bluuebunny/crossref_metadata_2025 huggingface dataset:
A descriptive study of foot problems in children with juvenile rheumatoid arthritis (JRA)
Authors: Spraul Gayle , Koenning Gaye
Published: February 2007

In this study, we evaluated the feet of 144 consecutive children with juvenile rheumatoid arthritis (JRA) during a routine outpatient visit to discover patterns of foot problems. We found that all but nine subjects had at least 1 of 21 foot problems, categorized as inflammation, limitation of motion, and abnormal alignment. Overall, pronated rearfoot and midfoot were observed in 73% and 72% of JRA patients, respectively. Additionally, 36% had splayfoot, whereas 35% of subjects had ankle limitation of motion. Other common foot problems included pronated forefoot, rearfoot and forefoot synovitis, forefoot limitation of motion, and toe valgus. Significant differences in the occurrence of various foot problems were observed among JRA onset/course subgroups and were influenced by both age and disease duration. Specifically, subjects with polyarticular JRA had more forefoot limitation and toe valgus, whereas subjects with pauciarticular JRA had pronated forefoot more often. Ankle limitation of motion, although unrelated to the JRA subgroup, was related to the duration of JRA. Subjects with longer disease histories also had toe valgus more often. Conversely, forefoot limitation of motion seemed to be more a function of age than of disease duration. These results indicate that foot problems are common in the JRA population, and they underscore the need for thorough evaluation and physical therapy management.
Preferred intraarticular corticosteroids and associated practice: A survey of members of the American College of Rheumatology
Authors: Centeno Ligaya M. , Moore Mary E.
Published: February 2007

Objective. To determine which intraarticular steroids are used by rheumatologists and whether this use and associated practice vary with time and place of training.

Method. American College of Rheumatology members were mailed questionnaires that focused on steroid use in the adult knee.

Results. The steroids favored by the respondents were methylprednisolone acetate (MPA), preferred most by those trained in the eastern U.S.; triamcinolone hexacetonide (TH), preferred by those trained in the Midwest and Southwest; and triamcinolone acetonide (TA), preferred by those trained in the West. Only TH was chosen primarily because of efficacy. Regardless of concentration, respondents used 1 ml of steroid. Most (especially those recently trained) combined steroid with local anesthetic. Post‐injection instructions varied: 29% did not restrict weight‐bearing; 8% recommended limited weight‐bearing for 1 week or more.

Conclusion. MPA, TH, and TA were favored. Associated techniques varied, based in part on where and when training took place. Research is needed to provide a more rational basis for clinical practice.
Issues in meta‐analysis: An overview
Authors: Bartolucci Alfred A. , Katholi Charles R. , Singh Karan P. , Alarcón Graciela S.
Published: February 2007

A summary is provided for the relevant issues that investigators must address when wishing to synthesize data via a meta‐analysis. The analogy is made to conducting a clinical trial and its components. Both design and statistical issues are discussed with the goal of assuring that the proper elements are included in the meta‐analysis. Further, global concerns are presented so that the researcher is aware of the clinical controversies faced when conducting a meta‐analysis. Finally a comparison is made of the advantages and disadvantages of a large‐scale clinical trial versus a meta‐analysis.
Post‐traumatic fibromyalgia: A case report narrated by the patient
Authors: Wolfe Frederick
Published: February 2007

This report describes a case of fibromyalgia developing following a workplace injury, but in which the issues of compensation and work disability were not relevant. A previously healthy 37‐year‐old woman developed back and groin pain after lifting a heavy box. Over the next months, pain and allodynia gradually spread over her body, and headaches, sleep disturbance, paresthesias, and bowel symptoms developed for the first time. The pain was constant and severe, invading and interfering with every area of daily function. Surprisingly, no previous case reports or definition of post‐traumatic fibromyalgia could be found. This case report, narrated by the patient, suggests that there is such an entity as post‐traumatic fibromyalgia, and that central nervous system plasticity plays a central role.
Promoting patient cooperation with exercise programs. Linking research, theory, and practice
Authors: Jensen Gail M. , Lorish Christopher D.
Published: February 2007

Managing patient‐nonadherence with prescribed exercise regimens is not an uncommon task for physical therapists working with individuals with arthritis. Yet little is known about the factors that influence patient adherence with exercise programs or therapist knowledge and use of theoretically based adherence management techniques. Survey research with physical therapists and patients was used to provide a database for further insight into the barriers experienced in implementing exercise programs in clinical practice. In this paper, we suggest that the cooperation with an exercise regimen is mediated by the patient's belief system and requires a therapeutic process of mutual inquiry, problem solving, and negotiation between the therapist and patient. Concepts from research, theory, and practice are integrated into a Process Model for Patient‐Practitioner Collaboration for use in clinical practice.
Exercise considerations for postmenopausal women with osteoporosis
Authors: Allen Susan H.
Published: February 2007

