Osteoarthritis: clinical evaluation of diclofenac combined with the B complex vitamins / Osteoartrite: avaliação clínica da ação do diclofenaco com as vitaminas do complexo B

A double-blind, placebo controlled evaluation was performed on parallel groups of patients presenting osteoarthritis of the knee, hip or hand. The study aimed to evaluate the use of a combination of sustained-release diclofenac and vitamins B1, B6 and B12 in the treatment of the signs and symptoms of osteoarthritis. After screening and informed consent, randomized subjects underwent a 7-day treatment period with twice-daily oral therapy. Osteoarthritis pain, mobility and satisfaction assessments by both the subjects and the investigating physician were performed at each of the three visits to the study center before, during and at the end of the treatment period, along with physical examinations, laboratory evaluations and monitoring of adverse events and concomitant medications. Results were compared between the active and placebo treated groups (Group A and Group B, respectively).The active treatment was found to be superior to placebo in all of the pain, mobility and satisfaction assessments. Patients treated with the active substance were more willing to continue treatment at the end of the study. No significant difference was observed between the treatment groups in the physical examinations and laboratory evaluations performed.Based on the results observed in this double-blind clinical evaluation, we conclude that the combination of sustained-release diclofenac and vitamins B1, B6 and B12 is both well-tolerated and superior to placebo in the treatment of the signs and symptoms of OA in the study population evaluated.

Safety and efficacy of a B-vitamin combination in the treatment of osteoarthritis-related pain / Segurança e eficácia da associação das vitaminas B1, B6, B12 na analgesia da osteoartrite

We evaluated the safety and efficacy of the use of an oral combination of vitamins B1, B6, and B12 in the treatment of osteoarthritis-related pain and loss of mobility. A 14-day, open-label treatment period was adopted for patients presenting osteoarthritis of the knee or hip. Patients underwent a series of clinical and laboratory evaluations prior to the first treatment dose, following 7 days of treatment, and at the end of the 14-day drug administration period. The incidence of adverse events and use of concomitant medication was also monitored at each study visit. At each study visit, osteoarthritis evaluations were performed, including a 100mm VAS pain assessment, and global and satisfaction surveys completed by both patients and investigating physician. At the conclusion of the study, an additional assessment was performed to evaluate the patient's willingness to continue treatment with the B-vitamin combination.Clinical safety was evaluated by comparing the differences between the pretreatment, mid-study, and end-of-study clinical and laboratory evaluations as well as the incidence and severity of any adverse events. A comparison between the patient and physician assessments at each study visit was used to evaluate efficacy.A total of 54 patients were treated with the study medication. A clinically significant change was observed from pretreatment to end-of-study efficacy evaluations, including those for pain, mobility, and global osteoarthritis condition. The physician's evaluation of global patient condition and treatment satisfaction evaluation also presented a clinically significant change from pretreatment to the final study evaluation. No clinically significant changes in the patients clinical and laboratory evaluations were observed during the study.Based on the results of this clinical study, we conclude that the combination of cyanocobalamin, thiamine mononitrate and pyridoxine chlorihydrate at the concentrations employed is safe and effective in the treatment of the pain and loss of mobility associated with osteoarthritis.

Infecções por Staphylococcus aureus: relato de caso e discussão da literatura / Staphylococcus aureus infections: case related and literature review

Os autores apresentam um caso clínico de sepse por Staphylococcus aureus, a partir de um foco primário cutâneo que evolui para osteomielite crônica, comprometendo a metáfise e a cartilagem de crescimento em criança de 12 anos de idade

Fixaçäo das fraturas da diáfise da tíbia com as hastes flexíveis de Ender / Fixation of fractures of the tibial shaft with Ender nailing

Quinze fraturas da diáfise tibial foram fixadas com as hastes de Ender, sem o uso de intensificador de imagens, baseando-se na técnica original de Ender. Foi ressaltada a importância do método para a formaçäo do calo externo e a contribuiçäo das fixaçöes elásticas para rápida deambulaçäo e para o menor tempo de consolidaçäo. Viu-se, contudo, que as fraturas com foco aberto demoraram mais para consolidar, em comparaçäo com as de foco fechado