RESUMO
OBJECTIVE: To evaluate the effects of triazolam upon insomnia and daytime sleepiness in patients with rheumatoid arthritis (RA). METHODS: Triazolam or placebo was administered during two 7 night periods to 15 patients with RA in a double blind crossover study. Polysomnographic recordings were conducted on the last 2 nights of each condition, and multiple sleep latency tests and mood and arthritis assessments were performed during the intervening day in each condition. RESULTS: In the triazolam condition, total sleep time was increased, daytime sleepiness was reduced, and morning stiffness was improved compared to placebo. Objective measures of sleep fragmentation were unchanged. Clinical arthritis assessments were similar during both conditions. CONCLUSION: Short term hypnotic therapy improves sleep in patients with RA and appears to improve morning stiffness and daytime sleepiness.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/fisiopatologia , Fases do Sono/efeitos dos fármacos , Sono/efeitos dos fármacos , Triazolam/uso terapêutico , Adulto , Idoso , Estudos Cross-Over , Método Duplo-Cego , Elasticidade/efeitos dos fármacos , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dor , Triazolam/administração & dosagemRESUMO
Pachydermoperiostosis (primary hypertrophic osteoarthropathy) is a familial disorder characterized by clubbing, periosteal bone changes, and furrowing of the skin. A 40 year old male with this syndrome and chronic arthritis was recently studied. The synovial fluid was non-inflammatory. Histologically the synovium exhibited hyperplasia and microvascular alterations. Immunofluorescent staining failed to identify deposits of immunoglobulin. Electron microscopy revealed multilayered basement laminae around small subsynovial blood vessels but no electron-dense deposits as described in studies of hypertrophic pulmonary osteoarthropathy. The pathogenesis is obscure and appears to be non-immunological.