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Biomedical subjects

J J Anderson

Publications and source records attributed to J J Anderson.

At least 127 records · Page 7Linked to original sources
PubMed1992

AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement Scales Health Status Questionnaire.

OBJECTIVE: The goal of this project was to develop a more comprehensive and sensitive version of the Arthritis Impact Measurement Scales (AIMS). METHODS: AIMS scale items were revised, and 3 new scales were added to evaluate arm function, work, and social support. Sections were also added to assess satisfaction with function, attribution of problems to arthritis, and self-designation of priority areas for improvement. The new instrument was designated the AIMS2. A pilot test of format and content and a performance test of reliability and validity were carried out. RESULTS: Questionnaire completion times in a pilot study of 24 subjects averaged 23 minutes, and evaluations were positive regarding the instrument's length and ease of completion, and the subjects' willingness to complete serial forms and return them by mail. Measurement performance was tested in 408 subjects: 299 with rheumatoid arthritis (RA) and 109 with osteoarthritis (OA); 45 of these subjects completed a second AIMS2 within 3 weeks. Internal consistency coefficients for the 12 scales were 0.72-0.91 in the RA group and 0.74-0.96 in the OA group. Test-retest reliability was 0.78-0.94. All within-scale factor analyses produced single factors, except for mobility level in OA. Validity analyses in both the RA and the OA groups showed that patient designation of an area as a problem or as a priority for improvement was significantly associated with a poorer AIMS2 scale score in that area. Reliability, factor analysis, and validity results were consistent in age, sex, and education subgroups. Satisfaction was moderately correlated with level of function in the same health status area, and the satisfaction items formed a reliable scale. Responses to the arthritis attribution items showed that most dysfunction in this sample was due to arthritis. CONCLUSION: The AIMS2 is a revised and expanded health status questionnaire with excellent measurement properties that should be useful in arthritis clinical trials and in outcomes research.

Arm↗
PubMed1992

The rapid assessment of disease activity in rheumatology (radar) questionnaire. Validity and sensitivity to change of a patient self-report measure of joint count and clinical status.

OBJECTIVE: This study documents the measurement properties of a brief, self-administered questionnaire of disease signs and symptoms in patients with rheumatoid arthritis. METHODS: The Rapid Assessment of Disease Activity in Rheumatology (RADAR) questionnaire assesses joint pain/tenderness and clinical status. One hundred ninety-three pairs of RADAR forms were completed by 45 subjects and their assigned clinician evaluators. RESULTS: Subject-clinician agreement (intraclass correlation coefficients [ICC]) for joint pain/tenderness and clinical status ranged from 0.52 to 0.87 (P = 0.0001), with 83% greater than or equal to 0.65. The ICC for change in joint scores over 6 months was 0.83 (P = 0.0001). CONCLUSION: The 2-page RADAR questionnaire produces valid estimates of joint count and clinical status that are sensitive to change.

Adult↗
PubMed1992

Use of short-term efficacy/toxicity tradeoffs to select second-line drugs in rheumatoid arthritis. A metaanalysis of published clinical trials.

OBJECTIVE: Preferred drugs for rheumatoid arthritis (RA) should be those that have maximal efficacy with the least toxicity. We evaluated the efficacy and toxicity tradeoffs for drugs frequently used in the treatment of RA. METHODS: We updated 2 metaanalyses of published clinical trials, by adding trials published through 1990 and trials of azathioprine (AZA). We tested 3 different definitions of efficacy, each plotted against 3 different toxicity measures, for antimalarial drugs, methotrexate (MTX), auranofin, injectable gold, D-penicillamine, sulfasalazine (SSZ), AZA, and placebo. Efficacy measures included composite efficacy (a combination of joint count, grip strength, and erythrocyte sedimentation rate), tender joint count alone, and a measure based on how many patients dropped out due to inefficacy. Toxicity measures were the proportion dropping out due to toxicity, the same dropouts with side effects weighted for severity using a modification of a published toxicity index, and the proportion with severe toxicities (defined as a score of at least 7 of 10 on the toxicity index). The latter were usually organ toxicities (e.g., cytopenias and renal involvement). RESULTS: All 9 efficacy/toxicity tradeoff plots suggested that MTX and antimalarial drugs had the highest efficacy relative to toxicity. MTX scored among the most efficacious of the drugs and, of these, had the least toxicity. Antimalarial drugs, though showing only moderate efficacy, had the lowest toxicity rate of all the drugs. SSZ scored close to MTX but was, in general, slightly more toxic. CONCLUSION: In the short-term context of clinical trials, antimalarial drugs and MTX have the best efficacy/toxicity tradeoffs and may, therefore, be the preferred drugs.

