bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the most appropriate radiologic scoring method for ankylosing spondylitis?
Authors: Wanders Astrid J. B. , Landewé Robert B. M. , Spoorenberg Anneke , Dougados Maxime , van der Linden Sjef , Mielants Herman , van der Tempel Hille , van der Heijde Désirée M. F. M. 
Published: August 2004

AbstractObjectiveTo select the most appropriate radiologic scoring method for the evaluation of radiographic progression in ankylosing spondylitis (AS) in clinical trials.MethodsThe validity of the currently available methods, the Bath Ankylosing Spondylitis Radiology Index (BASRI), the Stoke Ankylosing Spondylitis Spine Score (SASSS), and the modified SASSS (M‐SASSS), was tested according to the aspects of the Outcome Measures in Rheumatology Clinical Trials filter: truth, discrimination (reliability and sensitivity to change), and feasibility, using radiographs of 133 patients at 4 different time points (baseline, 1 year, 2 years, and 4 years). One observer scored these sets in chronological order. To assess interobserver reliability, a second observer scored radiographs of 20 patients at the 4 different time points.ResultsAfter 4 years, 9% and 8% of patients showed changes >0 in the sacroiliac (SI) joints and hips, respectively. Independent of the method chosen, ∼40% of patients showed changes in both the lumbar and cervical spine. Therefore, it was concluded that, for the assessment of progression, SI joints and hips are of minor importance. The intraclass correlation coefficient (ICC) varied from 0.87 to 0.98 and ICCs for intraobserver scores varied from 0.96 to 0.99. Concerning progression scores, only the ICC for the M‐SASSS measured after 2 years remained acceptable (0.82). The intraobserver scores for progression after 2 years of followup were an ICC of 0.93 for the BASRI, an ICC of 0.79 for the SASSS, and an ICC of 0.95 for the M‐SASSS. Concerning sensitivity to change, it was found that the M‐SASSS classified the highest percentage of patients with a change >0.ConclusionThe M‐SASSS is the most appropriate method by which to score the radiographic progression in AS patients in clinical trials.
Reduced infiltration and increased apoptosis of leukocytes at sites of inflammation by systemic administration of a membrane‐permeable IκBα repressor
Authors: Blackwell Nathan M. , Sembi Phupinder , Newson Justine S. , Lawrence Toby , Gilroy Derek W. , Kabouridis Panagiotis S. 
Published: August 2004

AbstractObjectiveNF‐κB activation is associated with several inflammatory disorders, including rheumatoid arthritis (RA), making this family of transcription factors a good target for the development of antiinflammatory treatments. Although inhibitors of the NF‐κB pathway are currently available, their specificity has not been adequately determined. IκBα is a physiologic inhibitor of NF‐κB and a potent repressor experimentally when expressed in a nondegradable form. We describe here a novel means for specifically regulating NF‐κB activity in vivo by administering a chimeric molecule comprising the super‐repressor IκBα (srIκBα) fused to the membrane‐transducing domain of the human immunodeficiency virus Tat protein (Tat‐srIκBα).MethodsThe Wistar rat carrageenan‐induced pleurisy model was used to assess the effects of in vivo administration of Tat‐srIκBα on leukocyte infiltration and on cytokine and chemokine production.ResultsSystemic administration of Tat‐srIκBα diminished infiltration of leukocytes into the site of inflammation. Analysis of the recruited inflammatory cells confirmed uptake of the inhibitor and reduction of the NF‐κB activity. These cells exhibited elevated caspase activity, suggesting that NF‐κB is required for the survival of leukocytes at sites of inflammation. Analysis of exudates, while showing decreases in the production of the proinflammatory cytokines tumor necrosis factor α and interleukin‐1β, also revealed a significant increase in the production of the neutrophil chemoattractants cytokine‐induced neutrophil chemoattractant 1 (CINC‐1) and CINC‐3 compared with controls. This result could reveal a previously unknown feedback mechanism in which infiltrating leukocytes may down‐regulate local production of these chemokines.ConclusionThese results provide new insights into the etiology of inflammation and establish a strategy for developing novel therapeutics by regulating the signaling activity of pathways known to function in RA.
Fever in biopsy‐proven giant cell arteritis: Clinical implications in a defined population
Authors: Gonzalez‐Gay Miguel A. , Garcia‐Porrua Carlos , Amor‐Dorado Juan C. , Llorca Javier 
Published: August 2004

