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Physical Functioning, Perceived Disability, and Depressive Symptoms in Adults with Arthritis  [PDF]
Katie Becofsky,Meghan Baruth,Sara Wilcox
Arthritis , 2013, DOI: 10.1155/2013/525761
Abstract: This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis ( ). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models ( ). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models ( ). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy. 1. Introduction For public health purposes, the term arthritis refers to over 100 musculoskeletal conditions of varying etiologies that cause pain, aching, or stiffness in or around a joint [1]. During 2007–2009, an estimated 50 million adults in the United States reported doctor-diagnosed arthritis [2]. As the US population grows in number and the baby boomers continue to enter older adulthood, arthritis is projected to affect 67 million Americans by 2030 [3]. When rising obesity rates are also considered, an even larger public health burden can be expected, as obesity has been associated with both the development and progression of arthritis [4]. A recent study estimates that 18% of adults with arthritis also have comorbid depression [5], compared with 7% of the general US population [6]. This high prevalence may be due, in part, to the functional limitations associated with arthritis symptoms. Depression may also be linked to perceived disability, a construct closely related to functional limitation, but with an important distinction: functional limitations alone, defined as alterations in the performance of a functional task, are not the equivalent
Assessment of memory in patients with rheumatoid arthritis  [PDF]
Toma?evi?-Todorovi? Sne?ana,Bo?kovi? Ksenija,Filipovi? Danka,Naumovi? Nada
Vojnosanitetski Pregled , 2011, DOI: 10.2298/vsp1106481t
Abstract: Background/Aim. The diagnosis of emotional and cognitive dysfunction in patients with rheumatoid arthritis is often not noticed, regardless of their importance and frequency. The aim of this research was to assess memory function in patients with rheumatoid arthritis with respect to its emotional manifestation, pain intensity, the duration and degree of disease activity, and functional and anatomical stages of the disease. Methods. The study involved 60 patients with rheumatoid arthritis and 30 healthy subjects of both sexes, aged up to 55, who were examined and tested in the Special Hospital for Rheumatic Diseases in Novi Sad. Depression was diagnosed by using the Beck’s scale for depression (Beck Depression Inventory - BDI), anxiety by using the Spielberger Trait Anxiety Inventory - State and Traité; we evaluated the cognitive status (by the Wechsler scale-based memory - WBsp), the functional status (Health Assesment Questionnaire, HAQ) and disease activity by analyzing the index of disease activity (DAS 28). Results. Depressive symptoms were registered in 38 (63.33%) patients, and anxiety symptoms in 22 (36.67%) patients. The average values of the memory coefficient were significantly lower in the group of patients with rheumatoid arthritis compared with the control group. Conclusion. High frequency of emotional dysfunction and damaged memory abilities in patients with rheumatoid arthritis requires in time diagnosis and adequate treatment.
The Impact of Signs and Symptoms on the Quality of Life in Patients with Rheumatoid Arthritis Referred to the Hospitals of Tehran University of Medical Sciences in Year 2005
Z. Monjamed,F. Razavian
Qom University of Medical Sciences Journal , 2007,
Abstract: Background and objectivesRheumatoid arthritis is one of the most common chronic diseases of unknown cause leading to significant disabilities especially in the adult patients. The physical signs and symptoms of this chronic disease can considerably affect the patients’ quality of life. MethodsIn this relationship survey, 190 randomly selected patients with rheumatoid arthritis. The data were collected through self-reports, interview and observation by questionnaire, and using the pain and fatigue severity scales, which consisted of eight items. Statistical analyses using descriptive and inferential methods were performed by SPSS software (version 11.5).ResultsThe results showed that the quality of life was high to moderate in half of the subjects (%50) and low in the other 50%. The status of physical dimensions, socio-economic, mental, sleep and rest, and general health was high to moderate in 50% and low in the other 50% of patients. The intensities of pain, fatigue, anxiety, and depression were severe in most cases, but the disability in mobility was mild. There was a significant relationship between intensity of pain, intensity of fatigue, disability in mobility, intensity of anxiety, intensity of depression and the quality of life.ConclusionThe results showed that the quality of life in half of the subjects (50%) was low. There was a significant relationship between pain, fatigue, disability in mobility, anxiety and depression and the quality of life. Keywords: Quality of Life; Arthritis, Rheumatoid ; Pain; Fatigue; Anxiety; Depression
The Impact of Signs and Symptoms on the Quality of Life in Patients with Rheumatoid Arthritis Referred to the Hospitals of Tehran University of Medical Sciences in Year 2005  [cached]
Z Monjamed
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and objectives Rheumatoid arthritis is one of the most common chronic diseases of unknown cause leading to significant disabilities especially in the adult patients. The physical signs and symptoms of this chronic disease can considerably affect the patients’ quality of life. Methods In this relationship survey, 190 randomly selected patients with rheumatoid arthritis. The data were collected through self-reports, interview and observation by questionnaire, and using the pain and fatigue severity scales, which consisted of eight items. Statistical analyses using descriptive and inferential methods were performed by SPSS software (version 11.5). Results The results showed that the quality of life was high to moderate in half of the subjects (%50) and low in the other 50%. The status of physical dimensions, socio-economic, mental, sleep and rest, and general health was high to moderate in 50% and low in the other 50% of patients. The intensities of pain, fatigue, anxiety, and depression were severe in most cases, but the disability in mobility was mild. There was a significant relationship between intensity of pain, intensity of fatigue, disability in mobility, intensity of anxiety, intensity of depression and the quality of life. Conclusion The results showed that the quality of life in half of the subjects (50%) was low. There was a significant relationship between pain, fatigue, disability in mobility, anxiety and depression and the quality of life.
