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Age-Dependent Changes In The Articular Cartilage And Subchondral Bone Of C57bl/6 Mice After Surgical Destabilization Of Medial Meniscus, Henry Huang, Jordan D. Skelly, David C. Ayers, Jie Song 2017 University of Massachusetts Medical School

Age-Dependent Changes In The Articular Cartilage And Subchondral Bone Of C57bl/6 Mice After Surgical Destabilization Of Medial Meniscus, Henry Huang, Jordan D. Skelly, David C. Ayers, Jie Song

Jie Song

Age is the primary risk factor for osteoarthritis (OA), yet surgical OA mouse models such as destabilization of the medial meniscus (DMM) used for evaluating disease-modifying OA targets are frequently performed on young adult mice only. This study investigates how age affects cartilage and subchondral bone changes in mouse joints following DMM. DMM was performed on male C57BL/6 mice at 4 months (4 M), 12 months (12 M) and 19+ months (19 M+) and on females at 12 M and 18 M+. Two months after surgery, operated and unoperated contralateral knees were harvested and evaluated using cartilage histology scores ...


Using Mhealth App To Support Treatment Decision-Making For Knee Arthritis: Patient Perspective, Hua Zheng, Bengisu Tulu, Wonchan Choi, Patricia Franklin 2017 University of Massachusetts Medical School

Using Mhealth App To Support Treatment Decision-Making For Knee Arthritis: Patient Perspective, Hua Zheng, Bengisu Tulu, Wonchan Choi, Patricia Franklin

Patricia D. Franklin

Introduction: Mobile health (mHealth) technology can be used to integrate into medical decision-making for patients with advanced knee arthritis. We explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR).

Methods: Patient focus groups were conducted to gather requirements for mHealth app development and to refine the design and content of the app. Clinician (physical therapist, surgeon) interviews were conducted to understand clinician expectations from the summary trend report generated by the app.

Results: Sixteen ...


Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer 2017 DePaul University

Alternative Interventions For Children Coping With Chronic Conditions: A Critical Review Of The Literature, Nina M. Pelsi, Kim S. Amer

DePaul Discoveries

Reduction of stressors and anxiety levels in adolescents with chronic illnesses is a critical concept in pediatric health care in America today. The many stressors associated with chronic illness include displaying physical and mental differences, social stigma, financial difficulty, and family stress. These stressors may affect the adolescent’s ability to learn and cope in everyday life. The current research was a critical review of the literature examining studies done with adolescents coping with chronic diseases and illnesses. The aim was to analyze the most efficacious non-pharmacological methods for reducing stressors in adolescents with chronic illness. A critical review of ...


Fatigue In Children And Adolescents With Duchenne Muscular Dystrophy, Basmah El-Aloul 2017 The University of Western Ontario

Fatigue In Children And Adolescents With Duchenne Muscular Dystrophy, Basmah El-Aloul

Electronic Thesis and Dissertation Repository

Fatigue was recently reported to be the largest predictor of poor health-related quality of life (HRQOL) in children and adolescents with Duchenne muscular dystrophy (DMD). The objectives of this thesis were to describe fatigue from patients’ and parents’ perspectives and to explore associations of patient characteristics with fatigue in children and adolescents with DMD using a multicentre cross-sectional study design. Eligible patients and their parents were identified via the Canadian Neuromuscular Disease Registry and received mailed paper questionnaires. Children and adolescents with DMD experienced greater fatigue compared to healthy controls from published data. Fatigue was a significant issue in children ...


Infusion-Related Reactions With Pegloticase, A Recombinant Uricase For The Treatment Of Chronic Gout Refractory To Conventional Therapy, Herbert S. B. Baraf, Robert A. Yood, Faith D. Ottery, John S. Sundy, Michael A. Becker 2017 Center for Rheumatology & Bone Research

Infusion-Related Reactions With Pegloticase, A Recombinant Uricase For The Treatment Of Chronic Gout Refractory To Conventional Therapy, Herbert S. B. Baraf, Robert A. Yood, Faith D. Ottery, John S. Sundy, Michael A. Becker

Robert A. Yood

BACKGROUND: In clinical trials of pegloticase, a PEGylated uricase developed for treatment of gout refractory to conventional therapy, infusion-related reactions (IRs) were the second most frequent adverse event reported.

OBJECTIVE: The objective of this study was to provide a detailed account of IRs with pegloticase therapy.

METHODS: Data from 2 replicate, 6-month randomized trials and an open-label extension study were pooled. Infusions of pegloticase (8 mg) were administered biweekly or monthly; all patients received prophylaxis (antihistamine, acetaminophen, and corticosteroid) and were tested for urate levels prior to each infusion. An IR was defined by protocol as any otherwise unexplained adverse ...


