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ID PMID Title PublicationDate abstract
16819262 [Relationship between abnormalities of genes involved in DNA damage responses and malignan 2006 Jun The maintenance of genomic stability is an essential cellular function for a variety of well-coordinated regulation of biological activities of organisms, and a failure in its function results in the accumulation of mutations and/or abnormality in the induction of apoptosis, eventually leading to onsets of various diseases, including malignant tumors. DNA damage responses, in particular cell-cycle checkpoint regulation, play important roles in maintaining genomic integrity. In response to DNA damages induced by gamma-irradiation, ultraviolet irradiation, various chemicals, or reactive oxygen species (ROS), intrinsic cell-cycle checkpoint machinery is rapidly activated to arrest cells at particular cell-cycle points, and during cell-cycle checkpoint arrest cells may try to repair damaged DNAs, and then re-start cell-cycle upon the completion of DNA repair. Alternatively, if the extents of DNA damage overwhelm the capacity of the cellular repair machinery, cells may undergo apoptosis to prevent the accumulation of mutations within the organisms. In this article, we will first explain about our current view of DNA damage responses, in particular cell-cycle checkpoint regulation, and summarize our knowledge of the relationships between abnormalities of genes involved in DNA damage responses and malignant tumors, including hematopoietic malignancies. We will also discuss a possible implication of DNA damage responses in autoimmune diseases, such as rheumatoid arthritis.
16819158 The role of Salicornia herbacea in ovariectomy-induced oxidative stress. 2006 Jul Ovarian hormone deficiency increases the generation of reactive oxygen species. Their excess induces oxidative stress, which results in the cell damage or death. It causes the aging diseases-atherosclerosis, rheumatoid arthritis, osteoporosis, etc. Ovariectomized rats are used as oxidative stress models. We verified the effects of ovariectomy-induced oxidative stress on free radical production as evaluated by DPPH elimination, lipoperoxidation evaluated by malondialdehyde levels, and antioxidant activation of superoxide dismutase, catalase, glutathione peroxidase, and estradiol in the liver and sera. Ovariectomized rats were given Salicornia herbacea (SH) intraperitoneally at the dose of 100 mg/kg daily for 2 months. Free radical-scavenging activity of SH was measured in comparison with that of L-ascorbic acid. The histopathology of liver tissue was also investigated. Antioxidative values in the ovariectomized group decreased, but those in the SH-treated group increased due to the free radical-scavenging activity of SH. Moreover, inflammation and cirrhosis in the liver tissue of SH-treated rats decreased significantly. These results suggest that SH may be a potential candidate for an antioxidative reagent.
16817646 Localized pulsed magnetic fields for tendonitis therapy. 2006 Energy medicine has existed for centuries in some parts of the world, but in recent years, western health care practitioners have taken a heightened interest in these therapies. Treatment by use of pulsed magnetic fields (PMF) is currently being explored in both chronic and inflammatory diseases such as cancer, epilepsy, psoriasis, rheumatoid arthritis, and tendinitis. In the U.S., PMFs have already been approved for use in treatment of bone fractures in humans and clinical trials have been conducted for lower back pain. This study presents a summary of the therapeutic potential of a localized PMF treatment for tendinitis using the Softpulse III system. This system has been used to accelerate wound healing and soft tissue swelling. It generates a specific PMF that induces an electrical field within the tendon. This induced electrical field is thought to influence the healing process by affecting the inflammatory cells that line the tendon sheath. In this study, we have used an established model of tendinitis along with a validated method for appraising edema and gait (Achilles' Functional Index), to test the hypothesis that the proposed PMF signal is effective in reducing the indicators of acute tendinitis injury. These experiments were approved by the Institutional Animal Care and Use Committee. Our findings suggest a role for the treatment of soft tissue injury using the Softpulse III therapeutic device. The symbolic stand point of PMF treatments is to push the need for a revolutionary leap, from the more dominant pharmaceutical and surgical interventions, to the advanced applications of non-invasive therapies that would minimize the medicinal risk of side effects, and eliminate the risk of complicated drug interactions.
