Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey.

Background: Fatigue is a common disabling symptom of multiple sclerosis (MS) and has a significantly negative impact on quality of life. Persons with MS enrolled in the North American Research Committee on Multiple Sclerosis (NARCOMS) Patient Registry are invited to complete follow-up surveys every six months to update their original registration information. One of these surveys was designed to focus on the severity and impact of fatigue, and its association with other clinical parameters of MS such as physical disability.

Employment in multiple sclerosis. Exiting and re-entering the work force.

Multiple sclerosis (MS) is associated with significant economic burden and high rates of unemployment. This investigation evaluated patient and disease characteristics associated with work loss and work initiation using the NARCOMS patient registry. Patient and disease characteristics associated with transitions to unemployment or employment were evaluated cross-sectionally and prospectively over the course of two assessment periods (mean interval of 1.

Persistent pain and uncomfortable sensations in persons with multiple sclerosis.

The experience of pain has been documented in small studies of individuals with multiple sclerosis (MS). The present study examines the prevalence of persistent pain and uncomfortable sensations among participants in the large North American Research Committee on MS (NARCOMS) Patient Registry. Registrants (10,176) responded to a questionnaire on pain and 7579 reported experiencing some level of pain during the month prior to the survey.

Costs and quality of life in multiple sclerosis: a cross-sectional study in the United States.

Objective: To estimate current costs and quality of life (utility) of patients treated with disease modifying drugs (DMDs) in the United States, and to investigate the effect of disease severity on costs and utility.

Methods: Data on demographics, disease information, resource utilization (including work capacity), and utility were collected directly from patients in a cross-sectional postal survey. Patients were selected randomly among participants in the North American Committee on Multiple Sclerosis Patient Registry (NARCOMS) receiving DMDs.

Validation of the NARCOMS registry: fatigue assessment.

Participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry report disability using Performance Scales (PS), which assess eight domains. We aimed to validate the PS fatigue subscale (PSF) using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS) as external criteria. We measured correlations between the PSF and age, disease duration and PS subscales to assess construct validity.

Validation of the NARCOMS Registry: pain assessment.

The North American Research Committee on Multiple Sclerosis (NARCOMS) Registry is a multiple sclerosis (MS) self-report registry with more than 24,000 participants. Participants report disability status upon enrollment, and semi-annually using Performance Scales (PS), Patient Determined Disease Steps (PDDS) and a pain question. In November 2000 and 2001, we also collected the Pain Effects Scale (PES).

Treatment patterns of multiple sclerosis patients: a comparison of veterans and non-veterans using the NARCOMS registry.

Multiple sclerosis (MS) is a chronic illness of the central nervous system, with a highly variable clinical course. Available therapies are only partially effective and as a consequence treatment patterns between patients can be varied. Longitudinal databases consisting of large cohorts where successive and sequential data is collected may reveal disease and treatment characteristics not apparent when data is gathered during clinical trials that consist usually of relatively homogeneous patients followed for short durations.

A prospective study of adherence to glatiramer acetate in individuals with multiple sclerosis.

The purpose of this prospective study was to investigate whether self-efficacy, hope, level of disability, perceived support, and previous use of an immunomodulatory therapy when measured at the initiation of a therapy can accurately predict adherence. A convenience sample included 108 individuals with multiple sclerosis who initiated therapy with glatiramer acetate (Copaxone), plus or minus 21 days, and completed instruments online that included the Multiple Sclerosis Self-Efficacy Scale (MSSE), the Herth Hope Index, Performance Scales, and a sociodemographic data sheet that included questions about previous use of immunomodulators and individuals considered most supportive of glatiramer acetate therapy. Logistic regression analysis revealed that the MSSE total (Control and Function subscales combined) was the only significant predictor of adherence.

Distribution of human papillomavirus types 16 and 18 variants in squamous cell carcinomas and adenocarcinomas of the cervix.

The distributions of human papillomavirus (HPV) types detected in cervical adenocarcinomas and squamous cell tumors differ. However, whether the distributions of intratypic HPV variants seen in these two histological forms of cervical disease differ is unknown. Our objective was to compare the distribution of HPV intratypic variants observed in squamous cell carcinomas (SCC) and cervical tumors of glandular origin (e.

Predictors of alternative medicine use by multiple sclerosis patients.

Objective: To determine the frequency of alternative medicine use among multiple sclerosis (MS) patients, and the factors which predict such use.

Methods: We examined 20778 MS patients enrolled in the North American Research Consortium on Multiple Sclerosis (NARCOMS) Patient Registry, residing in the USA. We used demographic and clinical data to create multivariate logistic regression models for i) lifetime use of any alternative medicine, ii) lifetime use of any alternative provider (AP), and iii) lifetime use of each of the three most common AP.

Obesity as a potential risk factor for adenocarcinomas and squamous cell carcinomas of the uterine cervix.

Background: Hormonal factors may play a more prominent role in cervical adenocarcinoma than squamous cell carcinoma. The authors evaluated whether obesity, which can influence hormone levels, was associated with adenocarcinoma and squamous cell carcinoma.

Methods: This case-control study included 124 patients with adenocarcinoma, 139 matched patients with squamous cell carcinoma, and 307 matched community control participants.

Predictors of adherence to glatiramer acetate therapy in individuals with self-reported progressive forms of multiple sclerosis.

The purpose of this study was to evaluate psychological, biophysical, and sociodemographic variables as predictors of adherence to glatiramer acetate (Copaxone) therapy in individuals with self-reported progressive forms of multiple sclerosis (MS). The literature lends support for self-efficacy, self-esteem, hope, and disability to be predictors of adherence. Therefore the hypotheses for this study were (a) higher self-efficacy will be a significant predictor of adherence, (b) higher self-esteem will be a significant predictor of adherence, (c) higher hope will be a significant predictor of adherence, and (d) a lower level of disability will be a significant predictor of adherence.

Comparison of human papillomavirus genotypes, sexual, and reproductive risk factors of cervical adenocarcinoma and squamous cell carcinoma: Northeastern United States.

Objective: Although human papillomavirus causes essentially all cervical carcinoma, cofactors may differ by cancer histologic type. We examined human papillomavirus genotypes and sexual and reproductive risk factors for cervical adenocarcinoma and squamous cell carcinoma.

Study Design: One hundred twenty-four women with adenocarcinoma, 139 women with squamous cell carcinoma, and 307 control subjects participated in this case-control study.

Disability and treatment patterns of multiple sclerosis patients in United States: a comparison of veterans and nonveterans.

The Veterans Health Administration (VHA) is the largest integrated healthcare system in the world and provides care to approximately 20,000 multiple sclerosis (MS) patients. Here, we report that these MS patients are disproportionately more likely to be older, male, unemployed, and disabled with lower levels of education and financial resources when compared to veterans not receiving care within the VHA or to nonveteran MS patients. When comparing the VHA MS patients to a cohort of nonveteran MS patients matched for age, sex, and disability, we found that veterans receiving care within the VHA were equally likely to have received care from a neurologist and more likely to have received care from rehabilitation specialists and primary care physicians than nonveterans.