Abstract:
:The role of opioid therapy in chronic musculoskeletal disease continues to be controversial. However, recent years have seen a gradual shift towards the use of opioid therapy in chronic non-malignant pain (CNMP) following recognition that at least a subpopulation of such patients appears to benefit from long-term opioid treatment. Misconceptions about opioids and the associated risk of dependence stemmed from older research that was fundamentally flawed. More recent, rigorous research has yielded clearer statistics on opioid dependence and has highlighted the need for screening to identify individuals who may require closer monitoring during long-term opioid therapy. Controlled-release formulations (oral and transdermal) for the management of steady pain, in conjunction with fast-acting, immediate-release formulations for the management of breakthrough pain, may be available for a wide range of opioid analgesics, providing comprehensive therapy systems for use in CNMP. However, there are no universal criteria that can be confidently used to select CNMP patients who might profit from or be responsive to opioid therapy. Opioid treatment must therefore be individualised for each patient, based on a clear understanding of drug absorption, metabolism, toxicity and binding characteristics, using opioid switching strategies where appropriate. Practical guidelines for opioid therapy in CNMP include regular and systematic checks of treatment results to adjust therapy for each individual patient and to ensure optimum benefit.
journal_name
Clin Rheumatoljournal_title
Clinical rheumatologyauthors
Simpson KHdoi
10.1007/s100670200029subject
Has Abstractpub_date
2002-02-01 00:00:00pages
S5-8eissn
0770-3198issn
1434-9949journal_volume
21 Suppl 1pub_type
杂志文章,评审abstract:INTRODUCTION/OBJECTIVES:Interstitial lung disease (ILD) is frequent and highly disabling in systemic sclerosis (SSc). Magnetic resonance imaging (MRI) is not routinely used to evaluate the lung, due to poorer spatial resolution compared to high-resolution computed tomography (HRCT). We aimed to compare lung MRI signal ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05491-9
更新日期:2020-11-07 00:00:00
abstract::Current Canadian osteoporosis guidelines recommend routine bone density screening of men at age 65. The purpose of this study is to determine the prevalence of osteoporosis in men aged 65-75 in after application of screening guidelines. All males aged 65-75 years who attended a large primary care clinic were advised o...
journal_title:Clinical rheumatology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10067-014-2642-y
更新日期:2015-03-01 00:00:00
abstract::Two patients with coexistent Down's syndrome and gout are described. Although increased serum urate levels are frequently reported in Down's syndrome, only a few such patients have been described with concomitant gout. In our patients no significant alterations of the purine salvage pathway were found, and the turnove...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02030760
更新日期:1984-06-01 00:00:00
abstract:OBJECTIVE:To investigate the clinical characteristics, laboratory features, and treatment outcomes of Thai patients compared between those with necrotizing autoimmune myopathy (NAM) and those with other idiopathic inflammatory myopathies (IIMs) or non-NAM. METHODS:This multicenter case-control study included patients ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10067-019-04756-2
更新日期:2019-12-01 00:00:00
abstract::This cross-sectional investigation examined the prevalence and severity of dysphonia, globus pharyngeus, and dysphagia in patients affected by immunomediated (IM) diseases. Seventy subjects were administered the Voice Handicap Index (VHI) (scale 0-4), Glasgow-Edinburgh Throat Scale (GETS) (scale from 0 to 7) for globu...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-018-4129-8
更新日期:2019-01-01 00:00:00
abstract::The aims of this study were to characterize a minimally invasive technique of minor salivary gland biopsy of the lower lip and to present a large patient material undergoing this procedure because of a suspicion of Sjögren's syndrome (SS), as well as to assess the procedure's short-term and long-term value as a diagno...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-006-0457-1
更新日期:2007-07-01 00:00:00
abstract::The effect of long-term (18-70 months) chloroquine treatment 250 mg daily, in rheumatoid arthritis (RA) was studied in 20 patients. Sedimentation rates were significantly reduced, as compared to a reference group of 10 RA patients on no treatment of disease modifying anti-rheumatic drugs. Radiographical progression of...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02041561
更新日期:1983-12-01 00:00:00
abstract::Two major complications in scleroderma patients that cause substantial morbidity and mortality are ischemic digital lesions (DL) and pulmonary hypertension (PH). The clinician's ability to predict which patients will develop these complications is imperfect. We conducted a prospective observational cohort study of 300...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-018-4148-5
更新日期:2018-09-01 00:00:00
abstract::To evaluate the influence of TNF-α inhibitor on lipid profile and atherogenic index of plasma (AIP) in axial spondyloarthritis (axSpA) patients with long-term use of stable dose TNF-α inhibitor. AxSpA patients were enrolled in the Catholic Axial Spondyloarthritis COhort (CASCO). We collected their data annually and an...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-019-04767-z
更新日期:2020-02-01 00:00:00
abstract::The authors describe an atypical case of a patient having giant cell arteritis presenting only with fever, diagnosed by positron emission tomography and subsequently confirmed by temporal artery biopsy. ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-007-0831-7
更新日期:2008-06-01 00:00:00
abstract::The purpose of this report is to describe the overall safety profile of both short- and longer-term duloxetine treatment of fibromyalgia. Data from four double-blind, randomized, placebo-controlled studies (two with 6-month open-label extension phases) and a 1-year, open-label safety study were included. Safety measur...
