pinecone/core-2020-05-10-deduplication huggingface dataset:
Prevalence of Fibromyalgia: A Population‐Based Study in Olmsted County, Minnesota, Utilizing the Rochester Epidemiology Project

Objective  To estimate and compare the prevalence of fibromyalgia by 2 different methods in Olmsted County, Minnesota.    Methods  The first method was a retrospective review of medical records of potential cases of fibromyalgia in Olmsted County using the Rochester Epidemiology Project (from January 1, 2005, to December 31, 2009) to estimate the prevalence of diagnosed fibromyalgia in clinical practice. The second method was a random survey of adults in Olmsted County using the fibromyalgia research survey criteria to estimate the percentage of responders who met the fibromyalgia research survey criteria.    Results  Of the 3,410 potential patients identified by the first method, 1,115 had a fibromyalgia diagnosis documented in the medical record by a health care provider. The age‐ and sex‐adjusted prevalence of diagnosed fibromyalgia by this method was 1.1%. By the second method, of the 2,994 people who received the survey by mail, 830 (27.6%) responded and 44 (5.3%) met the fibromyalgia research survey criteria. The age‐ and sex‐adjusted prevalence of fibromyalgia in the general population of Olmsted County by this method was estimated at 6.4%.    Conclusion  To the best of our knowledge, this is the first report of the rate at which fibromyalgia is being diagnosed in a community. This is also the first report of prevalence as assessed by the fibromyalgia research survey criteria. Our results suggest that patients, particularly men, who meet the fibromyalgia research survey criteria are unlikely to have been given a diagnosis of fibromyalgia
Shoulder pain in the community: an examination of associative factors using a longitudinal cohort study

OBJECTIVE: To determine factors that are predictive of incident, recurrent, or resolved shoulder pain in a community-based sample from the general population. METHODS: This study used data from the North West Adelaide Health Study, a cohort study located in the northwestern suburbs of Adelaide, South Australia. Data were obtained between 2004 and 2006 and between 2008 and 2010, with time between measurements ranging from 2-6 years (median 4 years), using a computer-assisted telephone interview, a clinical assessment, and a self-completed questionnaire. Multivariate logistic regression was used to examine the factors associated with shoulder pain. RESULTS: Overall, 14.6% (95% confidence interval [95% CI] 12.7-16.7) of 2,337 eligible participants reported that they had developed (or had incident) shoulder pain between 2 time points of the cohort study, 8.8% (95% CI 7.5-10.3) reported recurrent shoulder pain, and 8.7% (95% CI 7.0-10.6) had resolved shoulder pain. Incident shoulder pain was significantly associated with physically heavier occupational activities and pain in other joints after adjustment for age, sex, and body mass index. Recurrent shoulder pain was also associated with pain in other joints, but also with depressive symptoms, smoking, and decreased shoulder range of movement. Resolved shoulder pain was associated with being female, other areas of pain, and decreased shoulder range of movement, but higher grip strength. CONCLUSION: Different factors were associated with incident, recurrent, or resolved shoulder pain in a longitudinal cohort study. Consideration of all of these factors may assist in the prevention and management of shoulder pain and the possible identification of those at risk of long-term shoulder problems.T. K. Gill, E. M. Shanahan, A. W. Taylor, R. Buchbinder, and C. L. Hil
Feasibility, reliability, and sensitivity to change of four radiographic scoring methods in patients with psoriatic arthritis

