Therapeutic advances in musculoskeletal disease, 2011
We tested the ability of the VASFIQ, a seven-item scale composed of Fibromyalgia Impact Questionn... more We tested the ability of the VASFIQ, a seven-item scale composed of Fibromyalgia Impact Questionnaire (FIQ) visual analog scales (VASs), to quantify fibromyalgia global disease severity and identify fibromyalgia patients with significant symptoms of fatigue, poor sleep, depression or anxiety. Spearman rank correlations were used to compare global VASFIQ, FIQ and Patient Global Impression of Change (PGIC) scores and individual FIQ VAS scores with full-length, validated questionnaire scores for fatigue (Multidimensional Assessment of Fatigue-Global Fatigue Index [MAF-GFI]), poor sleep (Medical Outcomes Study Sleep Problems Index [SPI]) and depression and anxiety (Hospital Anxiety and Depression Scale [HADS]). Patient scores used in the analyses were derived from 2229 patients enrolled in three pregabalin fibromyalgia trials. Receiver operating characteristic analyses determined VASFIQ cutoff scores identifying patients with clinically significant symptom levels using full-length, vali...
Therapeutic Advances in Musculoskeletal Disease, 2010
Fibromyalgia syndrome (FMS) is a complex disorder of widespread pain and tenderness associated wi... more Fibromyalgia syndrome (FMS) is a complex disorder of widespread pain and tenderness associated with numerous other symptoms including fatigue, cognitive dysfunction, nonrestorative sleep, depression, anxiety, and stiffness. While new diagnostic criteria and previous management guidelines require quantitation of the severity of associated FMS symptoms experienced by individual patients, no system for rapid patient assessment has been made available to provide a basis for diagnosis, treatment selection and follow-up for clinicians in busy practices who have limited time. This review presents the FIBRO System, an easily remembered system for FMS symptom quantitation using the FIBRO mnemonic along with verbal questions on simple 010 scales to assess symptom severity (the FIBRO Problem Scale) and response to treatment (the FIBRO Change Scale) along with recommendations for pharmacologic and nonpharmacologic therapies to address individual FIBRO symptoms. This symptom-based approach can improve the care of FMS patients by providing a comprehensive, focused assessment in limited time.
Journal of the American Medical Informatics Association, 2012
Objectives Electronic health records (EHR) can allow for the generation of large cohorts of indiv... more Objectives Electronic health records (EHR) can allow for the generation of large cohorts of individuals with given diseases for clinical and genomic research. A ratelimiting step is the development of electronic phenotype selection algorithms to find such cohorts. This study evaluated the portability of a published phenotype algorithm to identify rheumatoid arthritis (RA) patients from EHR records at three institutions with different EHR systems. Materials and Methods Physicians reviewed charts from three institutions to identify patients with RA. Each institution compiled attributes from various sources in the EHR, including codified data and clinical narratives, which were searched using one of two natural language processing (NLP) systems. The performance of the published model was compared with locally retrained models.
Catecholamine regulation of nitric oxide NO production by IFNg-primed macrophages infected with M... more Catecholamine regulation of nitric oxide NO production by IFNg-primed macrophages infected with Mycobacterium aÕium was investigated. Epinephrine treatment of IFNg-primed macrophages at the time of M. aÕium infection inhibited the anti-mycobacterial activity of the cells. The anti-mycobacterial activity of macrophages correlated with NO production. Using specific adrenergic receptor agonists, the abrogation of mycobacterial killing and decreased NO production by catecholamines was shown to be mediated via the b2-adrenergic receptor. Elevation of intracellular cAMP levels mimicked the catecholamine-mediated inhibition of NO in both M. aÕium infected and LPS stimulated macrophages. Specific inhibitors of both adenylate cyclase and protein kinase A prevented the b2-adrenoceptor-mediated inhibition of nitric oxide production. b2-adrenoreceptor stimulation at the time of M. aÕium infection of IFNg-primed macrophages also inhibited expression of iNOS mRNA. These observations show that catecholamine hormones can affect the outcome of macrophage-pathogen interactions and suggest that one result of sympathetic nervous system activation is the suppression of the capacity of macrophages to produce anti-microbial effector molecules. q
The results of this investigation provides evidence that catecholamine hormones interact with mac... more The results of this investigation provides evidence that catecholamine hormones interact with macrophages that are infected with Mycobacterium aÕium resulting in the induction of IL-10 mRNA and protein. The effect of catecholamine hormones was prevented by treating the cells with the beta-adrenergic receptor antagonist propranolol but not by alpha-adrenergic antagonist phentolamine. The effect of catecholamine stimulation was mimicked by the addition of beta-2 adrenergic agonists and by the addition of cAMP to the infected macrophage cultures. These observations suggest that sympathetic nervous system activation together with microbial infection results in a synergistic interaction that could result in the control of inflammatory processes. q
Therapeutic advances in musculoskeletal disease, 2011
We tested the ability of the VASFIQ, a seven-item scale composed of Fibromyalgia Impact Questionn... more We tested the ability of the VASFIQ, a seven-item scale composed of Fibromyalgia Impact Questionnaire (FIQ) visual analog scales (VASs), to quantify fibromyalgia global disease severity and identify fibromyalgia patients with significant symptoms of fatigue, poor sleep, depression or anxiety. Spearman rank correlations were used to compare global VASFIQ, FIQ and Patient Global Impression of Change (PGIC) scores and individual FIQ VAS scores with full-length, validated questionnaire scores for fatigue (Multidimensional Assessment of Fatigue-Global Fatigue Index [MAF-GFI]), poor sleep (Medical Outcomes Study Sleep Problems Index [SPI]) and depression and anxiety (Hospital Anxiety and Depression Scale [HADS]). Patient scores used in the analyses were derived from 2229 patients enrolled in three pregabalin fibromyalgia trials. Receiver operating characteristic analyses determined VASFIQ cutoff scores identifying patients with clinically significant symptom levels using full-length, vali...