Comparative Effectiveness Of Abatacept Versus Tocilizumab In Rheumatoid Arthritis Patients With Prior Tnfi Exposure In The Us Corrona Registry, Leslie R. Harrold, George W. Reed, Daniel H. Solomon, Jeffrey R. Curtis, Mei Liu, Jeffrey D. Greenberg, Joel M. Kremer 2017 University of Massachusetts Medical School

Comparative Effectiveness Of Abatacept Versus Tocilizumab In Rheumatoid Arthritis Patients With Prior Tnfi Exposure In The Us Corrona Registry, Leslie R. Harrold, George W. Reed, Daniel H. Solomon, Jeffrey R. Curtis, Mei Liu, Jeffrey D. Greenberg, Joel M. Kremer

Leslie R. Harrold

BACKGROUND: We compared the effectiveness of abatacept (ABA) vs tocilizumab (TCA) in tumor necrosis factor inhibitor (TNFi) experienced patients. METHODS: We identified rheumatoid arthritis (RA) patients from a large observational US cohort (1 January 2010-31 May 2014) who had discontinued at least one TNFi and initiated ABA or TCZ in moderate or high disease activity based on the Clinical Disease Activity Index (CDAI) and had no prior exposure to the comparator drug. Using propensity score matching (1:1) stratified by prior TNF use (1 TNFi vs ≥2 TNFis), effectiveness at 6 months after initiation was evaluated. Mean change in CDAI ...


Dermatomyositis As Paraneoplastic Manifestation Of Tonsillar Squamous Cell Carcinoma, Jatinder S. Patti, Kate Daniello, Lan Qin 2017 University of Massachusetts Medical School

Dermatomyositis As Paraneoplastic Manifestation Of Tonsillar Squamous Cell Carcinoma, Jatinder S. Patti, Kate Daniello, Lan Qin

UMass Center for Clinical and Translational Science Research Retreat

OBJECTIVE: Discussion of a rare case of dermatomyositis associated with tonsillar neoplasm in an African American woman.

BACKGROUND: Dermatomyositis is a syndrome of inflamatory myopathy with multiorgan manifestations which has been linked to immune dysregulation and neoplasia.

INTRODUCTION: Many studies have shown five to seven fold increased risk of developing malignancy with dermatomyositis within two years of presentation. Most common cancers reported are adenocarcinomas of lung, breast, ovaries, stomach, pancreas and bladder. Dermatomyositis as a paraneoplastic manifestation of tonsillar squamous cell carcinoma has not previously been described.

DESIGN: This is a case report of a 52 year old woman who ...


Using Mhealth App To Support Tkr Decision Making For Knee Arthritis Patients, Hua Zheng, Bengisu Tulu, Wonchan Choi, Patricia D. Franklin 2017 University of Massachusetts Medical School

Using Mhealth App To Support Tkr Decision Making For Knee Arthritis Patients, Hua Zheng, Bengisu Tulu, Wonchan Choi, Patricia D. Franklin

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Mobile health (mHealth) technology can be used to integrate into medical decision making for patients with advanced knee arthritis. We explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR).

Methods: We developed an Android-based smart phone app for knee arthritis patients to assess arthritis symptoms and individual readiness for TKR surgery. Patient focus groups were conducted to gather requirements for mHealth app development and to refine the design and content of the app ...


C1qbp Inhibits Dux4-Dependent Gene Activation And Can Be Targeted With 4mu, Alec M. DeSimone, Genila Bibat, Kathryn Wagner, Guido Stadler, Woodring E. Wright, John D. Leszyk, Charles P. Emerson Jr. 2017 University of Massachusetts Medical School

C1qbp Inhibits Dux4-Dependent Gene Activation And Can Be Targeted With 4mu, Alec M. Desimone, Genila Bibat, Kathryn Wagner, Guido Stadler, Woodring E. Wright, John D. Leszyk, Charles P. Emerson Jr.

UMass Center for Clinical and Translational Science Research Retreat

FSHD is linked to the misexpression of the DUX4 gene contained within the D4Z4 repeat array on chromosome 4. The gene encodes the DUX4 protein, a cytotoxic transcription factor that presumably causes the symptoms of the disease. However, individuals have been identified who express DUX4 in their muscle biopsies, but who remain asymptomatic, suggesting that there are other factors that modify FSHD penetrance or severity. We hypothesized that an FSHD-modifying factor would physically interact with DUX4, and we took a proteomic approach to identify DUX4-interacting proteins. We identified the multifunctional C1QBP protein as one such factor. C1QBP is known to ...


The Smoking Paradox In The Development Of Psoriatic Arthritis Among Psoriasis Patients – A Population-Based Study, Uyen-Sa D. T. Nguyen, Yuqing Zhang, Na Lu, Qiong Louie-Gao, Jingbo Niu, Thorvador J. Love, Alexis Ogdie, Joel M. Gelfand, Michael P. LaValley, Maureen Dubreuil, Jeffrey A. Sparks, Elizabeth W. Karlson, Hyon K. Choi 2017 University of Massachusetts Medical School

The Smoking Paradox In The Development Of Psoriatic Arthritis Among Psoriasis Patients – A Population-Based Study, Uyen-Sa D. T. Nguyen, Yuqing Zhang, Na Lu, Qiong Louie-Gao, Jingbo Niu, Thorvador J. Love, Alexis Ogdie, Joel M. Gelfand, Michael P. Lavalley, Maureen Dubreuil, Jeffrey A. Sparks, Elizabeth W. Karlson, Hyon K. Choi

UMass Center for Clinical and Translational Science Research Retreat

Objectives: Smoking is strongly associated with an increased risk of psoriatic arthritis (PsA) in the general population, but not among psoriasis patients. We sought to clarify the possible methodologic mechanisms behind this paradox.