21794326 [Complementary and alternative medicine in patients attending a rheumatology department fo 2006 Jul OBJECTIVES: To determine the frequency of the use of complementary and alternative medicine (CAM) in patients attending a rheumatology department in a general hospital for the first time. SUBJECTS AND METHODS: We included consecutive patients attending our rheumatology department for the first time. All the patients completed a self-administered questionnaire containing items on demographic data, and prior diagnosis. The patients were also given a list of 22 different CAM and marked those they had previously used. RESULTS: Eight hundred patients were studied. Eighty percent were women. The mean age was 44.8±14.9 years and the mean number of years of education was 7±4. The main diagnoses were osteoarthritis (29.4%), rheumatoid arthritis (22.3%), and fibromyalgia (6.5%). Seventy-one percent had previously used CAM, with a median of two (0-14) different types. The most common were vitamin supplements (38%), arnica (18%), Aloe vera (15%) and homeopathy (15%). No significant differences were found in sex, age, educational level, or diagnosis. The use of CAM was more frequent in patients with longer disease duration. CONCLUSIONS: The frequency of use of CAM is high in patient with rheumatologic manifestations.
16789432 Novel N-acyl dehydroalanine derivatives as antioxidants: studies on rat liver lipid peroxi 2006 Apr Oxidative stress has been implicated in the development of many neurodegenerative diseases such as Parkinson and Alzhemier's disease and is also responsible for aging, artherosclerosis, rheumatoid arthritis and carcinogenesis. Olefins such as dehydroalanines have been shown to inactivate free radicals by forming stabilized free radical adducts. Among these molecules N-acyl dehydroalanines react with and scavenge oxygen and hydroxyl radicals. This study describes the synthesis, characterization and in vitro effects on rat liver lipid peroxidation levels, and DPPH free radical scavenging activities of some N-acyl dehydroalanine derivatives. Compounds c, f and j slightly scavenged the level of DPPH radical at 10(-3) M concentration by about 27, 46, and 56%, respectively while compounds a, d, e, f, g, h showed a strong inhibitory effect on lipid peroxidation at 10(-3)M and 10(-4)M concentrations and inhibition was in the range of 76-90%. The possible antioxidant mechanism of the compounds was discussed.
16678033 Serum hyaluronan--a potential marker of cardiac allograft rejection? 2006 May BACKGROUND: The connective tissue component hyaluronan accumulates within the transplanted organ at rejection. Increased tissue content of hyaluronan is seen also in synovial tissue in rheumatoid arthritis and in skin in scleroderma. In these diseases, the elevated hyaluronan levels are reflected by increased concentrations of hyaluronan in serum. The aim of the present study was to study the changes in serum hyaluronan after organ transplantation. METHODS: The experiments were performed in a rat model of heterotopic heart transplantation. Serum hyaluronan was assessed at various times after allogeneic (rejection) and syngeneic (non-rejection) transplantation and correlated with tissue hyaluronan. In addition, serum hyaluronan in animals who had long-term-surviving allogeneic grafts was studied. RESULTS: The hyaluronan concentration in serum was significantly higher in the rejecting than in the non-rejecting group 4 and 6 days after transplantation (p < 0.01). On Day 6, serum hyaluronan had increased by 400% in animals with an allogeneic transplant and by 100% in those with a syngeneic transplant. There was a positive correlation between serum hyaluronan and tissue hyaluronan (p < 0.05). Animals with long-term-surviving grafts displayed normal serum hyaluronan levels. CONCLUSIONS: Rejection of rat heart transplants is associated with strongly increased serum hyaluronan that parallels the hyaluronan accumulation within the transplant.
