No abstract

The restless legs syndrome (RLS), defined by Gibb and Lees criteria, was investigated in patients with RA. RLS symptoms were more frequent in RA patients (25%) than in non-RA controls with OA or seronegative arthropathy (4%). RLS was significantly more common in females. Judged by a variety of clinical and laboratory indices, RA disease severity and current disease activity were greater in patients with RLS than in RA patients unaffected by RLS. In five out of 14 RLS patients undergoing neurophysiological study, delays in the P40 component of posterior tibial somatosensory evoked potentials (SSEPs) were observed suggesting the existence of myelopathy, whilst in another four RLS patients evidence of peripheral neuropathy was found. Though the higher frequency of neurophysiological abnormalities in RA patients with RLS was not statistically significant, possibly because of the small numbers of patients studied, these data suggest that RLS symptoms in RA may reflect the presence of neurological disorder.

NSAIDs significantly reduce overall pain over 4 weeks. This short-term responsiveness is retained, and even after several years of therapy with tiaprofenic acid pain scores increased over 2 weeks when it was changed to placebo. Our results do not show long-term benefits from the use of NSAIDs in OA and the majority of patients had persisting pain and disability despite therapy.

No abstract

A major aim of the government's white paper Working f6r Patients is to make the services provided by general practitioners more responsive to patients' needs.' Patients consider that the convenience of surgery hours is important," but no reliable information exists to show what appointment times patients prefer. We therefore collected and analysed data on this subject. Subjects, methods, and resultsWe performed the study in a general practice in Leyland, Lancashire, that had seven partners and a list of 11 655 patients. Surgeries were held continuously from 8 am to 6 pm on Mondays to Fridays. All patients on the age-sex register of the practice who were over 18 and had their birthday in April were sent a questionnaire that asked what time they would prefer to attend the surgery, both generally and for specific clinics; how often they had visited a doctor at the surgery in the past year; and whether inconvenient times of access had caused problems. Patients with children were asked what time they would prefer to have appointments for them, and whether this differed from their choice for their own appointment. Patients were also asked when they worked and whether they would like surgeries at weekends.We sent 949 questionnaires and 586 (62%) were returned completed. Four hundred and fifty three patients had a convenient time in mind when they made a routine appointment. Clinics before 9 am were preferred by 133 patients, from 9 to 11 am (the conventional time of morning clinics) by 192, from 3 to 6 pm by 147, and after 6 pm by only 29 (table). Appointments between 9 and 11 am were preferred by the largest proportion (44%) of parents with children aged under 5. Women with children aged under 5 were significantly more likely to want an appointment between 9 am and 11 am for their children than for themselves (p<0-0001, X2 test). One hundred and nine (57%) parents with children of school age preferred appointments for them between 3 and 6 pm. Patterns ofwork influenced preferences: the 29 patients who preferred appointments after 6 pm all worked during the day, and the 20 who worked only in the afternoons preferred to attend during the morning. The table shows the appointment times preferred by people attending well woman clinics and for health checks.