Medicine and Health Sciences Commons^™

Enhancing Physician Perspectives Of Skilled Occupational Therapy Services For Patients With Rheumatoid Arthritis, Valerie S. Trinidad

Department of Occupational Therapy Entry-Level Capstone Projects

This Capstone Project, with a focus in research, sought to identify a relationship between self-reported functional performance and participation restriction as described by satisfaction with one’s execution or participation in a described occupation. A correlational study design was employed under the mentorship of Dr. Thomas Decker, EdD, OTD, OTR/L who oversaw all IRB processes, documentation, study development and deployment, as well as co-authored and provided mentorship for creation of a publishable manuscript of this project. The established Health Assessment Questionnaire Disability Index (HAQ-DI) and the newer Keele Assessment of Participation (KAP) were the two outcome measures of focus for surveying …

Development Of Macromolecular Prodrug Of Sinomenine For The Treatment Of Rheumatoid Arthritis, Roshni Mukundan

Theses & Dissertations

Inflammation is a natural response of the body to infections or any potential threat to the body. But, sometimes the immune system attacks its own body causing persistent inflammation leading to inflammatory diseases. One of the common chronic inflammatory diseases is rheumatoid arthritis (RA) which causes inflammation of the synovial membrane. The current treatments for RA are effective in controlling the symptoms but they come with severe side effects and economic burden. Further, the management of pain is still a problem with these drugs. Sinomenine is a natural alkaloid obtained from the Chinese medicinal plant Sinomenium acutum that has been …

Testing A Novel Peptide-Infused Cream For Treatment Of Rheumatoid Arthritis In Dr4tg Mice, Alisha J. Moynahan

Electronic Thesis and Dissertation Repository

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes joint pain and damage. Studies have shown that inducing immune tolerance towards RA-specific proteins/peptides in RA mouse models can reduce arthritis severity and pro-inflammatory responses. The objectives of this study were to determine if a novel peptide cream treatment could modify RA-specific immune responses and reduce joint swelling in a humanized mouse model expressing the HLA-DRB1*0401 allele (known as DR4tg mice), the strongest genetic risk-factor for RA. Hyaluronan-Phosphatidylethanolamine cream infused with synthetic peptides HomoCitJED and CitJED was applied to HomoCitJED-immunized DR4tg mice before or after arthritis induction. Knee joint …

Comparison Of The Therapeutic Efficacy Of Rheumatoid Arthritis Treatments, Kacy Smith Davis

Walden Dissertations and Doctoral Studies

Rheumatoid arthritis (RA) is an autoimmune condition that causes chronic joint pain and destruction. The current standard regimen of monotherapy disease modifying anti-rheumatic drug (DMARD) treatments may not be as effective as that of combination therapy of a DMARD and a biologic agent in treating RA. The purpose of this study was to answer the question, is there a difference in the therapeutic efficacy of combination DMARD treatments with a biologic, compared to monotherapy DMARDs without a biologic, in U.S. Caucasian women between the ages of 30 and 60 that have been diagnosed with RA? Guided by the theoretical framework …

Joint Protection Programs For People With Hand Arthritis, Pavlos Bobos

Electronic Thesis and Dissertation Repository

The fact that Joint Protection Programs (JPP) can reduce pain and improve function is based on small, but definitive Randomized Controlled Trials (RCTs), conducted in the 1980s. However, changes over time in the nature of hand use, the rapid expansion of technology, and improvements in our understanding of health literacy mean that these programs are now outdated. Further, problems with adherence to JPP are well documented. The purpose of this thesis was 1) to conduct a scoping review to map all the available evidence around joint protection programs in published and unpublished studies 2) to evaluate the effectiveness of joint …

The Effects Of E-Vapor On The Pathogenesis Of Rheumatoid Arthritis Mouse Models And Potential Implications For Future Generations, Christiana Daas