Individuals with osteoporosis are at an increased risk of fracture due to a net loss of bone mass. The cellular mechanisms causing decreased bone mass are increased osteoclast‐mediated bone resorption and/or decreased osteoblast‐mediated bone formation. Clinical studies have shown that bone loss can be prevented by estrogen replacement therapy and calcium supplementation. Weight‐bearing and strengthening exercise may also play a role in retarding bone loss in the postmenopausal woman, and it may even increase bone mass. The essential components of an exercise program include intensity, duration, frequency, and type of activity. Additional goals of a therapeutic exercise program are to improve flexibility and balance, and to prevent falls. Structure‐function relationships in normal and osteoporotic bone and the effects of exercise on bone are reviewed. A rational approach for exercise strategies is discussed.
Dissatisfaction, disability, and rheumatoid arthritis
Authors: Hewlett Sarah , Young Phillip , Kirwan John
Published: February 2007

Objectives. To investigate dissatisfaction with function in patients with rheumatoid arthritis [RA], and to see if dissatisfaction can be adequately explained by level of function.

Methods. Fifty patients with RA were assessed for disease activity, psychological status, disability, expectation of future disability, and satisfaction with both global function and individual activities of daily living [ADL].

Results. Fifty percent of patients expressed dissatisfaction with global function, which correlated more strongly with pain (r = 0.474) and psychological status than with function (r = 0.398). Only 10% predicted improvement in global function. Seventy‐two percent expressed dissatisfaction with performing at least one ADL.

Conclusions. Patient dissatisfaction with both global function and individual ADL function is high and cannot adequately be explained by disability alone. Correlation with pain and psychological status implies that modifying these variables (perhaps through education programs about pain relief or relaxation) could reduce dissatisfaction.
Arthritis hand function test: Inter‐rater reliability among self‐trained raters
Authors: Backman Catherine , Mackie Hazel
Published: February 2007

Objective. The purpose of this project was to examine the inter‐rater reliability of the Arthritis Hand Function Test (AHFT), a new instrument for measuring hand strength and dexterity in adults with arthritis.

Methods. Six occupational therapists (two at each of three sites) trained themselves as AHFT administrators using the test manual and training videotape. They recruited 30 adult subjects (10 at each site) with rheumatoid arthritis or osteoarthritis affecting the hands. There were 21 women and 9 men in the sample (mean age, 57.5 years; average time since diagnosis, 14.8 years). Subjects were tested twice, once by each rater from that site.

Results. Inter‐rater reliability ranged from 0.45 to 0.99 (Pearson r). Because subjects were tested twice, AHFT scores were examined for an order effect. Although scores on all strength items declined by the second test session, and improved for all dexterity items, only the aggregate applied dexterity score showed significant change across all three sites (P = 0.002, 0.001, and 0.031, respectively).

Conclusions. These results suggest the AHFT is a reliable instrument for measuring hand strength and dexterity that requires minimal training on the part of occupational therapist raters.
Predictors of hand function in patients with rheumatoid arthritis
Authors: Dellhag Berit , Burckhardt Carol S.
Published: February 2007

Objectives. The aims of this study were to determine: (1) what factors predict patient self‐estimated hand function; (2) what factors predict actual hand function; and (3) the relationship among actual hand function, patient estimates of hand function, and self‐assessed activities of daily living (ADL).

Methods. Fifty‐two patients with rheumatoid arthritis completed wrist and hand mobility measures, grip strength, pain, stiffness, and estimated hand function tests, along with the Sollerman Grip Function Test (actual hand function), Health Assessment Questionnaire (HAQ), and subscales of the Arthritis Impact Measurement Scales (AIMS).

Results. Grip strength and stiffness were the strongest predictors of self‐estimated hand function. Flexion and extension deficits in digits II through V were the strongest predictors of actual hand function. Actual hand function and self‐estimated hand function were significantly correlated with each other and with the HAQ and AIMS subscales.

Conclusions. Measures of deficit are the most useful in predicting actual hand function, whereas measures of strength and flexibility are most useful for estimated hand function.
Reliability and validity of the CSSRD functional assessment survey in rheumatoid arthritis
Authors: Egger Marlene J. , Ward John R. , Karg Miki B. , Williams H. James , Reading James C.
Published: February 2007

Objective. To demonstrate the reliability and validity characteristics of a fast, intensively focused functional assessment questionnaire that has been used in rheumatoid arthritis clinical trials by the Cooperative Systematic Studies of Rheumatic Diseases group (CSSRD).

Methods. Data from three double‐blind, controlled clinical trials by CSSRD were used to examine the properties of the Functional Assessment Survey as a measure of physiologic function.

Results. The Functional Assessment Survey has reasonable test‐retest reliability and convergent validity with the Steinbrocker et al. functional class. It demonstrated appropriate divergent validity with other clinical measures of response, as well as discriminant validity.

Conclusions. The CSSRD Functional Assessment Survey is brief, intensive, and focused. Reliability and validity characteristics have been documented.
The sense of coherence scale in patients with rheumatoid arthritis
Authors: Callahan Leigh F. , Pincus Theodore
Published: February 2007

Objective. To analyze Antonovsky's Sense of Coherence (SOC) Scale, in 828 patients with rheumatoid arthritis (RA) from 15 private rheumatology practices. This scale is designed to evaluate strengths within individuals that allow them to select appropriate strategies to deal with stressors; both the total 29‐item (SOC‐29) total scale and a 13‐item (SOC‐13) short form of the 29‐item scale were analyzed.

