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Insider Arthritis Tips Jan and Feb 2017
January 15, 2017
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A Quote to be Inspired By...

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“A dream doesn't become reality through magic; it takes sweat, determination, and hard work.” --Colin Powell


What's New

A surgical solution to gout?  Next…

Bariatric Surgery Thwarts Gout and Hyperuricemia 

 

 Dr. Jack Cush writing in Rheumnow reported the rising incidence of gout has been directly linked to the obesity epidemic.  The influence of obesity on gout was further tested in a cohort study of obese patients undergoing bariatric surgery as part of the Swedish Obese Subjects (SOS) study.

 

This prospective intervention trial compared those receiving bariatric surgery (n= 1982) against obese controls (1999) receiving conventional treatment. None of the subjects had gout at baseline. The median followup for both groups was nearly 19 years. 

The bariatric surgery had a significantly lower incidence of gout compared with usual care.

 Similarly, the bariatric surgery cohort had a lower incidence of hyperuricaemia .

The effectiveness of bariatric surgery in preventing gout and hyperuricaemia, underscores the value of weight reduction in gout prevention. 

 

Comment: The correlation between gout and obesity is confirmed here.

 

 

 

What is the safest anti-inflammatory drug?  Is there one?  Next

 

Celebrex arthritis drug safety study surprises heart experts

 

But today, Dr. Steven Nissen, chairman of the department of cardiovascular medicine at Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute. and colleagues reported findings of a major 10-year study which found no such problems with Celebrex, offering reassurance to millions of patients and potentially changing the way doctors approach treating arthritis pain.

 

For the study involving 24,081 heart patients and people at an increased risk for cardiovascular disease, the researchers compared celecoxib with the nonsteroidal anti-inflammatory drugs Naproxyn and Ibuprofen and found celecoxib no more dangerous to the heart than the two NSAIDs, which have been prescribed for decades. Celebrex was even safer when it came to certain side effects, like serious gastrointestinal problems.

 

Nissen said it’s important for the public to understand that the researchers weren’t studying the occasional use of these drugs — instead they focused on patients with osteoarthritis or rheumatoid arthritis who take the drugs every day to control pain.

 

Nissen said it was “very striking” that when it came to side effects, there was about a 50 percent lower risk of having a serious gastrointestinal complication from Celebrex compared to ibuprofen or naproxen.

“Celebrex, unlike the other agents, does not have anti-platelet effects so is safer to combine with other blood thinners and can be taken peri-operatively — and even before the operation without increasing bleeding — to reduce post-operative pain, and also does not block the potent anti-platelet effects of aspirin.

 

Comment: surprise… surprise.

 

 

 

Depression… it’s already starting in young doctors

 

Many Medical Students Appear To Struggle With Depression, Research Reveals

 

Liz Kowalczyk writing in the boston globe reported that future physicians appear to “suffer depression, or depressive symptoms, at higher rates than the general population,” a meta-analysis involving “nearly 200 smaller studies from 47 countries” suggests. In fact, about “27 percent” of medical students appear to suffer from “depression in medical school,” the research revealed. The findings were published in the Journal of the American Medication Association.

 

Comment: I have news for these students… medical practice today can be even more depressing.

 

 

 

Drowsy driving almost as bad as being drunk… maybe

 

AAA Study: Drowsy Driving As Risky As Drunk Driving

 

Scot Pelley reporting for CBS News stated a new AAA study  suggested “that getting behind the wheel on four or five hours’ sleep is just as dangerous as driving drunk.” According to the broadcast, a little over one in three drivers in the US does not get “the recommended seven hours of sleep daily,” and those who do get “just five or six hours” are “almost twice as likely to be involved in an accident.” As a driver’s hours of sleep decreased, the risk of an accident increased exponentially, with “teenagers, older adults, and people who have a sleep debt” at “the highest risk.”

 

Comment: Not surprising at all.

 

 

Disturbing trend in drug pricing… next

 

When Cheap Generics Morph Into Expensive Prescriptions 

 

Dr. Jack Cush writing in Rheumnow reported The Wall Street Journal has issued an alarming trend in generic drug pricing that affects many, especially the elderly and those with arthritis.

Pharmaceutical companies have developed a growing number of combined generic products whose sum is far more than the cost of the individual generics.  For example, the migraine medication Treximet has two active ingredients—sumatriptan and naproxen.  As generics these two drugs may result in a copay is zero dollars for the average patient.

 

A box of nine tablets of Treximet costs $728.67, according to Truven Health Analytics. But the average actual cost for a box is about $353, and the cost of its two constituents, sumatriptan and naproxen, would cost around $19, according to GoodRx.

 

Others combo agents in this category include acne cream Acanya, Duexis and Vimovo for arthritis pain and the weight-loss pill Qsymia.

 

Comment: Pharmaceutical companies can be sneaky I think.

