bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health‐related quality of life outcomes in patients with active ankylosing spondylitis treated with adalimumab: Results from a randomized controlled study
Authors: Davis John C. , Revicki Dennis , van der Heijde Désirée M. F. , Rentz Anne M. , Wong Robert L. , Kupper Hartmut , Luo Michelle P. 
Published: July 2007

AbstractObjectiveTo evaluate the impact of adalimumab on health‐related quality of life (HRQOL) in patients with active ankylosing spondylitis (AS).MethodsPatients ≥18 years enrolled in the Adalimumab Trial Evaluating Long‐Term Efficacy and Safety in Ankylosing Spondylitis, a randomized controlled study, were randomly assigned to receive either adalimumab 40 mg subcutaneously or placebo every other week for 24 weeks. ASsessment of Ankylosing Spondylitis (ASAS) International Working Group criteria were used to evaluate clinical efficacy. HRQOL outcomes were assessed using the Short Form 36 (SF‐36) Health Survey and Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire.ResultsA total of 315 patients enrolled (208 in the adalimumab group and 107 in the placebo group). Patients in the adalimumab group showed significant improvements in SF‐36 Physical Component Summary (PCS) and ASQoL scores versus placebo at weeks 12 and 24 (P < 0.001). The observed differences between adalimumab and placebo patients exceeded the a priori minimum important difference (MID) at the group level, and significantly more adalimumab‐treated patients achieved improvements greater than the MID on the patient level. These data suggest the HRQOL improvements were clinically meaningful. No differences were observed in SF‐36 Mental Component Summary (MCS) scores. Significant differences favoring adalimumab were observed for SF‐36 domains physical function, bodily pain, role‐physical, general health, vitality, social function, and role–emotional. There was significant association between HRQOL improvements (measured by SF‐36 PCS and MCS, and ASQoL scores) and ASAS clinical responses (P < 0.001).ConclusionAdalimumab significantly improved physical health status and overall HRQOL through 24 weeks in patients with active AS.
Primary knee and hip arthroplasty among nonagenarians and centenarians in the United States
Authors: Krishnan Eswar , Fries James F. , Kwoh C. Kent 
Published: July 2007

AbstractObjectiveThe number of individuals ages ≥100 years in the US is expected to increase considerably in the future along with the need for arthroplasties. This report focuses on the poorly studied epidemiology and mortality outcomes of arthroplasty among these individuals.MethodsWe describe the epidemiology of knee and hip arthroplasties among centenarians using data from a large hospital discharge database in the US (the Nationwide Inpatient Sample) during the period 1993 through 2002. We used nonagenarians as the comparison group with adjustment for differences in the prevalence of congestive heart failure, neurologic diseases such as dementia and stroke, renal and hepatic diseases, obesity, anemia, malignancy, coagulopathy, and depression and other psychiatric illnesses. Cox regression models were used to study the mortality outcomes following arthroplasty.ResultsOverall, there were 679 hip arthroplasties and 7 knee arthroplasties among centenarians in this database. The corresponding figures for nonagenarians were 33,975 and 2,050, respectively. A vast majority (83%) of hip arthroplasty recipients were women. Risk‐adjusted mortality estimates following arthroplasty for centenarians were higher than for nonagenarians (hazard ratio 1.46, 95% confidence interval 1.10–1.95). However, this was similar to differences in overall in‐hospital mortality (hazard ratio 1.36, 95% confidence interval 1.32–1.40) between these 2 age categories.ConclusionIn the US population, hip and knee arthroplasty are very rarely performed among centenarians. Our in‐hospital mortality data suggest that arthroplasties should not be denied to centenarians solely because of short‐term postoperative life expectancy estimates.
Influences on knee movement strategies during walking in persons with medial knee osteoarthritis
Authors: SchmitT Laura C. , Rudolph Katherine S. 
Published: July 2007

