Back to Back Issues Page
Insider Arthritis Tips Newsletter April 2011
April 15, 2011

"In prosperity our friends know us; in adversity we know our friends." -- John Churton Collins

Reporting Arthritis News For April 2011

Rilonacept Prevents Gout Flares In Study
Meg Perrell writing in Bloomberg News reported, Regeneron Pharmaceuticals "said its product," Arcalyst (rilonacept), helped "prevent gout flares in a late-stage study of patients starting therapy to lower uric acid levels." Rilonacept, also known as IL1TRAP, is a protein antibody that binds a nother inflammatory protein called interleukin 1. Interleukin 1 is said to be the inflammatory instigator of gout flares. Study participants who were given weekly injections of Arcalyst over four months had a decrease of 72 percent in gout flares compared with placebo."

Comment: Incredibly expensive treatment… but effective.

Current Treatments For Injured Joints, Tendons Ineffective?
Jane Brody writing in the New York Times reports that clinical trials are questioning the effectiveness of corticosteroid injections and resting an injured joint for an injured tendon. For example, a review of "41 'high-quality' studies involving 2,672 patients, published in November in The Lancet, revealed only short-lived benefit from corticosteroid injections. For the very common problem of tennis elbow, injections of platelet-rich plasma derived from patients' own blood had better long-term results." Still, the authors noted that more and better clinical research is needed to "determine which among the many suggested remedies works best for treating different tendons."

Comment: Bottom line is PRP works.

Bunions as common as onions?
Dr Laura Martin writing in WebMD reported, "Bunions -- deformities at the base of the big toe that can cause pain and disability -- are common and can really slow a person down," according to a study published in Arthritis Care & Research. For the study, "researchers in the UK surveyed more than 2,800 people ages 56 and over" and found that bunions were "about twice as common in women as in men, and that the likelihood of having a bunion increased with age. Overall, about 28% of people ages 50 to 59 reported having bunions, compared to nearly 56% of people over age 80."

Comment: That’s a lot of bunions!

Virus ruled out as cause of FM
Sally Koch Kubetin writing in Rheumatology News reported that Xenotropic murine leukemia virus-related virus –whew what a mouthful – often shortened to XMRV- has been touted as a possible cause of fibromyalgia. Researchers at the Hospital; Universitario, Madrid compared blood from 15 patients who met the American College of Rheumatology diagnostic criteria for fibromyalgia and 10 healthy controls. They screened using a DNA extraction and polymerase chain reaction. They failed to find evidence of XMRA in the blood.

Comment: There goes another theory…

Blood injection works for hamstring injuries
Susan Birk writing in Rheumatology News reported a study from the Royal National Orthopedic Hospital in London. Investigators used ultrasound guided dry needling and autologous blood injection to treat hamstring tendonitis. The 42 patients, all athletes, were randomized into one of three treatment groups. One group received steroid injections, another group received autologous blood- about 2-3 cc’s, and the third received both. The injections were ultrasound guided. All the patients then underwent physical therapy for 6 weeks three weeks after the treatment. Significant reductions in pain and improved function scores were seen in the steroid plus blood group followed by the blood only group. The steroid patients were better at 6 weeks but then declined thereafter. Ultrasound evaluation at 3 months showed healing in both blood groups and persistent microtearing in the steroid only group.

Comment: More ammunition for PRP use!

Balloon Kyphoplasty For Vertebral Fracture Reduces Pain, Improves QOL
Laura Dean writing in Medwire reported, "Balloon kyphoplasty for vertebral fracture rapidly reduces pain and improves function, disability, and quality of life (QoL) over the course of two years, compared with non-surgical management," according to a study published in Journal of Bone and Mineral Research. This type of fracture often cause severe pain between the shoulder blades. Researchers used the "100-point short-form (SF)-36 physical component summary (PCS) score to assess the patients' physical ability at regular intervals through the study period." They found that improvement in the "SF-36 PCS score from baseline over the 24-month period was, on average, 3.24-points higher among patients in the balloon kyphoplasty group compared with those in the non-surgical care group ."

