Abstract:
BACKGROUND:Current treatment for osteoarthritis (OA) is limited. Many patients with OA of the hand have areas of tender subcutaneous thickening in the forearm and upper scapular region. A pilot study showed an improvement in pain from OA at the first carpometacarpal joint after injection of such areas with 0.5% sodium salicylate or saline, an inexpensive treatment that can be administered by general practitioners and nurses. The study indicated that a randomised, sham-controlled trial was justified. METHODS:40 patients with OA of the first carpometacarpal joint were randomised to receive either injections of sodium salicylate into tender, thickened areas of subcutaneous tissue on the forearm (baseline) and upper scapular region (week 1) or sham injections consisting of pressure without skin penetration. Blinded assessments were made at weeks 3, 7 and 13 after baseline. RESULTS:Pain and tenderness during follow-up were both significantly lower in the active treatment group compared with the sham group: 19% and 14% greater reduction in mean visual analogue scale (VAS) score, respectively (p=0.007 and 0.02, baseline mean 5.65 and 5.35 cm, average difference in change from baseline VAS 1.9 and 1.4 cm, 95% CI 0.6 to 3.2 and 0.2 to 2.5). Active and sham injections were painful, the former significantly more so; however, there was no significant correlation between the pain of active injections and response. CONCLUSION:The data show that subcutaneous sodium salicylate injections are an effective symptomatic treatment for OA of the thumb. The results provide a basis for further physiological and therapeutic research in this area.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Smith AS,Doré CJ,Dennis L,Julius A,Mackworth-Young CGdoi
10.1136/pgmj.2009.087643subject
Has Abstractpub_date
2010-06-01 00:00:00pages
341-5issue
1016eissn
0032-5473issn
1469-0756pii
86/1016/341journal_volume
86pub_type
杂志文章,多中心研究,随机对照试验abstract::A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.660.746
更新日期:1980-10-01 00:00:00
abstract::Elective root replacement in Marfan syndrome has improved life expectancy in affected patients. Three forms of surgery are now available: total root replacement (TRR) with a valved conduit, valve sparing root replacement (VSRR) and personalised external aortic root support (PEARS) with a macroporous mesh sleeve. TRR c...
journal_title:Postgraduate medical journal
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doi:10.1136/postgradmedj-2013-305132rep
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abstract::Secondary hyperkalaemic paralysis is a rare condition often mimicking the Guillain-Barré syndrome. There have been a few case reports of hyperkalaemia caused by renal failure, trauma, and drugs where the presentation has been with muscle weakness. A case of hyperkalaemic paralysis caused by an angiotensin converting e...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.77.904.114
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abstract:BACKGROUND:Sleep deprivation and fatigue from long-shift work impacts doctors' personal safety, inhibits cognitive performance and risks clinical error. The aim of this study was to assess the sleep quality of surgical trainees participating in European Working Time Directive-compliant training rotations within a UK de...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2018-135795
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abstract::Clinical and biochemical data obtained from 163 patients who had taken an overdose of paracetamol were examined to determine which factors or measurements were of value in predicting the severity of ensuing liver damage early after ingestion of tablets. Although the overall severity of hepatic necrosis was found to in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.619.243
更新日期:1977-05-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of, and implement a diagnostic strategy for, imported helminth infection in the gastroenterology clinic. DESIGN:A retrospective study of eosinophil count and probable tropical exposure (phase I) followed by a prospective study of parasitological investigation (phase II). SETTING:G...
journal_title:Postgraduate medical journal
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doi:10.1136/pgmj.2010.003392rep
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abstract::The toxic effects of paracetamol in overdose quantities are well recognised but the occurrence of anaphylactoid reactions to paracetamol is infrequently identified by consumers and health care professionals. Nevertheless adverse reactions to this drug, even in therapeutic doses, can have fatal or near fatal consequenc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.898.501
更新日期:2000-08-01 00:00:00
abstract::Two sisters suffered from thrombotic thrombocytopenic purpura late in their first pregnancies. HLA typing of the patients and their immediate family members demonstrated no obvious relationship. Hereditary aspects, association with pregnancy, prognosis and management of pregnant women with TTP are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.809.229
更新日期:1993-03-01 00:00:00
abstract::Upper gastrointestinal bleeding is one of the commonest emergencies encountered by general physicians. Once haemodynamic stability has been achieved, therapeutic endoscopy is vital in control and arrest of bleeding. Various methods are available and the evidence is reviewed as to the most optimal approach. Clinical pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.020867
更新日期:2005-02-01 00:00:00
abstract::Duodenal carcinoids are rare tumours. There is an increased incidence of primary carcinomas, especially in the gastrointestinal tract, which occur synchronously with gastrointestinal tract carcinoids. However, the synchronous occurrence of adenocarcinoma of the gastro-oesophageal junction with a duodenal carcinoid has...
