bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of depression in a multiethnic cohort of patients with rheumatoid arthritis
Authors: Margaretten M. , Yelin E. , Imboden J. , Graf J. , Barton J. , Katz P. , Julian L. 
Published: October 2009

AbstractObjectivePatients with rheumatoid arthritis (RA) who experience depression have worse health outcomes. This study identifies predictors of depression in an ethnically and racially diverse population of patients with RA.MethodsPatients with RA in a prospective cohort at the San Francisco General Hospital outpatient rheumatology clinic were included if they were age ≥18 years, met the American College of Rheumatology classification criteria for RA, had a Health Assessment Questionnaire (HAQ) score collected, and had the RA‐specific Disease Activity Score performed by a rheumatologist. The outcome variable was a depression score measured by the Patient Health Questionnaire 9 (PHQ‐9), a self‐report questionnaire validated to correlate with a diagnosis of major depression.ResultsThree hundred forty‐nine clinical visits for 172 patients were included in the analysis. Forty percent of patients scored ≥10 on the PHQ‐9 during at least one clinic visit, which corresponds to a symptom severity of at least moderate depression. The mean PHQ‐9 score was 7, corresponding to a symptom severity of mild depression. In the multivariate analysis, higher HAQ scores were associated with depression, and Asians had lower depression scores compared with Hispanic, white, and African American subjects.ConclusionIdentifying associated predictors of depression in a diverse population of patients with RA can help guide treatment, which should include preventing disability and decreased function as well as targeting depressive symptoms more specifically in patients with RA.
Comparison of clinical versus ultrasound‐determined synovitis in juvenile idiopathic arthritis
Authors: Magni‐Manzoni Silvia , Epis Oscar , Ravelli Angelo , Klersy Catherine , Veisconti Chiara , Lanni Stefano , Muratore Valentina , Sciré Carlo Alberto , Rossi Silvia , Montecucco Carlomaurizio 
Published: October 2009

AbstractObjectiveTo compare clinical evaluation and ultrasonography (US) in the assessment of joint synovitis in children with juvenile idiopathic arthritis (JIA).MethodsThirty‐two patients underwent clinical evaluation of 52 joints by 2 pediatric rheumatologists. Joints were assessed for swelling, tenderness/pain on motion, and restricted motion. The same joints were scanned independently by an experienced sonographer for synovial hyperplasia, joint effusion, and power Doppler (PD) signal.ResultsIn total, 1,664 joints were assessed both clinically and with US. On clinical examination, 98 joints (5.9%) were swollen, 59 joints (3.5%) were tender, and 40 joints (2.4%) had restricted motion. On US evaluation, 125 joints (7.5%) had synovial hyperplasia, 153 joints (9.2%) had joint effusion, and 53 joints (3.2%) had PD signal. A total of 104 (6.3%) and 167 (10%) joints had clinical and US synovitis, respectively. Of the 1,560 clinically normal joints, 86 (5.5%) had subclinical synovitis (i.e., had synovitis on US). US led to classifying 5 patients as having polyarthritis who were classified as having oligoarthritis or were found to have no synovitis on clinical evaluation. US variables were moderately correlated with clinical measures of joint swelling, but poorly correlated with those of joint tenderness/pain on motion and restricted motion. Overall, correlations were lower for PD signal than for synovial hyperplasia and joint effusion.ConclusionWe found that subclinical synovitis as detected by US is common in children with JIA. This finding may have important implications for patient classification and may affect the choice of the optimal therapeutic strategy in individual patients.
Cartilage loss occurs in the same subregions as subchondral bone attrition: A within‐knee subregion‐matched approach from the multicenter osteoarthritis study
Authors: Neogi T. , Felson D. , Niu J. , Lynch J. , Nevitt M. , Guermazi A. , Roemer F. , Lewis C. E. , Wallace B. , Zhang Y. 
Published: October 2009

