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Pain therapy – Are there new options on the horizon?
This article reviews the role of analgesic drugs with a particular emphasis on opioids. Opioids are the oldest and most potent drugs for the treatment of severe pain, but they are burdened by detrimental side effects such as respiratory depression, addiction, sedation, nausea, and constipation. Their clinical application is undisputed in acute (e.g., perioperative) and cancer pain, but their long-term use in chronic pain has met increasing scrutiny and has contributed to the current opioid crisis. We discuss epidemiological data, pharmacological principles, clinical applications, and research strategies aiming at novel opi...
Source: Best Practice and Research Clinical Rheumatology - July 6, 2019 Category: Rheumatology Source Type: research

The management of surgery and therapy for rheumatic disease
Publication date: Available online 5 July 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): C. Ronald MacKenzie, Susan M. Goodman, Andy O. MillerAbstractAs a result of advances in surgery, anesthesiology, and perioperative care, patients of more advanced age and medical complexity are now considered suitable candidates for surgical intervention. Rheumatologists, though frequently called upon to advise their patient in the surgical domain, may not be fully cognizant of the principles underlying medical consultation and therapy in perioperative setting. This paper provides an approach for guiding such medi...
Source: Best Practice and Research Clinical Rheumatology - July 5, 2019 Category: Rheumatology Source Type: research

Editorial Board
Publication date: October 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 5Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 14, 2019 Category: Rheumatology Source Type: research

Index
Publication date: October 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 5Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 14, 2019 Category: Rheumatology Source Type: research

Neuroimaging the pain network – Implications for treatment
Publication date: Available online 12 June 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Martin DiersAbstractIn this chapter, we provide an overview of neuroimaging studies in chronic pain. We start with an introduction about the phenomenology of pain. In the following section, the application of functional and structural imaging techniques is shown in selected chronic pain syndromes (chronic back pain, fibromyalgia syndrome (FMS), phantom limb pain, and complex regional pain syndrome (CRPS)), and commonalities and peculiarities of imaging correlates across different types of chronic pain are discuss...
Source: Best Practice and Research Clinical Rheumatology - June 12, 2019 Category: Rheumatology Source Type: research

Management of fragility fractures in India
Publication date: Available online 6 June 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Nishank Mehta, Bhavuk Garg, Rajesh MalhotraAbstractOsteoporosis and fragility fractures have become a major healthcare challenge globally in the recent years. However, this problem has only recently been accorded its due importance in developing countries such as India. India is a model case study for the management of osteoporosis and fragility fractures in a resource-limited setting, as it harbors a large geriatric population and has the highest prevalence of osteopenia globally. It is imperative to identify the...
Source: Best Practice and Research Clinical Rheumatology - June 7, 2019 Category: Rheumatology Source Type: research

Index
Publication date: June 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 3Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 4, 2019 Category: Rheumatology Source Type: research

Editorial Board
Publication date: June 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 3Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 4, 2019 Category: Rheumatology Source Type: research

Index
Publication date: August 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 4Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 4, 2019 Category: Rheumatology Source Type: research

Editorial Board
Publication date: August 2018Source: Best Practice & Research Clinical Rheumatology, Volume 32, Issue 4Author(s): (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 4, 2019 Category: Rheumatology Source Type: research

Psychological therapies for chronic widespread pain and fibromyalgia syndrome
Publication date: Available online 31 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Winfried Häuser, Gareth JonesAbstractPsychological factors such as adverse childhood experiences, traumatic life events, interpersonal conflicts and psychological distress play an important role in the predisposition, onset and severity of chronic widespread pain (CWP) and fibromyalgia syndrome (FMS). Therefore, psychological therapies might have the potential to reduce disability as well as symptom and economic burden in patients with CWP and FMS. Recent interdisciplinary guidelines have suggested different stre...
Source: Best Practice and Research Clinical Rheumatology - June 1, 2019 Category: Rheumatology Source Type: research

The role of ferritin and adiponectin as predictors of cartilage damage assessed by arthroscopy in patients with symptomatic knee osteoarthritis
Publication date: Available online 30 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Oren Nugzar, Gisele Zandman-Goddard, Hadar Oz, Dror Lakstein, Zeev Feldbrin, Marina ShargorodskyAbstractThe aim of the present study was to evaluate whether circulating serum ferritin and adiponectin (ADP) in the serum and synovial fluid correlate with cartilage damage severity assessed by arthroscopy in patients with knee osteoarthritis.The 40 subjects with symptomatic knee osteoarthritis were divided into four groups according to arthroscopy assessed cartilage damage, using Outerbridge (OB) grading. Group I incl...
Source: Best Practice and Research Clinical Rheumatology - May 31, 2019 Category: Rheumatology Source Type: research

Management of difficult polymyalgia rheumatica and giant cell arteritis: Updates for clinical practice
Publication date: Available online 23 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Lindsay Lally, Robert SpieraAbstractPolymyalgia rheumatica (PMR) and giant cell arteritis (GCA) represent a family of systemic inflammatory diseases occurring in adults aged 50 years and above. Clinical presentation of PMR/GCA can be variable, making diagnosis at times challenging. There has been an increased appreciation of the role of various large-vessel imaging modalities to help confirm a diagnosis of GCA. Systemic corticosteroids (CS) remain the mainstay of treatment for both PMR and GCA, yet both relapses a...
Source: Best Practice and Research Clinical Rheumatology - May 25, 2019 Category: Rheumatology Source Type: research

Non-hip/non-vertebral fractures – How to treat best?
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Pierre Hoffmeyer, Hermes Miozzari, Nicolas HolzerAbstractFractures of the extremities in the elderly constitute more than two-thirds of all fragility fractures befalling frail, osteoporotic and sarcopenic patients. Although treatment controversies abound, consensus exists. Upper extremity fractures hinder activities of daily living and are debilitating. Open fractures or displaced fractures will need surgical intervention. Wrist fractures treated operatively allow early use of the hand. Most pelvic fractures are t...
Source: Best Practice and Research Clinical Rheumatology - May 17, 2019 Category: Rheumatology Source Type: research

Fracture liaison programs
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Piet Geusens, Sandrine P.G. Bours, Caroline E. Wyers, Joop P. van den BerghAbstractIn view of the high imminent risk of having subsequent fractures after a fracture, early evaluation and treatment decisions to prevent subsequent fractures are advocated. After a hip fracture, the fracture liaison service (FLS) and orthogeriatric care are considered the most appropriate organisational approaches for secondary fracture prevention following a recent fracture.Their introduction and implementation have been shown to inc...
Source: Best Practice and Research Clinical Rheumatology - May 17, 2019 Category: Rheumatology Source Type: research