Exercise is the treatment of choice for fibromyalgia (FM), but little is known about resistance exercise prescription to modulate pain in this condition. This study aimed to compare the effects of different resistance exercise models, comprising self-selected or prescribed intensity, on pain in FM patients. In a cross-over fashion, 32 patients underwent the following sessions: (i) standard prescription (STD; 3 × 10 repetitions at 60% of maximal strength); (ii) self-selected load with fixed number of repetitions (SS); (iii) self-selected load with volume load (i.e., load × sets × repetitions) matched for STD (SS-VM); and (iv) self-selected load with a free number of repetitions until achieving score 7 of rating perceived exertion (SS-RPE). Pain, assessed by Visual Analogic Scale (VAS) and Short-Form McGill Pain Questionnaire (SF-MPQ), was evaluated before and 0, 24, 48, 72, and 96 h after the sessions. Load was significantly lower in SS, SS-VM, SS-RPE than in STD, whereas rating perceived exertion and volume load were comparable between sessions. VAS scores increased immediately after all sessions (p < 0.0001), and reduced after 48, 72, 96 h (p < 0.0001), remaining elevated compared to pre-values. SF-MPQ scores increased immediately after all exercise sessions (p = 0.025), then gradually reduced across time, reaching baseline levels at 24 h. No significant differences between sessions were observed. Both prescribed and preferred intensity resistance exercises failed in reducing pain in FM patients. The recommendation that FM patients should exercise at preferred intensities to avoid exacerbated pain, which appears to be valid for aerobic exercise, does not apply to resistance exercise.
Background Baricitinib, an oral selective Janus kinase (JAK)1/JAK2 inhibitor, is approved in many countries for moderate-to-severe atopic dermatitis (AD) in adult patients who are candidates for systemic therapy. Objectives To evaluate the efficacy and safety of three doses of baricitinib in combination with low-to-moderate potency topical corticosteroids in pediatric patients with moderate-to-severe AD. Methods Patients (aged 2 to <18 years) were randomized (1:1:1:1) to once-daily baricitinib low dose (1-mg equivalent), medium dose (2-mg equivalent), high dose (4-mg equivalent), or placebo for 16 weeks. The primary endpoint was the proportion of patients achieving a validated Investigator Global Assessment® (vIGA-AD) of 0/1 with a ≥ 2-point improvement at week 16. Key secondary endpoints included proportions of patients achieving 75% and 90% improvement in the Eczema Area and Severity Index (EASI75, EASI90), 75% improvement in the SCORing Atopic Dermatitis (SCORAD75), mean change from baseline in EASI score, and proportion of patients achieving a 4-point improvement in the Itch Numeric Rating scale (NRS) for patients ≥10 years. Primary and key secondary efficacy analyses were conducted on the intent-to-treat population and adjusted for multiplicity. Safety analyses included all randomized patients who received ≥1 dose of study treatment. Results A total of 483 patients were randomized (mean age: 12 years). Baricitinib 4-mg equivalent achieved statistically significant (P < 0.05) improvement versus placebo on all 16-week endpoints (vIGA 0/1 with ≥2-point improvement, EASI75, EASI90, SCORAD75, mean change EASI score, and Itch NRS 4-point improvement for patients ≥10 years). Improvement (P < 0.05 non-multiplicity adjusted) was also observed for baricitinib 4-mg equivalent versus placebo in the ability to fall asleep and in reduction of topical corticosteroid use. Few patients discontinued due to adverse events (1.6% for placebo and 0.6% for baricitinib-treated). There were no deaths, venous thromboembolic events, arterial thrombotic events, major adverse cardiovascular events, malignancies, gastrointestinal perforations, or opportunistic infections. Discussion Study results indicate that baricitinib offers a potential therapeutic option with a favorable benefit-risk profile for pediatric patients with moderate-to-severe AD who are candidates for systemic therapies.
Calcinosis usually represents a late manifestation of systemic sclerosis (SSc), inducing tissue damage and chronic calcifications. To analyze clinical and bone metabolism parameters associated with calcinosis in limited systemic sclerosis (lSSc), thirty-six female lSSc patients with calcinosis were compared with 36 female lSSc patients without calcinosis, matched by age, disease duration, and body mass index. Organ involvement, autoantibodies, bone density, and laboratory parameters were analyzed. Statistical significance was considered if p < 0.05. Calcinosis was significantly associated with acroosteolysis (69% vs. 22%, p < 0.001), higher modified Rodnan skin score (mRSS 4.28 ± 4.66 vs. 1.17 ± 2.50, p < 0.001), and higher 25-hydroxyvitamin D (25OHD) (24.46 ± 8.15 vs. 20.80 ± 6.60 ng/ml, p = 0.040) and phosphorus serum levels (3.81 ± 0.41 vs. 3.43 ± 0.45 mg/dl, p < 0.001). 25OHD levels > 30 ng/ml were also significantly more frequent in patients with calcinosis (p = 0.041). Regarding treatment, current use of corticosteroids was lower in patients with calcinosis compared with patients without calcinosis (8% vs. 28%, p = 0.032). On logistic regression analysis, acroosteolysis (OR = 12.04; 95% CI, 2.73-53.04; p = 0.001), mRSS (OR = 1.37; 95% CI, 1.11-1.69; p = 0.003), phosphorus serum levels (OR = 5.07; 95% CI, 1.06-24.23; p = 0.042), and lower glucocorticoid use (OR = 0.07; 95% CI, 0.007-0.66; p = 0.021) are independent risk factors for calcinosis. This study showed that limited SSc patients with calcinosis present a distinct clinic and biochemical profile when compared with a matched group without calcinosis, paired by disease duration, age and BMI. Key Points• Calcinosis in patients with limited SSc was associated with acroosteolysis, higher mRSS and higher serum levels of phosphorus.
A síndrome da dor regional complexa ainda é uma condição de diagnóstico desafiador que causa uma limitação significativa para o paciente. Ela tipicamente afeta os membros e é caracterizada por dor desproporcional e incapacitante, associada a edema, eritema, alterações na sudorese e sensibilidade. Isso ocasiona uma disfunção importante no membro afetado, além de um impacto psicológico significativo. Distúrbio de patogênese indefinida, não possui diagnóstico definitivo por exame laboratorial ou de imagem, razão pela qual seu diagnóstico torna-se mais complexo. Entretanto, ela pode ser identificada por meio de critérios clínicos baseados em consensos internacionais. Nesse cenário, os critérios de Budapeste se tornam de extrema valia para auxiliar o médico no diagnóstico da síndrome da dor regional complexa, denotando a importância dos sinais objetivos, além dos sintomas relatados. Unitermos: Dor regional complexa. Distrofia simpático reflexa. Dor crônica. Critérios classificatórios. Diagnóstico.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.