 

 

 

Want to hit the gym now.  Wait… maybe there’s an alternative… next

 

A new study says a glass of red wine is the equivalent to an hour at the gym.

 

Research conducted by the University of Alberta, Canada has found that health benefits in resveratrol, a compound found in red wine, are similar to those we get from exercise.

 

Resveratrol was seen to improve physical performance, heart function and muscle strength in the same way as they’re improved after a gym session.

 

According to lead researcher, Jerry Behrens, these findings will particularly help those who are unable to exercise. Discussion over the health benefits of red wine have been well documented. Studies have revealed that those who drink a glass of red wine a day are less likely to develop dementia or cancer, that it’s good for your heart, anti-ageing and can regulate blood sugar.

 

Comment: And you sweat a lot less too.

 

 

An arthritis treatment for cancer? Next

 

IL-1 antagonists may have role in cancer fight

 

Anakinra, an interleukin antagonist commonly used in the treatment of rheumatoid arthritis, is also used for other inflammatory diseases and recently has been studied as a treatment with chemotherapy for some cancers, according to Charles Dinarello, MD, who presented the Rheumatology Research Foundation Philip Hench, MD Memorial Lecture on Monday.

Evidence of a role for anakinra in cancer therapy is growing as the IL-1 receptor blocker (IL-1Ra) is being studied in acute myelogenous leukemia, colorectal cancer, prostate cancer, and multiple myeloma, said Dr. Dinarello, Professor of Medicine and Immunology at the University of Colorado School of Medicine, and Professor of Experimental Medicine at Radboud University in the Netherlands.

 

Comment: Great news!

 

 

Mud… it’s not just for wrestling in anymore

 

Reported by the Academy of Integrative Pain Management this item…

 

Mud-Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: Economic Evaluation

 

An economic evaluation of mud-bath therapy was conducted alongside a randomized controlled trial. Patients (103) were randomly assigned to receive either a 2 weeks cycle of MBT in addition to their usual treatment or to continue routine care alone. The European Quality-of-Life Questionnaire-5 Dimensions (EQ-5D) questionnaire was administered at baseline, 2 weeks, 3, 6, 9, and 12 months. Direct healthcare resource consumption data up until 12 months were derived from a daily diary given to patients and returned at prescheduled follow-up visits. The results of this cost-effectiveness analysis support the use of the mud bath therapy as mid-term complementary therapy in the management of knee OA.

 

 

A new test to detect early arthritis… next

 

Study Shows Potential for Early Diagnosis of Arthritis

 

Pat Anson writing for Pain News Network reported a new study by British researchers has demonstrated the potential for an experimental blood test that can diagnose arthritis in its earliest stages. Such a test could lead to earlier treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), years before joint damage and physical symptoms begin.

 

Researchers at Warwick Medical School recruited 225 people with early or advanced OA, RA or another inflammatory joint disease, along with a control group of healthy volunteers with no joint problems.  Their blood and fluid from affected knee joints were then analyzed with mass spectrometry.

 

The test found patterns in blood plasma amino acids that were damaged by oxygen, nitrogen and sugar molecules. The damage was highest in the blood samples of patients with OA or RA, and markedly lower in the blood of healthy volunteers -- giving researchers identifiable biomarkers that could be used for an early diagnosis.

 

“This is a big step forward for early-stage detection of arthritis that will help start treatment early and prevent painful and debilitating disease,” said Naila Rabbani, PhD, of Warwick Medical School. “Damage to proteins in the arthritic joint have been known for many years but this is the first time it has been exploited for early-stage diagnosis.

 

“For the first time we measured small fragments from damaged proteins that leak from the joint into blood. The combination of changes in oxidised, nitrated and sugar-modified amino acids in blood enabled early stage detection and classification of arthritis – osteoarthritis, rheumatoid arthritis or other self-resolving inflammatory joint disease."

 

Comment: Interesting stuff.

 

 

 

How bad is the opioid epidemic in the US… worse than you think… particularly for kids…next

 

Opioids are Like Guns in the Hands of Children 

 

Dr. Jack Cush writing in Rheumnow reported the opioid abuse epidemic is well known and the focus of many regulators and health care personnel.  The problem also affects the youngest Americans, according to a recent Washington Post article. 

 

JAMA Pediatrics reports an analysis of pediatric hospital discharges nationwide between 1997 -2012 and found that 13,052 children were hospitalized for opioid overdoses with Oxycodone, Percocet, codeine and the like narcotics.

 

There were 176 pediatric deaths attributed to narcotic use. And, the data shows a doubling of opioid poisonings in children during those years. Most of the victims (73.5%) are white, and slightly more than half (53 percent) are female.

 

The authors draw a parallel between guns and narcotics and the need for parents and grandparents to store these safely and out of reach or access to children and adolescents. 