Methods. Data were collected through mailed self‐report questionnaires as a component of a long‐term monitoring program. Internal consistency was evaluated according to Cronbach's alpha. Split‐halves reliability was estimated according to the Spearman‐Brown prophecy formula. Associations of the SOC‐29 and the SOC‐13 scale scores with demographic, clinical, and psychological variables were analyzed according to Pearson product moment correlations.

Results. Lower SOC‐29 and SOC‐13 scale scores were correlated significantly with higher scores for difficulty in performing activities of daily living (ADL), a visual analog pain scale score, global health status, and perceived learned helplessness. The levels of correlation for these variables suggest that each measure represents a construct that differs from the SOC. Lower scale scores were also correlated significantly with fewer years of formal education, adjusted for age, sex, and disease duration.

Conclusions. The SOC‐29 and SOC‐13 scales are reliable and valid in patients with RA. The SOC scale explained in part variation in clinical status in patients with RA. The SOC‐13 provides utility comparable to the SOC‐29 in patients with RA.
Predicting pain among children with juvenile rheumatoid arthritis
Authors: Hagglund Kristofer J. , Schopp Laura M. , Alberts Kristin R. , Cassidy James T. , Frank Robert G.
Published: February 2007

Objective. Children and adolescents with juvenile rheumatoid arthritis (JRA) often report pain as a major symptom that affects their daily activities. Little is known about the factors that contribute to pain, however. Demographic, disease status, and social‐psychologic variables were used to predict pain of JRA.

Methods. Participants were 37 girls and 23 boys who were 7 to 17 years old. Measures included the Hopelessness Scale for Children, the Sadness Scale from the Differential Emotions Scale—IV, and the Social Support Questionnaire‐Revised. A pain visual analogue scale served as the criterion measure.

Results. Reported pain was modestly correlated with disease duration and age. A hierarchical regression indicated that the predictor variables accounted for a modest amount of variance in pain scores.

Conclusions. The results suggest that the factors contributing to pain in children with JRA are different from those in adults with rheumatoid arthritis (RA). Research is needed to identify the psychologic and socioenvironmental variables that influence pain among children with JRA.
Self‐efficacy, pain, and physical activity among fibromyalgia subjects
Authors: Buckelew Susan P. , Murray Susan E. , Hewett John E. , Johnson Jane , Huyser Bruce
Published: February 2007

Purpose.The purpose of this study was to examine the effects of self‐efficacy on self‐report pain and physical activities among subjects with fibromyalgia (FM). In addition, descriptive statistics of the Arthritis Impact Measurement Scale (AIMS), a measure developed for use with arthritis patients, were reported.

Methods.Seventy‐nine subjects with FM, as classified by the American College of Rheumatology (ACR) criteria, completed the Visual Analogue Scale for Pain, the AIMS, and the Arthritis Self‐Efficacy Scale. A myalgic score was obtained during a tender point evaluation. Hierarchical multiple regression analyses were used to assess the effect of self‐efficacy on self‐report pain and physical activities measures after controlling for demographic variables (age, education, and symptom duration), disease severity (myalgic scores), and psychological distress (negative affect from the AIMS).

Results.Higher self‐efficacy was associated with less pain and less impairment on the physical activities measure after controlling for demographic and disease severity measures.

Conclusions.This study underscores the unique importance of self‐efficacy in understanding pain and physical activities impairment.
Predicting health care use among older osteoarthritis patients in an HMO
Authors: Cronan Terry A. , Shaw William S. , Gallagher Ruth A. , Weisman Michael
Published: February 2007

Objective. To determine factors that predict health care use among members of Health Maintenance Organizations (HMOs). Demographic, health, and psychological factors were examined simultaneously.

Methods. Participants were HMO members 60 years of age or older who had osteoarthritis (OA). All participants reported symptoms of OA, with 90% of the diagnoses confirmed by evaluation of physician records.

Results. Age, the presence of other medical conditions, quality of well‐being, and the Health Worries subscale from the Arthritis Impact Measurement Scales accounted for 11.2% of the total variance in health care contacts. A model including prior health care use, age, quality of well‐being, physical impairment, and pain accounted for 29.5% of the variance in utilization rates.

Conclusion. The best single predictor of health care utilization was prior use of the system. Being older, more impaired, and having lower well‐being scores were also predictors of health care use.
Relative contributions of spousal support and illness appraisals to depressed mood in arthritis patients
Authors: Schiaffino Kathleen M. , Revenson Tracey A.
Published: February 2007

Objective. To examine the ability of cognitive appraisals of illness and spousal support to modify depressed mood in arthritis patients.

Methods. Psychosocial data were collected from 64 married patients with rheumatoid arthritis (RA) within 2 years of diagnosis and at an 18–month fol‐lowup.

Results. The interaction of challenge appraisals with positive support received from the spouse was related to changes in depression over time. There was an increase in depression as challenge appraisals increased when accompanied by greater receipt of positive support, whereas individuals who did not experience a sense of challenge in response to the diagnosis of RA had the lowest levels of residualized depression when they also received higher positive support from their spouses at the beginning of the study.