Objective We set out to assess the feasibility, reliability, and sensitivity to change of 4 radiographic scoring methods in psoriatic arthritis (PsA). Methods Hand and feet radiographs from 50 patients with PsA were scored at 2 time points by 2 assessors with each of the following methods: modified Steinbrocker score, modified Sharp score (MSS), modified Sharp/van der Heijde score (SHS), and the Ratingen score for PsA. The radiographs of 10 patients were scored by both assessors to assess reliability using intraclass correlation coefficients (ICCs). Sensitivity to change was estimated using a standardized response mean (SRM) and smallest detectable change (SDC). Results The patients' mean ± SD age at baseline was 50 ± 12.1 years, the mean ± SD disease duration was 10 ± 8.4 years, and the mean ± SD followup period was 25 ± 9.6 months. Intrarater reliability was excellent for all methods (ICC >0.97). Interrater reliability was highest for the SHS (ICC 0.95-0.99). The percentage SDC for the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 2.9%, 2.1%, 1.4%, and 1.2%, respectively, and the SRMs were 0.46, 0.44, 0.77, and 0.79, respectively. The mean time to score each of the Steinbrocker method, the Ratingen method, the MSS, and the SHS was 6.2, 10.5, 14.6, and 14.4 minutes, respectively. Conclusion The SHS method was the most reliable and sensitive to change but took longer to perform. The Steinbrocker method is the most feasible but lacks the sensitivity of the SHS. The SDC of the Ratingen method is close to that of the SHS and MSS, but is quicker to perform
Pilot study of reproductive health counseling in a pediatric rheumatology clinic

Objective: To assess perception and behavior after reproductive health counseling among adolescent patients in a tertiary care-based pediatric rheumatology clinic. 

Methods: Adolescent females seen at Stanford pediatric rheumatology clinic were prospectively enrolled during routine visits. At study start, standard clinic procedures for the following were reviewed with providers: 1) HEADSS (home, education, activities, drugs, sexual activity, and suicide/depression) assessment; 2) reproductive health counseling; and 3) medical record documentation. Patients were enrolled if providers indicated that they performed HEADSS assessment and reproductive health counseling. At enrollment, patients completed a survey to assess perceptions of reproductive health counseling. Chart review confirmed documented discussions. Follow-up survey 3-5 months after enrollment tracked reproductive health information seeking behavior. Results: Ninety females (ages 17 ± 2 years old) participated. Almost all patients (99%) agreed that reproductive health was discussed. Seventy-one percent reported that pregnancy risks were discussed, 42% had recent concerns about reproductive health, and 33% reported their provider recommended that they seek further reproductive health care. Eighty-four patients completed follow-up phone surveys, with 25% reporting seeking further information on reproductive health concerns but merely 9.5% actually sought further care. Only 18% reported having ever asked their rheumatology provider for guidance regarding reproductive health care concerns. 

Conclusion: Routine reproductive health discussion and counseling are necessary in a rheumatology clinic; as in our experience, a substantial number of adolescents have concerns and actively seek reproductive health information. Despite these discussions, teens rarely pursued further reproductive health care. Further work to bridge this gap is needed
Using the Juvenile Arthritis Disease Activity Score based on erythrocyte sedimentation rate or C-reactive protein level: results from the Portuguese register

Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR)
Knee power is an important parameter in understanding medial knee joint load in knee osteoarthritis.

Calder, K. M., Acker, S. M., Arora, N., Beattie, K. A., Callaghan, J. P., Adachi, J. D., & Maly, M. R. (2014). Knee Power Is an Important Parameter in Understanding Medial Knee Joint Load in Knee Osteoarthritis: Knee Power and OA. Arthritis Care & Research, 66(5), 687–694. https://doi.org/10.1002/acr.22223Objective To determine the extent to which knee extensor strength and power explain variance in knee adduction moment (KAM) peak and impulse in clinical knee osteoarthritis (OA). Methods Fifty-three adults (mean ± SD age 61.6 ± 6.3 years, 11 men) with clinical knee OA participated. The KAM waveform was calculated from motion and force data and ensemble averaged from 5 walking trials. The KAM peak was normalized to body mass (Nm/kg). The mean KAM impulse reflected the mean total medial knee load during stride (Nm × seconds). For strength, the maximum knee extensor moment attained from maximal voluntary isometric contractions (MVIC) was normalized to body mass (Nm/kg). For power, the maximum knee extensor power during isotonic contractions, with the resistance set at 25% of MVIC, was normalized to body mass (W/kg). Covariates included age, sex, knee pain on the Knee Injury and Osteoarthritis Outcome Score, gait speed, and body mass index (BMI). Relationships of the KAM peak and impulse with strength and power were examined using sequential stepwise forward linear regressions. Results Covariates did not explain variance in the KAM peak. While extensor strength did not, peak knee extensor power explained 8% of the variance in the KAM peak (P = 0.02). Sex and BMI explained 24% of the variance in the KAM impulse (P < 0.05). Sex, BMI, and knee extensor power explained 31% of the variance in the KAM impulse (P = 0.02), with power contributing 7% (P < 0.05). Conclusion Knee extensor power was more important than isometric knee strength in understanding medial knee loads during gait.Canadian Institutes of Health Research. Grant Number: 102643Canadian Institutes of Health Research Joint Motion Program Postdoctoral FellowshipNetwork Scholar Award through The Arthritis Society/Canadian Arthritis NetworkTier I Canada Research Chair in Spine Biomechanics and Injury PreventionAlliance for Better Bone Health Chair in RheumatologyNew Investigator Award from the Canadian Institutes of Health Researc
Development and testing of new candidate psoriatic arthritis screening questionnaires combining optimal questions from existing tools

