Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial.

To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: 'immediate versus delayed treatment' paradigm). All patients continued usual treatments during the 6-month follow-up period.

[Leprosy disclosed by polyarthritis].

Background: We report a case of leprosy observed in a French woman who had lived in Africa 30 years earlier. The clinical presentation was misleading, suggesting connective tissue disease.

Case Report: A 69-year-old woman was hospitalized in April 1996 for inflammatory joint disease.

An unusual case of hip septic arthritis due to Bacteroides fragilis in an alcoholic patient.

We describe a 53-year-old alcoholic man who presented with hip septic arthritis due to Bacteroides fragilis. This arthritis involved a severe destruction of the femoral head, which was completely devitalized. Recovery was achieved after 4 months of antimicrobial therapy with imipenem/cilastatin plus metronidazole, surgical debridement of the necrotic tissues and four sessions of hyperbaric oxygen.

[Levels of IgA rheumatoid factors in seropositive rheumatoid polyarthritis. Absence of correlation with disease activity or pejorative course].

Rheumatoid factors of the IgA isotype directed to human IgG Fc fragment were assayed, using an Elisa test, in the serum of 30 patients with seropositive rheumatoid arthritis and in the synovial fluid of 9 of them. A high incidence was found in the serum (90%) and synovial fluids (77%). Clinical, radiological and biological parameters of each patients were recorded at the time of the assay, and two years later.

The effect of food on the systemic availability of ketoprofen.

We have studied the pharmacokinetics of ketoprofen, a non-steroidal anti-inflammatory drug, in 12 patients after a single 100 mg oral dose both in fasting conditions and with a meal. Food significantly affected the peak plasma concentration of ketoprofen and decreased its absorption rate. However, the extent of absorption of ketoprofen, as reflected by the area under the plasma concentration time curve, appeared to be unchanged in the presence of food.

Total and free ketoprofen in serum and synovial fluid after intramuscular injection.

Free and total ketoprofen levels in serum and synovial fluid were determined in 37 patients after a single intramuscular injection of ketoprofen, 100 mg. Free drug was separated by equilibrium dialysis. Ketoprofen was assayed by HPLC.

Linear cutaneous neuromas (dermatoneurie en stries): a limited phakomatosis with striated pigmentation corresponding to cutaneous hyperneury (featuring multiple endocrine neoplasia syndrome?).

A 60-year-old woman developed a progressive linear pigmentation on the trunk. Skin biopsy demonstrated an increase in the number and size of neural fibers in the dermis. Clinical and paraclinical investigations of this unusual disease showed findings similar to the hereditary type of Sipple syndrome (multiple endocrine neoplasia syndrome, Type 2b).

[The contribution of computerized tomography to synovial pathology].

The authors have developed a technique of CT arthroscan which, by the use of a gas or opaque contrast medium, is able to demonstrate the synovial structures of the knee, the shoulder and the hip. Among the essential indications, they include the demonstration of neoplasia of the synovium and the evaluation of the pannus in rheumatoid arthritis. Their secondary indications include the demonstration of fluid effusions in the hip, the precise evaluation of hyperostotic lesions in the same joint, the detection of ossification phenomena in the capsule of the inter-apophyseal joints in ankylosing spondylitis and, in some cases, following negative or doubtful arthrography for the detection of synovial plica.

HLA antigens and toxic reactions to sodium aurothiopropanol sulphonate and D-penicillamine in patients with rheumatoid arthritis.

One hundred and forty-one patients with rheumatoid arthritis treated with aurothiopropanol sulphonate or D-penicillamine, or both were examined for HLA antigens to investigate the genetic influence on the occurrence of different adverse reactions during therapy. All 13 patients possessing HLA-DR3 had toxic reactions. The relative risk for DR3 positives of developing skin eruptions or proteinuria was calculated to be 10.

Diffusion of intramuscular ketoprofen into the cerebrospinal fluid.

Serum and cerebrospinal fluid (CSF) concentrations of ketoprofen have been measured in 36 patients hospitalised for sciatica. Diagnostic lumbar puncture was done 15 min to 13 h after a single 100 mg intramuscular dose of ketoprofen. Serum and CSF were sampled at the same time.

Thymulin (FTS-Zn) induced in vitro modulation of T cell subsets markers on lymphocytes from rheumatoid arthritis and systemic lupus erythematosus patients.

Perturbations in T cells and T cell subsets of peripheral blood lymphocytes were looked for, using monoclonal antibodies, in nine patients with rheumatoid arthritis (RA) and four patients with systemic lupus erythematosus (SLE). All SLE patients were in an acute phase of their disease, but had not yet received steroids. Seven of the nine RA patients presented an active illness, recently diagnosed in five cases, and received no steroids nor D-penicillamin.

[The bioavailability of ketoprofen (Profenid) administered orally in combination with a gastric protector (aluminum phosphate, Phosphalugel)].

Bioavailability of ketoprofen associated with aluminum phosphate was studied. Subjects were studied after an initial dose given without gastric protection, after ingestion of a single dose given with aluminum phosphate and, lastly, after four days of continuous treatment with this product. Results of plasma peak level and its time of occurrence, area under the curve, half-life and elimination constant establish that bioavailability of ketoprofen is not changed by association with aluminum phosphate.

[Pilomatrixoma (Malherbe's calcifying epithelioma). Apropos of 13 cases observed in 6 years].

Thirteen pilomatrixomas were seen over a six year period. These small benign cutaneous tumors are infrequent though not exceptional and occur mainly in children (mean age six years). The tumor's hard consistency, irregular shape and frequently cephalic location (nearly 50% of cases) are suggestive.

["Deep scleroderma" or diffuse fibromatous scleroderma. A case-report of uncertain nosologic classification (author's transl)].

An unusual form of scleroderma, seen in one patient, is described. Clinical and histological examinations demonstrated no dermal changes. Both the subcutaneous tissue and the fascias were involved.