Bacillus coagulans: a viable adjunct therapy for relieving symptoms of rheumatoid arthritis according to a randomized, controlled trial
David R Mandel, Katy Eichas, Judith Holmes
BMC Complementary and Alternative Medicine , 2010, DOI: 10.1186/1472-6882-10-1
Abstract: Forty-five adult men and women with symptoms of RA were randomly assigned to receive Bacillus coagulans GBI-30, 6086 or placebo once a day in a double-blind fashion for 60 days in addition to their standard anti-arthritic medications. Arthritis activity was evaluated by clinical examination, the American College of Rheumatology (ACR) criteria, the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI), and laboratory tests for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).Subjects who received Bacillus coagulans GBI-30, 6086 experienced borderline statistically significant improvement in the Patient Pain Assessment score (P = .052) and statistically significant improvement in Pain Scale (P = .046) vs placebo. Compared with placebo, Bacillus coagulans GBI-30, 6086 treatment resulted in greater improvement in patient global assessment and self-assessed disability; reduction in CRP; as well as the ability to walk 2 miles, reach, and participate in daily activities. There were no treatment-related adverse events reported throughout this study.Results of this pilot study suggest that adjunctive treatment with Bacillus coagulans GBI-30, 6086 LAB probiotic appeared to be a safe and effective for patients suffering from RA. Because of the low study population size, larger trials are needed to verify these results.ACTRN12609000435280Probiotics have been used to treat and prevent a wide range of infectious and inflammatory diseases [1,2]. Of particular interest are lactic acid bacteria (LAB) probiotics and their immunomodulating and anti-inflammatory effects, which have been shown to lessen the symptoms of arthritis [3-8].Rheumatoid arthritis (RA) affects more than 1.3 million American adults [9]. It commonly leads to significant disability and compromises quality of life. Pharmacological treatments for arthritis target the inflammatory process by suppressing the host reaction. Despite the number of effective pharmacological agents available to
Principal factor analysis of symptoms of rheumatoid arthritis and their correlations with efficacy of traditional Chinese medicine and Western medicine
Yi-ting HE,Ai-ping LU
Zhong Xi Yi Jie He Xue Bao , 2008,
Abstract: Objective: To explore the correlations between symptom-based principal factors of rheumatoid arthritis (RA) and the effect of traditional Chinese medicine or Western medicine on RA after factor analysis of RA symptoms.Methods: Four hundred and thirteen RA patients from 9 clinical centers were included in the clinical trial. They were randomly divided into Western medicine (WM) treated group with 204 cases and traditional Chinese medicine (CM) treated group with 209 cases. A complete physical examination and 18 common clinical manifestations were recorded before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included glucosidorum Tripterygll totorum tablet and Yishen Juanbi Tablet. The American College of Rheumatology 20 (ACR20) was used for efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. Eighteen symptoms in the RA patients were analyzed by factor analysis and the relationships between the factors and effects were analyzed with Chi-Square test.Results: Four principal factors were obtained from the analysis results of the 18 symptoms. The factors could represent the symptoms related to joints, cold-syndrome, deficiency syndrome and heat-syndrome in traditional Chinese medicine (TCM), respectively. The effect of WM therapy was better than CM therapy. After 12 weeks of treatment, the effect of CM on patients without deficiency-syndrome was better than the patients with deficiency-syndrome. After 24 weeks of treatment, WM therapy showed better effect on patients with cold syndrome than patients without cold syndrome.Conclusion: The results based on the factor analysis of RA symptoms are similar to the results of syndrome differentiation of TCM, and the factor-related different categories of symptoms are associated with the curative effect, thus further research on the symptoms is necessary.