16569363 Infliximab in recalcitrant severe atopic eczema associated with contact allergy. 2006 Jan Infliximab is an anti-tumour necrosis factor (TNF)-alpha chimeric monoclonal antibody which is effective in diseases associated with a T-helper (Th) 1 response, such as rheumatoid arthritis, Crohn's disease and psoriasis. There are sporadic case reports of atopic dermatitis (AD) induced or precipitated by anti-TNF-alpha therapy, which have been attributed to the switch towards Th2-mediated reactions. We report the case of a 30-year-old man with long-standing severe AD associated with contact allergy and poorly responding to conventional treatments. The use of infliximab resulted in a dramatic amelioration of AD lesions and pruritus, persisting at follow-up examinations over a 3-year period. Probably, the unexpected response to infliximab therapy in this case might be due to some peculiar features of AD in our patient (i.e. chronic-continuous course and concomitant contact allergy) which could have been responsible for a more preponderant recruitment of Th1 cells as compared to common forms of AD.
16526326 Pancytopenia after low dose methotrexate therapy in a hemodialysis patient: case report an 2006 Methotrexate (MTX) is widely used in the treatment of rheumatoid arthritis (RA) with a side effect of pancytopenia. However, only a few cases of severe pancytopenia caused by low-dose MTX therapy have been reported, and the condition is rarely reported in uremic patients on dialysis therapy. We thereby report a hemodialysis patient who developed severe pancytopenia after oral treatment with low-dose MTX for RA. A 55-year-old woman who had been on regular hemodialysis treatment for 7 yr suffered from RA for 10 yr. She was regularly treated with celecoxib, prednisolone, and sulfasalazine in the past year. Because of the increasing arthralgia, 7.5 mg per week MTX was prescribed 3 months before admission. Stomatitis, fever, general fatigue, multiple skin carbuncles, and easy bruising developed after a cumulative dose of 90 mg. Pancytopenia was found at admission and the nadir of white blood cell count was 250/microL with 28% neutrophils, hematocrit was 22%, and platelet count was 6000/microL. Eosinophil counts increased from 11.5% initially to 26.1% on the sixth admission day. Transfusion with red blood cells and platelets, and appropriate antibiotics and folic acid were prescribed. She continued receiving regular hemodialysis and eventually recovered within 3 weeks.
16338212 2nd conference on heart, rheumatism and autoimmunity, Pescara, Italy, May 19-20, 2005. 2006 Jan Systemic autoimmune diseases, which comprise a family of conditions which share common pathogenetic mechanisms, are frequently associated to cardiac involvement and to a high prevalence of ischemic coronary events often occurring at a younger age than in normal population. A large increase in mortality is related to premature atherosclerosis with coronary artery disease and stroke in patients with connective tissue diseases. Coronary heart disease is responsible for 40-50% of the death of patients with rheumatoid arthritis. Moreover, a growing body of evidence supports the view that autoimmune mechanisms are involved in the pathogenesis of cardiovascular disease. Inflammatory heart disease is a rising concern worldwide. Similar mechanisms link autoimmune diseases, including the association of increased disease with proinflammatory cytokines and the importance of regulatory mechanisms in the control of chronic inflammation. The role of the immune system in modulating atherosclerosis has recently been well documented. Studies have revealed that cellular and humoral immunity plays crucial roles in atherogenic plaque formation. This includes macrophages, CD4+ T cells and dendritic cells as well as autoantigens such as oxidized low-density lipoprotein (oxLDL), heat shock proteins and beta2-glycoprotein I. The inflammatory component is not localized to the "culprit" plaque, but it is diffused to the entire coronary vascular bed, and involves also the myocardium. The aim of the conference (2nd conference on heart, rheumatism and autoimmunity) was to focus the attention of the participants on some pathogenetic, clinical and therapeutic aspects at the boundary between cardiology and rheumatology and to encourage the debate among clinicians and basic researchers with different backgrounds and experiences.
