exposed to insecticides at home or in the workplace have an increased risk of rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE), according to a study published in the February issue of Arthritis Care & Research.

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Maternal Opioid Use Tied to Higher Birth Defect Risk

WEDNESDAY, March 2 (HealthDay News) -- Maternal use of opioid analgesics just prior to or during early pregnancy is associated with a modestly higher risk of certain birth defects, according to a study published online Feb. 24 in the American Journal of Obstetrics & Gynecology.

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Many Patients Do Not Consolidate Drugs Efficiently

TUESDAY, March 1 (HealthDay News) -- Many patients, especially those with low literacy, do not consolidate prescription regimens efficiently, according to a study published in the Feb. 28 issue of the Archives of Internal Medicine.

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