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Insider Arthritis Tips May 2014
May 20, 2014

A government that robs Peter to pay Paul can always depend on the support of Paul. George Bernard Shaw

An apology and an explanation...

As you might have noticed, I've missed two months of newsletters. The reason is that my staff and I have been working around the clock to put the Arthritis Symposium together. It was fantastic!

Great speakers, great food, and wonderful information.

But a LOT of work!

But that it's over, I can get back to the other work. So I've made this issue longer.

P.S. We were able to video some of the presentations and I'll let you know about that later.

First signs of arthritis cure seen by Irish researchers

The first signs of a cure for arthritis have been seen in research involving Irish scientists. Niall Murray writing in the Irish Examiner described a new study taking place at NUI Galway and other European universities in a project using stem cells derived from body fat and injecting it into diseased joints to see how well it can regenerate cartilage.

“From the clinical trials conducted so far, we have seen the first signs of finding a cure for this truly incapacitating disease which affects so many. Using the patient’s own stem cells, we have been able to treat their diseased joints and relieve their suffering and burden of pain,” said Professor Frank Berry, scientific director of the Regenerative Medicine Institute at NUI Galway.

“While we are still in the early stages of clinical trials, the results so far are extremely positive, such that the use of stem cell therapy for osteoarthritis could become a reality for patients within the next five years.”

Comment: Sounds good. Let’s hope for the best.

Genetics can explain why infections can trigger rheumatoid arthritis

Appearing in Science Codex was an article describing a new international study that has revealed how genetics could explain why different environmental exposures can trigger the onset of different forms of rheumatoid arthritis. A team at the Arthritis Research UK Centre for Genetics and Genomics at The University of Manchester published their findings in the American Journal of Human Genetics. A proportion of rheumatoid arthritis patients test positive for autoantibodies, while 30% remain sero-negative. In this study, the researchers have better defined the genetic distinction between these two disease subtypes: sero-positive and sero-negative rheumatoid arthritis. They have now established that different genetic variants of a protein that plays a vital role in how the body's immune system fights infection are associated with the two forms of rheumatoid arthritis. This provides clues to the theory that exposure to different infectious agents, such as bacteria or viruses, trigger the different forms of rheumatoid arthritis in susceptible individuals. Dr Steve Eyre from the genetics and genomics centre in Manchester commented: "We recognise that rheumatoid arthritis is a complex disease that can have variable presentation and outcomes for different people, in particular in the way they respond to treatment. These findings add to our ability to genetically define subtypes of rheumatoid arthritis, which is an important step towards selecting the best treatment for each patient."

Comment: Seropositive and sero negative rheumatoid arthritis behave differently and this is an exciting discovery.

CT Scans Might Help Diagnose Gout in Some Cases

Robert Preidt writing in Healthday reported that CT scans can help detect gout that's been missed by the current standard testing method, a new study suggests. The standard diagnostic test for gout -- called needle aspiration -- involves taking fluid or tissue samples from a gout-affected joint and checking them for uric acid crystals. This test usually detects gout in patients, but not always. In this study, Mayo Clinic researchers found that dual energy CT scans detected gout in one-third of patients who had negative results on the needle aspiration test. The CT scans were particularly effective in patients who'd had several gout-like episodes but had remained undiagnosed. After CT scans pinpointed what appeared to be uric acid crystals, ultrasound-guided needle aspiration was used to collect samples from those areas, according to the study published in the journal Annals of the Rheumatic Diseases. "These were in part patients that had been falsely diagnosed with diseases like rheumatoid arthritis or labeled with a different type of inflammatory arthritis, resulting in a completely different, and often not effective, treatment approach," study author Dr. Tim Bongartz.

Comment: Interesting. Needle aspiration is till the procedure of choice but CT may be useful in confusing cases.

Study Confirms High Prevalence of ADA in Adalimumab-Treated Psoriasis

Dr. Graeme M. Lipper, writing in Medscape described a recent study that might shed light on why some treatments for psoriatic arthritis may fail over time. Menting, Lumig, DeVries and colleagues published the results of a recent study entitled Extent and Consequences of Antibody Formation Against Adalimumab in Patients With Psoriasis: One-Year Follow-up Adalimumab, a humanized monoclonal antibody (IgG1) that binds to and inactivates the proinflammatory cytokine tumor necrosis factor alpha, is a highly effective treatment for moderate to severe psoriatic arthritis. Unfortunately, this drug may induce antidrug antibodies (ADAs) in almost one half of patients taking adalimumab long-term, and prior studies show that ADAs contribute to disease relapse and waning therapeutic response to adalimumab and other biologic therapies. In their study they found that 49 % of patients developed ADAs, with the vast majority (90%) forming antibody titers within the first 24 weeks of therapy.