16199044 Finite element modelling of glenohumeral kinematics following total shoulder arthroplasty. 2006 Due to the shallowness of the glenohumeral joint, a challenging but essential requirement of a glenohumeral prosthesis is the prevention of joint dislocation. Weak glenoid bone stock and frequent dysfunction of the rotator cuff, both of which are common with rheumatoid arthritis, make it particularly difficult to achieve this design goal. Although a variety of prosthetic designs are commercially available only a few experimental studies have investigated the kinematics and dislocation characteristics of design variations. Analytical or numerical methods, which are predictive and more cost-effective, are, apart from simple rigid-body analyses, non-existent. The current investigation presents the results of a finite element analysis of the kinematics of a total shoulder joint validated using recently published experimental data for the same prostheses. The finite element model determined the loading required to dislocate the humeral head, and the corresponding translations, to within 4% of the experimental data. The finite element method compared dramatically better to the experimental data (mean difference=2.9%) than did rigid-body predictions (mean difference=37%). The goal of this study was to develop an accurate method that in future studies can be used for further investigations of the effect of design parameters on dislocation, particularly in the case of a dysfunctional rotator cuff. Inherently, the method also evaluates the glenoid fixation stresses in the relatively weak glenoid bone stock. Hence, design characteristics can be simultaneously optimised against dislocation as well as glenoid loosening.
16195663 Comparative clinicopathology of obliterative bronchiolitis and diffuse panbronchiolitis. 2006 BACKGROUND: The progressive airway obliteration caused by obliterative bronchiolitis (OB) has been widely noted in the world. In contrast, the obstructive respiratory disorder caused by diffuse panbronchiolitis (DPB) has been reported mainly from Japan. Therefore, there might be a considerable overlap between OB and DPB in Japan. OBJECTIVES AND METHODS: To clarify the clinicopathological similarities as well as the differences between OB and DPB, 15 patients with OB and 6 patients with DPB were evaluated clinicopathologically. RESULTS: The underlying disorders in OB were graft-versus-host disease (GVHD) in 7, rheumatoid arthritis in 3, Kartagener's syndrome in 2, and polymyositis/dermatomyositis, non-tuberculous mycobacterial disease and mycoplasmal pneumonia in one each. The lung pathology demonstrated that the primary obstructive lesions were in the membranous bronchioli in OB. In contrast, they were confined to the respiratory bronchioli in DPB. In addition, OB was classified into two major morphologic types, namely, constrictive and cellular. Clinical manifestations included cough and/or dyspnea in 13 with OB and in 6 with DPB, chronic parasinusitis in 3 with cellular OB and in 6 with DPB. The pulmonary function tests revealed obstructive impairments in all patients with OB and DPB. The chest CT images showed small centrilobular nodules in 64% of those with OB and in all with DPB. The prognosis of constrictive OB was worse than that of cellular OB and DPB. CONCLUSIONS: This study demonstrated that histopathologically marked differences existed between OB and DPB, although striking similarities in clinical manifestations were also noted in both diseases.
21136940 Immunoglobulin 1 (IgG1) Fc-glycosylation profiling of anti-citrullinated peptide antibodie 2009 Jan In several autoimmune disorders, including rheumatoid arthritis (RA), autoantibodies are thought to be the driving force of pathogenicity. Glycosylation of the Fc-part of human Igs is known to modulate biological activity. Hitherto, glycosylation of human IgG-Fc has been analyzed predominantly at the level of total serum IgG, revealing reduced galactosylation in RA. Given the pathogenic relevance of autoantibodies in RA, we wished, in the present study, to address the question whether distinct Fc-glycosylation features are observable at the level of antigen-specific IgG subpopulations. For this purpose, we have developed a method for the microscale purification and Fc-glycosylation analysis of anti-citrullinated peptide antibodies (ACPA). ACPA represent a group of autoantibodies that occur with unique specificity in RA patients. Their presence is associated with increased inflammatory disease activity and rapid joint destruction. Results indicate that ACPA of the IgG1 subclass vary considerably from total serum IgG1 with respect to Fc-galactosylation, with galactosylation being higher on ACPA than on serum IgG1 for some patients, while other patients show higher galactosylation on serum IgG1 than on ACPA. Using this method, studies can be performed on the biological and clinical relevance of ACPA glycosylation within RA patient cohorts.