Methods: Using 1995-2015 data from The Health Improvement Network, we performed survival analysis to examine the association between smoking and incident PsA in the general population and among psoriasis patients. We clarified the paradox using mediation analysis and conducted bias sensitivity analyses to evaluate the potential impact of index event bias and quantify its magnitude from uncontrolled/unmeasured confounders.

Results: Of 6.65 million subjects without PsA ...


Macroglossia In Inclusion Body Myositis, Jatinder S. Patti, Kate Daniello, Lan Qin 2017 University of Massachusetts Medical School

Macroglossia In Inclusion Body Myositis, Jatinder S. Patti, Kate Daniello, Lan Qin

UMass Center for Clinical and Translational Science Research Retreat

OBJECTIVE: Discussion of a case of Inclusion body myositis (IBM) associated with macroglossia.

INTRODUCTION: IBM is one of the idiopathic inflammatory myopathies. Exact pathogenesis is unclear but there is an evidence of dysregulation of antigen driven immune response involving T cells. Typical onset is slowly progressive impacting quadriceps often more than hip flexors, ankle dorsiflexors and distal forearm flexor muscles. Swallowing difficulties often are present and mild facial weakness can be seen. Macroglossia has never been reported in association with IBM. In fact inflammatory myopathies of tongue are a rarity.

DESIGN: A case report of a 68 year old woman ...


Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews 2017 James Madison University

Effects Of Glucosamine Versus Chondroitin Sulfate In Reducing Joint Space Narrowing In Knee Osteoarthritis, Caroline Horton, Ashani Andrews

Physician Assistant Capstones

Objective: To determine if over the counter supplements, chondroitin sulfate and glucosamine, in combination or alone, are effective in the treatment of joint space narrowing (JSN) in knee osteoarthritis.

Design: Systematic Literature Review

Methods: Database search of PubMed and MEDLINE using the search terms “glucosamine”, “chondroitin sulfate”, “osteoarthritis”, and joint space narrowing. Filters were implemented to include articles that only dealt with human subjects, that were published in 2000 or later, and were full-text. Articles were excluded if they were cohort studies, reviews, non-English papers, or had pain as the only outcome.

Results: Sawitzke et al.primary outcomes revealed no ...


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 ...


Varying The Item Format Improved The Range Of Measurement In Patient-Reported Outcome Measures Assessing Physical Function, Gregor Liegl, Barbara L. Gandek, H. Felix Fischer, Jakob B. Bjorner, John E. Ware Jr., Matthias S. F. Rose, James F. Fries, Sandra Nolte 2017 Charité - Universitätsmedizin Berlin

Varying The Item Format Improved The Range Of Measurement In Patient-Reported Outcome Measures Assessing Physical Function, Gregor Liegl, Barbara L. Gandek, H. Felix Fischer, Jakob B. Bjorner, John E. Ware Jr., Matthias S. F. Rose, James F. Fries, Sandra Nolte

University of Massachusetts Medical School Faculty Publications

BACKGROUND: Physical function (PF) is a core patient-reported outcome domain in clinical trials in rheumatic diseases. Frequently used PF measures have ceiling effects, leading to large sample size requirements and low sensitivity to change. In most of these instruments, the response category that indicates the highest PF level is the statement that one is able to perform a given physical activity without any limitations or difficulty. This study investigates whether using an item format with an extended response scale, allowing respondents to state that the performance of an activity is easy or very easy, increases the range of precise measurement ...


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 ...


Large Family Cohorts Of Lymphoblastoid Cells Provide A New Cellular Model For Investigating Facioscapulohumeral Muscular Dystrophy, Takako I. Jones, Charis L. Himeda, Daniel P. Perez, Peter L. Jones 2017 University of Massachusetts Medical School

Large Family Cohorts Of Lymphoblastoid Cells Provide A New Cellular Model For Investigating Facioscapulohumeral Muscular Dystrophy, Takako I. Jones, Charis L. Himeda, Daniel P. Perez, Peter L. Jones

Open Access Articles

Facioscapulohumeral muscular dystrophy (FSHD) is associated with aberrant epigenetic regulation of the chromosome 4q35 D4Z4 macrosatellite repeat. The resulting DNA hypomethylation and relaxation of epigenetic repression leads to increased expression of the deleterious DUX4-fl mRNA encoded within the distal D4Z4 repeat. With the typical late onset of muscle weakness, prevalence of asymptomatic individuals, and an autosomal dominant mode of inheritance, FSHD is often passed on from one generation to the next and affects multiple individuals within a family. Here we have characterized unique collections of 114 lymphoblastoid cell lines (LCLs) generated from 12 multigenerational FSHD families, including 56 LCLs from ...


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