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Factors In Patient Responsiveness To Directional Preference-Matched Treatment Of Neck Pain With Or Without Upper Extremity Radiation, Benjamin Holmes, Ruta Brazauskas, Laura D. Cassidy, Rachel A. Wiegand 2017 Aurora Sheboygan Clinic Spine Institute; Medical College of Wisconsin

Factors In Patient Responsiveness To Directional Preference-Matched Treatment Of Neck Pain With Or Without Upper Extremity Radiation, Benjamin Holmes, Ruta Brazauskas, Laura D. Cassidy, Rachel A. Wiegand

Journal of Patient-Centered Research and Reviews

Purpose

Patient-related predictive factors in responsiveness to directional preference therapy for neck pain with or without upper extremity radiation (NP/R) have not been reported. A directional preference is any neck movement that, when performed repeatedly to end range, results in centralization and/or alleviation of NP/R. It was hypothesized that patient compliance with a prescribed, directional preference-matched home exercise program would improve positive responsiveness to NP/R treatment.

Methods

Patient-related factors thought to affect responsiveness to care were collected retrospectively from charts and de-identified for patients with NP/R who underwent chiropractic treatment at a multispecialty spine clinic ...


Impact Of Prior Biologic Use On Persistence Of Treatment In Patients With Psoriatic Arthritis Enrolled In The Us Corrona Registry, Leslie R. Harrold, Bradley S. Stolshek, Sabrina Rebello, David H. Collier, Alex Mutebi, Sally W. Wade, Wendi Malley, Jeffrey D. Greenberg, Carol J. Etzel 2017 University of Massachusetts Medical School

Impact Of Prior Biologic Use On Persistence Of Treatment In Patients With Psoriatic Arthritis Enrolled In The Us Corrona Registry, Leslie R. Harrold, Bradley S. Stolshek, Sabrina Rebello, David H. Collier, Alex Mutebi, Sally W. Wade, Wendi Malley, Jeffrey D. Greenberg, Carol J. Etzel

University of Massachusetts Medical School Faculty Publications

Psoriatic arthritis (PsA) is a chronic condition characterized by a diverse set of symptoms, from swollen joints to nail disease to skin disease. A variety of treatment options are available, including tumor necrosis factor inhibitors (TNFis). Little is known about treatment persistence in patients with PsA who initiate TNFi therapy, with and without prior biologic use. This study assessed persistence in these subgroups of patients with PsA and identified factors associated with persistence. This retrospective study utilized data from the Corrona registry of patients with PsA-with or without prior biologic experience-who initiated TNFi therapy between October 1, 2002, and March ...


Differential Burden Of Musculoskeletal Pain In African Americans And Whites Patients At The Time Of Total Joint Replacement Surgery, Leslie R. Harrold, Anthony Porter, Philip C. Noble, David C. Ayers, Jeroan J. Allison, Patricia D. Franklin 2017 University of Massachusetts Medical School

Differential Burden Of Musculoskeletal Pain In African Americans And Whites Patients At The Time Of Total Joint Replacement Surgery, Leslie R. Harrold, Anthony Porter, Philip C. Noble, David C. Ayers, Jeroan J. Allison, Patricia D. Franklin

Orthopedics and Physical Rehabilitation Publications and Presentations

Objective: African Americans patients have greater operative joint pain and functional limitation at the time of total joint replacement (TJR) compared to white patients. We examined the factors associated with this apparent disparity.

Methods: A consecutive sample of 5745 patients with advanced knee and hip osteoarthritis [who elected to undergo TJR in 2011-201] reported, preoperatively, medical comorbidities, operative and non-operative hip/ knee pain using Hip and Knee Disability and Osteoarthritis Outcome Scores (HOOS/KOOS), function using Short Form 36 Physical Component Score (PCS). Total burden of musculoskeletal pain was quantified as moderate/severe pain in non-operative hip and knee joints ...


Sex Differences In Gout Characteristics: Tailoring Care For Women And Men, Leslie R. Harrold, Carol J. Etzel, Allan Gibofsky, Joel Kremer, Michael H. Pillinger, Kenneth G. Saag, Naomi Schlesinger, Robert Terkeltaub, Vanessa Cox, Jeffrey D. Greenberg 2017 University of Massachusetts Medical School

Sex Differences In Gout Characteristics: Tailoring Care For Women And Men, Leslie R. Harrold, Carol J. Etzel, Allan Gibofsky, Joel Kremer, Michael H. Pillinger, Kenneth G. Saag, Naomi Schlesinger, Robert Terkeltaub, Vanessa Cox, Jeffrey D. Greenberg

University of Massachusetts Medical School Faculty Publications

BACKGROUND: To characterize the differences between women and men with gout.