18987580 Structure-efficiency relationship in derivatives of stilbene. Comparison of resveratrol, p 2008 Oct OBJECTIVES: Oxidative stress is related to a number of autoimmune diseases, e.g. rheumatoid arthritis, cancer, etc. The main source of pathologically working reactive oxygen species (ROS) are activated polymorphonuclear leukocytes (PMNL). OBJECTIVE: There are some papers comparing structure - pharmacological efficiency relationship of vegetal substances from the stilbenoid group. We compared the effect of trans-resveratrol, which is well-known by its antioxidative activity, with the effect of pinosylvin and pterostilbene. METHODS: Luminol-enhanced chemiluminescence (CL) was used to study the antioxidative action. The effect was observed in whole blood and in isolated PMNL. The concentrations of substances tested were 0.01-100 microM. Due to the different abilities of luminol and isoluminol to pass through the cell membrane, we studied the effect of the substances tested on intracellular and extracellular ROS. To stimulate the production of ROS we used phorbol-myristate-acetate (PMA), which activates PMNL via protein kinase C. RESULTS: Resveratrol, pinosylvin and pterostilbene inhibited significantly the CL of whole blood and extra- and intracellular CL of isolated PMNL in a dosedependent manner. Depending on different functional groups of the stilbene molecule, resveratrol inhibited CL of whole blood and isolated PMNL, whereas pinosylvin influenced mainly intracellular CL and pterostilbene extracellular CL. CONCLUSION: The presence of different functional groups in the molecules of stilbenoids influence their antioxidative effect. Modification of these functional groups may result in derivatives with required antioxidative properties, targeting mainly extracellular ROS which are responsible for tissue damage during chronic inflammation.
18946713 Relapsing polychondritis--case series from South India. 2009 Jun Relapsing polychondritis (RP) is a rare recurring inflammatory disorder with variable clinical course. It has been described mainly in Caucasian population. Reports from other ethnic groups are few. We report seven cases of relapsing polychondritis in south Indian population. In between 1995 and 2008, seven patients fulfilling the McAdam-Damiani-Levine criteria for diagnosis of relapsing polychondritis were identified. Records pertaining to these patients were studied and clinical presentation, course, and treatment offered were analyzed retrospectively. The female-to-male ratio in our series was 2.5:1. The age of onset of symptoms ranged from 28 to 54 years, with a mean of 40.2 years. An average of 20 months, ranging from 3 months to 6 years, elapsed before the patient presented to us seeking a diagnosis. Various structural involvement in our series were as follows: pinna in four (57%), nasal cartilage in five (71%), joints in three (43%), eyes in three (43%), laryngotracheal tree in three (43%), inner ear in one (14.3%), skin in one (14.3%), and heart in one (14.3%). Associated autoimmune diseases were present in four (57%) patients in the form of one of the following in each: vasculitis, autoimmune hemolytic anemia, hypothyroidism, and rheumatoid arthritis. All seven patients received prednisolone with three of them requiring additional immunosuppressants. There was no mortality amongst the four patients who had remained on follow-up at the time of this report. Although RP is an uncommon disorder, clinicians should be aware of the manifestations so as to initiate prompt treatment and prevent complications. Our series reports less frequent auricular cartilage and skin involvement and an exceptional case of basal cell carcinoma, although the other manifestations were similar to that seen in Caucasian and other Asian populations.