AbstractObjectiveTo investigate the movement and muscle activation strategies during walking of individuals with medial knee osteoarthritis (OA) to determine the influence of quadriceps strength, medial knee laxity, limb alignment, and self‐reported knee instability on knee motion.MethodsTwenty‐eight persons with medial knee OA and 26 control subjects participated. Quadriceps strength, medial knee laxity, and limb alignment were measured. Knee instability (IKOSscore) was assessed with the Activities of Daily Living Scale of the Knee Outcome Survey. Knee motion and muscle activation patterns were measured with motion analysis. Group differences were detected with independent samplest‐tests and predictive relationships were determined with linear and hierarchical regression analyses.ResultsIndividuals with OA were weaker, had greater medial knee laxity, and had more varus alignment. The OA group used less knee motion and higher muscle co‐contraction during weight acceptance and single‐limb support. Quadriceps strength and IKOSscore significantly strengthened the prediction of knee motion during weight acceptance and single‐limb support, whereas limb alignment and medial laxity did not.ConclusionThe knee stiffening and higher muscle co‐contraction used by the OA group may be detrimental to joint integrity. IKOSscores predicted knee motion after accounting for quadriceps strength, underscoring the importance of addressing knee instability with appropriate rehabilitation strategies in persons with medial knee OA in order to promote long‐term joint integrity.
Treatment of older adult patients diagnosed with rheumatoid arthritis: Improved but not optimal
Authors: Schmajuk Gabriela , Schneeweiss Sebastian , Katz Jeffrey N. , Weinblatt Michael E. , Setoguchi Soko , Avorn Jerry , Levin Raisa , Solomon Daniel H. 
Published: July 2007

AbstractObjectiveThe National Committee on Quality Assurance has determined that all patients with rheumatoid arthritis (RA) should be treated with disease‐modifying antirheumatic drugs (DMARDs). Our objective was to determine the rate and predictors of DMARD use in a cohort of elderly patients with RA.MethodsWe analyzed health care utilization data for 5,864 Medicare beneficiaries with RA who also participated in a state‐run pharmaceutical benefit program in Pennsylvania. Patients with RA were defined as those with at least 3 diagnoses of RA (International Classification of Diseases, Ninth Revision code 714.xx) at least 1 week apart who were enrolled in these programs for at least 12 months during 1995–2004. Multivariate logistic regression was used to assess predictors of synthetic or biologic DMARD use in the 12 months after cohort entry.ResultsThirty percent of patients filled a DMARD prescription during 12 months of followup. Frequency of DMARD use increased steadily over time: 24% received DMARDs in 1996 compared with 43% in 2003 (P for trend <0.001). Of patients with at least 1 rheumatologist visit, 41% received a DMARD in 1996 compared with 70% in 2003 (P < 0.001). After the introduction of biologic DMARDs in 1998, 6% of all patients with RA received a biologic, including 12% who saw a rheumatologist. Patients ages 75–84 were 52% less likely to receive DMARDs (95% confidence interval [95% CI] 46–58%) and patients ages ≥85 were 74% less likely (95% CI 69–79%) compared with patients ages 65–74.ConclusionIn this cohort of patients in the community with full prescription drug coverage, most patients diagnosed with RA did not receive a DMARD during the 12 months after cohort entry. Older patients and those not seeing a rheumatologist were less likely to receive a DMARD and may provide a target for quality improvement interventions.
Validation of a radiographic damage index in chronic gout
Authors: Dalbeth Nicola , Clark Barnaby , McQueen Fiona , Doyle Anthony , Taylor William 
Published: July 2007