Objective: Several questionnaires have been developed to screen for psoriatic arthritis (PsA) but head to head studies have found limitations. This study aimed to develop new questionnaires encompassing the most discriminative questions from existing instruments. Methods: Data from the CONTEST study, a head to head comparison of three existing questionnaires, were used to identify items with a Youden's index of ≥0.1. These were combined using four approaches: CONTEST- simple additions of questions; CONTESTw- weighting using logistic regression; CONTESTjt- addition of a joint manikin and CONTESTtree- additional questions identified by CART analysis. These candidate questionnaires were tested in independent datasets. Results: 12 individual questions with a Youden's index of ≥0.1 were identified but 4 of these were excluded due to duplication and redundancy. Weighting for two of these questions, was included in CONTESTw. Receiver operating characteristic (ROC) curve analysis showed that involvement in six joint areas on the manikin was predictive of PsA for inclusion in CONTESTjt. CART analysis identified a further 5 questions for inclusion in CONTESTtree. CONTESTtree was not significant on ROC analysis and discarded. The other three were significant in all datasets, although CONTESTw was slightly inferior to the others in the validation datasets. Potential cut points for referral are discussed. Conclusion: Of four candidate questionnaires combining existing discriminatory items to identify psoriatic arthritis in people with psoriasis three were found to be significant on ROC analysis. Testing in independent datasets identifies two questionnaires: CONTEST and CONTESTjt that should be pursued for further prospective testing
Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort.

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This article is open access.To estimate the early prevalence of various electrocardiographic (EKG) abnormalities in patients with systemic lupus erythematosus (SLE) and to evaluate possible associations between repolarization changes (increased corrected QT [QTc] and QT dispersion [QTd]) and clinical and laboratory variables, including the anti-Ro/SSA level and specificity (52 or 60 kd).We studied adult SLE patients from 19 centers participating in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Registry. Demographics, disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), disease damage (SLICC/American College of Rheumatology Damage Index [SDI]), and laboratory data from the baseline or first followup visit were assessed. Multivariate logistic and linear regression models were used to asses for any cross-sectional associations between anti-Ro/SSA and EKG repolarization abnormalities.For the 779 patients included, mean ± SD age was 35.2 ± 13.8 years, 88.4% were women, and mean ± SD disease duration was 10.5 ± 14.5 months. Mean ± SD SLEDAI-2K score was 5.4 ± 5.6 and mean ± SD SDI score was 0.5 ± 1.0. EKG abnormalities were frequent and included nonspecific ST-T changes (30.9%), possible left ventricular hypertrophy (5.4%), and supraventricular arrhythmias (1.3%). A QTc ≥440 msec was found in 15.3%, while a QTc ≥460 msec was found in 5.3%. Mean ± SD QTd was 34.2 ± 14.7 msec and QTd ≥40 msec was frequent (38.1%). Neither the specificity nor the level of anti-Ro/SSA was associated with QTc duration or QTd, although confidence intervals were wide. Total SDI was significantly associated with a QTc interval exceeding 440 msec (odds ratio 1.38 [95% confidence interval 1.06, 1.79]).A substantial proportion of patients with recent-onset SLE exhibited repolarization abnormalities, although severe abnormalities were rare
Footwear Experiences of People with Chronic Musculoskeletal Diseases

Objective: Foot pain and deformities are frequently reported by people with chronic musculoskeletal diseases, but only limited research has been conducted to explore the key issues concerning footwear difficulties in this population. The aim of this study was to explore, identify and describe the main issues surrounding the footwear experiences of people with chronic musculoskeletal diseases.