METHODS: We analyzed a US national cohort of gout patients cared for by rheumatologists.

RESULTS: Compared with the 1012 men with gout, women with gout (n = 262) were older (71 vs. 61 years, p < 0.001) and had a greater burden of comorbid conditions (p < 0.001 for hypertension, diabetes, renal disease and obesity). Risk factors for gout differed with women more often taking diuretics (p < 0.001), while men more frequently had dietary triggers (p < 0.05).

CONCLUSIONS: The profiles of women and men with gout are markedly different, suggesting a need to tailor treatment recommendations.


Antisense Oligonucleotides Used To Target The Dux4 Mrna As Therapeutic Approaches In Faciosscapulohumeral Muscular Dystrophy (Fshd), Eugenie Ansseau, Celine Vanderplanck, Armelle Wauters, Scott Q. Harper, Frederique Coppee, Alexandra Belayew 2017 University of Mons

Antisense Oligonucleotides Used To Target The Dux4 Mrna As Therapeutic Approaches In Faciosscapulohumeral Muscular Dystrophy (Fshd), Eugenie Ansseau, Celine Vanderplanck, Armelle Wauters, Scott Q. Harper, Frederique Coppee, Alexandra Belayew

Wellstone Center for FSHD Publications and Presentations

FacioScapuloHumeral muscular Dystrophy (FSHD) is one of the most prevalent hereditary myopathies and is generally characterized by progressive muscle atrophy affecting the face, scapular fixators; upper arms and distal lower legs. The FSHD locus maps to a macrosatellite D4Z4 repeat array on chromosome 4q35. Each D4Z4 unit contains a DUX4 gene; the most distal of which is flanked by a polyadenylation site on FSHD-permissive alleles, which allows for production of stable DUX4 mRNAs. In addition, an open chromatin structure is required for DUX4 gene transcription. FSHD thus results from a gain of function of the toxic DUX4 protein that normally ...


A Window Of Opportunity For Abatacept In Ra: Is Disease Duration An Independent Predictor Of Low Disease Activity/Remission In Clinical Practice, Leslie R. Harrold, Heather J. Litman, Sean E. Connolly, Sheila Kelly, Winnie Hua, Evo Alemao, Lisa Rosenblatt, Sabrina Rebello, Joel M. Kremer 2017 University of Massachusetts Medical School

A Window Of Opportunity For Abatacept In Ra: Is Disease Duration An Independent Predictor Of Low Disease Activity/Remission In Clinical Practice, Leslie R. Harrold, Heather J. Litman, Sean E. Connolly, Sheila Kelly, Winnie Hua, Evo Alemao, Lisa Rosenblatt, Sabrina Rebello, Joel M. Kremer

University of Massachusetts Medical School Faculty Publications

The objective of the study was to examine whether disease duration independently predicts treatment response among biologic-naive patients with rheumatoid arthritis (RA) initiating abatacept in clinical practice. Using the Corrona RA registry (February 2006-January 2015), biologic-naive patients with RA initiating abatacept with 12-month (+/-3 months) follow-up and assessment of disease activity (Clinical Disease Activity Index [CDAI]) at initiation and at 12 months were identified. The primary outcome was mean change in CDAI (DeltaCDAI) from baseline to 12 months. Secondary outcomes at 12 months included achievement of low disease activity (LDA; CDAI 10 years, n = 79). Increased disease duration was associated ...


Two Cases Of Lyme Arthritis In Winter In New England: A Case Series, Jennifer Baima, Lauren Woo 2017 University of Massachusetts Medical School

Two Cases Of Lyme Arthritis In Winter In New England: A Case Series, Jennifer Baima, Lauren Woo

Orthopedics and Physical Rehabilitation Publications and Presentations

Case Diagnosis: Lyme Arthritis

Case Description: Patient 1 is a 26 year old male who presented in March with severe right knee pain and swelling for two weeks. He had a similar episode a month prior, but it resolved. The second episode progressed with pain from knee to foot and numbness on top of the foot. He had no known history of tick bites, travel, or trauma, but endorsed contact with a dog. On physical exam, he had a right knee effusion with limited ROM, diffuse joint line tenderness, positive McMurray’s, and pain with ligamentous testing. Synovial fluid of ...