AbstractObjectiveTo identify a valid method to measure radiographic damage in patients with chronic gout.MethodsThe scoring method that best represented radiographic damage in individual joints was analyzed by comparing a gold standard rheumatologist consensus global score with recognized scoring methods, including the Sharp/van der Heijde erosion and narrowing scores, Ratingen destruction score, and Steinbrocker score. Ninety‐five proximal interphalangeal joints from 12 patients with gout were included in this analysis. Scoring of hand and feet radiographs from an additional 35 patients with gout was used to analyze the sites to be included in a scoring system and the additional features to be recorded.ResultsFor individual joints, the combination of the Sharp/van der Heijde erosion and narrowing scores correlated best with the consensus global score. In addition, the limits of agreement were narrowest for the combined Sharp/van der Heijde erosion and narrowing score. All joint areas in the Sharp/van der Heijde rheumatoid arthritis score and the distal interphalangeal joints were affected by chronic gout and contributed to the total score. Additional features (extraarticular erosions, joint space widening, and ankylosis) occurred infrequently, and scoring of these features did not increase the reliability of the total score. The reliability of the total score was high: intraclass correlation coefficient for intraobserver reproducibility was 0.993–0.998 and for interobserver reproducibility was 0.963–0.966. The modified Sharp/van der Heijde score was able to discriminate between early and advanced disease.ConclusionA modified Sharp/van der Heijde system accurately and reliably represents radiographic joint damage in chronic gout.
Efficacy and cost‐effectiveness of physiotherapy following glenohumeral joint distension for adhesive capsulitis: A randomized trial
Authors: Buchbinder Rachelle , Youd Joanne M. , Green Sally , Stein Alicia , Forbes Andrew , Harris Anthony , Bennell Kim , Bell Simon , Wright Warwick J. L. 
Published: July 2007

AbstractObjectiveTo determine whether an active physiotherapy program following arthrographic joint distension for adhesive capsulitis provides additional benefits.MethodsWe performed a randomized, placebo‐controlled, participant and single assessor blinded trial. A total of 156 participants with pain and stiffness in predominantly 1 shoulder for ≥3 months and restriction of passive motion >30° in ≥2 planes of movement entered the study, and 144 completed the study. Following joint distension, participants were randomly assigned to either manual therapy and directed exercise or placebo (sham ultrasound), both administered twice weekly for 2 weeks then once weekly for 4 weeks. Pain, function, active shoulder movements, participant‐perceived success, and quality of life were assessed at baseline, 6, 12, and 26 weeks. Costs were also collected.ResultsBoth groups improved over time with no significant differences in improvement between groups for pain, function, or quality of life at any time point. Significant differences favored the physiotherapy group for all active shoulder movements (e.g., pooled difference in mean change between groups across all time points for total shoulder abduction was 10.6°, 95% confidence interval [95% CI] 3.1, 18.1) and participant‐perceived success (pooled relative risk 1.4, 95% CI 1.1, 1.65; number needed to treat = 5). Net cost of physiotherapy was $136.8 Australian (95% CI −177.5, 223.1) over the 6 months.ConclusionPhysiotherapy following joint distension provided no additional benefits in terms of pain, function, or quality of life but resulted in sustained greater active range of shoulder movement and participant‐perceived improvement up to 6 months.
Sociodemographic associations with early disease damage in patients with systemic lupus erythematosus
Authors: Cooper Glinda S. , Treadwell Edward L. , William St.Clair E. , Gilkeson Gary S. , Dooley Mary Anne 
Published: July 2007

AbstractObjectiveTo examine the extent of organ damage among recently diagnosed patients with systemic lupus erythematosus (SLE), and to assess the association between sociodemographic variables and total damage and organ‐specific damage scores.MethodsWe evaluated damage in 132 patients with SLE (70 African Americans and 62 whites), 2–6 years (median 4 years) after diagnosis, using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. The associations between demographic characteristics and total damage and organ‐specific damage measures were evaluated using logistic regression, adjusting for age, income, and ethnicity.ResultsA total of 61% of patients scored ≥1 point on the damage index. Damage was most prevalent in the musculoskeletal (28%), skin (20%), neuropsychiatric (16%), and renal (12%) subscales. African American ethnicity and lower household income were independently associated with total damage scores (score ≥2: adjusted odds ratio [95% confidence interval] 6.0 [2.3–16.2] in African Americans and 2.7 [1.1–6.7] in patients with an annual household income ≤$30,000). The odds of having skin damage, alopecia, or diabetes were at least 5 times higher in African Americans compared with whites, but ethnicity was not associated with renal damage (adjusted odds ratio 1.6, 95% confidence interval 0.40–6.1).ConclusionConsiderable damage is seen in SLE patients early in the disease course, and the pattern varies between ethnic groups. This analysis also highlights the importance of sociodemographic characteristics (particularly income) in predicting damage.
Self‐management education for persons with arthritis: Managing comorbidity and eliminating health disparities
Authors: Goeppinger Jean , Armstrong Brian , Schwartz Todd , Ensley Donald , Brady Teresa J. 
Published: July 2007