Antimalarials↗
PubMed1992

Do self-reported arthritis symptom (RADAR) and health status (AIMS2) data provide duplicative or complementary information?

This study assessed whether self-report measures of symptoms and functional health status provide unique outcome information, or whether functional status assessments primarily serve as a proxy for self-reported arthritis symptoms. Symptom scores of 138 individuals with rheumatoid arthritis (RA) collected with the Rapid Assessment of Disease Activity in Rheumatology (RADAR) measure were compared with same-day functional health scores collected with the recently revised Arthritis Impact Measurement Scales (AIMS2). Correlational and factor analyses revealed that self-assessed arthritis symptoms, physical function and work impact, psychological status, and social health each made independent contributions to outcome. Satisfaction with health status was shown not to be independent of symptoms, functional capacity, or psychological status. It is important to document that self-reported symptom and health status information, when collected concurrently, provides complementary rather than duplicative information.

Activities of Daily Living↗
PubMed1992

Bone mineral density in elderly men and women: results from the Framingham osteoporosis study.

Our study investigated bone mineral density of the proximal femur and ultradistal and proximal radius in a population of elderly men and women. The Framingham study started in 1948, following a population-based sample for evaluation of cardiovascular risk factors and events. During the 20th biennial Framingham examination (1988-89) we conducted the Framingham osteoporosis study, measuring bone mineral density in the proximal femur and distal and proximal radius for 1154 study participants. Ages ranged from 68 to 98 years, with a mean age of 76 years. Bone mineral density was measured using Lunar SP2 and DP3 densitometers. This cross-sectional study evaluates mean bone mineral density measurements at each site by 5 year age intervals for men and women, testing for trends in bone density with age. Analyses were repeated adjusting for weight and height. Among the 446 and 708 women, bone mineral density of the femur and bone mineral content of the proximal radius were inversely and significantly related to age in both sexes and were considerably higher in men than women at all sites. The linear decline with age group in our cross-sectional study remained after multivariate adjustment for height and weight. The ultradistal radius showed no significant correlation with age for either sex. There were significant correlations between the bone measurements made at different sites for both men and women (range in r = 0.27-0.89). Cross-sectional curves of bone mineral density with age showed no significant differences in slope between males and females.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1992

Effect of aging and dopaminomimetic therapy on mitochondrial respiratory function in Parkinson's disease.

Oxygen consumption and enzyme activity were evaluated in platelet mitochondria from 17 patients with Parkinson's disease. In comparison with age-matched controls, no consistent abnormality could be discerned in complex I, complex II-III, or complex IV oxygen consumption, or in the enzyme activity of these respiratory chain complexes. Neither chronic therapy with levodopa/carbidopa alone nor in combination with deprenyl significantly affected any measure of mitochondrial respiratory function. There was no discernible relationship between patient age or disease severity and any parameter of mitochondrial respiration. Moreover, blood lactate levels following glucose loading were not different in patients and controls. These results fail to support the occurrence of a generalized defect in any mitochondrial respiratory function in Parkinson's disease.

Age Factors↗
PubMed1992

Are calcium intakes and physical activity patterns during adolescence related to radial bone mass of white college-age females?

The determinants of bone mass, i.e., size and density, in young adult women after cessation of growth in length of the bones are not well understood. Usual dietary calcium (Ca) intakes and physical activity (PA) patterns during the post-pubertal half-decade have been considered as two important factors contributing to bone mass. In the present hypothesis-generating cross-sectional study, radial bone mineral content and density were measured by single-photon absorptiometry at two sites containing different proportions of trabecular and cortical bone tissue in 705 healthy, Caucasian college women (18-22 years). Ca intake during high school and college, as estimated by milk and cheese intake only, was categorized into low, moderate and high groups; and physical activity, estimated during the same time frame, was also categorized into low, moderate and high groups. Bone measurements were related to both long-term dietary Ca intake from milk and cheese and long-term PA in sports, dance or other exercises, as assessed by recall. By univariate analyses, both distal and mid-radial bone mineral content (BMC) and areal bone mineral density (BMD) were found to be positively related to gynecological age (GA) (p less than 0.01). Also, independent effects of long-term Ca intake (p less than 0.05) on distal BMC and BMD, and of long-term PA (p less than 0.05) on distal and mid-BMC and BMD were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

The use of microdialysis for studying the regional effects of pharmacological manipulation on extracellular levels of amino acids--some methodological aspects.