Conclusion. The results are considered in terms of the cognitive‐behavioral mediation model suggested by Kerns and associates concerning the relationship of chronic pain to depression and have implications for interventions aimed at arthritis patients and their spouses.
Health‐related quality of life in patients with osteoarthritis in a family practice setting
Authors: De Bock G. H. , Kaptein A. A. , Touw‐Otten F. , Mulder J. D.
Published: February 2007

Objective. To study the impact of osteoarthritis (OA) on all areas of a patient's health‐related quality of life.

Methods. The Sickness Impact Profile (SIP) was administered to a group of patients with OA selected from a family medicine setting. The results were compared to a reference population, stratified by age, and adjusted for sex.

Results. OA was associated with significant impairment, and had an important impact on, health‐related quality of life in the areas of ambulation, body care and movement, emotional behavior, sleep and rest, home management, and work, especially in patients ages 41–60. The older patients differed less from the controls than did the younger ones. Items that contributed to the differences between OA patients and controls were mainly related to physical limitations.

Conclusion. Most dysfunctions related to OA are physical.
Concordant and discrepant views of patients' physical functioning
Authors: Berkanovic Emil , Hurwicz Margo‐Lea , Lachenbruch Peter A.
Published: February 2007

Objective. Although considerable research has been done on patient‐physician interaction, few studies have examined discrepancies between patients and physicians in their assessments of the patient's physical functioning. One recent study reports such discrepancies between rheumatologists and 41 % of their rheumatoid arthritis patients. This article reports data replicating that study and examining the relationships between such discrepancies and a number of other variables.

Methods. This is a longitudinal study of 158 patients with rheumatoid arthritis who were interviewed 4 times over a 2‐year period and who reported their levels of physical functioning on the Arthritis Impact Measurement Scales. At the time of the fourth interview, the rheumatologists rated each patient's physical functioning on the revised criteria published by the American College of Rheumatology.

Results. Rheumatologists' assessments of their patients' physical functioning were discrepant with the patient's assessment for 35% of these patients. Twenty‐seven patients were rated as worse than they rated themselves and 28 were rated as better. There were no differences between the concordant and the two discrepant groups in demographic or health status characteristics.

Conclusions. Taken together, these data imply that it is important for physicians to verify their perceptions with the patient and that it is important for patients to verify that the physician understands them correctly.
Use of commercially produced elastic wrist orthoses in chronic arthritis: A controlled study
Authors: Kjeken Ingvild , Møller Greta , Kvien Tore K.
Published: February 2007

Objective. To examine the efficacy of wrist or‐thoses on pain, motion, and function of the wrist.

Methods. Consecutive patients were randomized to a treatment group using wrist orthoses or to a control group using no wrist orthoses, in a prospective, controlled, 6‐month study.

Results. Changes in wrist joint variables and general disease activity variables were not statistically different between the orthosis group (n = 36) and the control group (n = 33). Patients in the orthosis group had 25% and 12% improvements in grip strength and pinch grip and 50% reduction in pain while using the wrist orthosis.

Conclusion. Use of wrist orthoses improves function and reduces pain, but has no effects after 6 months, compared to a control group, on measures of local or general disease activity.
Musculoskeletal complications of systemic lupus erythematosus in the hopkins lupus cohort: An update
Authors: Petri Michelle
Published: February 2007

Objective. To determine the frequency of musculoskeletal system damage among patients in the Hopkins Lupus Cohort, over time, and to determine predictors of musculoskeletal damage [including avascular necrosis of bone, osteoporosis, and fracture] in the same cohort.

Methods. Evaluation of the cohort visit database [from 1989 or at the time of entry into the cohort if later than 1989] for the 407 patients with systemic lupus erythematosus [SLE]. Musculoskeletal damage was measured by the SLICC/ACR Damage Index.

Results. Total damage and musculoskeletal damage accumulated from the time of diagnosis of SLE, and musculoskeletal damage continued over time, with avascular necrosis of bone being the most common form. African‐Americans and SLE patients of lower socioeconomic status were more likely to experience musculoskeletal damage. Use of corticosteroids was a major risk factor for both avascular necrosis of bone and osteoporosis.

Conclusio. Musculoskeletal damage remains one of the major sequela of SLE. Reduction of the modifiable risk factors [especially prednisone dose] is the key to both primary and secondary prevention efforts.
Physical fitness and work capacity in women with rheumatoid arthritis
Authors: Minor Marian A. , Hewett John E.
Published: February 2007

Objective. To investigate physical fitness and work capacity in women with rheumatoid arthritis (RA).

Methods. The 42 subjects were a subset of a prospective trial of conditioning exercise in rheumatic disease. Assignment to an exercise or nonexercise group was determined by proximity to the intervention, a 3‐month supervised group exercise program. Physical fitness and work capacity were assessed at baseline, 3 months, and 12 months.

