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Biomedical subjects

L F Callahan

Publications and source records attributed to L F Callahan.

80 records · Page 5Linked to original sources
PubMed1986

Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status.

The Minnesota Multiphasic Personality Inventory (MMPI) scales for Hypochondriasis, Depression, and Hysteria were studied in patients with rheumatoid arthritis (RA). The RA patients showed elevated scores on these scales, and these results are similar to those reported in each of 6 published studies. The elevated MMPI scale scores can be explained largely by 5 "disease-related" MMPI statements which met 2 criteria: they were among 11 of the 117 MMPI statements that two-thirds of rheumatologists predicted would be RA-associated; and RA patients and normal subjects differed significantly in their responses to these statements. The responses of RA patients and normal subjects to most other statements in the MMPI Hypochondriasis, Depression, and Hysteria scales were quite similar. In RA patients, responses to "disease-related" statements were correlated with results of measures of disease activity, which indicates that responses to these MMPI items reflect the severity, as well as the presence, of RA. These findings suggest that new criteria are needed for validation of the MMPI as a clinical tool for the recognition of hypochondriasis, depression, and hysteria in a patient who has RA.

Arthritis, Rheumatoid↗
PubMed1986

Observer variation in quantitative assessment of rheumatoid arthritis. Part I. Scoring erosions and joint space narrowing.

Six observers, including two bone and joint radiologists, two general radiologists, and two senior radiology residents, compared scores to quantitate radiographic findings in the hands and wrists of patients with rheumatoid arthritis. In the scoring system used, erosions and joint-space narrowing are graded separately. This scoring system differs from other methods in that equivocal findings are not scored, while ankylosis, subluxation, and dislocation are scored, and data from postoperative joints are included. Total radiographic scores were highly significantly correlated for all observers (R = .908-.958, P less than .001), as were subtotal scores for erosions (R = .723-.931, P less than .001) and joint-space narrowing (R = 0.843-0.966, P less than .001). Analysis of proximal interphalangeal, metacarpophalangeal, and wrist-joint scores showed highly significant correlations for all observers in each location. Highly significant correlations were found among three separate readings of two bone and joint radiologists (R = .950-.961, P less than .001). This scoring system provides highly consistent and reproducible results, even in the hands of less experienced observers.

Analysis of Variance↗
PubMed1985

Formal education as a marker for increased mortality and morbidity in rheumatoid arthritis.

Increased mortality and morbidity was seen in association with lower formal educational levels in 75 rheumatoid arthritis (RA) patients over 9 years. Nine of the 20 patients with 8 or fewer years of education had died, compared to 10 of 34 with 9-12 years of education, and only one of 21 with more than 12 years of education. Among survivors with functional capacity data available from baseline and 9 year review, declines greater than 20% were seen in 8 of 10, 13 of 21, and 9 of 19 patients in the three education categories. Overall, 79% of grade-school educated, 43% of high-school educated, and 20% of college-educated patients had either died or declined more than 50% in functional capacity. Patients of different formal educational levels were similar at baseline in age, duration of disease, measures of functional capacity, number of involved hand joints, number of severe radiographic changes, use of gold, oral corticosteroids or other therapies, and associations between formal educational level and disease course are not explained by these variables. Formal educational level appears a simple quantitative marker which identifies a surrogate or composite variable associated with increased mortality and morbidity in RA.

Activities of Daily Living↗
PubMed1985

The measurement of helplessness in rheumatoid arthritis. The development of the arthritis helplessness index.

We describe the development of the Arthritis Helplessness Index (AHI), a self-report instrument designed to measure patients' perceptions of loss of control with arthritis. The participants in this research were 219 patients with rheumatoid arthritis (RA) who completed a quantity of mailed materials, including the AHI, functional measures and other psychological scales. Significant evidence of reliability and validity of the AHI was found. Greater helplessness correlated with greater age, lesser education, lower self-esteem, lower internal health locus of control, higher anxiety, and depression, and impairment in performing activities of daily living using a health assessment questionnaire. Over one year, changes in helplessness correlated with changes in difficulty in performing activities of daily living. The AHI appears to be a useful measure for further studies in RA and a valuable clinical tool in monitoring the psychological status of patients with RA.

Adolescent↗
PubMed1984

Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years.

Seventy-five patients with rheumatoid arthritis (RA) were reviewed 9 years after an extensive evaluation which included quantitative measures of functional capacity. These patients had received multiple intraarticular injections of thiotepa with corticosteroids early in their course, but appear demographically and functionally similar to other RA patients who had not received this therapy. Severe morbidity was seen over the 9-year period in the 55 surviving patients, including significantly lower overall functional capacity in 92% of patients studied, lower grip strength in 93%, and longer button test results in 84%. Work disability occurred in 85% of patients under age 65 who had been working full-time at disease onset. There was increased mortality at the 9-year review, similar to most reported series of RA patients from referral centers; however, a significant increase in neoplasia, which was of concern because of the use of intraarticular thiotepa, was not seen. In terms of functional capacity, including responses to questions about ability to perform activities, walking time, and the button test, those patients who had died prior to review had significantly lower baseline values than did those who survived. Of the 75 patients, 20 had died and 51 had lost significant functional capacity over a 9-year period, documented by quantitative measures of functional capacity.

Activities of Daily Living↗
PubMed1982

Evidence that retrovirus expression in mouse spleen cells results from B cell differentiation.

Induction of endogenous retroviral proteins from spleen cells exposed to lipopolysaccharide (LPS) was studied in individual cells in relation to polyclonal B cell differentiation. After 4 days of culture with LPS, 30 to 40% of cells in many mouse strains stained for cytoplasmic mu heavy chains. A smaller number of lymphoid cells stained for cytoplasmic viral proteins, with a characteristic proportion for each strain, including 21% of lymphoid cells of AKR mice, 125 of DBA/2 cells, 7% of C57BL/6 cells, and 2% of BALB/c cells. More than 75% of retrovirus-positive cells were also mu-chain-positive in all strains. Cells from young (3- to 8-week-old) and old (43- to 46-week-old) mice of several strains showed similar proportions of retrovirus-positive cells typical for each strain, without differences at different ages. The induction of retrovirus proteins, as well as mu-chains, by LPS was markedly inhibited by goat anti-mu-chain antibody added to the culture medium (10 to 100 micrograms/ml). These data suggest that retrovirus induction may result from B cell differentiation.

Animals↗
PubMedDate not supplied

Arthritis and women's health: prevalence, impact, and prevention.

INTRODUCTION: Our objectives were to review the prevalence and impact of arthritis in women and to present information regarding strategies for prevention of arthritis in women. DISCUSSION: Arthritis is one of the most prevalent chronic conditions in the United States and the most prevalent chronic condition in women. In addition, arthritis is one of the leading causes of disability and limitations in activities of daily living, and its economic, psychological, and social impact is enormous. Some of the effects of arthritis, such as medical care costs and lost wages, are easily translated into economic terms, but others, such as the inability to play sports, a reduction in housekeeping activities, or pain, are not. CONCLUSIONS: Although arthritis is the most frequent and disabling chronic condition among women, its public health importance has not been previously emphasized. Public health agencies and health care providers should consider the following strategies to reduce the impact of arthritis among women: (1) promote primary prevention of arthritis through weight reduction and the reduction of sports- or occupational-related joint injury and (2) encourage the early detection and appropriate management of arthritis in women through use of medical and physical therapy, exercise, and established educational programs.

Activities of Daily Living↗