What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds 2017 Adelphi Values

What Outcomes Are Important For Gout Patients? In-Depth Qualitative Research Into The Gout Patient Experience To Determine Optimal Endpoints For Evaluating Therapeutic Interventions, Sophi Tatlock, Katja Rudell, Charlotte Panter, Rob Arbuckle, Leslie R. Harrold, William J. Taylor, Tara Symonds

University of Massachusetts Medical School Faculty Publications

BACKGROUND AND OBJECTIVES: Characterized by sudden onset of severe joint pain, swelling, redness, and tenderness to touch, gout 'flare ups' have a substantial impact on quality of life (QoL). This research employed a patient-centered approach to explore the symptoms and impacts of gout, and assess the content validity of existing patient-reported outcomes (PROs).

METHODS: Qualitative interviews were conducted with 30 US gout patients (non-tophaceous: n = 20, tophaceous: n = 10) and five expert rheumatologists. Each interview included both concept elicitation (CE) questioning to learn about the patient experience and cognitive debriefing to assess the content validity of three PRO instruments (HAQ-DI ...


Risk Of Infection Associated With Subsequent Biologic Agent Use After Rituximab: Results From A National Rheumatoid Arthritis Patient Registry, Leslie R. Harrold, George W. Reed, Chitra Karki, Robert P. Magner, Ashwini Shewade, Ani John, Joel Kremer, Jeffrey D. Greenberg 2016 University of Massachusetts Medical School

Risk Of Infection Associated With Subsequent Biologic Agent Use After Rituximab: Results From A National Rheumatoid Arthritis Patient Registry, Leslie R. Harrold, George W. Reed, Chitra Karki, Robert P. Magner, Ashwini Shewade, Ani John, Joel Kremer, Jeffrey D. Greenberg

University of Massachusetts Medical School Faculty Publications

OBJECTIVE: To assess whether the time between the last rituximab infusion and initiation of a different biologic agent influenced infection risk in patients with rheumatoid arthritis (RA).

METHODS: Patients with RA who newly initiated rituximab within the Consortium of Rheumatology Researchers of North America registry were included if they switched to a nonrituximab biologic agent and had > /=1 followup visit within 12 months of switching. Patients were categorized by duration of time between their last rituximab infusion and initiation of a subsequent biologic agent (< /=5 months, 6-11 months, and > /=12 months). The primary outcome was time to first infectious event. Adjusted Cox regression models estimated ...


When It Isn’T Always Lyme: Expanding The Differential Diagnosis For Acute-Onset Polyarthralgia In The West Virginia Eastern Panhandle, Natalie A. Moffett, Rosemarie Lorenzetti 2016 West Virginia University

When It Isn’T Always Lyme: Expanding The Differential Diagnosis For Acute-Onset Polyarthralgia In The West Virginia Eastern Panhandle, Natalie A. Moffett, Rosemarie Lorenzetti

Marshall Journal of Medicine

This case presentation discusses a 36 year-old female animal care worker presenting with an acute-onset polyarthropathy during the summer months in a Lyme endemic region. Though she appeared to be a good candidate for the diagnosis of Lyme borreliosis, her screening serology reported negative results and alternative diagnoses were considered. Her subsequent diagnosis with parvovirus B19 acts to remind the general practitioner to have confidence in the accuracy of a negative Lyme screen and, upon negative result, to expand the differential to include less common infections including parvovirus B19. It also highlights the need to remember parvovirus B19 in a ...


Ataluren Stimulates Ribosomal Selection Of Near-Cognate Trnas To Promote Nonsense Suppression, Bijoyita Roy, Westley J. Friesen, Yuki Tomizawa, John D. Leszyk, Jin Zhuo, Briana Johnson, Jumana Dakka, Christopher R. Trotta, Xiaojiao Xue, Venkateshwar Mutyam, Kim M. Keeling, James A. Mobley, Steven M. Rowe, David M. Bedwell, Ellen M. Welch, Allan Jacobson 2016 University of Massachusetts Medical School

Ataluren Stimulates Ribosomal Selection Of Near-Cognate Trnas To Promote Nonsense Suppression, Bijoyita Roy, Westley J. Friesen, Yuki Tomizawa, John D. Leszyk, Jin Zhuo, Briana Johnson, Jumana Dakka, Christopher R. Trotta, Xiaojiao Xue, Venkateshwar Mutyam, Kim M. Keeling, James A. Mobley, Steven M. Rowe, David M. Bedwell, Ellen M. Welch, Allan Jacobson

Microbiology and Physiological Systems Publications and Presentations

A premature termination codon (PTC) in the ORF of an mRNA generally leads to production of a truncated polypeptide, accelerated degradation of the mRNA, and depression of overall mRNA expression. Accordingly, nonsense mutations cause some of the most severe forms of inherited disorders. The small-molecule drug ataluren promotes therapeutic nonsense suppression and has been thought to mediate the insertion of near-cognate tRNAs at PTCs. However, direct evidence for this activity has been lacking. Here, we expressed multiple nonsense mutation reporters in human cells and yeast and identified the amino acids inserted when a PTC occupies the ribosomal A site in ...