The purpose of this study was to examine and validate the use of microdialysis for sampling and pharmacologically manipulating extracellular amino acids in the brain. Repeated use of microdialysis probes in acute intracerebral experiments did not significantly alter the relative recovery in vitro for the amino acids quantitated (GABA, aspartate, glutamate, glycine, taurine, and alanine). Regional differences in basal levels of some of the amino acids were detected in dialysates collected from the dorsomedial hypothalamus, striatum, and frontal cortex. The percent in vitro recoveries for the amino acids from the probes used in the three regions were not significantly different suggesting that the regional differences in basal levels of amino acids were functionally derived and not a consequence of variations in probe recovery. Perfusion with nipecotic acid, an inhibitor of GABA uptake, resulted in selective elevations in extracellular GABA in the three regions studied. Conversely, perfusion with high-potassium, a depolarizing agent, resulted in significant elevations in not only extracellular GABA but also aspartate, glutamate, and taurine. Thus, microdialysis is a method which can be employed to assess and to pharmacologically manipulate extracellular amino acids in the rat brain.

Amino Acids↗
PubMed1992

Educational attainment and osteoarthritis: differential associations with radiographic changes and symptom reporting.

Educational attainment has been negatively associated with the prevalence, morbidity and mortality of many diseases. With knee osteoarthritis as an example, we used NHANES I data to examine whether the cross-sectional association between formal education and disease is due to known risk factors, and also whether educational attainment is more strongly associated with self-reported symptoms or with radiographic change. We found univariate associations between osteoarthritis and low levels of education. For radiographic knee osteoarthritis in women, and in both sexes combined, this relationship was explained by controlling for known risk factors, which included age, knee injury, race, obesity, and occupation. However, even after adjusting for these major risk factors and the presence of radiographic changes, reporting of knee pain and arthritis at any site remained significantly associated with low educational attainment, especially for those with less than or equal to 8 years of education.

Adult↗
PubMed1991

Identification and characterization of the ribosomal RNA-encoding genes in Clavibacter xyli subsp. cynodontis.

Clavibacter xyli subsp. cynodontis (Cxc) is a xylem-inhabiting bacterial endophyte of Bermudagrass. This organism is classified with Gram-positive, high G + C content, coryneform-actinomycete bacteria. Southern-blot analysis showed that Cxc contains only one copy of the ribosomal RNA-encoding genes (rRNA). A clone containing the rRNA genes was isolated from a genomic library of Cxc DNA cloned in the lambda EMBL3 vector. The gene cluster was partially sequenced, revealing the gene order 5'-16S-23S-5S-3', similar to that found in other prokaryotes. Low-resolution S1 mapping suggested multiple transcription start points of the rRNA operon.

Actinomycetales↗
PubMed1991

Thiazide diuretics and the risk of hip fracture. Results from the Framingham Study.

Thiazide diuretics may preserve bone mass and prevent elderly women's osteopenic fractures, but studies have not distinguished between thiazide preparations or examined former users. We performed a case-control study looking at thiazide use and subsequent hip fracture in postmenopausal female members of the Framingham Study cohort. Cases who had experienced a first hip fracture (n = 176) were compared with age-matched controls (n = 672). Results showed a modest protective effect of any recent thiazide use (not significant). However, recent pure thiazide users experienced significant protection against fracture (adjusted odds ratio, 0.31; 95% confidence interval, 0.11 to 0.88), whereas recent users of combination drugs containing thiazides experienced no protection (adjusted odds ratio, 1.16; 95% confidence interval, 0.44 to 3.05). Combination drugs generally contained only 25 mg of hydrochlorothiazide, suggesting that the small amount of thiazide was insufficient to preserve bone mass. Former thiazide users were not protected against fracture. In sum, recent pure thiazide use in women protects against hip fracture.

Aged↗
PubMed1991

The impact of rheumatoid arthritis on the household work performance of women.

We conducted a study to assess whether and to what degree household work disability exists in women with rheumatoid arthritis (RA) and to examine the role of health versus family and personal factors as predictors of household work disability. In addition, the participation of other family members and paid employees in household work was evaluated. One hundred forty-two women with RA and 58 female friends/neighbors completed questionnaires which assessed household work performance and health, family, and personal variables. Performance was measured in 4 ways: the current amount of time spent on household work, the proportion of the household work done, and the changes in time and proportion since just before the onset of RA. Functional status was measured via the Health Assessment Questionnaire. Pain, anxiety and depression, and general health perception were measured via the Arthritis Impact Measurement Scales. The results indicate that household work disability exists in women with RA, but is substantial only in women with moderate-to-severe disease. In families in which the wife/mother has moderate-to-severe RA, the other family members spend 7 hours more per week on household work than in control families, but there was no increase in the use of paid household employees. Health factors were the strongest predictors of household work disability, but family and personal factors also had significant effects. Household work disability in women with moderate or severe RA merits more attention because of the importance of household work to family functioning and the negative effects that changes in this area can produce.