Selected Honors Theses

Rheumatoid arthritis is the most prevalent autoimmune disease. Rheumatoid arthritis (RA) has no cure, and the direct cause of the disease is still unknown. The two leading hypotheses concerning its etiology are based on the effects of HLA-DRB1 gene expression, and cigarette smoke. Conjunctively, the use of vaping devices amongst adolescents has increased significantly since introduced in 2007. There is no long-term data on the effects of e-vapor and its aerosols on bodily health. Cigarette smoke is the most noteworthy environmental factor contributing to RA therefore the question is raised as to whether or not vaping relates to rheumatoid arthritis …

An Assessment Of Potential Causal Pathways Between Two Autoimmune Diseases: Mendelian Randomization Studies Of Rheumatoid Arthritis And Crohn’S Disease; And A Phenome-Wide Association Study To Assess Potential New Targets For Tocilizumab, An Interleukin-6 Inhibitor, Staci Abramsky Risman

Dissertations and Theses

Background

Rheumatoid arthritis (RA) and Crohn’s disease (CD) are two among a group of immune-mediated inflammatory diseases (IMIDs). These diseases are common, collectively affecting as many as two million Americans and as many as 28 million people worldwide. They have different clinical presentations but may have a common pathogenesis. An over-expression of tumor necrosis factor (TNF) and interleukin-6 (IL-6) have been proffered as a causal factor for IMIDs. These and other IMIDs may co-occur in patients, and it has been shown that patients with one IMID may have an increased risk of another IMID. What is not clear is whether …

To Study Disease Activity And Various Counseling Techniques In Rheumatoid Arthritis Patients, Kanav Khera Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Education and counseling creates awareness amongst RA patients regarding the nature of their disease, drugs and lifestyle. Often, early diagnosis of RA prevents permanent disability. However, this does not happen in many cases. With the intention of coping with RA related complications and promoting healthy living, this study assessed the importance of counseling interventions with the aid of patient information leaflets and digital media as an adjunct for better patient care. Objectives: To study three counseling interventions, drug utilization, disease activity and quality of life in Rheumatoid Arthritis patients. Methods: A prospective study was conducted where 30 patients were …

Aging With Hiv: Biomarkers Of Inflammation And Incident Rheumatologic Disease, Jennifer Leslie Simon Hanberg

Yale Medicine Thesis Digital Library

Chronic Human Immunodeficiency Virus (HIV) infection results in multimorbidity and shortened lifespan. Inflammation and immune dysfunction contribute to these outcomes. The aim of this thesis is (1) to investigate the utility of two inflammatory biomarkers evaluated in other settings (neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)) for prognostication in patients living with HIV (PLWH) and comorbid inflammatory states; and (2) to compare the frequency and severity with which rheumatologic disease states occur in PLWH to demographically and behaviorally similar uninfected individuals (“controls”).

Three cohorts were created from the Veterans Aging Cohort Study. In each cohort, patients were stratified by presence …

Enhancing The Identification Of Rheumatoid Arthritis-Associated Lung Disease, Bryant England

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic autoimmune disease that predisposes afflicted individuals to reduced quality of life, physical disability, and premature mortality. While joint involvement is the primary manifestation of RA, extra-articular features including lung disease are responsible for a significant portion of the excess mortality. In this dissertation I demonstrate the contribution of chronic lung diseases to premature mortality in RA, contrasting with the more widely recognized comorbidity in RA of cardiovascular disease. Then, I establish that a novel serum biomarker, anti-malondialdehyde-acetaldehyde adduct (MAA) antibody, is associated with the presence of interstitial lung disease (ILD) in RA subjects. Further …

Behavioral And Anti-Inflammatory Effects Of Magl Inhibition In A Mouse Model Of Inflammatory Arthritis, Floyd Franklin Steele Iii

Graduate Theses, Dissertations, and Problem Reports

Cannabinoids have analgesic and anti-inflammatory properties. For example, in preclinical models of acute inflammatory pain, cannabinoid receptor subtype 2 (i.e., CB_2, Table 1) agonists decrease paw inflammation and resulting pain. Yet, the anti-inflammatory properties of cannabinoid receptor manipulation in chronic inflammatory pain states are unknown. Monoacylglycerol lipase (MAGL) is the primary catabolic enzyme of the endocannabinoid (i.e., endogenous cannabinoid ligand) 2-arachidonoyl glycerol (i.e., 2-AG). Compounds that inhibit MAGL indirectly increase tissue levels of 2-AG by preventing its catabolism. MAGL inhibitors demonstrate efficacy in acute models of inflammatory/rheumatic disease. Thus, in this study, the MAGL inhibitor JZL184 was tested …