journal_title:Clinical rheumatology
pub_type: 杂志文章,meta分析
doi:10.1007/s10067-009-1203-2
更新日期:2009-09-01 00:00:00
abstract:INTRODUCTION/OBJECTIVES:The primary objective was to evaluate the impact of an in-department pharmacist on the prevention of drug iatrogenesis in a rheumatology department. Secondary objectives were to determine (i) if medication history discrepancies were detected more frequently in the elderly or not, and (ii) if the...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-020-05138-9
更新日期:2021-01-01 00:00:00
abstract::Acute phase proteins, synovial fluid (SF) cellular infiltrates, pro-inflammatory (TNF-alpha, IL-1alpha, IL-6) and Th1 (IL-2) and Th2 (IL-4) derived cytokine levels both in plasma and SF were examined in pauciarticular and polyarticular juvenile chronic arthritis (JCA) patients during the active (n = 22) and inactive (...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF01451007
更新日期:1998-01-01 00:00:00
abstract::We report three cases of tricho-rhino-phalangeal syndrome (TRPS) type I in a Belgian family. They presented typical characteristics such as a pear-shaped nose, and short, deformed fingers with cone-shaped epiphyses of some middle phalanges of the hands. Hair growth was practically normal in our patients, except for so...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02201022
更新日期:1987-06-01 00:00:00
abstract::Although a number of reports have now described an association between polymorphism of the LMP2 gene and disease phenotype in HLA-B27 positive individuals with ankylosing spondylitis (AS), some describe associations with acute anterior uveitis, others with juvenile onset disease, and one report provides no association...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02238938
更新日期:1997-09-01 00:00:00
abstract::The tendency of patients with DISH towards obesity or an adult onset of diabetes has been reflected in marked hyperinsulinaemia following glucose challenge. It is hypothesized that insulin at prolonged and high physiologic levels promotes new bone growth, particularly in the entheseal regions. These areas are also sub...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02031611
更新日期:1985-09-01 00:00:00
abstract::We describe two patients with pancreatitis. One patient had acute pancreatitis of biliary origin and presented with small joint polyarthritis and panniculitis lesions. The other patient was originally hospitalised for dyspnoea with bilateral pleural effusion, and subsequently developed migratory polyarthritis. During ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF01451017
更新日期:1998-01-01 00:00:00
abstract::We aimed to evaluate the presence of peripheral antineutrophil cytoplasmic antibodies (p-ANCA) and cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) in children with SLE and to correlate its association of laboratory findings. Twenty-one children with SLE were studied. Serum samples in patients were tested by...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/BF01451065
更新日期:1998-01-01 00:00:00
abstract::Very recently, several studies have convincingly demonstrated the role of infection in the development of the antiphospholipid syndrome. Cross antibody-mediated reactivity due to molecular mimicry between endothelial glycoproteins and microbial products was considered as an important pathogenic mechanism. However, ano...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-006-0352-9
更新日期:2007-03-01 00:00:00
abstract::The association of different autoimmune diseases in the same subject is not uncommon, also in the pediatric age. The coexistence of morphea and juvenile idiopathic arthritis (JIA) is however exceptional. We report four such cases. Unlike the few other reported cases, in 3/4 of our patients, morphea appeared well after...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-019-04850-5
更新日期:2020-04-01 00:00:00
abstract::Interstitial lung disease (ILD) is a common manifestation of systemic autoimmune diseases and a leading cause of death in these patients. A proportion of patients with autoimmune ILDs develop a progressive fibrosing form of ILD, characterized by increasing fibrosis on high-resolution computed tomography, worsening of ...