AbstractObjectiveTo compare short‐term and long‐term effectiveness of the Arthritis Self‐Help Course (ASHC) and the Chronic Disease Self‐Management Program (CDSMP) for persons with arthritis concerning health care use, health‐related quality of life, health behaviors, and arthritis self‐efficacy.MethodsForty‐eight workshops were randomized to the ASHC (n = 26) or CDSMP (n = 22). A total of 416 individuals, including 365 African Americans, participated. The mean age for each group was 64 years, mean years of education was 11.7, mean number of chronic conditions was 4, and 75–80% of participants in each group were female. Multivariate statistical tests were used to assess effectiveness within and between programs for all workshop participants and African Americans.ResultsAt 4 months all ASHC participants including African Americans, had significant improvements (P ≤ 0.05) in self‐efficacy, stretching and strengthening exercises, aerobic exercises, and general health. All CDSMP participants had statistically significant improvements in self‐efficacy, disability, pain, and general health. African American CDSMP participants showed statistically significant improvements in general health. Trends toward improvement (P = 0.051–0.100) were shown in 5 variables among African American CDSMP participants and in 4 variables among all CDSMP participants. Statistically significant differences between the 2 programs at 4 months were seen in pain and disability in both groups. The CDSMP produced stronger results. Significant results at 1 year within and between programs were minimal for both groups.ConclusionWhen populations with arthritis and multiple comorbid conditions are targeted, the CDSMP may be most cost effective.
Aerobic and anaerobic exercise capacity in adolescents with juvenile idiopathic arthritis
Authors: Lelieveld Otto T. H. M. , van Brussel Marco , Takken Tim , van Weert Ellen , van Leeuwen Miek A. , Armbrust Wineke 
Published: July 2007

AbstractObjectiveTo examine the aerobic and anaerobic exercise capacity in adolescents with juvenile idiopathic arthritis (JIA) compared with age‐ and sex‐matched healthy individuals, and to assess associations between disease‐related variables and aerobic and anaerobic exercise capacity.MethodsOf 25 patients enrolled in a JIA transition outpatient clinic, 22 patients with JIA were included in this study (mean ± SD age 17.1 ± 0.7 years, range 16–18 years). Aerobic capacity was examined using a Symptom Limited Bicycle Ergometry test. Anaerobic capacity was assessed with the Wingate Anaerobic Test. Functional ability was assessed with the Childhood Health Assessment Questionnaire. Pain and overall well‐being were measured using a visual analog scale. Disease duration and disease activity were also assessed.ResultsAbsolute and relative maximal oxygen consumption in the JIA group were significantly impaired (85% and 83% for boys, respectively; 81% and 78% for girls, respectively) compared with healthy controls. Mean power was also significantly impaired (88% for boys and 74% for girls), whereas peak power was significantly impaired for girls and just failed significance for boys (67% for girls and 92% for boys). A post hoc analysis correcting for underweight and overweight demonstrated that body composition did not influence the results substantially.ConclusionThis study demonstrated that adolescents with JIA have an impaired aerobic and anaerobic exercise capacity compared with healthy age‐ and sex‐matched peers. The likely cause for this significant impairment is multifactorial and needs to be revealed to improve treatment strategies.
Effectively measuring adherence to medications for systemic lupus erythematosus in a clinical setting
Authors: Koneru Sri , Shishov Michael , Ware Avis , Farhey Yolanda , Mongey Anne‐Barbara , Graham T. Brent , Passo Murray H. , Houk J. Lawrence , Higgins Gloria C. , Brunner Hermine I. 
Published: July 2007