journal_title:Postgraduate medical journal
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abstract::Both the quality and the quantity of food ingested are relevant to the genesis of risk factors for coronary heart disease and the two are inseparable. Nevertheless they have a major common pathway through hypertension, which may well be the most important consequence of a high-protein, high-carbohydrate, high-fat, hig...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.629.171
更新日期:1978-03-01 00:00:00
abstract::A case of post-thyroidectomy hypothyroidism is reported. The patient became euthyroid in three consecutive pregnancies, reverting to hypothyroid within three months of delivery on each occasion. The alteration in thyroid status is attributed to pregnancy related changes in antibody titres, though the laboratory data t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.77.911.591
更新日期:2001-09-01 00:00:00
abstract::Overdosage with cardiac glycosides is well documented, but not usually fatal. A case is described in which cardiac arrest in asystole was associated with a serum digoxin level of 50-4 microgram/1, the highest concentration yet reported after oral administration. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.619.280
更新日期:1977-05-01 00:00:00
abstract::Severe acute respiratory syndrome (SARS) is a newly emerged infectious disease with a significant morbidity and mortality. The major clinical features include persistent fever, chills/rigor, myalgia, malaise, dry cough, headache, and dyspnoea. Older subjects may present without the typical febrile response. Common lab...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.020263
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.749.217
更新日期:1988-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2003.010835
更新日期:2004-04-01 00:00:00
abstract::This review examines the appropriate timing of intervention in acute pancreatitis. In gallstone pancreatitis, it is now clear that cholecystectomy during the primary admission carries no greater risk of complications than delayed cholecystectomy and enables earlier recovery to normal activity. This course of action pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.69.813.509
更新日期:1993-07-01 00:00:00
abstract::We report a case of eosinophilic fasciitis, with the unusual features of pulmonary and pleural involvement. Similar cases which involve the lungs have been reported after exposure to L-tryptophan, but there is no relevant drug history in this case. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.891.36
更新日期:2000-01-01 00:00:00
abstract::The nature of rehabilitation medicine is outlined in terms of its objectives, its methods, the patient groups which it seeks to help and its relationships to other specialties. Some major advances of recent years are discussed, such as the development of the impairment/disability/handicap framework. With particular em...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.841.665
更新日期:1995-11-01 00:00:00
abstract::A patient with chronic pancreatitis presented with a series of massive upper gastrointestinal haemorrhages due to bleeding into the pancreatic duct. This report emphasizes the value of intensive investigation before surgery, since it may be impossible to identify the site of bleeding at laparotomy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.716.533
更新日期:1985-06-01 00:00:00
abstract::A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-136760
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.766.589
更新日期:1989-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1985-01-01 00:00:00
abstract::Prospective measurements of serum thyrotrophin and thyroxine concentrations were made in six patients with primary hypothyroidism treated consecutively with an incremental regimen of oral thyroxine. A fall in thyrotrophin occurred over several months, accompanied by a concurrent slow rise in serum thyroxine. Those pat...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.723.11
更新日期:1986-01-01 00:00:00
abstract::Thirty-one patients with radiolucent common bile duct stones received medical treatment. Nineteen had Rowachol, a terpene preparation, eight (42%) achieving complete stone disappearance within 3 to 48 months. Fifteen (including 3 of the above) took Rowachol with bile acid (chenodeoxycholic in 11, ursodeoxycholic in 4)...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.714.313
更新日期:1985-04-01 00:00:00
abstract::Granulomatous disorders comprise a large family sharing the histological denominator of granuloma formation. A granuloma is a focal compact collection of inflammatory cells, mononuclear cells predominating, usually as a result of the persistence of a non-degradable product and of active cell mediated hypersensitivity....
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.898.457
更新日期:2000-08-01 00:00:00
abstract::We report the case of a patient with multiple myeloma who developed acute life-threatening water intoxication following treatment with oral indomethacin and low dose intravenous cyclophosphamide. We describe a possible drug interaction between these two drugs and recommend that they should only be used together with c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.770.950
更新日期:1989-12-01 00:00:00
abstract:OBJECTIVE:To assess parent preferences for utilisation of a parent-focused, telephone-based coaching service, or 'FITLINE,' to prevent or manage childhood obesity. METHODS:A cross-sectional survey of parents of children aged 2-12 years was conducted at a paediatric practice in Greater Boston, Massachusetts, USA, betwe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132928
更新日期:2015-04-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.721.1015
更新日期:1985-11-01 00:00:00