Respiratory symptoms and disease characteristics as predictors of pulmonary function abnormalities in patients with rheumatoid arthritis: an observational cohort study
Dimitrios A Pappas, Jon T Giles, Geoffrey Connors, Noah Lechtzin, Joan M Bathon, Sonye K Danoff
Arthritis Research & Therapy , 2010, DOI: 10.1186/ar3037
Abstract: A total of 159 individuals with RA and without clinically evident cardiovascular disease were evaluated. Respiratory symptoms were assessed with the Lung Tissue Research Consortium questionnaire and all patients underwent evaluation with PFTs. Demographic, lifestyle, RA disease and treatment characteristics were collected. Subclinical coronary artery disease was assessed by cardiac computed tomography. Multivariable regression analysis was used to identify pulmonary symptoms and nonpulmonary parameters associated with PFT abnormalities. Areas under the receiver operating characteristic curves (AUC) were calculated to evaluate the discrimination of these variables for identifying patients with PFT abnormalities.Respiratory symptoms were reported by 42% of the patient population. Although only 6% carried a prior diagnosis of lung disease, PFT abnormalities were identified in 28% of the subjects. Symptoms combined with other patient and RA characteristics (body mass index, current smoking, anti-cyclic citrullinated peptide antibodies, and current prednisone use) performed satisfactorily in predicting the PFT abnormalities of obstruction (AUC = 0.91, 95% confidence interval = 0.78 to 0.98), restriction (AUC = 0.79, 95% confidence interval = 0.75 to 0.93) and impaired diffusion (AUC = 0.85, 95% confidence interval = 0.59 to 0.92). Co-morbid subclinical coronary artery disease did not modify these relationships.Assessment of respiratory symptoms along with a limited number of clinical parameters may serve as a useful and inexpensive clinical tool for identifying RA patients in need of further pulmonary investigation.Rheumatoid arthritis (RA) is a highly inflammatory chronic disease associated with diminished physical function and premature mortality [1-5]. Lung involvement is a common extra-articular manifestation of RA [6], conferring significant morbidity and mortality [7]. Interstitial lung disease (ILD) is the most common and most serious form of lung involvement in R
Correlations of clinical symptoms and treatment efficacy in patients with rheumatoid arthritis treated with Chinese herbal drugs or Western medicine
LU Ai-Ping
Zhong Xi Yi Jie He Xue Bao , 2005,
Abstract: Objective: To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA). Methods: Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American college of rheumatology 20 (ACR20) was used as efficacy evaluation criteria. Results: In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications. Conclusion: The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.
Relationship between Thyroid Autoimmunity and Depression, Quality of Life, and Disease Symptoms in Patients with Fibromyalgia and Rheumatoid Arthritis  [cached]
Bedriye Mermerci Ba?kan,Filiz Sivas,Lale Akbulut Aktekin,Fatma Gül Yurdakul
Turkish Journal of Rheumatology , 2010,
Abstract: Objective: The aim of this study was to evaluate the presence of thyroid autoantibodies in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) and to investigate the relationship of these antibodies with depression, quality of life, and disease symptoms.Materials and Methods: Sixty-five patients with FM, 39 patients with RA, and 40 healthy controls were included in the study. Serum-free thyroxine, free triiodothyronine, thyrotropin, and anti-thyroglobulin (TgAb) and anti-thyroid peroxidase antibodies (TPOAb) were measured by immunometric assay. Sociodemographic characteristics, alcohol use, smoking status, morning stiffness, number of joints affected by pain, and presence of accompanying symptoms were recorded. All patients were questioned about the severity of pain, sleep disturbances, fatigue, and morning fatigue. The Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate the quality of life and Beck Depression Inventory (BDI) was used to evaluate the presence of depression. Results: The rates of TPOAb and TgAb positivity were 13.8% and 15.4%, 2.6% and 5.1%, and 5.0% and 5.0% in the FM, RA, and control groups, respectively; there was no significant difference between the groups. Thyroid autoimmunity was noted in 18.5%, 5.1%, and 7.5% of the patients in the FM, RA, and control groups, respectively; there was no significant difference between these groups. There were significant differences between the groups with respect to widespread pain, sleep disturbances, fatigue, and morning fatigue evaluated by VAS and the mean FIQ and BDI scores; the highest values were noted in the FM group. Significantly higher ESR, CRP and TSH levels, and proportion of postmenopausal women were noted in FM patients with thyroid autoimmunity compared to FM patients without thyroid autoimmunity. No significant difference existed between RA patients with or without thyroid autoimmunity.Conclusion: No significant differences existed between FM patients, RA patients, and healthy controls in terms of thyroid autoimmunity. We suggest that there is no association between thyroid autoimmunity and quality of life, severity and frequency of accompanying symptoms, and presence of depression in patients with FM and RA.
Ruptured Baker’s Cycst Mimicking the Symptoms of Deep Vein Thrombosis in a Rheumatoid Arthritis Patient  [PDF]
Demet Gocmen Demir,Lale Altan,Nuray Diraz
Romatizma , 2008,
Abstract: A 50- year- old male patient who had a diagnosis of rheumatoid arthritis was admitted to our clinic with the complaint of sudden onset of severe pain and swelling in his right knee and calf. An initial diagnosis of deep vein thrombosis was made, however, ultrasound imaging revealed bilateral popliteal Baker’s cysts. The cyst on the right side was ruptured. Both of the cysts were aspirated. Concomitant occurrence of rheumatoid arthritis and Baker’s cyst which could be confused with deep venous thrombosis was discussed in this case presentation.
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