AbstractObjectiveTo assess the reliability and concurrent validity of the Medication Adherence Self‐report Inventory (MASRI) when used in systemic lupus erythematosus (SLE), to investigate the predictive validity of the MASRI using pharmacy refill information as the criterion standard, and to propose a sensible approach to the screening for nonadherence in a clinical setting.MethodsAdherence to 2 medications (hydroxychloroquine and prednisone) was measured in 55 patients using the MASRI, pill counts, and physician ratings (MD scale). Adherence based on pharmacy refill information served as a criterion standard with nonadherence defined as adherence rates <80%. To determine test–rest reliability of the MASRI, 20 patients completed the measure twice within a 2‐week period.ResultsUsing pharmacy information, 39% of the patients were nonadherent to prednisone and 51% to hydroxychloroquine. The MASRI had acceptable internal consistency (Cronbach's α 0.7) and good reliability. Irrespective of the drug assessed, MASRI ratings were moderately correlated with patient adherence (pharmacy), supporting the concurrent validity of the MASRI. The combination of adherence estimation by MD scale rating at <85% and by MASRI at <90% was 87% sensitive and 86% specific for identifying patients who were nonadherent to prednisone. These cutoff values also appeared suitable for identifying nonadherence to hydroxychloroquine.ConclusionThe MASRI is a reliable measure of adherence to medications in SLE. The measure has concurrent and predictive validity. When combined with the MD scale, the MASRI appears to be a useful screening tool for nonadherence in patients with SLE that could be suitable for clinical practice.
Test–retest reliability of the peak knee adduction moment during walking in patients with medial compartment knee osteoarthritis
Authors: Birmingham Trevor B. , Hunt Michael A. , Jones Ian C. , Jenkyn Thomas R. , Giffin J. Robert 
Published: July 2007

AbstractObjectiveTo estimate the test–retest reliability of the peak external knee adduction moment during walking in patients with medial compartment knee osteoarthritis (OA), and to describe the interpretation of the reported values.MethodsA total of 31 patients diagnosed with knee OA confined primarily to the medial compartment underwent quantitative gait analyses during 2 separate test sessions at least 24 hours apart and within 1 week. The peak knee adduction moment was calculated for each patient at each session based on the mean of 5 walking trials. Reliability was estimated using the intraclass correlation coefficient (ICC2,1) and the standard error of measurement (SEM).ResultsThe mean difference in peak adduction moments between test sessions was 0.1% body weight × height (BW × ht; 95% confidence interval [95% CI] −0.1, 0.3). The point estimate for the ICC was 0.86 (95% CI 0.73, 0.96). The point estimate for the SEM was 0.36% BW × ht (95% CI 0.29, 0.48).ConclusionThe ICC suggests that the peak knee adduction moment is appropriate for use when distinguishing among patients, for example, in studies of various interventions intended to decrease dynamic load on the knee medial compartment. The SEM illustrates the importance of considering measurement error and incorporating confidence levels when interpreting an individual patient's peak knee adduction moment value.
Depression in patients with systemic sclerosis: A systematic review of the evidence
Authors: Thombs Brett D. , Taillefer Suzanne S. , Hudson Marie , Baron Murray 
Published: July 2007

AbstractObjectiveTo assess the prevalence, course, and predictors of depression in patients with systemic sclerosis (SSc).MethodsWe conducted a comprehensive search in November 2006 of MEDLINE, PsycINFO, and CINAHL databases to identify original research studies published in any language that used a structured interview or validated questionnaire to assess major depressive disorder or clinically significant symptoms of depression in patients with SSc. The search was augmented by hand searching 26 selected journals through December 2006 and references from identified articles and reviews. Studies were excluded if only an abstract was provided or if depression was not measured by a validated method.ResultsNo studies used a structured clinical interview to assess the prevalence of major depressive disorder. The prevalence of clinically significant depressive symptoms was 51–65% based on 2 studies that used a Beck Depression Inventory (BDI) score ≥10 and 46–56% based on 2 studies that used a BDI score ≥11. These rates and those reported in 4 other studies that used different assessment tools (36–43%) were consistently high compared with other medical patient groups assessed with the same instruments and cutoffs. Methodologic issues limited the ability to draw strong conclusions from studies of predictors.ConclusionSymptoms of depression are common among patients with SSc. The high rates reported across studies suggest that routine screening is recommended. There is a need for studies that examine depression at different time points from the diagnosis of SSc and that systematically investigate factors associated with high levels of depressive symptoms.