AbstractObjectiveBy magnetic resonance imaging (MRI), subchondral bone attrition (SBA) can be seen in early osteoarthritis (OA), but the significance of this is unknown. We therefore evaluated whether SBA was associated with cartilage loss within the same subregion of the knee.MethodsThe Multicenter Osteoarthritis Study is a cohort of individuals who have or are at high risk for knee OA. At baseline and 30 months, participants' knee MRIs were graded using the Whole‐Organ Magnetic Resonance Imaging Score in the 10 subregions of the tibiofemoral joint for cartilage morphology and SBA. We conducted analyses within a knee to eliminate between‐person confounding, using an M:N (cases:controls) matched case–control approach with the 10 subregions of a person's knee forming a matched set. Cases within a knee were defined as subregions with cartilage loss, while controls were subregions in that same knee without cartilage loss. We evaluated the association of cartilage loss over 30 months with the presence of baseline SBA in the same subregion within that knee using conditional logistic regression.ResultsSBA was associated with an odds ratio of 7.5 (95% confidence interval 5.6–9.9, P < 0.0001) for cartilage loss in the same subregion compared with subregions without any baseline SBA in our sample of 459 knees from participants, 64% of whom were women, with a mean age of 63 years and a mean body mass index of 30.5 kg/m2.ConclusionSBA is strongly associated with cartilage loss within the same subregion of a knee. SBA may directly influence overlying cartilage loss or serve as a marker of an area undergoing great compressive stress and in which cartilage loss is inevitable.
UK‐based physical therapists' attitudes and beliefs regarding exercise and knee osteoarthritis: Findings from a mixed‐methods study
Authors: Holden Melanie A. , Nicholls Elaine E. , Young Julie , Hay Elaine M. , Foster Nadine E. 
Published: October 2009

AbstractObjectiveWithin the UK, differences exist between physical therapists' use of exercise for patients with knee osteoarthritis (OA) and recent exercise recommendations. This may be explained by their underlying attitudes and beliefs. We aimed to describe UK physical therapists' attitudes and beliefs regarding exercise and knee OA, and understand and explain them.MethodsA survey was mailed to 2,000 UK‐based chartered physical therapists that included 23 attitude statements derived from recently published recommendations. Semistructured telephone interviews were conducted with a purposeful sample of questionnaire respondents (n = 24), and were recorded and analyzed thematically.ResultsThe questionnaire response rate was 58% (n = 1,152); 538 respondents reported treating a patient with knee OA in the last 6 months. The survey highlighted uncertainty about potential benefits of exercise for knee OA: only 56% largely/totally agreed that knee problems are improved by local exercise. Although exercise adherence was deemed important, it was seen as the patient's, not the therapist's, responsibility. Interviews revealed an underlying biomedical model of care of knee pain, with knee OA viewed as a progressive degenerative condition. A paternalistic treatment approach was evident. Health care systems presented a number of barriers to best practice, including limited opportunity to provide followup.ConclusionAlthough the attitudes and beliefs of physical therapists may help to explain differences between current practice and recent exercise recommendations, the wider health care system also plays a part. Further research is needed to support meaningful shifts in physical therapy care in line with the best practice recommendations.
Arthritic pain among Latinos: Results from a community‐based survey
Authors: Cheriel Chad , Huguet Nathalie , Gupta Shalini , McClure Heather , Leman Richard F. , Ngo Duyen L. 
Published: October 2009

AbstractObjectiveTo examine factors associated with pain among Latinos with arthritis, identify common coping strategies and potentially effective interventions, and determine whether pain levels affect the level of interest in potentially useful programs.MethodsUsing a convenience sampling approach and a combination of face‐to‐face and telephone surveys, 588 Latino adults in Oregon with arthritis were interviewed. The intensity of pain during a typical day was assessed using a scale ranging from 0 (no pain) to 10 (worst pain). A score of ≥7 was defined as severe pain.ResultsMore than 60% of Latinos reported severe pain. Results from an ordinary least square regression indicated that among Latinos with arthritis, women, those with lower levels of education, and those reporting poor or fair self‐rated health and functional limitations had higher levels of pain, after controlling for confounders. Those with severe pain were more likely than those with lower levels of pain to use over the counter medicine and home remedies to manage their arthritis. In addition, Latinos with greater pain were more likely to be interested in arthritis management programs.ConclusionThese findings have important implications for public health policy. The strong interest of Latinos in various arthritis and joint pain management programs could prove to be an important avenue for supporting a population with high levels of arthritic pain and lack of health insurance. These pain management programs are all the more appealing, given the availability of a number of evidence‐based, low‐cost interventions.
Tai Chi is effective in treating knee osteoarthritis: A randomized controlled trial
Authors: Wang Chenchen , Schmid Christopher H. , Hibberd Patricia L. , Kalish Robert , Roubenoff Ronenn , Rones Ramel , McAlindon Timothy 
Published: October 2009