Activities of Daily Living↗
PubMed1991

Secular changes in published clinical trials of second-line agents in rheumatoid arthritis.

The present investigation was undertaken to explore changes over time in the design and reporting of trials of second-line drugs in rheumatoid arthritis, in the characteristics of patients included in the trials, and in the sources of funding. We studied 105 trials of second-line agents for the treatment of rheumatoid arthritis, including placebo-controlled and comparative trials involving 8 different agents. Three time periods, 1945-1969, 1970-1979, and 1980-1989, were compared. We found little change in the standards for reporting on the design of trials or for reporting information on patient dropout and drug side effects, some increase in the complexity of the statistical methods used, but no increase in the use of power analysis (reported in only 13% of trials). The average age of patients in clinical trials has increased. In recent years, there has been a substantial shift from placebo-controlled to comparative trials, and it is increasingly common for trials to be financially supported by pharmaceutical companies. The possible effects of secular trends should be considered when combining or comparing results of trials conducted in different years.

Age Factors↗
PubMed1991

Correlates of cortical bone mass among premenopausal and postmenopausal Japanese women.

Few studies have examined the multifactorial risk factors of bone mass in Asian populations. This cross-sectional study was designed to explore relationships between bone mass and environmental variables, including dietary and life-style factors, in Japanese women living in Japan. A total of 178 Japanese women completed the study: 89 premenopausal, ages 35-40, and 89 postmenopausal, ages 55-60. Midradial bone mineral content (MBMC) and bone mineral content per unit area, referred to as bone density (MBMD), were measured using single-photon absorptiometry. The major results of this investigation were the following: (1) The postmenopausal women differed significantly from the premenopausal women in having lower radial bone parameters, lower mean height, later age of menarche, and higher dietary intakes of carbohydrates, vegetables, and milk with a lower intake of caffeine. (2) Current protein intake was a positive correlate of MBMC in both groups. (3) Intake of vegetables (leafy green, yellow, orange, and white) and current milk intake were positively associated with MBMC in the postmenopausal women. (4) For the premenopausal women, irregular menstrual cycles was a negative correlate of MBMC, and for the postmenopausal women, years of menopause was negatively associated with MBMC and MBMD. Longitudinal studies are needed to establish more conclusively associations among diet, life-style, and reproductive history and bone mass of Japanese women.

Adult↗
PubMed1991

Recognition of respiratory syncytial (RS) virus proteins by human and BALB/C CD4+ lymphocytes.

Lymphocyte proliferation assays were used to determine the ability of human and BALB/c T-lymphocytes to recognise and respond to in vitro challenge with purified preparations of four respiratory syncytial (RS) virus proteins. Human peripheral blood lymphocytes (PBLs) collected from adult donors as well as primed BALB/c mouse splenocytes each responded specifically to challenge with intact RS virus and preparations of the fusion (F), attachment (G), 23 kilodalton (23K), and 34K phospho- (P) proteins of the virus. F protein was recognised most frequently by human PBLs, and elicited higher levels of response than equivalent concentrations of the other protein preparations examined. The human PBL proliferative responses elicited by in vitro challenge with intact virus antigen as well as with each of the four protein preparations were found to be confined to the CD4+ T-helper (Th) sub-population of lymphocytes. However, proliferative responses to intact virus and F protein were found to be accompanied by only modest and inconsistent production of Interleukin-2 (IL-2). Finally, no evidence was obtained to indicate that any of the challenge antigens employed in this study were intrinsically mitogenic, as neither naive human cord blood lymphocytes, nor un-primed BALB/c mouse splenocytes proliferated when challenged with intact RS virus or with F, G, 23K, or P protein preparations.

Adult↗
PubMed1991

L-dopa does not affect electron transfer chain enzymes and respiration of rat muscle mitochondria.

Alterations in mitochondrial respiratory chain enzymes have been found in skeletal muscle of parkinsonian patients. Most of these patients had received treatment with L-dopa in combination with an inhibitor of peripheral decarboxylase for several years. In order to determine whether these effects are only dependent on the disease or are partially due to its therapy, the effects of L-dopa methyl ester and benserazide, a peripheral dopa decarboxylase inhibitor, were studied on various parameters related to energy metabolism in rat skeletal muscle mitochondria. The maximum activities related to complexes of the respiratory chain: rotenone-sensitive NADH-cytochrome c reductase, succinate-cytochrome c reductase, cytochrome c oxidase, state 3, state 4, uncoupled state, and respiratory control ratio were measured after 17-19 days of treatment. The results indicate that L-dopa treatment does not interfere with any of the parameters investigated and suggest that changes in muscle mitochondrial function found in parkinsonian patients are the result of the disease process and not its treatment.

Animals↗