Results. At baseline, subjects were deconditioned and limited in hand function, lifting ability, and lower extremity mobility. Only the exercise group improved their aerobic capacity and exercise tolerance. There were no significant changes in measured work capacity in either group. Moderate to strong correlations were found between aerobic capacity. mobility, hand function, and work capacity. Grip strength was a strong and consistent correlate of work capacity.

Conclusion. Our findings suggest that physical capacity, particularly hand function, may be important in the complex phenomenon of work disability in RA.
Health insurance problems among insured rheumatoid arthritis patients
Authors: Reisine Susan , Fifield Judith
Published: February 2007

Objective. To describe limitations in insurance coverage and their financial impact among a sample of rheumatoid arthritis (RA) patients.

Methods. A national sample of RA patients followed since 1988, completed a telephone interview about health insurance coverage, experiences with preexisting conditions clauses, and the financial impact of arthritis. Descriptive and multivariate logistic regression techniques were used to analyze the demographics and health status data.

Results. Trends in insurance coverage among people in this sample showed that participants were more likely to be in an HMO or PPO currently than 5 years previously. A majority of participants (67%) experienced financial impact from arthritis; 35% said that arthritis limited their ability to earn a living. Twenty‐one percent had some insurance limitation because of arthritis as a preexisting condition. Eleven percent had been denied insurance. Those who had higher scores on the Stanford Health Assessment Questionnaire, were younger, were covered by Blue Cross/ Blue Shield, and were more likely to be affected by a preexisting condition limitation.

Conclusion. The data clearly indicate that even well‐insured RA patients receiving care from rheumatologists experience limitations related to preexisting conditions and considerable financial impact.
A comparison of recruitment methods for an osteoarthritis exercise study
Authors: Maurer Brian T. , Moreno Steven I. , Pickard Amy R. , Wurst Brooke E. , Norden Daniel K. , Schumacher H. Ralph
Published: February 2007

Objective. Patient recruitment often involves a great deal of effort and cost. We sought to determine successful recruitment methods for an osteoarthritis (OA) exercise study, and to subsequently focus on using those approaches.

Methods. Eleven methods were developed to recruit subjects for this large research project. Financial constraints ensured that we focused on low‐cost measures. Over a 20‐month period, the numbers of both total respondents and eventual participants were recorded.

Results. Responses were recorded for 263 individuals, and 108 subjects entered the study. The most successful recruitment method was via physician referrals from affiliated clinics. In general, methods that were free of direct cost seemed no less successful than those requiring expenditures.

Conclusion. Successful subject recruitment, even for a large study, may not require costly advertising. Direct contact and frequent reminders rendered to our own clinics proved most effective, but other free and low‐cost approaches were also of benefit.
Predictors of blood loss during total hip replacement surgery
Authors: Grosflam Jodi M. , Wright Elizabeth A. , Cleary Paul D. , Katz Jeffrey N.
Published: February 2007

Objective. To determine total blood loss and transfusion requirements during primary total hip replacement (THR) surgery; and, to identify predictors of increased blood loss.

Methods. This was a prospective cohort study of 295 consecutive patients undergoing primary THR at α 700‐bed teaching hospital in Boston, Massachusetts. The main outcome measures were the total blood loss, which was defined (in units) as the initial hematocrit minus final hematocrit divided by 3 plus the number of units transfused, and the number of autologous and homologous units of blood transfused.

Results. The mean total blood loss was 3.6 units, and the mean total units transfused was 2.1. Univariate predictors of greater total blood loss (at P < 0.05) included being male, receiving general anesthesia, and higher American Society of Anesthesiologists (ASA) class. In multiple linear regression models which controlled for demographic and clinical variables (age, race, marital status, education, smoking history, obesity, underlying disease, payor status, cemented prosthesis, comorbidity, and season of operation), being male, receiving general anesthesia, and having an ASA score of 3 predicted greater total blood loss.

Conclusion. Preoperative characteristics can help determine which patients should donate either more or less than the customary 2 units of blood.
Association of radiographic features of osteoarthritis of the knee with knee pain: Data from the baltimore longitudinal study of aging
Authors: Lethbridge‐Çejku Margaret , Scott William W. , Reichle Ralph , Ettinger Walter H. , Zonderman Alan , Costa Paul , Plato Chris C. , Tobin Jordan D. , Hochberg Marc C.
Published: February 2007

Objective. To examine the association between selfreported knee pain and radiographic features of osteoarthritis (OA) of the knee.

Methods. A sample of participants in the Baltimore Longitudinal Study of Aging (452 Caucasian males and 223 Caucasian females) completed questionnaires and underwent a standing radiograph of both knees at the same biennial visit between 1984 and 1989. Radiographs were interpreted using both the Kellgren‐Lawrence and individual features scales. Odds ratios were calculated for the association of radiographic features with knee pain after adjustment for age, sex, and body mass index.

Results. Overall, 156 (23%) persons reported ever having knee pain, and 104 (15%) reported current knee pain (within the previous year). Both ever knee pain and current knee pain were significantly associated with the presence of definite knee OA (Kellgren‐Lawrence grade ≥2) and with the presence of all individual features. There was a direct relationship between all measures of severity of radiographic OA and knee pain.