Disability And Return To Work Following Musculoskeletal Injury, Qiyun Shi 2016 The University of Western Ontario

Disability And Return To Work Following Musculoskeletal Injury, Qiyun Shi

Electronic Thesis and Dissertation Repository

Musculoskeletal disorders (MSDs) are injuries, damage or disorders affecting the musculoskeletal system including muscles, ligaments, nerves, tendons, bones or cartilage etc. MSDs are highly prevalent and associated with sickness absence, reduced work efficiency, job changes and earlier retirement.. They also affect daily activity and social functioning. Although many MSDs are accompanied by minor symptoms and settled spontaneously, approximately 10% of the workforce with MSDs have difficulty resuming their original work or exit the workforce permanently. Return to work after MSDs is complex, and is influenced by many factors including physical, psychological, economic and social factors.

Although there are extensive studies ...


Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin 2016 University of Massachusetts Medical School

Using Interviews To Understand Patients’ Post-Operative Pain Management Educational Needs Before And After Elective Total Joint Replacement Surgery, Celeste A. Lemay, Patricia D. Franklin

Celeste A. Lemay

Objective: To better understand the education needs of patients electing to have TJR in managing their pain in the post-operative period after discharge from the hospital.

Methods: An exploratory, descriptive, qualitative design. Convenience sample of people who reported that they had not received information about pain management prior to TJR surgery were recruited from 9 surgeon practices in 8 states to participate in telephone interviews, utilizing open-ended questions. Questions included: recollection of pre-op class attended and content; experiences with surgical pain after surgery and how it was managed; experiences with pain medicine; experience using non-medicine related pain reduction methods; suggestions ...


Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin 2016 University of Massachusetts Medical School

Effective Pain Information Pre-Operatively Is Associated With Improved Functional Gain After Total Joint Replacement, Celeste A. Lemay, David Ayers, Patricia D. Franklin

Celeste A. Lemay

Objective: We evaluated receipt of pre-operative pain management education in a national prospective cohort on post-operative pain and function.

Methods: Preoperative, 2 week and 6 month postoperative data from a nationally representative cohort of 1404 primary unilateral TJR patients with a date of surgery between May 2011 and December 2014. Data included demographics, comorbid conditions, operative joint pain severity (HOOS/KOOS), musculoskeletal disease burden, physical function (SF36 PCS), and mental health (SF36 MCS). At 2 weeks post-op, patients were asked if they had received information prior to surgery about pain management options and if so, how helpful the information was ...


Morpholino-Mediated Knockdown Of Dux4 Toward Facioscapulohumeral Muscular Dystrophy Therapeutics, Jennifer C. J. Chen, Oliver D. King, Yuanfan Zhang, Nicholas P. Clayton, Carrie Spencer, Bruce M. Wentworth, Charles P. Emerson Jr., Kathryn R. Wagner 2016 University of Massachusetts Medical School

Morpholino-Mediated Knockdown Of Dux4 Toward Facioscapulohumeral Muscular Dystrophy Therapeutics, Jennifer C. J. Chen, Oliver D. King, Yuanfan Zhang, Nicholas P. Clayton, Carrie Spencer, Bruce M. Wentworth, Charles P. Emerson Jr., Kathryn R. Wagner

Cell and Developmental Biology Publications and Presentations

Derepression of DUX4 in skeletal muscle has emerged as a likely cause of pathology in facioscapulohumeral muscular dystrophy (FSHD). Here we report on the use of antisense phosphorodiamidate morpholino oligonucleotides to suppress DUX4 expression and function in FSHD myotubes and xenografts. The most effective was phosphorodiamidate morpholino oligonucleotide FM10, which targets the polyadenylation signal of DUX4. FM10 had no significant cell toxicity, and RNA-seq analyses of FSHD and control myotubes revealed that FM10 down-regulated many transcriptional targets of DUX4, without overt off-target effects. Electroporation of FM10 into FSHD patient muscle xenografts in mice also down-regulated DUX4 and DUX4 targets. These ...