AbstractObjectiveTo evaluate the effectiveness of Tai Chi in the treatment of knee osteoarthritis (OA) symptoms.MethodsWe conducted a prospective, single‐blind, randomized controlled trial of 40 individuals with symptomatic tibiofemoral OA. Patients were randomly assigned to 60 minutes of Tai Chi (10 modified forms from classic Yang style) or attention control (wellness education and stretching) twice weekly for 12 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score at 12 weeks. Secondary outcomes included WOMAC function, patient and physician global assessments, timed chair stand, depression index, self‐efficacy scale, and quality of life. We repeated these assessments at 24 and 48 weeks. Analyses were compared by intent‐to‐treat principles.ResultsThe 40 patients had a mean age of 65 years and a mean body mass index of 30.0 kg/m2. Compared with the controls, patients assigned to Tai Chi exhibited significantly greater improvement in WOMAC pain (mean difference at 12 weeks −118.80 mm [95% confidence interval (95% CI) −183.66, −53.94; P = 0.0005]), WOMAC physical function (−324.60 mm [95% CI −513.98, −135.22; P = 0.001]), patient global visual analog scale (VAS; −2.15 cm [95% CI −3.82, −0.49; P = 0.01]), physician global VAS (−1.71 cm [95% CI −2.75, −0.66; P = 0.002]), chair stand time (−10.88 seconds [95% CI −15.91, −5.84; P = 0.00005]), Center for Epidemiologic Studies Depression Scale (−6.70 [95% CI −11.63, −1.77; P = 0.009]), self‐efficacy score (0.71 [95% CI 0.03, 1.39; P = 0.04]), and Short Form 36 physical component summary (7.43 [95% CI 2.50, 12.36; P = 0.004]). No severe adverse events were observed.ConclusionTai Chi reduces pain and improves physical function, self‐efficacy, depression, and health‐related quality of life for knee OA.
Erythrocyte sedimentation rate, C‐reactive protein level, and serum amyloid A protein for patient selection and monitoring of anti–tumor necrosis factor treatment in ankylosing spondylitis
Authors: de Vries Mirjam K. , van Eijk Izhar C. , van der Horst‐bruinsma Irene E. , Peters Mike J. L. , Nurmohamed Michael T. , Dijkmans Ben A. C. , Hazenberg Bouke P. C. , Wolbink Gerrit J. 
Published: October 2009

AbstractObjectiveTo study the usefulness of erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), and serum amyloid A (SAA) for response prediction and monitoring of anti–tumor necrosis factor (anti‐TNF) treatment in ankylosing spondylitis (AS) patients.MethodsPatients were included consecutively before starting etanercept or infliximab treatment. ASsessment in Ankylosing Spondylitis (ASAS) response, defined as a 50% improvement or an absolute improvement of 2 points of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI; 0–10 scale), was assessed at 3 months. Inflammatory markers and the BASDAI were collected at baseline and 1 and 3 months. Longitudinal data analysis was performed to compare associations between inflammatory markers and the BASDAI over time by calculating standardized betas. Predictive values of baseline levels of inflammatory markers for ASAS response were calculated.ResultsIn total, 155 patients were included, of whom, after 3 months of treatment, 70% in the etanercept cohort and 71% in the infliximab cohort responded. All markers, notably SAA, decreased significantly (P < 0.0001). Standardized betas were 0.49 for ESR, 0.43 for CRP, and 0.39 for SAA. Normal baseline levels of CRP and SAA were significantly associated with nonresponse. A combination of elevated CRP and SAA levels at baseline revealed the highest predictive value (81%) for ASAS response.ConclusionESR, CRP, and SAA were significantly associated with the BASDAI over 3 months, and the association with ESR was the strongest. Elevated baseline CRP and SAA levels revealed the highest predictive value for response. Together, this study demonstrates that inflammatory markers, and notably CRP and SAA, may facilitate patient selection and monitoring of efficacy of anti‐TNF treatment in AS, and could be added to response criteria.
Whole‐body bone scintigraphy provides a measure of the total‐body burden of osteoarthritis for the purpose of systemic biomarker validation
Authors: Addison Shelby , Coleman R. Edward , Feng Sheng , McDaniel Gary , Kraus Virginia Byers 
Published: October 2009