Conclusion. These data demonstrate that radiographic features of knee OA are significantly associated with knee pain. The data also support the continued use of the Kellgren‐Lawrence grading scale for defining knee OA in population studies.
Concurrent validity of the health assessment questionnaire disability index in scleroderma
Authors: Poole Janet L. , Williams Catherine A. , Bloch Daniel A. , Hollak Brooke , Spitz Patricia
Published: February 2007

Objective. To establish the concurrent validity of the Health Assessment Questionnaire (HAQ) Disability Index in systemic sclerosis (SSc; scleroderma).

Methods. Eighty subjects with SSc completed the HAQ Disability Index questionnaire. An occupational therapist, who was blind to the subjects' responses, observed each subject's performance on 10 of the items.

Results. Paired t‐tests showed significant differences between the observer and subjects' responses for tying shoes, buttoning, gripping, and walking. Intra‐class correlations between observer and subjects ranged from 0.38 to 0.76.

Conclusion. The results support the validity of the HAQ Disability Index in patients with systemic sclerosis.
Women, men, and osteoarthritis
Authors: Verbrugge Lois M.
Published: February 2007

Objectives and Methods. Gender differences in the prevalence and impact of arthritis are discussed, using data and analytic results from national health surveys.

Results. Most cases of arthritis are osteoarthritis, an ancient disease that causes pain, physical dysfunction, and social disability, but not death. Arthritis prevalence rates rise sharply with age; it is the leading chronic condition in mid and late life. Women's rates exceed men's at all ages. Women's higher rates of disability and medical services for arthritis in the population are due mainly to higher prevalence. Among persons with arthritis, women are only a little more likely than men to be disabled or receive medical services. Persons with arthritis often have other chronic conditions as well (called comorbidity). Combining arthritis and visual problems gives a strong exacerbating push to disability.

Conclusions. Because biomedical research emphasizes pathogenesis and therapies for fatal conditions, Americans' health future will become dominated by nonfatal ones, especially arthritis. I recommend a better balance and new orientation for arthritis research that stays true to older persons' health and disability experience.
Mortality in the rheumatic diseases
Authors: Callahan Leigh F. , Pincus Theodore
Published: February 2007

Objective. To review mortality data in published studies of various rheumatic diseases.

Methods. A MEDLINE search of the literature on the rheumatic diseases, including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, scleroderma, polymyositis, and vasculitis.

Results. Mortality rates higher than expected have been reported in most rheumatic conditions, considerably higher for inflammatory rheumatic diseases. The mortality rates in patients with systemic lupus erythematosus, scleroderma, polymyositis, and vasculitis are often comparable to mortality rates seen in patients with neoplastic or cardiovascular diseases, although the causes of death often are not identified as the rheumatic disease.

Conclusion. Mortality has been found to be predicted in most instances by more severe clinical status, and therefore death should not be considered as “unrelated” to the rheumatic disease. These observations may have important implications for clinical care and health policies regarding patients with rheumatic diseases.
Arthritis and the family
Authors: Reisine Susan T.
Published: February 2007

Objectives. This paper reviews the literature on arthritis and the family in two areas, juvenile rheumatic diseases and adult‐onset arthritis.

Methods. All published papers related to arthritis and the family were identified through a Medline search and through hand searching of the major rheumatology journals.

Results. The literature on the family and juvenile arthritis is somewhat inconsistent, in that some studies demonstrate significant psychosocial impact among children and families, while others find no differences in children who have arthritis compared to normative data or to siblings. Lack of consistency in the literature is largely related to methodologic problems, as most studies are retrospective reports, consisting of relatively small, nonrepresentative samples of children with rheumatic diseases. The influence of adult‐onset rheumatoid arthritis and osteoarthritis on family role functioning and the performance of household responsibilities is well documented, and a body of literature on the importance of family functioning to well‐being is accumulating.

Conclusions. Future studies should expand sample sizes in order to investigate family impact on juvenile rheumatoid arthritis more thoroughly. More studies on the factors that contribute to improved family functioning and subsequent improvements in well‐being, especially in conditions other than rheumatoid arthritis and osteoarthritis, are needed. Intervention studies to reduce perceived pain and functional disability in arthritis by incorporating a family‐systems perspective are particularly lacking.
The impact of rheumatoid arthritis on life activities
Authors: Katz Patricia P.
Published: February 2007

Objective. To examine the proportion of valued activities performed by persons with rheumatoid arthritis (RA) and the change in this proportion over a 5‐year period and to compare the performance and loss of valued activities of persons with and without RA.

Methods. Data were drawn from a longitudinal panel study of persons with RA. Valued activities were assessed using a standardized questionnaire.

Results. Over a 5‐year period, persons with RA lost approximately 10% of the activities they had valued. Losses were noted in every domain of activity. The greatest losses were seen in work‐related, service, nurturant, cultural and leisure, and social participation activities. Compared to persons without arthritis, persons with RA performed fewer valued activities at baseline, and lost more valued activities over the 5‐year period.