Comment: Interesting and answers a lot of questions about failing therapy.

Crackle, Clunk after Knee Replacement?

Jeannette Wick writing for HCP live reported on an interesting but perplexing issue that occurs in patients after knee replacement surgery. Total knee arthroplasty (TKA) is a generally successful surgery. However, straightening the knee from a bent position creates a clunk or crackle in up to 18% of TKA patients.

Patellar clunk syndrome and patellofemoral crepitus can be annoying, but for a few TKA patients, they are painful. Physicians with the biomedical engineering departments at the University of Colorado and the University of Tennessee addressed this problem in a review published in Clinics in Orthopedic Surgery.

The authors found clunk and cracking are due to a fibrous bump of tissue that becomes trapped in the femoral notch. The article reviewed several reasons including design of the knee replacement components, previous knee surgery, and other possible causes. They suggested surgeons include the potential for clunk or crepitus while providing informed consent to patients who have had prior TKAs. Since most patients with crepitus have minimal symptoms, they require no treatment. However, those with measureable disability usually find relief after arthroscopic debridement of the fibrosynovial hyperplasia.

Comment: An irritating problem for many patients for sure.

Platelet-Rich Plasma Treatment More Effective than Cortisone for Chronic Hip Bursitis

Rachel Lutz writing for HCP live reported that platelet-rich plasma (PRP) treatment is more effective than cortisone for chronic severe hip bursitis, according to a study presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

For the study, 40 patients were selected to receive a single injection of either 40 mg of methylprednisolone or PRP. The patients’ functionality was assessed before and after hip treatment using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Before the injections, both groups’ scores were nearly the same; the first group’s HHS and WOMAC scores were 50.5 and 58.3, respectively, and the second group scored 51.7 and 58.8.

After 3 months, the methylprednisolone group reported an average HHS score of 75.3 and a WOMAC score of 83.6, compared to the PRP patients, who scored 84.2 and 91.4, respectively.

At 1 year after treatment, the PRP scores remained high at 87.4 for HHS and 89.3 for WOMAC, while the cortisone patients’ scores lowered to near pre-treatment levels of 58.8 for HHS and 63.4 for WOMAC.

“This study suggests that PRP injection is significantly more effective and durable than cortisone injection for the treatment of severe chronic greater trochanteric bursitis refractory to traditional non-operative management,” study author Raymond R. Monto, MD, concluded.

Comment: Cortisone may provide short term relief but the long term effect is weakening of soft tissue.

Stem cells don’t work for osteoarthritis?

Investigators from the University of Sydney performed a study to determine the efficacy and safety of using autologous fat-derived mesenchymal stem cells (MSCs) for relief of pain in patients with knee osteoarthritis (OA). Patients with Grade 1 or 2 knee OA underwent liposuction to collect 250 mls of. An independent radiologist injected either the cell suspension or saline prepared in identical syringes. The participants and investigators remained blinded to treatment allocation throughout the trial. Primary outcomes were OMERACT-OARSI responder criteria and total pain at six months post-treatment. Both treatment and placebo groups experienced a significant decrease in total pain score from baseline. There was no difference between groups in OMERACT-OARSI responder criteria. Residual lumpiness from the liposuction occurred in three patients. Their conclusions… The treatment process was well tolerated and there were no major safety concerns. The effect on symptom modification at 6 months was similar in both groups.

Comment: So a pretty good study design wise… but a negative one.

Heartland virus starts in May

Jennie Smith writing in Rheumatology News reported that the Heartland virus will be making a comeback in May. Infections caused by this virus lead to fever as well as drops in white blood cell and platelet counts. The virus is transmitted by the lone star tick and has been reported mostly in Missouri and Tennessee. Other symptoms include headache, nausea, muscle aches, and joint pain.

Comment: Whew… another thing to worry about

Colchicine protects the heart

Bruce Jancin writing in Rheumatology News reported that three observational studies indicate that colchicine, a drug that has been used since before the time of Christ may reduce the incidence of heart attacks in gout patients. One pivotal study showed that the incidence of heart attack was 1.2% in colchicine users, and 2.6% in non-colchicine users… for a significant 54% relative risk reduction. The findings were published in the Journal of Rheumatology.

Comment: An oldie but goodie.

Surgeons 3D print stem cells and repair bone with biopen

Reported in Designboom, researchers from the University of Wollongong’s Australian Research Council Center of Excellence for Electromaterials Science have developed a handheld ‘biopen’, providing doctors with a platform to design customized implants on-site and at the time of surgery. The ‘biopen’ works similar to 3D printing methods by delivering cell material inside a biopolymer such as a seaweed extract, protected by a second outer layer of gel material. It works when two layers of gel are combined in the pen head, extruding onto the bone surface. The surgeon then ‘draws’ with the ink to fill in the damaged bone section. The biopen will help build on recent work by ACES researchers where they were able to grow new knee cartilage from stem cells on 3D-printed scaffolds to treat cancers, osteoarthritis and traumatic injury. The device can also be seeded with growth factors or other drugs to assist regrowth and recovery from sporting or motor vehicle injuries.