Comment: This is a procedure that has come of age

Uric Acid: A new predictor for Heart Disease?
Eswar Krishnan and Jeremy Sokolove in the journal Current Opinion in Rheumatol. reviewed the recently published data on elevated blood uric acid levels and cardiovascular disease. Evidence has accumulated in prospective observational studies that link hyperuricemia with the risk of hypertension. Newer data confirm the link between hyperuricemia and cardiovascular mortality. The use of allopurinol has been shown to be associated with reduced mortality risk and with reduced blood pressure in short-term randomized controlled trials. The available evidence has established a link between hyperuricemia and cardiovascular disease and this may be causal.

Comment: One can start using serum uric acid concentration as an inexpensive cardiovascular risk marker.

Gout Epidemic?

Gout and elevated blood uric acid which leads to gout is increasingly rapidly in the United States. Gout prevalence increased by 1.2% over the past 20 years, affecting 8.3 million Americans according to the most recent data from the National Health and Nutrition Examination Survey. Researchers say it is because of the increasing frequency of obesity as well as other metabolic problems such as hypertension, chronic kidney disease, and diabetes.

Comment: Another problem associated with the obesity epidemic!

Early Rehabilitation May Help Speed Recovery From Knee-Replacement Surgery
Robert Preidt writing in HealthDay reported, "The sooner rehabilitation begins after knee replacement, the better for both patients and hospitals," according to a study in the journal Clinical Rehabilitation. The researchers "compared more than 150 patients who began rehabilitation within 24 hours after knee replacement surgery and a matched control group of patients who began rehabilitation 48 to 72 hours after surgery." They found that on average, patients "who started rehabilitation earlier spent two days less in the hospital and had five fewer rehabilitation sessions before they were discharged than those in the control group."

Comment: Makes sense to me!

Back Pain Genetic
Anahad O’Connor writing in the New York Times reports that "a growing number of studies are finding that chronic back pain has a strong genetic component." For example, an analysis published in the Journal of Bone and Joint Surgery, based on records from a "large health and genealogic database to study more than a million Utah residents," found that having a "second-degree relative (aunt, uncle or grandparent) or third-degree relative (cousin) with the condition increased a person's risk, regardless of environmental factors." Moreover, the data indicated that having "an immediate family member raised a person's risk more than four times."

Comment: There are some family get togethers that are less fun than others.

Gout Increasing In US
Arthur Allen, author of "Vaccine: the Controversial Story of Medicine's Greatest Lifesaver" writing in the Washington Post, notes that according to recent surveys, cases of gout in the US have "roughly tripled since the late 1970s," with about "8-million Americans" now suffering from the condition. Allen suggests the increase may be attributed to a "number of lifestyle changes. First, we are awfully 'easy in our circumstances,' in the sense that most of us can afford cheap animal protein, alcohol and sweet" beverages. Moreover, paradoxically, we are seeing increased life spans. Lastly, some of the drugs that "keep older Americans alive despite high blood pressure, kidney disease and other conditions," such as niacin, thiazide and loop diuretics, have also been shown to "raise bloodstream levels of uric acid."

Comment: The disease of kings is now the disease for everyone.

Rituxan Combined With a TNF Inhibitor and Methotrexate Safe But Not Any More Effective For RA
ScienceDaily reports a recent trial of rituximab in combination with a t umor necrosis factor (TNF) inhibitor and methotrexate (MTX) in patients with active rheumatoid arthritis (RA) found the safety profile to be consistent with other RA trials with TNF inhibitors. While the trial reported no new safety risks, clear evidence of an efficacy advantage in RA patients receiving the combination therapy was not observed in this study sample. Results of the trial are published in Arthritis & Rheumatism

Comment: Sometimes what makes sense doesn't.

Need Exercise: Get a dog
Tara Pope-Parker writing in the New York Times Reported that several studies now show that dogs can be powerful motivators to get people moving. Not only are dog owners more likely to take regular walks, but new research shows that dog walkers are more active over all than people who don’t have dogs. One study even found that older people are more likely to take regular walks if the walking companion is canine rather than human. “You need to walk, and so does your dog,” said Rebecca A. Johnson, director of the human-animal interaction research center at the University of Missouri College of Veterinary Medicine. “It’s good for both ends of the leash.” Researchers at the Michigan State University reported that among dog owners who took their pets for regular walks, 60 percent met federal criteria for regular moderate or vigorous exercise. Nearly half of dog walkers exercised an average of 30 minutes a day at least five days a week. By comparison, only about a third of those without dogs got that much regular exercise.

Comment: Woof woof!!

