Migraine, Fibromyalgia, and Depression among People with IBS: A Prevalence Study

BACKGROUND. Case descriptions suggest IBS patients are more likely to have other disorders, including migraine, fibromyalgia, and depression. We sought to examine the prevalence of these conditions in cohorts of people with and without IBS. METHODS. The source of data was a large U.S. health plan from January 1, 1996 though June 30, 2002. We identified all people with a medical claim associated with an ICD-9 code for IBS. A non-IBS cohort was a random sample of people with an ICD-9 code for routine medical care. In the cohorts, we identified all claims for migraine, depression, and fibromyalgia. We estimated the prevalence odds ratios (PORs) of each of the three conditions using the Mantel-Haenszel method. We conducted quantitative sensitivity analyses to quantify the impact of residual confounding and in differential outcome identification. RESULTS. We identified 97,593 people in the IBS cohort, and a random sample of 27,402 people to compose the non-IBS comparison cohort. With adjustment, there was a 60% higher odds in the IBS cohort of having any one of the three disorders relative to the comparison cohort (POR 1.6, 95% CI 1.5 – 1.7). There was a 40% higher odds of depression in the IBS cohort (POR 1.4, 95% CI 1.3 – 1.4). The PORs for fibromyalgia and migraine were similar (POR for fibromyalgia 1.8, 95% CI 1.7 – 1.9; POR for migraine 1.6, 95% CI 1.4 – 1.7). Differential prevalence of an unmeasured confounder, or imperfect sensitivity or specificity of outcome detection would have impacted the observed results. CONCLUSION. People in the IBS cohort had a 40% to 80% higher prevalence odds of migraine, fibromyalgia, and depression

Psychiatric genetics and the structure of psychopathology

For over a century, psychiatric disorders have been defined by expert opinion and clinical observation. The modern DSM has relied on a consensus of experts to define categorical syndromes based on clusters of symptoms and signs, and, to some extent, external validators, such as longitudinal course and response to treatment. In the absence of an established etiology, psychiatry has struggled to validate these descriptive syndromes, and to define the boundaries between disorders and between normal and pathologic variation. Recent advances in genomic research, coupled with large-scale collaborative efforts like the Psychiatric Genomics Consortium, have identified hundreds of common and rare genetic variations that contribute to a range of neuropsychiatric disorders. At the same time, they have begun to address deeper questions about the structure and classification of mental disorders: To what extent do genetic findings support or challenge our clinical nosology? Are there genetic boundaries between psychiatric and neurologic illness? Do the data support a boundary between disorder and normal variation? Is it possible to envision a nosology based on genetically informed disease mechanisms? This review provides an overview of conceptual issues and genetic findings that bear on the relationships among and boundaries between psychiatric disorders and other conditions. We highlight implications for the evolving classification of psychopathology and the challenges for clinical translation

Book Notes

Matt Tomlinson In God\u27s Image: The Metaculture of Fijian Christianity 2009 Berkeley, CA: The University of California Press Reviewed by Michael A. Rynkiewich S. T. Kimbrough Jr. and Kenneth G. C. Newport, eds. The Manuscript Journal of the Reverend Charles Wesley, M.A. Vols. 1,2 2008. Nashville: Kingswood Books John R. Tyson Assist Me to Proclaim: The Life and Hymns of Charles Wesley 2007 Grand Rapids, Michigan: William B. Eerdmans Reviewed by Kenneth J. Collins Brian Stanley The World Missionary Conference, Edinburgh 1910 Studies in the History of Christian Missions 2009. Grand Rapids, MI: Eerdmans Reviewed by Marcella Hoesl Geordan Hanunond and David Rainey, eds. Wesley & Methodist Studies. Volume I 2009. Manchester, UK- Didsbury Press Reviewed by Howard A. Snyde

The effect of caffeine mouth rinse on self-paced cycling performance

The aim of the study was to determine whether caffeine mouth rinse would improve 30 min self-paced cycling trial. Twelve healthy active males (age 20.5±0.7 years, mass 87.4±18.3 kg) volunteered for the study. They attended the laboratory on 3 separate occasions performing a 30 min self-paced cycling trial. On one occasion water was given as a mouth rinse for 5 s (PLA), on another occasion a 6.4% maltodextrin (CHO) solution was given for 5 s and finally a caffeine solution (containing 32 mg of caffeine dissolved in 125 ml water; CAF) was given for 5 s. Distance cycled, heart rate, ratings of perceived exertion, cadence, speed and power output were recorded throughout all trials. Distance cycled during the CAF mouth rinse trial (16.2±2.8 km) was significantly greater compared to PLA trial (14.9±2.6 km). There was no difference between CHO and CAF trials (P=0.89). Cadence, power and velocity were significantly greater during the CAF trial compared to both PLA and CHO (P0.05). Caffeine mouth rinse improves 30 min cycling performance by allowing the participant to increase cadence, power and velocity without a concurrent increase in perceived exertion and heart rate

