Featured Research Studies
MCS America
News, Volume 3, Issue 2, February 2008.
The impact of judges' perceptions of
credibility in fibromyalgia claims.
Le Page JA, Iverson GL, Collins P.
University of British Columbia, Department of Psychiatry, Vancouver, B.C.,
Canada.
Fibromyalgia (FM) is a confusing and controversial diagnosis, characterized by
widespread pain and tenderness at specific anatomical sites. The cause of this
syndrome is unknown, and the course of the condition is difficult to predict.
Without a known cause, predictable course, or effective treatment, it is not surprising
that FM is a contentious diagnosis from a medical perspective, as well as a
civil litigation and disability insurance industry perspective. The purpose of
this study was to investigate judges' perceptions of credibility in litigated
cases involving FM claims in the Canadian courts, and the relation between
perceived credibility and awards granted. A systematic review was conducted of
every trial-by-judge litigated FM claim in
PMID: 18191454 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/18191454?dopt=AbstractPlus
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Environmental Health Perspectives Volume 116, Number 1, January 2008
Air Pollution and Postneonatal Infant
Mortality in the United States, 1999–2002
Tracey J. Woodruff,1* Lyndsey A. Darrow,2 and Jennifer D. Parker3
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of
California, San Francisco, California, USA; 2Department of Epidemiology, Emory
University, Atlanta, Georgia, USA; 3National Center for Health Statistics, Centers
for Disease Control and Prevention, Hyattsville, Maryland, USA
Abstract
Objective: Our goal was to evaluate the relationship between cause-specific
postneonatal infant mortality and chronic early-life exposure to particulate
matter and gaseous air pollutants across the United States.
Methods: We linked county-specific monitoring data for particles with
aerodiameter of ≤ 2.5 µm (PM2.5) and ≤ 10 µm (PM10) , ozone, sulfur
dioxide, and carbon monoxide to birth and death records for infants born from
1999 to 2002 in U.S. counties with > 250,000 residents. For each infant, we
calculated the average concentration of each pollutant over the first 2 months
of life. We used logistic generalized estimating equations to estimate odds
ratios of postneonatal mortality for all causes, respiratory causes, sudden
infant death syndrome (SIDS) , and all other causes for each pollutant,
controlling for individual maternal factors (race, marital status, education,
age, and primiparity) , percentage of county population below poverty, region,
birth month, birth year, and other pollutants. This analysis includes about 3.5
million births, with 6,639 postneonatal infant deaths.
Results: After adjustment for demographic and other factors and for other
pollutants, we found adjusted odds ratios of 1.16 [95% confidence interval (CI)
, 1.06–1.27] for a 10-µg/m3 increase in PM10 for respiratory causes and 1.20
(95% CI, 1.09–1.32) for a 10-ppb increase in ozone and deaths from SIDS. We did
not find relationships with other pollutants and for other causes of death
(control category) .
Conclusions: This study supports particulate matter air pollution being a risk
factor for respiratory-related postneonatal mortality and suggests that ozone
may be associated with SIDS in the United States.
Environ Health Perspect 116:110–115 (2008) . doi:10.1289/ehp.10370 available
via http://dx.doi.org/ [Online 24 October 2007]
.
http://www.ehponline.org/docs/2007/10370/abstract.html
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Semin Arthritis Rheum. 2008 Jan 11 [Epub ahead of print]
Central Sensitivity Syndromes: A New
Paradigm and Group Nosology for Fibromyalgia and Overlapping Conditions, and
the Related Issue of Disease versus Illness.
Yunus MB.
Professor of Medicine, Section of Rheumatology, The University of Illinois
College of Medicine at Peoria, Peoria, Illinois.
OBJECTIVES: To discuss the current terminologies used for fibromyalgia syndrome
(FMS) and related overlapping conditions, to examine if central sensitivity
syndromes (CSS) is the appropriate nosology for these disorders, and to explore
the issue of disease versus illness. METHODS: A literature search was performed
through PubMed, Web of Science, and ScienceDirect using a number of keywords,
eg, functional somatic syndromes, somatoform disorders, medically unexplained
symptoms, organic and nonorganic, and diseases and illness. Relevant articles
were then reviewed and representative ones cited. RESULTS: Terminologies
currently used for CSS conditions predominantly represent a psychosocial
construct and are inappropriate. On the other hand, CSS seems to be the logical
nosology based on a biopsychosocial model. Such terms as "medically
unexplained symptoms," "somatization," "somatization
disorder," and "functional somatic syndromes" in the context of
CSS should be abandoned. Given current scientific knowledge, the concept of
disease-illness dualism has no rational basis and impedes proper
patient-physician communication, resulting in poor patient care. The concept of
CSS is likely to promote research, education, and proper patient management.
CONCLUSION: CSS seems to be a useful paradigm and an appropriate terminology
for FMS and related conditions. The disease-illness, as well as organic/non-organic
dichotomy should be rejected.
PMID: 18191990 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/18191990?dopt=AbstractPlus
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