journal_title:Clinical rheumatology
pub_type: 杂志文章,评审
doi:10.1007/s10067-019-04720-0
更新日期:2019-10-01 00:00:00
abstract::Forty-three of fifty-eight (74.1%) female patients with fibromyalgia completed an eight-week treatment period testing the combination of carisoprodol, paracetamol (acetaminophen) and caffeine versus placebo. Twenty-three patients received placebo and twenty active medication. In the placebo group 56.5% of the patients...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02030081
更新日期:1989-06-01 00:00:00
abstract::A correlation study was performed on the degree of muscle weakness in 36 patients with dermatomyositis and 69 with polymyositis in relation to muscle biopsy findings, electromyography (EMG) abnormalities, and serum concentrations of creatine kinase (CK), aspartate aminotransferase (AST) and alanine aminotransferase (A...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02030515
更新日期:1990-12-01 00:00:00
abstract::The higher incidence of arterial and venous events is well established in patients with rheumatoid arthritis (RA). Our aim here was to investigate whether there is a prothrombotic state in RA patients by using rotational thromboelastometry (ROTEM) method and to demonstrate whether the disease variables play a role in ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s10067-018-4134-y
更新日期:2018-09-01 00:00:00
abstract::The aim of the study was to demonstrate the effectiveness of sulphurous water in patients with osteoarthritis of the hand. Forty-seven patients with osteoarthritis of the hand were enrolled into the double-blind, randomized, controlled study, satisfying ACR criteria. One group of the patients (n = 24) received balneot...
journal_title:Clinical rheumatology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10067-012-2026-0
更新日期:2012-10-01 00:00:00
abstract::Amyloidosis in association with Systemic Lupus Erythematosus (SLE) has rarely been reported. We report a patient with "SLE" and Amyloidosis presenting with recurrent bloody diarrhea and review the relevant literature. ...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF02242463
更新日期:1997-06-01 00:00:00
abstract::Heart rate variability (HRV) gives information about sympathetic parasympathetic autonomic balance. Our purpose was to determine whether HRV is abnormal in patients with Sjögren's syndrome. In 16 patients with Sjögren's syndrome and 30 matched controls, a short time analysis of HRV was performed for both the frequency...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/pl00011180
更新日期:2000-01-01 00:00:00
abstract::The objective of the current work is to report our preliminary experience with the mizoribine (MZR) intermittent pulse protocol for induction therapy for newly diagnosed pediatric-onset systemic lupus erythematosus (SLE). Five consecutive patients who were newly diagnosed as having SLE with biopsy-proven lupus nephrit...
journal_title:Clinical rheumatology
pub_type: 临床试验,杂志文章
doi:10.1007/s10067-007-0635-9
更新日期:2008-01-01 00:00:00
abstract::Reactive arthritis (ReA) due to Gram-negative intestinal bacteria or Chlamydia, is associated by an unknown mechanism with HLA-B27. Like other MHC class I molecules, HLA-B27 presents antigenic peptides derived from intracellular proteins to CD8+ cytotoxic T cells (CTL). In humans however, CTL specific for ReA associat...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/BF03342653
更新日期:1996-01-01 00:00:00
abstract::The aim of the study was to analyse the gynaecologic history of 150 Brazilian patients with systemic sclerosis (SSc) by comparing the outcome of the pregnancies before and after disease onset and in the two clinical variants of SSc, as well as to assess the effects of the pregnancy on the progress of the disease. A re...
journal_title:Clinical rheumatology
pub_type: 杂志文章
doi:10.1007/s100670050152
更新日期:2000-01-01 00:00:00