18855125 Health-related quality of life in unselected outpatients with heart failure across Spain i 2008 Dec AIMS: To assess health-related quality of life (HRQL) in Spanish outpatients with chronic heart failure (CHF). METHODS: Cross-sectional study carried out in a sample of CHF patients (echocardiography was performed in all of them) followed either in Primary Care (PC) centres or Cardiology outpatient clinics throughout Spain. HRQL was evaluated using the EuroQol 5D (EQ-5D) and Minnesota Living with Heart Failure (MLWHF) Questionnaire. RESULTS: The study subjects were 2161 CHF patients (1412 PC; 749 Cardiology). Patients were older and had more severe disease in PC than in Cardiology settings. Their HRQL scores were likewise worse. After adjusting for clinical variables, the differences in global and physical MLWHF disappeared, but persisted to a smaller degree in EQ-5D and mental MLWHF. HRQL was worse than in a representative sample of the Spanish population and in other chronic conditions such as rheumatoid arthritis or type 2 diabetes, being only comparable to severe chronic obstructive pulmonary disease (COPD). CONCLUSION: All domains of HRQL were significantly impaired in CHF patients. Differences found in HRQL between PC and Cardiology should possibly be attributed to a large extent to the different clinical characteristics of the patients attended. In spite of the differences between EQ-5D and MLWHF, our results suggest that both questionnaires adequately reflect the severity of the disease.
16720373 Transglutaminase 2 in inflammation. 2006 Sep 1 Many reports have shown that the expression of transglutaminase 2 (TG 2) is increased in inflammatory diseases. Although during the last several decades multiple physiological roles for TG 2 have been demonstrated in various cell types, its role in the inflammatory process is not yet clear. TG 2 is a crosslinking enzyme that is widely used in many biological systems for tissue stabilization purposes and immediate defense against injury or infection. Aberrant activation of TG 2 activity in tissues contributes to a variety of diseases including neurodegenerative diseases, autoimmune diseases, and cancers. In most cases, TG 2 appears to form an inappropriate protein aggregate that may be cytotoxic enough to trigger inflammation and/or apoptosis. In some cases, such as celiac disease and rheumatoid arthritis, TG 2 is also associated with the pathogenic progression, as well as in the generation of autoantibodies. Recently, we discovered that increased TG 2 activity triggers NF-kappaB activation without I-kappaBalpha kinase signaling. TG 2 induces the polymerization of I-kappaBalpha rather than stimulating I-kappaBalpha kinase. This polymerization of I-kappaB results in the direct activation of NF-kappaB in various cell lines. We also found that TG inhibition reverses NF-kappaB activation. Interestingly, this coincides with the reversal of inflammation in conjunctivitis models by treatment with TG 2 inhibitors. Here, I introduce a new role for TG 2 as a signal modulator, which may suggest a new paradigm for the inflammatory process.
16643778 [Construction of Tet-on inducible CXCR1 eukaryotic expression plasmid and identification o 2006 May AIM: To construct tetracycline (Tet)-controlled inducible vector CXCR1-pTREhyg, and then detect the expression character of CXCR1 under the regulation of Dox in NIH3T3 cells. METHODS: A full length cDNA of human CXCR1 was cloned from sample of fibroblast like synovium (FLS) in rheumatoid arthritis (RA) patient by RT-PCR and then sub-cloned into the pTREhyg plasmid after sequence analysis. CXCR1-pTREhyg and pTet-on was co-transfected with Lipofect2000 to NIH3T3 cells, and the expression of IL-8RA was detected by Western blot after given different concentration of Dox. RESULTS: Western blot showed that CXCR1 could be induced by Dox in NIH3T3 cells, and the phosphorylated Erk-1/2 level was significantly increased after IL-8 stimulation. CONCLUSION: Tet inducible recombinant vector of CXCR1-pTREhyg was successfully constructed, and it could be expressed in NIH3T3 cells. The stimulation of IL-8 obviously changed the activity of Erk-1/2 in the transfected NIH3T3 cells. This work has laid foundations for further study on the relationship between CXCR1 and RA disease.