A Comparison Of Cervical And Trunk Musculoskeletal Characteristics Between Female And Male Army Helicopter Pilots, Takashi Nagai, Karen A. Keenan, John P. Abt, Timothy C. Sell, Brian W. Smalley, Michael D. Wirt, Scott M. Lephart 2016 University of Pittsburgh

A Comparison Of Cervical And Trunk Musculoskeletal Characteristics Between Female And Male Army Helicopter Pilots, Takashi Nagai, Karen A. Keenan, John P. Abt, Timothy C. Sell, Brian W. Smalley, Michael D. Wirt, Scott M. Lephart

International Journal of Aviation, Aeronautics, and Aerospace

Introduction: Neck pain (NP) and low back pain (LBP) are prevalent among military helicopter pilots. Although there have been few studies on sex differences in the NP/LBP prevalence in this population, females are shown to be at a greater risk of NP/LBP in civilian studies. This disparity may be due to musculoskeletal characteristics differences that predispose females for NP/LBP. The purpose of this study was to compare cervical and trunk musculoskeletal characteristics between male and female pilots. Methods: A total of 8 female pilots (Age: 27.6 ± 4.2yrs, HT: 166.1 ± 7.7cm, WT: 67.9 ...


Tumor Necrosis Factor Alpha, Citrullination, And Peptidylarginine Deiminase 4 In Lung And Joint Inflammation, Mandar Bawadekar, Annette Gendron-Fitzpatrick, Ryan Rebernick, Daeun Shim, Thomas F. Warner, Anthony P. Nicholas, Lennart K. Lundblad A, Paul R. Thompson, Miriam A. Shelef 2016 University of Wisconsin - Madison

Tumor Necrosis Factor Alpha, Citrullination, And Peptidylarginine Deiminase 4 In Lung And Joint Inflammation, Mandar Bawadekar, Annette Gendron-Fitzpatrick, Ryan Rebernick, Daeun Shim, Thomas F. Warner, Anthony P. Nicholas, Lennart K. Lundblad A, Paul R. Thompson, Miriam A. Shelef

Open Access Articles

BACKGROUND: The relationship between lung and joint inflammation in rheumatoid arthritis is poorly understood. Lung inflammation with resultant protein citrullination may trigger anti-citrullinated protein antibodies, inflammation, and arthritis. Alternatively, lung and joint inflammation may be two manifestations of a single underlying pathology. The lung has increased citrullination and TNF-alpha levels are high in rheumatoid arthritis; however, it is unknown if TNF-alpha can induce lung protein citrullination. The citrullinating enzyme peptidylarginine deiminase 4 (PAD4) exacerbates TNF-alpha-induced arthritis, but a role for PAD4 in lung citrullination and TNF-alpha-induced lung inflammation has not been explored. Our aim was to use TNF-alpha-overexpressing mice to ...


Inpatient Versus Outpatient Total Hip Arthroplasty, Michael Pollock 2016 The University of Western Ontario

Inpatient Versus Outpatient Total Hip Arthroplasty, Michael Pollock

Electronic Thesis and Dissertation Repository

We conducted a randomized controlled trial to evaluate patients undergoing a total hip arthroplasty (THA) who were discharged from the hospital either on the day of surgery (outpatient) or were admitted overnight following surgery (inpatient). Our primary outcome was the rate of serious adverse events during the first three months postoperatively. Secondary outcome measures included cost, patient satisfaction, functional outcomes, quality of life and pain. We found no statistically significant difference between the two groups in serious adverse events. We found that outpatient THA was less expensive from the perspectives of the hospital and ministry of health; but the difference ...


Statin Therapy For Elderly Patients Should Be Assessed For Each Individual, Raymond Gong 2016 Wayne State University School of Medicine

Statin Therapy For Elderly Patients Should Be Assessed For Each Individual, Raymond Gong

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002;360(9346):1623-30. doi:10.1016/S0140-6736(02)11600-X


Patient-Reported Outcome Measures In Arthroplasty Registries, Ola Rolfson, Kate Eresian Chenok, Eric Bohm, Anne Lubbeke, Geke Denissen, Jennifer Dunn, Stephen Lyman, Patricia D. Franklin, Michael Dunbar, Soren Overgaard, Goran Garellick, Jill Dawson, Patient-Reported Outcome Measures Working Group of the International Society of Arthroplasty Registries 2016 University of Gothenburg

Patient-Reported Outcome Measures In Arthroplasty Registries, Ola Rolfson, Kate Eresian Chenok, Eric Bohm, Anne Lubbeke, Geke Denissen, Jennifer Dunn, Stephen Lyman, Patricia D. Franklin, Michael Dunbar, Soren Overgaard, Goran Garellick, Jill Dawson, Patient-Reported Outcome Measures Working Group Of The International Society Of Arthroplasty Registries

University of Massachusetts Medical School Faculty Publications

The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and ...


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