Cush adds, mitigating these risks will require comprehensive strategies that target opioid storage, packaging, and misuse.

 

Comment: A terrible public health issue that requires our attention.

 

 

 

A commonly used medication for heart disease may have another use… next

 

Statins May Reduce Alzheimer’s Risk, Study Suggests

 

Muir reporting for ABC World News Tonight stated, “A new study shows that high use of...statins” may be associated with “a lower risk of Alzheimer’s for patients over the age of 65.” The study was published in JAMA Neurology.

 

Comment: It’s interesting how drugs for one disease may help another.


Food For Thought

Cream of Mushroom Soup

Find your favorite mushroom in your local grocery store or find several varieties and combine them.  This is a hearty soup--great for those chilly nights or a when you come in from shoveling snow.  Experiment and have fun - Yum!

Ingredients

  • 1 Tube of sausange (I use Jimmy Deans breakfast sausage) browned

  • 5 cups sliced fresh mushrooms

  • 1 1/2 cups chicken broth

  • 1/2 cup chopped onion

  • 1/8 teaspoon dried thyme

  • 3 tablespoons butter

  • 3 tablespoons all-purpose flour

  • 1/4 teaspoon salt

  • 1/4 teaspoon ground black pepper

  • 1 cup half-and-half or heavy cream

  • 1 tablespoon sherry

Directions

  1. In a large heavy saucepan, brown sausage and set aside.

  2. Lightly saute the mushrooms, onion, and thyme about 10 to 15 minutes and set aside.

  3. In a large saucepan, melt the butter, whisk in the flour until smooth. Add the salt, pepper, half and half or heavy cream. Add broth, sausage, and mushroom mixture.

  4. Stirring constantly, bring soup to a boil and cook until thickened. Adjust seasonings to taste, and add sherry.


Curmeric

The magical golden spice …a thousand years old…

 A member of the ginger family, turmeric is a perennial plant that is cultivated throughout various regions of Asia and India.  It’s been used for thousands of years as a culinary spice and medicinal herb.  The bulb is collected, cleaned, boiled, and dried for use in medicinal and food
preparations in what we know as curcumin. 

 

The rich golden-yellow color provides a plethora of compounds with medicinal properties and contains powerful anti-inflammatory effects as well as a very strong antioxidant.

 

It is now believed that chronic, low-level inflammation plays a major role in almost every chronic, Western disease. This includes arthritis, heart disease, cancer, metabolic syndrome, Alzheimer’s and various degenerative conditions.   Therefore, anything that can help fight chronic inflammation is of potential importance in preventing and even treating these diseases.  Because Curcumin is a strong anti-inflammatory, studies have reported that it is so powerful that it matches the effectiveness of some anti- inflammatory drugs without the side effects presented in manufactured NSAIDs.

 

Directions: 

Take one 500mg capsule three times daily.  To obtain the full effects of Curmeric, you can add 1-2 peppercorns which will enhance curmeric’s effects to absorb into the bloodstream by 2000 percent.  90ct

 

The Arthritis Treatment Center now offers a potent formula in Curmeric.  We invite you to try Curmeric at an introductory offer of $19.99.  It’s a 30 day supply and available for only 10 days at this price.   If you begin to see results, which I’m sure you will… purchase an additional three months at buy two, get one free during the months of January and February 2017.


3 Super Berries That Cause Cancer Cells to Self-Destruct…

Super foods are not a new concept in the health and nutrition world, but we are proud to create the term “super berries.”

What is a super berry? Super berries contain high amounts of specialized nutrients and powerful antioxidants that create apoptosis (pronounced a-pop-toe-ses).

Apoptosis, often called “cellular suicide,” is a natural process creating the fine balance between cell death and cell renewal. It’s a crucial system used by the body to get rid of cells that are abnormal, mutated, or no longer functioning properly.

Cancer cells alter and grow in a way that avoids the self-destruction caused by apoptosis. Traditional forms of cancer therapies such as radiation, drug therapy, and chemotherapy can’t tell the difference between healthy cells and mutated cancerous cells – so all fast growing cells are destroyed, whereas apoptosis only targets cancerous cells.

Scientists have now discovered that certain super-foods and super berries can help prevent cancer and/or trigger natural cell death against cancer cells.

Since emerging evidence proves diet influences the cancer process before it begins, it is crucial you discover which foods can make a difference between preventing cancer or accelerating the spread of cancer.

The David Geffen School of Medicine at the University of California studied extracts of six popular berries: blackberry, black raspberry, blueberry, cranberry, red raspberry, and strawberry for their ability to stimulate apoptosis of the COX-2 colon cancer cell line.

The researchers also evaluated these berries for the prevention of oral, breast, colon, and prostate tumor cell growth. They learned black raspberry and strawberry extracts had the most effective apoptosis inducing effects.