16506237 Absence of the medial sesamoid bone associated with metatarsophalangeal pain. 2006 Oct Pain at the first metatarsophalangeal (MTP) joint can result from inflammation, chondromalacia, flexor hallucis brevis tendinitis, osteochondritis dessecans, fracture of a sesamoid bone, avascular necrosis of sesamoids, inflamed bursae, intractable keratoses, infection, sesamoiditis, gout arthropathy, and rheumatoid arthritis. Congenital absence of a sesamoid bone is extremely rare. We present a 17-year-old male patient with pain at the plantar aspect of the right MTP joint associated with congenital absence of the medial sesamoid. There was tenderness and the range of motion was minimally restricted. He described the pain as necessitating changes in his social life. On radiographs, the medial hallucial sesamoid was absent on the right side. The MTP joint was also evaluated using magnetic resonance imaging (MRI). A metatarsal pad was prescribed and the patient was satisfied with the treatment at the 2 months follow-up period. MRI revealed no pathological tissue at the medial sesamoid site. Hallucial sesamoids absorb pressure, reduce friction, protect the tendons, act like a fulcrum to increase the mechanical force of the tendons, and provide a dynamic function to the great toe by elevating first metatarsal head. Congenital absence of these bones is very rare but we must consider it in a patient with MTP joint pain.
18803413 Selectins ligand decorated drug carriers for activated endothelial cell targeting. 2008 Oct New active particulate polymeric vectors based on branched polyester copolymers of hydroxy-acid and allyl glycidyl ether were developed to target drugs to the inflammatory endothelial cell surface. The hydroxyl and carboxyl derivatives of these polymers allow grafting of ligand molecules on the polyester backbones at different densities. A known potent nonselective selectin ligand was selected and synthesized using a new scheme. This synthesis allowed the grafting of the ligand to the polyester polymers, preserving its binding activity as assessed by docking simulations. Selectin expression on human umbilical cord vascular endothelial cells (HUVEC) was induced with the pro-inflammatory bacterial lipopolysaccharide (LPS) or with the nonselective inhibitor of nitric oxide synthase L-NAME. Strong adhesion of the ligand decorated nanoparticles was evidenced in vitro on activated HUVEC. Binding of nanoparticles bearing ligand molecules could be efficiently inhibited by prior incubation of cells with free ligand, demonstrating that adhesion of the nanoparticles is mediated by specific interaction between the ligand and the selectin receptors. These nanoparticles could be used for specific drug delivery to the activated vascular endothelium, suggesting their application in the treatment of diseases with an inflammatory component such as rheumatoid arthritis and cancer.
18792996 Systematic review of discriminating power of outcome measures used in clinical trials of f 2008 Nov OBJECTIVE: Fibromyalgia (FM) comprises many symptoms and features. Consequently, studies on the condition have used a wide variety of outcome measures and assessment instruments. We investigated those outcome measures and instruments in association with the OMERACT (Outcome measures in Rheumatoid Arthritis Clinical Trials) FM Workshop initiative to define core outcome measures that should be used to assess FM. METHODS: A systematic literature review up to December 2007 was carried out using the keywords "fibromyalgia," "treatment" or "management," and "trial." Data were extracted on outcome measures and assessment instruments used and the pre and post mean and standard deviation to calculate effect sizes (ES). Further sensitivity analysis was carried out according to treatment type, blinding status, and study outcome. RESULTS: The outcome domains identified fell largely within those defined by OMERACT. Morning stiffness was frequently assessed and therefore has been included here. The number of assessment instruments used was wide-ranging, so sensitivity analysis was only carried out on the top 5 within each domain. ES ranged from 0.54 to 3.77 for the key OMERACT domains. Health-related quality of life (HRQOL) was the only exception that had no instrument with moderate sensitivity. Of the secondary domains, dyscognition was lacking any sensitive instrument, as were fatigue and anxiety in pharmacological trials. CONCLUSION: Each of the key OMERACT domains has an instrument that appears to be sensitive to change, with the exception of HRQOL, which requires further research. Dyscognition, fatigue, and anxiety would all benefit from more research into their assessment instruments.