Arthritis Chronicle

This abstract linking arthritis and breast cancer is by Candelaria et al from the department of Hematologia in Mexico. 

BACKGROUND: Estrogen plays a critical role in breast cancer. Thereafter, endocrine therapy is a standard of care in patients with breast carcinoma, expressing ER or PR.

CASE PRESENTATION: Herein we report the case of a 53-year old patient, who developed cholestasis and vasculitis during the treatment with tamoxifen. This toxicity was reversable after the removal of the drug. Thereafter she continued adjuvant treatment for breast carcinoma with anastrazole. Since tamoxifen has been widely indicated for patients with breast carcinoma, we did a literature review, looking for other cases with this type of toxicity.

CONCLUSION: This case is the third with vasculitis informed in the literature, but the first one that additionally developed cholestasis and arthritis. Although it is rare, we discuss the indication of this drug in the actual era, where aromatase inhibitors offer a better security profile.

Pubmed ID is 17244373

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This paper comes from Strand et al in Norway.

The objective of the study was to analyze the relationships between Pain Readiness to Change, weekly measures of positive and negative affect and pain over eight subsequent weeks in patients with rheumatoid arthritis (RA). Factor analysis based on data from three different samples of patients with rheumatic diseases and other chronic pain conditions suggested a three factor solution for the Norwegian version of the Pain Stages of Change questionnaire (PSOCQ) representing Precontemplation, Contemplation, and Action/Maintenance (ACT) stages from the original Transtheoretical Model. Multilevel analyses on the weekly assessed data from a sub sample of 40 patients with RA revealed that higher levels of Pain Readiness to Change represented by high ACT scores were associated with more positive affect from week to week while no association was found between Readiness to Change and weekly pain. However, there was an interaction effect between Pain Readiness to Change and weekly positive affect on weekly pain, indicating that those persons having a higher level of Readiness to Change reported less pain in weeks when they also experienced increased positive affect. This may imply that a combination of cognitive factors and positive affect is most effective in relation to pain reduction.

Results encourage continued investigation of apparent interactions between chronic pain, affect, and pain self-management.

PMID:Available on pubmed Id = 16997472

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Today I am going to write about a recent paper that was published by Linda Li and colleague’s entitled “Effectiveness of the primary therapist model for rheumatoid arthritis rehabilitation”. In this study they investigated the outcome of treatment of people with rheumatoid arthritis by health care providers. The methods they compared were traditional treatments (such as occupational and physical therapy) with those carried out by a primary rheumatologic arthritis trained therapist. The latter method was first put forward by the Arthritis society of Canada and involves therapists acting as managers of a single patient, they are allowed to get advice from fellow therapists who act in a consultancy role, this means that the patient will not be constantly shipped off from one therapist to another. Linda Li and friends carried out an investigation of 111 patients who were undergoing either primary therapy (63 partakers) or more traditional arthritis treatments (48 partakers). The candidates were chosen so as not to have had any kind of treatment for rheumatism within the last two years, and they were analysed over a period of six months. It was found that in comparison to traditional methods, patients treated with the primary therapy methods suffered less pain overall than those who did not receive treatment. However both treatments methods resulted in a loss of pain from arthritis. So the adage is that any treatment for rheumatoid arthritis is better than none.

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