Strawberries and raspberries – also contain a unique phytochemical called ellagic acid, which has the power to prevent skin, bladder, lung, esophagus, and breast cancers.

Three super berries you should add to your anti-cancer diet.

1. Black Raspberries Don’t let anyone tell you black raspberries are blackberries. They are not. The easiest way to differentiate between the two is where the stem attaches to the berry; black raspberries are hollow in the center like raspberries while blackberries have a white core. Black raspberries are rich in anthocyanins.

Studies have shown that this type of potent antioxidant found in berries, grapes, and red cabbage − give fruits and vegetables a blue, red, or purple color. These powerful compounds fight diseases caused by oxidative stress and free radicals including certain types of cancer, cardiovascular disease and chronic inflammation.

Cervical cancer is the second most common female cancer worldwide. One of the challenges in treating cervical cancer is that it is difficult to manage pre-invasive and invasive lesions. Recent studies from the College of Public Health at Ohio State University, Comprehensive Cancer Center in Columbus, Ohio, discovered that black raspberries prevent cervical cancer cell growth and tumor formation. Furthermore, they inhibit inflammation and induce apoptosis in esophageal and colorectal cancer tissues. Black raspberries also contain chemo preventive compounds, including: vitamins A, C, E, folic acid, ellagic acid, and quercetin that can help prevent strokes.

2. Strawberries The humble and widely loved strawberry has many benefits. Strawberries have proven to prevent heart attacks in women. In China, 36 participants at high risk for developing esophageal cancer ate strawberries for six months and researchers found that consuming strawberries prevented esophageal lesions from developing into tumors. What a powerful berry!

The volunteers drank freeze-dried strawberry powder mixed with water, since the freeze-dried process concentrates the benefits of the berries. Researcher Tong Chen discovered that 29 out of 36 participants had lesions revert from moderate to mild after six months of consuming two ounces of strawberries a day. The ellagic acid in strawberries deactivated specific carcinogens and decreased the replication of cancer cells.

3. Jamun berry (or Indian blackberry) These juicy purple berries of the native Indian plant, Eugenia jambolana, known as Jamun, jambolan, or black plum are available in the United States, Florida, and Hawaii. The fruit has a sour-sweet taste and due to its tart nature, is usually eaten with a sprinkling of salt.

Traditionally Jamun is used in Ayurvedic medicine to treat digestive disorders, as an antimicrobial, and to control diabetes. Jamun is also a good source of potassium, magnesium, phosphorus, and vitamin C. The College of Pharmacy at the University of Rhode Island analyzed the extract of Jamun berries. They found it exhibited pro-apoptotic effects against breast cancer cells but not towards normal breast cells. This study reveals the potential benefits of Jamun berry extract against breast cancer.

Breast cancer accounts for more than 1 in 4 cancers diagnosed in women in the United States. Since the role of plant extracts are now emerging as equally effective therapies, these preventative strategies are definitely worth exploring as a safe and effective way to naturally prevent cancer.

These 3 powerful cancer-fighting berries are an essential part of your cancer prevention diet and have key nutrients that can reduce your risk of a stroke, prevent blood clots, and much more. Why not enjoy a bowl of these delicious berries right now?

Cancer fighting foods have been around for decades, but only recently have scientists discovered how and why they actually prevent specific types of cancer. RSCI suggests that you learn these truths and then teach your loved ones.

FEEL FREE TO PASS THIS ON TO THOSE YOU LOVE AND CARE ABOUT

Don Margolis Chairman, Repair Stem Cells Institute Dallas, Texas


Wei's World

Words…

I am not a fan of scientific jargon. Unfortunately, as a practicing rheumatologist who is active in clinical research, I've been exposed to many scientific presentations where that jargon is substituted for plain English. Among the words that I detest include "robust", "apoptosis", and "cohort".

There are certainly many others. When I am listening to a presentation, the first thing that strikes me is that many of these lectures have numerous words in common. It is as if the speakers were in the same classroom years ago and were told to use these words in their talks.

What's the point?

I would find it more useful if plain and simple English was used. For example, instead of describing data as "robust," why not refer to the "strong association" between independent and dependent variables? Or even more simply, just say that the study yielded "great results." Instead of apoptosis, why not just say "cell death." And cohort ?! Just say "group." Sure, it makes the person standing up there on the podium look very important and appear to be erudite.

Unfortunately, it defeats the purpose of a talk. I think the talk should convey information that is readily understandable to the audience.

I guess this is akin to what we see from lawyers. They have their own, incomprehensible vocabulary. I think in medicine, we can do better. It's incumbent upon us as practicing physicians to explain things to patients and other physicians in terms that are readily understandable. Most of the scientific presentations I have attended work better than Ambien. I would much prefer that talks be given in simpler terms.

Is it a crime to want language to be transpicuous?

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