Methods: A qualitative manifest content analysis of open-ended survey responses concerning footwear experiences was conducted from a national footwear survey of people with chronic musculoskeletal diseases in New Zealand. Eighty-five respondents submitted usable responses. Specific statements in the text were identified as ‘units of analysis’ prior to coding and organisation of these units into emerging mutually-exclusive categories. Content analysis was independently undertaken by three researchers and final categories and coding was achieved through consensus. Frequencies of assigned units of analysis were calculated in order to obtain a quantitative description for each category.

Results: Four categories encompassing a total of nine subcategories related to the footwear experiences of respondents emerged from the qualitative data content analysis including: 1) difficulties in finding appropriate footwear; 2) dissatisfaction with therapeutic footwear provision and foot care access; 3) high costs of footwear, foot care and self-care; and 4) satisfaction with therapeutic footwear and foot care.

Conclusion: Key categories describing the important issues surrounding the footwear experiences of respondents with chronic musculoskeletal diseases were identified which may provide important targets for improving footwear and foot care services, and self-management strategies. This article is protected by copyright. All rights reserved
Alcohol Consumption in Relation to Risk and Severity of Chronic Widespread Pain : Results from a UK population-based study

Acknowledgements The study was funded by Arthritis Research UK, Chesterfield, UK (Grant award number 17292). The funder did not have any role in the design, conduct of the study, in the collection, analysis or interpretation of the data, nor in the preparation, review or approval of the manuscript. We are grateful to the following practices and their patients for participating in the study: in Aberdeen: Carden Medical Centre, Elmbank Medical Practice, Great Western Medical Practice, Garthdee Medical Group, and in East Cheshire: Readesmoor Medical Group Practice, Lawton House Surgery, Bollington Medical Centre, Park Lane Surgery. The Scottish Primary Care Research Network facilitated access to patient information at the practices in Aberdeen city. Investigators on the MUSICIAN study were: Gordon J Prescott, Paul McNamee, Philip C Hannaford (all University of Aberdeen), John McBeth, Karina Lovell, Phil Keeley, Deborah PM Symmons (all University of Manchester) and Steve Woby (Penine Acute NHS Trust). Charlie Stockton was the study manager during the setting up and for part of the conduct of the study and Chrysa Gkazinou for the remainder of the study. Elizabeth Jones was part of the study team and undertook her PhD using data from the study (unrelated to the current analysis). John Norrie was originally an investigator of the MUSICIAN study while Director of the Centre for Health Care Randomised Trials (CHART) at the University of Aberdeen. We are grateful for the input of members of the Health Services Research Unit (HSRU) at The University of Aberdeen in the conduct of the study: Alison MacDonald and Gladys McPherson. The study was conceived by GJM who also drafted the manuscript. MB undertook the data analysis and critically reviewed the manuscript.Peer reviewedPublisher PD
Maintenance of clinical efficacy and radiographic benefit through two years of ustekinumab therapy in patients with active psoriatic arthritis : results from a randomized, placebo‐controlled phase III trial