Conclusions. RA takes a considerable toll on the ability of people with the disease to perform valued life activities. Other research has shown that the loss of valued activities is a strong risk factor for the development of depressive symptoms among women with RA.
The psychological impact of arthritis: Prevalence of depression
Authors: DeVellis Brenda McEvoy
Published: February 2007

Attempts to estimate the prevalence of depression in people with arthritis are complicated by conceptual, definitional, and measurement problems and inconsistencies. Following a description of these methodologic problems, recent studies of depressive disorders and depressive symptoms in clinical and community samples are reviewed. The review suggests that although most people with rheumatic diseases do not experience them, depressive disorders and symptoms are probably more prevalent among people with rheumatic diseases than among people with no chronic diseases. This somewhat increased prevalence is probably no greater than that found in other serious chronic diseases, however. Additional research is needed.
From early twinges to mastery: The process of adjustment in living with rheumatoid arthritis
Authors: Shaul Muriel P.
Published: February 2007

Objective.To describe the experiences of women who have learned to live with rheumatoid arthritis (RA), and to explore how women manage this chronic illness and the demands of their everyday lives.

Methods.Thirty women with a diagnosis of RA were interviewed in their homes. The women were encouraged to “tell their story of living with RA,” from the first symptom to the present, using a semistructured questionnaire. Qualitative data were analyzed using a constant comparative analytic process.

Results.Learning to live with RA was characterized by periods of uncertainty, of learning about the illness, discovering strategies that allowed the women to meet the expectations of their roles as women, and the establishment of new patterns of daily life. The women became experts at managing their RA and developed a sense of mastery in coping with their symptoms.

Conclusions.Persons with RA need support and guidance, beginning with the onset of the disease, to facilitate achieving mastery in living with this chronic illness.
Musculoskeletal conditions and employment
Authors: Yelin Edward H.
Published: February 2007

Objective. To describe the prevalence, incidence, and correlates of work disability among persons with musculoskeletal conditions.

Methods. Literature review and analysis of the Health and Retirement Survey, a national, probability sample of community‐based adults ages 51–61.

Results. Clinical samples of persons with RA report work disability rates of 51% to 60%. Communitybased studies of persons with a broad range of musculoskeletal conditions find work disability rates of 38% to 72%, depending on the mix of symptoms and particular sampling strategy. Persons with musculoskeletal conditions and comorbidity are particularly prone to work loss, with three‐quarters leaving work prior to the normal age of retirement. In multivariate models, after adjusting for demographic and functional characteristics, persons with musculoskeletal conditions actually are more likely to work than those without.

Conclusions. Persons with musculoskeletal conditions have high rates of work disability, but given their level of impairment, are more likely to work than persons without musculoskeletal conditions.
Synthesis of [18,19,21,22‐13C4]‐Labeled Tautomycin as an NMR Probe of Protein Phosphatase Inhibitor
Authors: Isobe Minoru , Kurono Masakuni , Tsuboi Katsunori , Takai Akira
Published: February 2007

We have accomplished the synthesis of 13C‐labeled tautomycin at the C18, C19, C21, and C22 positions starting from 100 % [13C]triethylphosphonoacetate for the purpose of elucidating the dynamics and conformation of the C17–C26 moiety. NMR spectroscopy of 13C‐labeled tautomycin revealed strong binding with protein phosphatase type 1 and new features in the 13C NMR spectrum, such as the very small three‐bond coupling constants (2J).
Accelerated formation of multicellular 3‐D structures by cell‐to‐cell cross‐linking
Authors: De Bank Paul A. , Hou Qingpu , Warner Robert M. , Wood Ian V. , Ali Bahaa E. , MacNeil Sheila , Kendall David A. , Kellam Barrie , Shakesheff Kevin M. , Buttery Lee D.K.
Published: February 2007

The three‐dimensional (3‐D) arrangement of cells within tissues is integral to their development and function. Advances in stem cell science and regenerative medicine have stimulated interest in the replication of this architecture in vitro. We have developed a versatile method for controlling short‐term cell–cell and cell–matrix interactions via a facile cell surface engineering process that enables the rapid formation of specific 3‐D interactions for a range of cell types. We demonstrate that chemical modification of cell surfaces and matrix proteins can artificially accelerate the cell adhesion process and confirm the ability to control the formation of multicellular aggregates with defined architectures and heterotypic cell types. Direct comparison with a natural aggregation process seen during differentiation of embryonic stem (ES) cells revealed increased expression of developmental regulatory proteins and a concomitant enhancement of ES cell differentiation. Furthermore, this new methodology has numerous applications in generating layered structures. For example, we demonstrate improved transfer of therapeutic human keratinocytes onto a dermal layer in a skin repair model. Biotechnol. Bioeng. 2007; 97: 1617–1625. © 2007 Wiley Periodicals, Inc.
Bacterial oxidation of ferrous iron at low temperatures
Authors: Kupka Daniel , Rzhepishevska Olena I. , Dopson Mark , Lindström E. Börje , Karnachuk Olia V. , Tuovinen Olli H.
Published: February 2007