AbstractObjectiveTo assess the frequency and clinical features of biopsy‐proven giant cell arteritis (GCA) patients who had fever at the time of diagnosis of the disease, and the relationship between fever, ischemic complications, and the systemic inflammatory response in GCA.MethodsA retrospective study of biopsy‐proven GCA patients diagnosed between 1981 and 2001 was performed at the single referral hospital for a well‐defined population in the Lugo region of northwest Spain. Patients were considered as having fever if the axillary temperature at the time of admission or during the followup prior to the onset of corticosteroid therapy was ≥38°C.ResultsDuring the period of study, 21 (10%) of the 210 biopsy‐proven GCA patients had fever. Two of them fulfilled criteria for fever of unknown origin. Patients with fever had a lower frequency of severe ischemic manifestations than the rest of biopsy‐proven GCA patients. They also exhibited a more severe inflammatory disease, with significant abnormality in most laboratory variables, including higher elevation of erythrocyte sedimentation rate, lower values of hemoglobin, and higher proportion of patients with increased alkaline phosphatase. By logistic regression analysis, we observed that patients with fever had an increased risk of developing anemia (odds ratio [OR] 12.24). In contrast, a negative association between severe ischemic manifestations and fever was found (OR 0.41).ConclusionBiopsy‐proven GCA patients with fever constitute a subgroup of patients with more severe inflammatory response and less ischemic disease.
Efficacy and safety of four doses of lumiracoxib versus diclofenac in patients with knee or hip primary osteoarthritis: A phase II, four‐week, multicenter, randomized, double‐blind, placebo‐controlled trial
Authors: Schnitzer Thomas J. , Beier Jannie , Geusens Piet , Hasler Paul , Patel Sanjay K. , Senftleber Ingo , Gitton Xavier , Moore Alan , Sloan Victor S. , Poór Gyula 
Published: August 2004

AbstractObjectiveTo compare the efficacy and tolerability of the novel cyclooxygenase 2‐selective inhibitor lumiracoxib with placebo and diclofenac in osteoarthritis (OA).MethodsAdults (n = 583) with knee or hip OA were randomized to receive for 4 weeks lumiracoxib 50, 100, or 200 mg twice daily or 400 mg once daily; placebo; or diclofenac 75 mg twice daily. Efficacy assessments included overall joint pain intensity and Western Ontario and McMaster Universities Osteoarthritis Index subscales; tolerability was evaluated by adverse event and physician reporting.ResultsAll lumiracoxib doses were superior to placebo in relieving pain, improving stiffness, and improving physical function after 4 weeks. At study endpoint, pain relief was comparable among all lumiracoxib dosages and similar to diclofenac. Lumiracoxib tolerability was superior to diclofenac and comparable to placebo.ConclusionLumiracoxib provides predictable and sustained relief from pain, stiffness, and impaired physical function in OA. Lumiracoxib shows clinically comparable efficacy and superior tolerability to diclofenac.
Education level and mortality in systemic lupus erythematosus (SLE): Evidence of underascertainment of deaths due to SLE in ethnic minorities with low education levels
Authors: Ward Michael M. 
Published: August 2004

AbstractObjectiveTo determine if socioeconomic status, as measured by education level, is associated with mortality due to systemic lupus erythematosus (SLE), and to determine if these associations differ among ethnic groups.MethodsSex‐ and race‐specific mortality rates due to SLE by education level were computed for persons age 25–64 years using US Multiple Causes of Death data from 1994 to 1997. SLE‐specific mortality rates were compared with all‐cause mortality rates in 1997 to determine if the association between education level and mortality in SLE was similar to that in other causes of death.ResultsAmong whites, the risk of death due to SLE was significantly higher among those with lower levels of education, and the risk gradient closely paralleled the 1997 all‐cause mortality risks by education level. However, in African American women and men and Asian/Pacific Islander women, the risk of death due to SLE was lower among those with lower education levels, contrary to the associations between education level and all‐cause mortality in these groups. Comparing the distribution of education levels among deaths due to SLE and all deaths in 1997, persons with lower education levels were underrepresented among deaths due to SLE in African Americans and Asian/Pacific Islanders.ConclusionAmong whites, higher education levels are associated with lower mortality due to SLE. These associations were not present in ethnic minorities, likely due to underascertainment of deaths due to SLE in less‐well educated persons. This underascertainment may be due to underreporting of SLE on death certificates, but may also represent underdiagnosis of SLE in ethnic minorities with low education levels.
Costs of workups for the diagnosis of early arthritis: Results of a nationwide survey
Authors: Fautrel Bruno , Saraux Alain , Maillefert Jean‐Francis , Kaye Olivier , Lafforgue Pierre , Flipo René‐Marc , Penrod John R. , Guillemin Francis ,   for the Club Rhumatisme & Inflammation of the French Society for Rheumatology
Published: August 2004