AbstractObjectiveTo evaluate the association of serum and synovial fluid cartilage oligomeric matrix protein (COMP) with systemic and local measures of osteoarthritis (OA) activity by bone scintigraphy.MethodsSamples of serum and knee joint synovial fluid (275 knees) were obtained from 159 patients with symptomatic OA of at least 1 knee. Bone scintigraphy using99mTc‐labeled methylene diphosphonate was performed, and early‐phase knee scans and late‐phase whole‐body bone scans of 15 additional joint sites were scored semiquantitatively. To control for within‐subject correlations of knee data, generalized linear modeling was used in the correlation of the bone scan scores with the COMP levels. Principal components analysis was used to explore the contribution of each joint site to the variance in serum COMP levels.ResultsThe correlation between synovial fluid and serum COMP levels was significant (r = 0.206,P= 0.006). Synovial fluid COMP levels correlated most strongly with the early‐phase knee bone scan scores (P= 0.0003), even after adjustment for OA severity according to the late‐phase bone scan scores (P= 0.015), as well as synovial fluid volumes (P< 0.0001). Serum COMP levels correlated with the total‐body bone scan scores (r = 0.188,P= 0.018) and with a factor composed of the bone scan scores in the shoulders, spine, lateral knees, and sacroiliac joints (P= 0.0004).ConclusionSynovial fluid COMP levels correlated strongly with 2 indicators of knee joint inflammation: early‐phase bone scintigraphic findings and synovial fluid volume. Serum COMP levels correlated with total‐body joint disease severity as determined by late‐phase bone scintigraphy, supporting the hypothesis that whole‐body bone scintigraphy is a means of quantifying the total‐body burden of OA for systemic biomarker validation.
The robust association between childhood physical abuse and osteoarthritis in adulthood: Findings from a representative community sample
Authors: Fuller‐Thomson Esme , Stefanyk Maria , Brennenstuhl Sarah 
Published: October 2009

AbstractObjectiveResearch suggests a role of early‐life trauma in the development of arthritis. This study investigated the relationship between childhood physical abuse and osteoarthritis (OA) while controlling for age, sex, race, and socioeconomic status (SES), in addition to the following types of risk factors for OA: 1) concurrent childhood stressors, 2) adult health behaviors, and 3) depression.MethodsData from the provinces of Manitoba and Saskatchewan were selected from the 2005 Canadian Community Health Survey (n = 13,093). Respondents with missing arthritis data or with arthritis types other than OA were excluded (n = 1,985). Of the 11,108 remaining respondents, 6.9% (n = 854) reported childhood physical abuse by someone close to them, and 10.1% (n = 1,452) reported that they had been diagnosed with OA by a health professional. The regional‐level response rate was 84%.ResultsWhen adjusting for all 3 types of risk factors, a significant association between childhood physical abuse and OA was found (odds ratio [OR] 1.56, 95% confidence interval [95% CI] 1.21–2.00). In contrast, when adjusting for age, sex, race, and SES only, the OR was 1.99 (95% CI 1.57–2.52).ConclusionThe association between childhood physical abuse and OA remained significant, even after controlling for many risk factors that may mediate the relationship. Further research is needed to investigate potential pathways through which arthritis develops as a consequence of childhood physical abuse.
Improved influenza and pneumococcal vaccination in rheumatology patients taking immunosuppressants using an electronic health record best practice alert
Authors: Ledwich Lindsay J. , Harrington Thomas M. , Ayoub William T. , Sartorius Jennifer A. , Newman Eric D. 
Published: October 2009