The Meaning Of Instagram Use For Rheumatoid Arthritis Information, Deborah Lewis

Walden Dissertations and Doctoral Studies

Social media use related to chronic disease has become pervasive, yet few researchers have examined the influence of social media on health care message dissemination and health care outcomes. In this study, the use of Instagram, an image-rich social media platform, for sharing health information was examined. Nurses, as key providers of patient information, need to understand the relative effectiveness of different types of social media for health information, how social media is currently used by health care consumers, and how to best use various social media platforms to improve patient outcomes. The purpose of this study was to gain …

Environmental Influences On Rates Of Osteo- And Rheumatoid Arthritis, Azad Abdulrahman Mohammed

Legacy Theses & Dissertations (2009 - 2024)

Abstract

Lower Osteocalcin Is Linked To Genetic Polymorphisms In Tnfrsf1a/1b And Mycobacterium Paratuberculosis Infection Among Rheumatoid Arthritis Patients, Ahmad K. Odeh

Honors Undergraduate Theses

Rheumatoid Arthritis (RA) is an autoimmune disorder that results in inflamed joints and osteoporosis. Previous studies have shown that Mycobacterium avium subspecies Paratuberculosis (MAP) has a role in the downregulation of active osteocalcin in Crohn’s disease (CD). Since RA and CD have a similar pathology, we hypothesize that active inflammation following MAP infection will result in downregulation of active osteocalcin in RA patients. In this study, a total of 82 individuals (48 RA and 34 healthy) were examined for MAP status and for active osteocalcin. Out of the 48 RA patients, 18 were MAP positive compared to only 1 out …

Development Of Macromolecular Prodrugs For The Treatment Of Chronic Inflammatory Pain, Laura Weber

Theses & Dissertations

Chronic pain afflicts millions of people worldwide. Particularly, the inflammatory conditions in the incurable disease rheumatoid arthritis (RA) generate persistent pain in its sufferers, for which a number of different analgesics have been prescribed, such as glucocorticoids (GCs) and opioids. However, administration of these pain- mitigating pharmaceutics is implicated in the development of adverse systemic effects due to their non-specific tissue distribution and quick excretion, eliciting the need for high dosing frequencies. To address this issue, this thesis is focused on the development of prodrugs based on a macromolecular design approach to instill preferential inflammation-targeting and retentive properties to common …

Viral Etiology Of Rheumatoid Arthritis, Fatima Kudaeva

Electronic Thesis and Dissertation Repository

Viruses can trigger rheumatoid arthritis (RA) or inflammatory arthritis (IA). Our study provides insight into etiology of RA/IA. We analyzed the evidence relating to the risk of RA after viral infections; estimated the distribution of IA onsets over time; quantified the effect of influenza on the risk of IA.

Results of systematic review and meta-analysis showed that the risk of RA/IA is increased after parvovirus B19 and chikungunya virus. There seems to be a risk of RA after chronic hepatitis C (HCV), but whether it is a true RA or HCV-associated arthritis is not clear.

We estimated the distribution of …

Rheumatoid Arthritis, Ana Vigil

Nursing Student Class Projects (Formerly MSN)

No abstract provided.

Cardiovascular Risk Management For Patients With Rheumatoid Arthritis: A Case Report, Rachel Bethke

Nursing Capstones

No abstract provided.

Does Yoga Therapy Improve Physical Pain In Females And Males With Diagnosed Rheumatoid Arthritis?, Rebecca Nolan

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not yoga therapy improves physical pain in females and males over the age of 18 with diagnosed rheumatoid arthritis.

