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Rheumatology Outpatient Clinic (rheumatology + outpatient_clinic)
Selected AbstractsRickets and osteomalacia in northeast Iran: report of 797 casesINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 2 2008Mohammadhassan JOKAR ABSTRACT Aim:, To study the clinical, biochemical and radiographic features of rickets and osteomalacia in north-east of Iran. Methods:, We retrospectively reviewed the medical records of all patients with diagnosis of rickets and osteomalacia during the past 20 years (1986,2006) in the rheumatology outpatient clinic of Imam Reza Hospital, Mashhad, Iran. Results:, There were 797 patients (795 female, 2 male). Their ages were between 8,74 years. Most cases were in their second decade of life. The most common clinical findings were: bone pain 96.4%, muscle weakness 81%, abnormal gait 43%, and bone deformity 19.6%. The most common laboratory finding was high serum alkaline phosphatase (92%) followed by hypophosphatemia 54.6%, and hypocalcemia (21%). Radiographic findings were: epiphyseal growth plate alterations 74.4%, osteopenia 63%, ground glass appearance 28.6%, and Looser's zones 26.5%. All except four patients were cured with vitamin D and calcium. Conclusion:, Rickets and osteomalacia are common disorders in our region. Females especially in the growing years are often involved. The most common cause of rickets and osteomalacia in our region is vitamin D deficiency probably due to inadequate sun exposure. [source] Occupational balance of women with rheumatoid arthritis: a qualitative studyMUSCULOSKELETAL CARE, Issue 2 2004Tanja Stamm MSc MBA MagPhil OTR Abstract Objective: Occupational balance has been shown to be an important factor in maintaining health. Rheumatoid arthritis (RA) reduces functional ability and quality of life and may thus reduce occupational balance. The aim of this qualitative pilot study was to explore occupational balance in women who have RA. Methods: Nine women with RA with past, but not current, paid work experience, no other confounding neuro-motor disease and with disease duration of 0.75,31 years were selected from an Austrian rheumatology outpatient clinic. Age range of the participants was 28,68 years. A semi-structured interview was conducted with each participant and transcribed verbatim. Data were analysed by the constant comparative method from an occupational perspective. Results: Three main categories emerged: (1) The participants experienced a process of change that affected their occupational balance. (2) This new state of occupational balance was characterized by changed levels of involvement in physical, mental, social and rest occupations and by a certain level of unpredictability of symptoms. (3) Overall, the new state of occupational balance was valued differently: positively, indifferently or negatively. Conclusion: RA was found to have a considerable impact on occupational balance. The experience is not invariably seen as negative as previous literature would suggest. Further research should explore the longitudinal dimension of occupational balance in people with RA. Copyright © 2004 Whurr Publishers Ltd. [source] Subjective pain experience of people with chronic back painPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2000Professor Lorraine H De Souza Chair of Rehabilitation Abstract Background and Purpose Studies into the effect of pain experience on those who have it have largely focused on the views and interpretations of researchers gained by the use of assessment tools aimed at measuring pain. The purpose of this study was to explore and describe pain, as experienced by those with chronic back pain, and to document ,insider' accounts of how pain is perceived and understood by those who have it. Method Unstructured interviews using the framework approach. Subjects were sampled for age, sex, ethnicity and occupation, from new referrals with back pain to a rheumatology outpatient clinic. Eleven subjects (5 M; 6 F) agreed to be interviewed. Interviews were unstructured, but followed a topic guide. Subjects were interviewed in English (nine) or their preferred language (two). Tape-recordings of interviews were transcribed verbatim and read in depth twice to identify the topics or concepts. Data were extracted in the form of words and phrases by use of thematic content analysis. The themes were pain description and amount of pain. An independent researcher reviewed the data and confirmed or contended the analysis. Results All subjects, except one, provided