Systems, Methods and Apparatus for Position Sensor Digital Conditioning Electronics

Systems, methods and apparatus are provided through which in some implementations determine the amplitude of an amplitude modulated signal, modulated by the position of an object being sensed. In some aspects, the apparatus accepts an excitation signal and the amplitude modulated signal and divides the amplitude modulated by the excitation signal to produce an output signal that is proportional to the position of the object being sensed. In other aspects, the division is performed only when the excitation signal is non-zero, such as close to the peaks in the excitation signal. In other aspects, the excitation signal and amplitude modulated signal are degraded due to an air gap and the degraded signals are used to correct for amplitude fluctuations due to the air gap, and produce an output signal, tolerant of the air gaps, that is proportional to the position of the object being sensed

Heterogeneity and Variability in the Context of Flow Lines

We propose a model in which between-individual differences in performance (heterogeneity) and within-individual differences in performance over time (variability) affect flow line performance. The impact of heterogeneity and variability is contingent upon the flow line context, particularly the rules of governing the way work moves between employees (work flow policy). We show how subtle changes in this policy can have a motivational effect on heterogeneity and variability and how these, in turn, and impact the relationship between work flow policy and flow line performance

Reconfigurable Sensor Monitoring System

A reconfigurable sensor monitoring system includes software tunable filters, each of which is programmable to condition one type of analog signal. A processor coupled to the software tunable filters receives each type of analog signal so-conditioned

Reconfigurable Drive Current System

A reconfigurable drive current system includes drive stages, each of which includes a high-side transistor and a low-side transistor in a totem pole configuration. A current monitor is coupled to an output of each drive stage. Input channels are provided to receive input signals. A processor is coupled to the input channels and to each current monitor for generating at least one drive signal using at least one of the input signals and current measured by at least one of the current monitors. A pulse width modulation generator is coupled to the processor and each drive stage for varying the drive signals as a function of time prior to being supplied to at least one of the drive stages

Motor Controller System For Large Dynamic Range of Motor Operation

A motor controller system uses a rotary sensor with a plurality of signal conditioning units, coupled to the rotary sensor. Each of these units, which is associated with a particular range of motor output shaft rotation rates, generate a feedback signal indicative of the position of the motor s output shaft. A controller (i) converts a selected motor output shaft rotation rate to a corresponding incremental amount of rotational movement for a selected fixed time period, (ii) selects, at periodic completions of the selected fixed time period, the feedback signal from one of the signal conditioning units for which the particular range of motor output shaft rotation rates associated therewith encompasses the selected motor output shaft rotation rate, and (iii) generates a motor drive signal based on a difference between the incremental amount of rotational movement and the feedback signal from the selected one of the signal conditioning Units

Assessing the discordance rate between local and central HER2 testing in women with locally determined HER2-negative breast cancer.

BackgroundThe importance of human epidermal growth factor receptor 2 (HER2) as a prognostic and predictive marker in invasive breast cancer is well established. Accurate assessment of HER2 status is essential to determine optimal treatment options.MethodsBreast cancer tumor tissue samples from the VIRGO observational cohort tissue substudy that were locally HER2-negative were retested centrally with both US Food and Drug Administration (FDA)-approved immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assays, using FDA-approved assay cutoffs; results were compared.ResultsOf the 552 unique patient samples centrally retested with local HER2-negative results recorded, tumor samples from 22 (4.0%) patients were determined to be HER2-positive (95% confidence interval [CI] = 2.5%-5.7%). Of these, 18 had been tested locally by only one testing methodology; 15 of 18 were HER2-positive after the central retesting, based on the testing methodology not performed locally. Compared with the 530 patients with centrally confirmed HER2-negative tumors, the 22 patients with centrally determined HER2-positive tumors were younger (median age 56.5 versus 60.0 years) and more likely to have ER/PR-negative tumors (27.3% versus 22.3%). These patients also had shorter median progression-free survival (6.4 months [95% CI = 3.8-15.9 months] versus 9.1 months [95% CI = 8.3-10.3 months]) and overall survival (25.9 months [95% CI = 13.8-not estimable] versus 27.9 months [95% CI = 25.0-32.9 months]).ConclusionsThis study highlights the limitations of employing just one HER2 testing methodology in current clinical practice. It identifies a cohort of patients who did not receive potentially efficacious therapy because their tumor HER2-positivity was not determined by the test initially used. Because of inherent limitations in testing methodologies, it is inadvisable to rely on a single test to rule out potential benefit from HER2-targeted therapy