AbstractObjectiveTo examine whether an electronic health record (EHR) best practice alert (BPA), a clinical reminder to help guideline adherence, improved vaccination rates in rheumatology patients receiving immunosuppressants. Guidelines recommend yearly influenza and pneumococcal vaccination with revaccination for patients age >65 years who are taking immunosuppressive medications.MethodsA vaccination BPA was developed based on immunosuppressant treatment, age, and prior vaccinations. At site 1, a hospital‐based academic practice, physicians ordered vaccinations. At site 2, a community‐based practice, physicians signed orders placed by nurses. Demographics, vaccination rates, and documentation (vaccination or no administration) were obtained. Chi‐square and Fisher's exact test analysis compared vaccination and documentation rates for October 1 through December 31, 2006 (preBPA), and October 1 through December 31, 2007 (postBPA). Breslow‐Day statistics tested the odds ratio of improvement across the years between the sites.ResultsPostBPA influenza vaccination rates significantly increased (47% to 65%;P< 0.001), with significant improvement at both sites. PostBPA pneumococcal vaccination rates likewise significantly increased (19% to 41%;P< 0.001). PostBPA documentation rates for influenza and pneumococcal vaccinations also increased significantly. Site 2 (nurse‐driven) had significantly higher preBPA vaccination rates for influenza (69% versus 43%;P< 0.001) than pneumococcal (47% versus 15%;P< 0.001).ConclusionThe use of a BPA significantly increased influenza and pneumococcal vaccination and documentation rates in rheumatology patients taking immunosuppressants. A nurse‐driven process offered higher efficacy. An EHR programmed to alert providers is an effective tool for improving quality of care for patients receiving immunosuppressants.
A novel T cell cytokine, secreted osteoclastogenic factor of activated T cells, induces osteoclast formation in a RANKL‐independent manner
Authors: Rifas Leonard , Weitzmann M. Neale 
Published: October 2009

AbstractObjectiveChronic T cell activation is central to the etiology of rheumatoid arthritis (RA), an inflammatory autoimmune disease that leads to severe focal bone erosions and generalized systemic osteoporosis. Previous studies have shown novel cytokine‐like activities in medium containing activated T cells, characterized by potent induction of the osteoblastic production of interleukin‐6 (IL‐6), an inflammatory cytokine and stimulator of osteoclastogenesis, as well as induction of an activity that directly stimulates osteoclast formation in a manner independent of the key osteoclastogenic cytokine RANKL. This study was undertaken to identify the factors secreted by T cells that are responsible for these activities.MethodsHuman T cells were activated using anti‐human CD3 and anti‐human CD28 antibodies for 72 hours in AIM V serum‐free medium to obtain T cell–conditioned medium, followed by concentration and fractionation of the medium by fast‐protein liquid chromatography. Biologically active fractions were resolved using sodium dodecyl sulfate–polyacrylamide gel electrophoresis. Major bands were analyzed by mass spectrometry, and a major candidate protein was identified. This novel cytokine was cloned, and its expression was analyzed using recombinant DNA technologies.ResultsA single novel cytokine that could induce both osteoblastic IL‐6 production and functional osteoclast formation in the absence of osteoblasts or RANKL and that was insensitive to the effects of the RANKL inhibitor osteoprotegerin was identified in the activated T cell–conditioned medium; this cytokine was designated secreted osteoclastogenic factor of activated T cells (SOFAT). Further analysis of SOFAT revealed that it was derived from an unusual messenger RNA splice variant coded by the threonine synthase–like 2 gene homolog, which is a conserved gene remnant coding for threonine synthase, an enzyme that functions only in microorganisms and plants.ConclusionSOFAT may act to exacerbate inflammation and/or bone turnover under inflammatory conditions such as RA or periodontitis and in conditions of estrogen deficiency.