AbstractObjectiveTo evaluate the costs of workups to diagnose early arthritis.MethodsIn 2000, the French Society for Rheumatology conducted a survey of a representative sample of French and Belgian rheumatologists (n = 239). The respondents were asked to consider 2 hypothetical scenarios, 1 describing undifferentiated arthritis and the other more suggestive of rheumatoid arthritis. They were then asked what diagnostic workup they would order. Costs for each study were determined in 2001 euros, according to the French public health system fee schedules.ResultsIn total, 151 rheumatologists participated in the study (63%). The mean ± SD diagnostic costs were 406.5 ± 194.3 € for the case with no diagnostic clues, and 280.7 ± 154.3 € for the case suggestive of early RA. Responses were very heterogeneous. The 2 main sources of expenditure were immunology tests and imaging. Hospital staff physicians tended to order more expensive workups, and costs tended to vary inversely with physician experience. The most important predictor of cost was diagnostic doubt, as estimated by the number of diagnoses proposed by respondents in each case; each additional diagnosis cost an additional 19.1–26.1 €.ConclusionDiagnostic workups after a first medical visit for early polyarthritis result in substantial direct costs. This observation and the great variability observed in physicians' practices point out the need for consensus on the appropriate workups for these patients.
Burden of caregiving: Evidence of objective burden, subjective burden, and quality of life impacts on informal caregivers of patients with rheumatoid arthritis
Authors: Brouwer Werner B. F. , van Exel N. Job A. , van de Berg Bernard , Dinant Huib J. , Koopmanschap Marc A. , van den Bos Geertrudis A. M. 
Published: August 2004

AbstractObjectiveTo improve understanding of the nature and magnitude of the burden of informal care and also to indicate important areas for improving the current ways in which informal care is investigated.MethodsInformation on objective burden (such as care tasks performed and time investment), subjective burden (using the Caregiver Reaction Assessment instrument and a self‐rated burden score), and quality of life (using the EuroQoL instrument) were collected in a postal questionnaire of 153 informal caregivers who provide care for rheumatoid arthritis (RA) patients.ResultsCaregivers had been caring for the RA patients on average for >11 years, reflecting the chronic nature of RA. They provide a substantial amount of care (27.4 hours per week) and are moderately strained (24.6 on the self‐rated burden scale). Caregivers are relatively healthy on average but caregivers of more severe RA patients are relatively unhealthy, which may indicate health losses due to caregiving.ConclusionInformal care can be burdensome in the context of RA. More information may help assist informal caregivers in caring for RA patients and help to avoid health problems and high subjective burden.
Validity of the childhood health assessment questionnaire is independent of age in juvenile idiopathic arthritis
Authors: Pouchot Jacques , Ecosse Emmanuel , Coste Joël , Guillemin Francis ,   French Quality of Life Study Group,   Paediatric Rheumatology International Trials Organisation
Published: August 2004

AbstractObjectiveTo determine whether the Childhood Health Assessment Questionnaire (CHAQ) is valid for the comparison of different age subgroups and for longitudinal studies in juvenile idiopathic arthritis (JIA).MethodsA CHAQ was administered to 306 children with JIA. Rasch analyses were used to compare the difficulty of each of the 30 items of the questionnaire for children of 2 age groups (≥10 years old and <10 years old).ResultsIndependent of the physical disability level assessed by the Rasch model, 8 of the 30 items (27%) of the CHAQ were rated significantly different in the 2 age groups. Despite this age‐related variation in item difficulty, the impact on the CHAQ disability index using its original scoring system remained low (about 0.25 points on a scale of 0–3).ConclusionThe difficulty of 8 of 30 items of the CHAQ depends on the respondent's age. Nevertheless, the design of the CHAQ and its scoring system remove most of the expected physical development bias.
Differences between participants and nonparticipants in an exercise trial for adults with rheumatoid arthritis
Authors: Jong Z. De , Munneke M. , Jansen L. M. , Ronday K. , van Schaardenburg D. J. , Brand R. , van den Ende C. H. M. , Vliet Vlieland T. P. M. , Zuijderduin W. M. , Hazes J. M. W. 
Published: August 2004