Therapeutic Advances in Musculoskeletal Disease, 2010
Fibromyalgia syndrome (FMS) is a complex disorder of widespread pain and tenderness associated wi... more Fibromyalgia syndrome (FMS) is a complex disorder of widespread pain and tenderness associated with numerous other symptoms including fatigue, cognitive dysfunction, nonrestorative sleep, depression, anxiety, and stiffness. While new diagnostic criteria and previous management guidelines require quantitation of the severity of associated FMS symptoms experienced by individual patients, no system for rapid patient assessment has been made available to provide a basis for diagnosis, treatment selection and follow-up for clinicians in busy practices who have limited time. This review presents the FIBRO System, an easily remembered system for FMS symptom quantitation using the FIBRO mnemonic along with verbal questions on simple 010 scales to assess symptom severity (the FIBRO Problem Scale) and response to treatment (the FIBRO Change Scale) along with recommendations for pharmacologic and nonpharmacologic therapies to address individual FIBRO symptoms. This symptom-based approach can improve the care of FMS patients by providing a comprehensive, focused assessment in limited time.
Journal of the American Medical Informatics Association, 2012
Objectives Electronic health records (EHR) can allow for the generation of large cohorts of indiv... more Objectives Electronic health records (EHR) can allow for the generation of large cohorts of individuals with given diseases for clinical and genomic research. A ratelimiting step is the development of electronic phenotype selection algorithms to find such cohorts. This study evaluated the portability of a published phenotype algorithm to identify rheumatoid arthritis (RA) patients from EHR records at three institutions with different EHR systems. Materials and Methods Physicians reviewed charts from three institutions to identify patients with RA. Each institution compiled attributes from various sources in the EHR, including codified data and clinical narratives, which were searched using one of two natural language processing (NLP) systems. The performance of the published model was compared with locally retrained models.
Catecholamine regulation of nitric oxide NO production by IFNg-primed macrophages infected with M... more Catecholamine regulation of nitric oxide NO production by IFNg-primed macrophages infected with Mycobacterium aÕium was investigated. Epinephrine treatment of IFNg-primed macrophages at the time of M. aÕium infection inhibited the anti-mycobacterial activity of the cells. The anti-mycobacterial activity of macrophages correlated with NO production. Using specific adrenergic receptor agonists, the abrogation of mycobacterial killing and decreased NO production by catecholamines was shown to be mediated via the b2-adrenergic receptor. Elevation of intracellular cAMP levels mimicked the catecholamine-mediated inhibition of NO in both M. aÕium infected and LPS stimulated macrophages. Specific inhibitors of both adenylate cyclase and protein kinase A prevented the b2-adrenoceptor-mediated inhibition of nitric oxide production. b2-adrenoreceptor stimulation at the time of M. aÕium infection of IFNg-primed macrophages also inhibited expression of iNOS mRNA. These observations show that catecholamine hormones can affect the outcome of macrophage-pathogen interactions and suggest that one result of sympathetic nervous system activation is the suppression of the capacity of macrophages to produce anti-microbial effector molecules. q
The results of this investigation provides evidence that catecholamine hormones interact with mac... more The results of this investigation provides evidence that catecholamine hormones interact with macrophages that are infected with Mycobacterium aÕium resulting in the induction of IL-10 mRNA and protein. The effect of catecholamine hormones was prevented by treating the cells with the beta-adrenergic receptor antagonist propranolol but not by alpha-adrenergic antagonist phentolamine. The effect of catecholamine stimulation was mimicked by the addition of beta-2 adrenergic agonists and by the addition of cAMP to the infected macrophage cultures. These observations suggest that sympathetic nervous system activation together with microbial infection results in a synergistic interaction that could result in the control of inflammatory processes. q
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Papers by C. Boomershine