This study comprises the first report of ferrous iron oxidation by psychrotolerant, acidophilic iron‐oxidizing bacteria capable of growing at 5°C. Samples of mine drainage‐impacted surface soils and sediments from the Norilsk mining region (Taimyr, Siberia) and Kristineberg (Skellefte district, Sweden) were inoculated into acidic ferrous sulfate media and incubated at 5°C. Iron oxidation was preceded by an approximately 3‐month lag period that was reduced in subsequent cultures. Three enrichment cultures were chosen for further work and one culture designated as isolate SS3 was purified by colony isolation from a Norilsk enrichment culture for determining the kinetics of iron oxidation. The 16S rRNA based phylogeny of SS3 and two other psychrotolerant cultures, SS5 from Norilsk and SK5 from Northern Sweden, was determined. Comparative analysis of amplified 16S rRNA gene sequences showed that the psychrotolerant cultures aligned within Acidithiobacillus ferrooxidans. The rate constant of iron oxidation by growing cultures of SS3 was in the range of 0.0162–0.0104 h−1 depending on the initial pH. The oxidation kinetics followed an exponential pattern, consistent with a first order rate expression. Parallel iron oxidation by a mesophilic reference culture of Acidithiobacillus ferrooxidans was extremely slow and linear. Precipitates harvested from the 5°C culture were identified by X‐ray diffraction as mixtures of schwertmannite (ideal formula Fe8O8(OH)6SO4) and jarosite (KFe3(SO4)2(OH)6). Jarosite was much more dominant in precipitates produced at 30°C. Biotechnol. Bioeng. 2007;97:1470–1478. © 2007 Wiley Periodicals, Inc.
Concurrent nitrite oxidation and aerobic denitrification in activated sludge exposed to volatile fatty acids
Authors: Oguz Merve T. , Robinson Kevin G. , Layton Alice C. , Sayler Gary S.
Published: February 2007

The goal of this research was to investigate the simultaneous occurrence of nitrification and denitrification by activated sludge exposed to volatile fatty acids (VFAs) during aerobic wastewater treatment using a single‐stage reactor. A mixture of VFAs was spiked directly into a continuous‐stirred tank reactor (CSTR) to assess subsequent impacts on nitrite removal, nitrate formation, CO2 fixation, total bacterial density, and dominant nitrite oxidizing bacteria (NOB) concentration (i.e., Nitrospira). The activity of the periplasmic nitrate reductase (NAP) enzyme and the presence of nap gene were also measured. A rapid decrease in the nitrate formation rate (>70% reduction) was measured for activated sludge exposed to VFAs; however, the nitrite removal rate was not reduced. The total bacterial density and Nitrospira concentration remained essentially constant; therefore, the reduction in nitrate formation rate was likely not due to heterotrophic uptake of nitrogen or to a decrease in the dominant NOB population. Additionally, VFA exposure did not impact microbial CO2 fixation efficiency. The activity of NAP enzyme increased in the presence of VFAs suggesting that nitrate produced as a consequence of nitrite oxidation was likely further reduced to gaseous denitrification products via catalysis by NAP. Little, if any, nitrogen was discharged in the aqueous effluent of the CSTR after exposure to VFAs demonstrating that activated sludge treatment yielded compounds other than those typically produced solely by nitrification. Biotechnol. Bioeng. 2007; 97: 1562–1572. © 2007 Wiley Periodicals, Inc.
Cryopreservation in micro‐volumes: Impact upon caco‐2 colon adenocarcinoma cell proliferation and differentiation
Authors: Malpique Rita , Katsen‐Globa Alisa , Carrondo Manuel J.T. , Zimmermann Heiko , Alves Paula M.
Published: February 2007

Recent advances in cell‐based therapies require new approaches for cell cryopreservation, capable of dealing with large number of samples and providing specific conditions for each cell type. Reduction of sample volume from the commonly used 1 mL to 25 µL in 30‐well micro‐cryosubstrates improves cryopreservation by allowing automation, data handling and access to individual wells without thawing the whole cryosubstrate. This system was evaluated for the storage of Caco‐2 colon adenocarcinoma cells, which differentiate spontaneously after long‐term culture. The impact of the cryosample small volume upon post‐thawing membrane integrity of the cells and their capacity to proliferate and differentiate was studied. Two different cryoprotectants commonly employed, dimethyl sulfoxide (Me2SO) and glycerol, were evaluated as well as the possibility of decreasing their concentration from the 10% concentration, usually used, down to 3% (v/v). The process automation by pipette robotic addition of the cryoprotectant to the micro‐cryosubstrates was also evaluated. The micro‐cryosubstrates have proven to be at least as efficient as typical 1 mL cryovials for cryopreservation of Caco‐2 cells using either Me2SO or glycerol. Compared to the manual process, the automatic addition of glycerol to the micro‐cryosubstrates allowed higher cell viabilities after thawing while with Me2SO no significant changes were observed. Me2SO has shown to be more effective than glycerol in maintaining high post‐thaw cell membrane integrity, either in micro‐cryosubstrates or cryovials, for any of the concentrations tested. The ability of Me2SO in maintaining high cell membrane integrity post‐thawing was confirmed by long‐term (up to 22 days) proliferation and differentiation studies performed with cells cultured immediately after thawing. Biotechnol. Bioeng. 2007; 98: 155–166. © 2007 Wiley Periodicals, Inc.