descriptors of the quality of their pain. The use of simile was common to emphasize both what the pain was, and what it was not. Five subjects expressed a loss of words in trying to describe their pain. Only 13 of 29 different pain descriptors used were commensurate with those in the McGill Pain Questionnaire (Melzack, 1983). Subjects had great difficulty quantifying their pain intensity. Several explained how the pain fluctuated, thus, quantifying pain at one point in time was problematic. Only one subject offered a numerical description of pain intensity. Conclusions Subjects provided graphic and in-depth descriptions of their pain experience, but these bore little resemblance to commonly used assessment tools. The findings challenge the appropriateness of such formal instruments. Copyright © 2000 Whurr Publishers Ltd. [source] Patient priorities of care in rheumatology outpatient clinics: a qualitative studyMUSCULOSKELETAL CARE, Issue 4 2007Vicky Ward PhD Abstract Objective:,To provide more understanding of what rheumatoid arthritis (RA) patients want and need from an outpatient visit. Methods:,25 patients who experienced care in a nurse practitioner clinic (n = 10), junior doctor clinic (n = 9) or consultant clinic (n = 6) in a large teaching hospital in West Yorkshire were interviewed about their perceptions and experiences of care. Interviews were approximately 11/2 hours in duration and were carried out in a neutral environment by a research nurse. Interview data were subjected to atheoretical content analysis, which resulted in the identification of emergent themes. Results:,Five main themes emerged from the analysis of interview data: 1) patients want to be communicated to clearly and effectively and value positive relationships with practitioners. These help to give patients confidence in the care they are receiving; 2) patients want to feel in control of their condition and tend to refuse interventions as a way of gaining control; 3) patients want to be given clear explanations during consultations, and want information in oral and written forms; 4) patients want to be able to access practitioners between scheduled appointments as a way of gaining reassurance; and 5) patients want to feel valued by society through having their difficulties appreciated and understood by others. Conclusion:,This research adds to the body of evidence on what patients want from their rheumatology care, and each theme has clear implications for future practice. Copyright © 2007 John Wiley & Sons, Ltd. [source] Role of the urate transporter SLC2A9 gene in susceptibility to gout in New Zealand M,ori, Pacific Island, and Caucasian case,control sample setsARTHRITIS & RHEUMATISM, Issue 11 2009Jade E. Hollis-Moffatt Objective To examine the role of genetic variation in the renal urate transporter SLC2A9 in gout in New Zealand sample sets of M,ori, Pacific Island, and Caucasian ancestry and to determine if the M,ori and Pacific Island samples could be useful for fine-mapping. Methods Patients (n= 56 M,ori, 69 Pacific Island, and 131 Caucasian) were recruited from rheumatology outpatient clinics and satisfied the American College of Rheumatology criteria for gout. The control samples comprised 125 M,ori subjects, 41 Pacific Island subjects, and 568 Caucasian subjects without arthritis. SLC2A9 single-nucleotide polymorphisms rs16890979 (V253I), rs5028843, rs11942223, and rs12510549 were genotyped (possible etiologic variants in Caucasians). Results Association of the major allele of rs16890979, rs11942223, and rs5028843 with gout was observed in all sample sets (P = 3.7 × 10,7, 1.6 × 10,6, and 7.6 × 10,5 for rs11942223 in the M,ori, Pacific Island, and Caucasian samples, respectively). One 4-marker haplotype (1/1/2/1; more prevalent in the M,ori and Pacific Island control samples) was not observed in a single gout case. Conclusion Our data confirm a role of SLC2A9 in gout susceptibility in a New Zealand Caucasian sample set, with the effect on risk (odds ratio >2.0) greater than previous estimates. We also demonstrate association of SLC2A9 with gout in samples of M,ori and Pacific Island ancestry and a consistent pattern of haplotype association. The presence of both alleles of rs16890979 on susceptibility and protective haplotypes in the M,ori and Pacific Island sample is evidence against a role for this nonsynonymous variant as the sole etiologic agent. More extensive linkage disequilibrium in M,ori and Pacific Island samples suggests that Caucasian samples may be more useful for fine-mapping. [source] | ||||||||||