To evaluate the efficacy and safety of ustekinumab through 2 years in adult patients with active psoriatic arthritis (PsA). A total of 615 adult patients with active PsA were randomized to placebo, ustekinumab 45 mg, or ustekinumab 90 mg, at weeks 0, 4, and every 12 weeks through week 88 (last dose). At week 16, patients with <5% improvement in both tender and swollen joint counts entered blinded early escape (placebo to 45 mg, 45 mg to 90 mg, and 90 mg to 90 mg). All remaining placebo patients crossed over to ustekinumab 45 mg at week 24. Clinical efficacy measures included American College of Rheumatology criteria for 20% improvement (ACR20), Disease Activity Score in 28 joints using the C‐reactive protein level (DAS28‐CRP), and ≥75% improvement in the Psoriasis Area and Severity Index (PASI75). Radiographic progression was evaluated using the modified Sharp/van der Heijde score (SHS). At week 100, ACR20, DAS28‐CRP moderate/good response, and PASI75 rates ranged from 56.7–63.6%, 71.9–76.7%, and 63.9–72.5%, respectively, across the 3 treatment groups. In both ustekinumab groups, the median percent improvement in dactylitis and enthesitis was 100% at week 100. The mean changes in SHS score from week 52 to week 100 were similar to those observed from week 0 to week 52 in the ustekinumab groups. Through week 108, 70.7% and 9.7% of patients had an adverse event (AE) or serious AE, respectively. The rates and type of AEs were similar between the dose groups. Clinical and radiographic benefits from ustekinumab treatment were maintained through week 100 in the PSUMMIT 1 study. No unexpected safety events were observed; the safety profile of ustekinumab in this population was similar to that previously observed in psoriasis patients treated with ustekinumab
Can creatine supplementation improve body composition and objective physical function in rheumatoid arthritis patients? A randomised controlled trial

Rheumatoid cachexia (muscle wasting) in rheumatoid arthritis (RA) patients contributes to substantial reductions in strength and impaired physical function. The objective of this randomised control trial was to investigate the effectiveness of oral creatine (Cr) supplementation in increasing lean mass and improving strength and physical function in RA patients.  Method. In a double-blind design, 40 RA patients, were randomised to either 12 weeks supplementation of Cr or placebo. Body composition (dual energy x-ray absorptiometry, DXA, and bioelectrical impedance spectroscopy, BIS), strength and objectively-assessed physical function were measured at: baseline, day 6, week 12 and week 24. Data analysis was performed by ANCOVA.  Results. Creatine supplementation increased appendicular lean mass (ALM; a surrogate measure of muscle mass) by 0.52 (Â± 0.13) kg (P = 0.004 versus placebo), and total LM by 0.60 (Â± 0.37) kg (P = 0.158). The change in LM concurred with the gain in intracellular water (0.64â��Â±â��0.22 L, P = 0.035) measured by BIS. Despite increasing ALM, Cr supplementation, relative to placebo, failed to improve isometric knee extensor (P = 0.408), handgrip strength (P = 0.833), or objectively-assessed physical function (P's = 0.335 â�� 0.764).  Conclusion. In patients with RA, creatine supplementation increased muscle mass, but not strength or objective physical function. No treatment-related adverse effects were reported suggesting that Cr supplementation may offer a safe and acceptable adjunct treatment for attenuating muscle loss; this treatment may be beneficial for patients suffering from severe rheumatoid cachexi
Being as Normal as Possible: How Young People Ages 16–25 Years Evaluate the Risks and Benefits of Treatment for Inflammatory Arthritis

Objective To explore how young people (ages 16–25 years) with inflammatory arthritis evaluate the risks and benefits of treatment, particularly treatment with biologic therapies. Methods This qualitative study involved in-depth interviews (n = 44) with young people, trusted others (e.g., parents), and health professionals; audio-recordings (n = 4) of biologic therapy–related consultations; and focus groups (n = 4). Analysis used techniques from grounded theory (open and focused coding, constant comparison, memoing, and mapping). Results Young people aspired to live what they perceived as a “normal” life. They saw treatment as presenting both an opportunity for and a threat to achieving this. Treatment changes were therefore subject to complex and ongoing evaluation, covering administration, associated restrictions, anticipated effects, and side effects. Information sources included expert opinion (of professionals and other patients) and personal experience. Previous treatments provided important reference points. Faced with uncertain outcomes, young people made provisional decisions. Both trusted others and health professionals expressed concern that young people were too focused on short-term outcomes. Conclusion Young people value treatment that helps them to live a “normal” life. There is more to this than controlling disease. The emotional, social, and vocational consequences of treatment can be profound and lasting: opportunities to discuss the effects of treatment should be provided early and regularly. While making every effort to ensure understanding of the long-term clinical consequences of taking or not taking medication, the wider impact of treatment should not be dismissed. Only through understanding young people's values, preferences, and concerns can a sustainable balance between disease control and treatment burden be achieved