AbstractObjectiveTo investigate the generalizability of the results of a randomized controlled trial on the effectiveness of long‐term, high‐intensity exercises in the rheumatoid arthritis patients in training (RAPIT) trial by comparing the characteristics of the participants with the nonparticipants.MethodsParticipants and nonparticipants were mailed questionnaires on sociodemographic characteristics, health status, reasons not to participate, and attitudes toward intensive exercise.ResultsThe questionnaires from 892 (75%) nonparticipants and 299 (97%) participants were collected. The nonparticipants were slightly older, more often male, and had longer disease duration than the participants. The nonparticipants perceived their disease as more serious, used fewer disease‐modifying antirheumatic drugs, had a lower level of education, and a more negative attitude toward intensive exercise.ConclusionThe results of the RAPIT trial might not be generalizable to the entire target population. To promote participation in long‐term, high‐intensity exercises, health professionals should more actively discuss the potential benefits of exercise with their RA patients while taking into consideration specific factors related to participation.
Impact of social support on valued activity disability and depressive symptoms in patients with rheumatoid arthritis
Authors: Neugebauer Alyson , Katz Patricia P. 
Published: August 2004

AbstractObjectiveTo examine the impact of instrumental and emotional support on valued life activity (VLA) disability and depressive symptoms. Instrumental support was expected to affect VLA disability; emotional support was expected to be associated with depressive symptoms and moderate the impact of VLA disability on depressive symptoms.MethodsData were collected over 3 years through interviews with the University of California, San Francisco, Rheumatoid Arthritis Panel. Analyses assessed whether instrumental support predicted later VLA disability and whether emotional support predicted both concurrent and later depressive symptoms.ResultsReceiving adequate instrumental support was associated with less subsequent VLA disability. Strong associations were noted between both VLA disability and emotional support with concurrent depressive symptoms. No relationship was found between emotional support and later depression. No evidence was found for the hypothesis that emotional support moderated the impact of VLA disability on depressive symptoms.ConclusionResults highlight the need to assess different types of support and their unique impact on critical outcomes. Instrumental support is beneficial to the maintenance of valued activities, a critical factor in the psychological adjustment of individuals living with rheumatoid arthritis. Emotional support has a significant short‐term impact on depression, although it may not buffer the impact of VLA disability on future depression.
Effects of a stress‐reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: A randomized controlled trial
Authors: Greco Carol M. , Rudy Thomas E. , Manzi Susan 
Published: August 2004

AbstractObjectiveTo assess the effects of a stress‐reduction program on pain, psychological function, and physical function in persons with systemic lupus erythematosus (SLE) who experience pain.MethodsNinety‐two SLE patients were assigned randomly to receive either biofeedback‐assisted cognitive‐behavioral treatment (BF/CBT), a symptom‐monitoring support (SMS) intervention, or usual medical care (UC) alone.ResultsBF/CBT participants had significantly greater reductions in pain and psychological dysfunction compared with the SMS group (pain, P = 0.044; psychological functioning, P < 0.001) and the UC group (pain, P = 0.028; psychological functioning, P < 0.001). BF/CBT had significantly greater improvement in perceived physical function compared with UC (P = 0.035), and improvement relative to SMS was marginally significant (P = 0.097). At a 9‐month followup evaluation, BF/CBT continued to exhibit relative benefit compared with UC in psychological functioning (P = 0.023).ConclusionThis study supports the utility of a brief stress management program for short‐term improvement in pain, psychological function, and perceived physical function among persons with SLE who experience pain.
Wegener's granulomatosis: Possible role of environmental agents in its pathogenesis
Authors: Albert Daniel , Clarkin Cheryl , Komoroski Jodi , Brensinger Colleen M. , Berlin Jesse A. 
Published: August 2004