Nitroglycerin for Osteoporosis
Bruno Oliveira, a rheumatologist, writing in Medscape reported on growing evidence suggesting that Nitroglycerin in the form of ointment works for Osteoporosis. A study in JAMA showed additional data supporting this claim.

Nitroglycerin treated subjects showed (at 2 years) a 6.7% increase in bone mineral density at the lumbar spine and 6.2% increase at the total hip. Bone quality seemed to be improved as well Nitroglycerin treated subjects experienced more headaches as expected. An inexpensive remedy that works.

Comment: Sounds promising.


Benefits of Bath Salts

Bath salts aren't just good for the body; they're also good for the mind. Bath salts help heal many ailments and can help you relax. They offer many added benefits that you might not expect to get from something as simple as tossing a little salt into your bath. For reducing pain, repairing damaged skin, and literally washing away stress, bath salts have many healing properties.

Bath salts, mixed with essential oils, can help promote greater relaxation. A leisurely soak in a nice warm bath with a scented salt can actually help reduce your level of stress.

You will feel rejuvenated and better able to cope with life’s demands once you are no longer overwhelmed by anxiety and pressure. You will be able to concentrate better and think more clearly when you allow yourself to relax and unwind.

Take your bath an hour or so before getting ready for bed and engage in only relaxing, quiet activities from that point on. You will be amazed at how refreshed you will feel once you have incorporated this routine.

Arthritis Strength Bath Salts are the Ultimate Soak to Relieve the Aches and Pains of Arthritis.

Try one of our new scents for $8 off (regularly $28):

  • Spicy Bergamot
  • The Zen of Yling Ylang
  • The exotic scent of Jasmine
  • A tranquil lavender or
  • The sweetness of vanilla

Click Here To Order Yours Now!


A quick reminder:

Visit our practice website. The address is: Arthritis Treatment Center Lots of good info and a daily video blog filled with really good stuff.

Wei's World April 2011

I was recently invited back to my medical school, the Jefferson Medical College in Philadelphia. For those who don't know about Jefferson, it is the oldest private medical school in the country and one of the most venerated.

My attending Jefferson for medical school was not by chance.

My mother was instrumental not only in my going into medicine (my birthday gift as a 4 year old was a doctor's kit… no subtle hint there!) , but also in my choosing to go to Jefferson.

We lived in the outskirts of Philadelphia during my growing up years. As a child, I had bad asthma and saw an allergist on a regular basis. If I remember correctly, he was a Jefferson grad and a real fan of the medical school. Also, everyone my mother talked with about medical schools did the same.

In Philadelphia, the University of Pennsylvania might have more "prestige" because it's an Ivy League school, but those in the know knew that Jefferson was the pinnacle of medicine in Philadelphia.

So my fate was sealed.

And I will be the first to admit that my time at Jeff was tremendous. Their mission is to educate and treat clinicians and they do their job superbly.

So, anyway, let’s get back to my visit...

It was amazing! Not only had the medical school campus increased in size about ten-fold since my days there, but they also had new developments that just took my breath away.

One building that was particularly impressive was the pristine Clinical Simulation Center building.

In the old days when I was going through med school, you spent the first two years in classrooms learning things like biochemistry, histology, anatomy and so on. Very dry and nothing to do with patients. That is why medical school was so hard… at least then. You studied all this science and wondered what the application was to taking care of patients.

With the new Clinical Simulation Unit, students are taken on the second day of classes to this building to practice their interview and examination skills on actors who are specially trained to behave as if they have real diseases. In addition they get to practice procedural skills on dummy patients. The students learn to correlate basic science theory with real world patient care immediately!

And everything is state of the art. They had real set ups for hospital rooms, intensive care units, and even operating suites. All connected by the way with cameras and other media so a student could be observed and critiqued from a remote location.

The clinical simulation unit is so popular that even attending physicians, fellows, and residents use it to hone their skills! Awesome!

There have been many times when I wished that my medical school experience could have been more like what I saw at Jeff that day.

Another unexpected pleasure… I went back to my old lecture hall and got to sit in the same seat I sat in forty years ago. Funny how the auditorium seemed smaller than I remembered. Sort of like going back to your elementary school. The hallways so much narrower than you recall.

Another treat…I got to see a classroom of students.

When I went to medical school, there were only a few women and very few minorities. Now the class is about fifty per cent women and there are minorities well represented.

The future is bright for medicine, I think.

Back to Back Issues Page