DESIGN: Review of three randomized control trials (RCTs), two written in English and one written in Hindi and translated to English, which were published in 2011, 2013, and 2015.

DATA SOURCES: Three randomized control trials, one of which was a double blind study, published in peer-reviewed journals found via PubMed.

OUTCOMES MEASURED: Physical pain due to rheumatoid arthritis was measured using Short form (SF36) Physical Component Summary, which …

Dopamine Levels In The Brain Of Rat Models Of Human Rheumatoid Arthritis, Amelia Stinson

Theses & Dissertations

Research Focus. Rheumatoid arthritis (RA) is a chronic, debilitating, autoimmune disease that causes the destruction of bone tissue and the articular structures of joints. At least 30% of RA patient populations have cognitive impairment. Acidic dopamine (DA) is the principal neuroimmunotransmitter that links the central nervous system and peripheral nervous system together. The aim of the present study was to determine the levels of DA and its two acidic metabolites: 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in arthritic induced rats, and whether their levels vary across four different parts of the brain: amygdala (AMG), front cerebral cortex (CX), hippocampus …

Are Antibiotics, Other Than Roxithromycin, An Effective Way To Manage Joint Pain In Rheumatoid Arthritis?, Kelly A. Hoffman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine “Are antibiotics, other than roxithromycin, an effective way to manage joint pain in rheumatoid arthritis?”

STUDY DESIGN: Review of three double-blind, randomized-controlled studies published in English between 2001-2007.

DATA SOURCES: Three randomized controlled trials published between 2001 and 2007 were found using PubMed/MEDLINE and Cochrane databases.

OUTCOMES MEASURED: Clinical outcome for all three studies used American College of Rheumatology (ACR) criteria, which assesses joints for swelling and tenderness.

RESULTS: In the Odell et al.1 study, at 24 months 28 participants did meet the ACR50 …

Joint Manifestations Of Rheumatoid Arthritis, Pamela Allen

Nursing Student Class Projects (Formerly MSN)

Poster project on Rheumatoid arthritis (RA) which is a common autoimmune disorder, affecting approximately 1% of the population worldwide. The interaction of genetic and environmental factors results in a cascade of immune reactions, which eventually lead to the development of structural bone damage, joint damage, and synovitis (Gibofsky, 2012).

Methotrexate And Cardiovascular Events, Alpesh Shah

Electronic Thesis and Dissertation Repository

We conducted a systematic review and meta-analysis to assess the association of MTX with cardiovascular morbidity, cardiovascular mortality and all-cause mortality in patients with autoimmune disease. Our primary outcome was incident cardiovascular events. After screening 13,479 citations, we identified a total of 30 eligible studies. We synthesized adjusted risk estimates using a random effects model. MTX was significantly associated with a 25% reduction in cardiovascular events (pooled RR: 0.75, 95% CI: 0.65, 0.86, I²: 11%), a 55% reduction in cardiovascular mortality (0.45, 95% CI: 0.26, 0.80, I²: 33%) and a 40% reduction in all-cause mortality (0.60, …

Role Of Vimf In Gingipain Maturation In Porphyromonas Gingivalis, Arun S. Muthiah

Loma Linda University Electronic Theses, Dissertations & Projects

Gingipain activity in Porphyromonas gingivalis, the major etiological agent in adult periodontitis, is post-translationally regulated by unique Vim proteins including VimF, a putative glycosyltransferase. To ascertain the VimF mediated phenotype we first inactivated the vimF gene in P. gingivalis ATCC 33277 (FLL476), a less virulent fimbriated strain. We observed that the vimF-defective mutant (FLL476) showed a phenotype similar to that of the vimF-defective mutant (FLL95) in the P. gingivalis W83 background. While hemagglutination was not detected and autoaggregationn was reduced, biofilm formation was increased in FLL476. Also, invasive capacity decreased for this mutant. Furthermore, fimbrial structures were missing in FLL476, …

What Is The Effectiveness Of Roxithromycin In Management Of The Signs And Symptoms Of Rheumatoid Arthritis?, Adriana Distanislao

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not roxithromycin is effective in management of the signs and symptoms of rheumatoid arthritis.