AbstractObjectiveTo investigate the possibility that environmental agents contribute to the pathogenesis of Wegener's granulomatosis (WG).MethodsWe undertook an extensive search for possible environmental exposures by developing a comprehensive questionnaire that was administered by telephone interview to 53 patients with WG and 2 control groups: one with osteoarthritis and the other with gout. Questions focused on hobbies and vocations, work, home, and allergies. Exact logistic regression was used to calculate odds ratios and 95% confidence intervals after adjusting for potential confounders. After adjusting for age and sex, data are reported for all exposures with odds ratios >2.0 against either control group or for any allergic propensity.ResultsResults suggest that mercury and perhaps lead exposure were positively associated with WG as compared with either control group, although the number of patients exposed was small. A prior history of allergy was also associated with WG as compared with either control group.ConclusionWe conclude that heavy metal exposure and a prior history of allergy may play a role in the etiopathogenesis of Wegener's granulomatosis.
Prevalence and impact of musculoskeletal disorders of the upper limb in the general population
Authors: Walker‐Bone Karen , Palmer Keith T. , Reading Isabel , Coggon David , Cooper Cyrus 
Published: August 2004

AbstractObjectiveTo determine the prevalence, interrelation, and impact of musculoskeletal disorders of the upper limb in the general population.MethodsA total of 9,696 randomly selected adults of working age were surveyed in a 2‐stage cross‐sectional study involving a screening questionnaire and a standardized physical examination in symptomatic subjects. Age‐ and sex‐specific prevalence rates were estimated for several musculoskeletal disorders and for nonspecific pain in the upper limbs. The overlap and impact on daily activities and healthcare utilization were explored.ResultsAmong 6,038 first‐stage responders, 3,152 reported upper limb symptoms and 1,960 were subsequently examined. Of subjects with pain, 44.8% had 1 or more specific soft‐tissue disorders. Site‐specific prevalence rates were as follows: shoulder tendinitis 4.5% among men and 6.1% among women; adhesive capsulitis 8.2% among men and 10.1% among women; lateral epicondylitis 1.3% among men and 1.1% among women; de Quervain's disease 0.5% among men and 1.3% among women; other tenosynovitis of the hand or wrist, 1.1% among men and 2.2% among women. Specific disorders tended to cluster (P < 0.001) in individuals, with particular overlap at the shoulder. Compared with subjects with nonspecific pain, those with specific disorders more often reported inability to perform everyday tasks (P < 0.05), consultation with a doctor (P < 0.05), and use of prescribed medication (P < 0.05).ConclusionUpper limb pain is common in the general population and is often associated with physical signs suggestive of specific upper‐limb disorders. These disorders have a substantial impact on physical function and use of health care.
Factors associated with the use of complementary and alternative medicine in juvenile idiopathic arthritis
Authors: Feldman Debbie Ehrmann , Duffy Ciaran , De Civita Mirella , Malleson Pete , Philibert Lise , Gibbon Michele , Ortiz‐Alvarez Oliva , Dobkin Patricia L. 
Published: August 2004

AbstractObjectiveTo describe the frequency of complementary and alternative medicine (CAM) use in patients with juvenile idiopathic arthritis (JIA) and to explore whether CAM was associated with patient‐specific characteristics, parent‐specific characteristics, and medical management factors.MethodsParents of children with JIA completed questionnaires that addressed the use of CAM, adherence and perceived problems, parental distress, and coping with childhood illness. Clinical variables were abstracted from the patients' medical files.ResultsOne hundred‐eighteen children with JIA, mean ± SD age of 10.4 ± 3.9 years and mean ± SD disease duration of 4.5 ± 3.5 years, participated in the study. Ever use of CAM was 33.9% and was higher in patients whose parents used CAM (odds ratio [OR] 5.1, 95% confidence interval [95% CI] 1.4–19.5) and among those who considered themselves as “Canadian” as opposed to belonging to a specific ethnic group (OR 10. 7, 95% CI 1.2–99.8). Adherence to conventional treatment was high for both users and nonusers of CAM.ConclusionUse of CAM is common among patients with JIA. CAM use is not related to any decrease in adherence to conventional medical treatment.