STUDY DESIGN: Review of three primary studies in the English language published in 2006, 2009, and 2011.

DATA SOURCES: Randomized, controlled and double blind clinical trials testing the effectiveness roxithromycin in management of inflammation and signs and symptoms of rheumatoid arthritis were found using the PubMed and Ovid databases.

OUTCOMES MEASURED: Improvement in the signs and symptoms of tenderness/inflammation using the American College of Rheumatology-20 (ACR-20) scoring approach, improvement of quality of …

Being An Austrian Mother With Rheumatoid Arthritis: An Institutional Ethnography About The Social Organization Of Everyday Life, Birgit Prodinger

Electronic Thesis and Dissertation Repository

This institutional ethnography research explored how women with rheumatoid arthritis, who are mothers, and of employable age, go about their daily lives given their social context. The social context for this research was Austria, which is characterized by social policies based on familialism and an emphasis on employment. This context may open up various resources and possibilities about what women can do and actually do in their daily lives, and thus, directs attention to the situated nature of human occupation.

In institutional ethnography particular attention is given to the social, which suggests that daily life becomes accomplished through coordinated activities …

Measuring Disease Activity And Use Of Complementary And Alternative Medicine In African-Americans With Rheumatoid Arthritis, Ashutosh Tamhane

All ETDs from UAB

The aims of this project were to: 1) compare disease activity scores 28 joints (DAS28) based on erythrocyte sedimentation rate (ESR) versus that based on C-reactive protein (CRP), and 2) describe prevalence of complementary and alternative medicine (CAM) use and examine differences of CAM use stratified by disease duration and sex. This analysis included participants from the Consortium for the Longitudinal Evaluation of African Americans with Early Rheumatoid Arthritis (CLEAR) Registry. Using tender and swollen joint counts separate ESR-based and CRP-based DAS28 scores (DAS28-ESR3 and DAS28-CRP3) were calculated, as were DAS28-ESR4 and DAS28-CRP4, which included the patient¡¯s assessment of disease …

The Role Of C-Reactive Protein In Arthritic Disease, Nicholas Ryan Jones

All ETDs from UAB

C-reactive protein (CRP) is an acute phase protein that is commonly used to evaluate systemic inflammation level. Blood CRP level also correlates very well with rheumatoid arthritis (RA) disease severity. However, CRP has many biological actions that lead one to suspect that it may be playing a role in the development or pathology of the disease. We have directly addressed whether this is the case by the use of novel mouse models (CRP deficiency or transgenic overexpression). We have shown that CRP positively affects collagen-induced arthritis development and progression. In order to thoroughly address the question, we have also reported …

Gender Perceptions In Rheumatic Disease: A Secondary Analysis, Jean Heise

All Graduate Theses, Dissertations, and Other Capstone Projects

Problem: Rheumatoid arthritis affects approximately 1.3 million people in the United States. A chronic disease with a variable course leaves affected individuals in a state of uncertainty. Many individuals experience joint and muscle pain, a major symptom of the disease. Current literature provides varying information of gender perceptions and management of joint and muscle pain in rheumatic diseases. Purpose: The purpose of this secondary analysis was to explore (1) gender perception of seriousness of joint and muscle pain in rheumatoid arthritis, (2) gender perception of joint and muscle pain interference with daily life, (3) gender perception of controllability of joint …

Radiographic Damage And Functional Disability In African American Patients With Recent-Onset Rheumatoid Arthritis, Jie Zhang

All ETDs from UAB

African Americans are under-represented in rheumatoid arthritis (RA) research and factors associated with the two main RA disease outcomes, radiographic damage and functional disability, have been insufficiently studied. The objective of this project was to examine such factors using data from the Consortium for the Longitudinal Evaluation of African Americans with rheumatoid arthritis (CLEAR), a longitudinal cohort of African American patients with recent onset RA. The association between baseline generalized bone mineral density and radiographic damage at 3 years disease duration was examined among 141 subjects. The total radiographic damage score at 3-years of disease duration in subjects with reduced …