Comment: Wow… now that’s good news.

RA should be treated as an emergency

Hugo Wilken writing in Rheumatology Update stated that billions of dollars could be saved if arthritis patients received earlier and better treatment, says an expert report released this week. An Australian white paper estimates the cost of early retirement due to arthritis as $9.4 billion in lost GDP, with an additional $5 billion a year in health and welfare expenditure. Authored by a panel of specialists, GPs, health groups and researchers and commissioned by Arthritis Australia, the report says a diagnosis of rheumatoid arthritis “needs to be treated as an emergency” as permanent joint damage can set in if treatment is delayed by more than 12 weeks. But the evidence is that RA is not being diagnosed early enough in Australia, with average delays of six months and longer in rural areas, argues Sydney-based rheumatologist and co-author Dr. Mona Marabani.

Comment: Unfortunately, the same holds true in the U.S. RA needs to be viewed as a medical emergency.

Bee sting therapy for osteoarthritis?

An unusual treatment for osteoarthritis is creating much buzz in the medical industry, according to CBS News. Honey bee venom is an ancient folk remedy that's been used for a number of years by alternative practitioners. But now the treatment may enter the mainstream markets; Axis Clinical Trials in Los Angeles is testing honey bee venom for the treatment of osteoarthritis. The new drug, known as Apimed, is standardized and purified "venom in a vial," which is injected into a patient's painful joints. A Korea-based pharmaceutical company contacted Dr. Lydie Hazan, who is currently recruiting U.S. trial participants. In order for the treatment to gain approval by the Food and Drug Administration, Hazan and her team will need to monitor the patients for six months and prove the injections are safe and effective. "Nobody is really sure on exactly the mechanism of the honey bee venom," Hazan told CBS in Los Angeles. "But it seems to have an affinity for inflammation in that it gobbles up the inflammation." However, Hazan warns a bee sting can be deadly to those who are allergic. She recommends being tested by a doctor before trying any type of bee venom therapy.

Comment: Interesting…

Acupuncture Relieves Knee Osteoarthritis – New Study

Reported in TMblr, researchers conclude that acupuncture has a significant curative effect on patients with knee osteoarthritis. This condition often involves joint pain, swelling, stiffness, decreased range of motion and the formation of bone spurs. More than 27 million people in the U.S. have osteoarthritis with the knee being one of the most commonly affected areas. In this recent study, the researchers from a community hospital in Beijing treated 200 cases of knee osteoarthritis using acupuncture. The overall effective rate was 98%. During the electroacupuncture treatment, researchers used different needling methods such as local single-needle puncture and local multi-needle puncture. Electroacupuncture was primarily applied using low frequency continuous waves. The type of the wave and intensity was chosen dependent upon patient tolerance Among the 200 patients receiving treatment, 64 patients (32%) fully recovered, 112 patients (56%) showed marked improvements, 20 patients (10%) showed moderate improvements and four patients (2%) showed no improvements. The overall effective rate was 98%. Based on the outcome, the researchers concluded acupuncture is effective for treating knee osteoarthritis. The article was published in the Journal of Beijing University of Traditional Chinese Medicine (Clinical Medicine).

Comment: The debate continues. I think acupuncture may be a helpful ancillary treatment for pain but I don’t see any evidence that it modifies disease.

Allopurinol Modestly Cuts Death Risk With Hyperuricemia, Gout

Reported in Healthday, allopurinol initiation is associated with a modestly reduced risk of death in patients with hyperuricemia and gout, according to a study published in the Annals of the Rheumatic Diseases. Maureen Dubreuil, M.D., from the Boston University School of Medicine, and colleagues examined the impact of allopurinol initiation on the risk of mortality among individuals aged ≥40 years with hyperuricemia. The researchers found that 654 allopurinol initiators and 718 comparators died during a mean follow-up of 2.9 years. The two groups had similar baseline characteristics, including the prevalence of gout in each group (84 percent). There was a lower risk of all-cause mortality associated with allopurinol initiation. "The overall benefit of allopurinol on survival may outweigh the impact of rare serious adverse effects," the authors write.

Comment: Allopurinol has many potential side effects but this study indicates that the benefits outweigh the risks.

Milk as a treatment for osteoarthritis

Lizette Borrell writing in Medical Daily reported drinking a glass of fat-free or low-fat milk every week may serve as a new knee arthritis treatment for women, reducing the progression of the disease. While we all know drinking milk is good for your bone health, a recent study published in the journal, Arthritis Care & Research, found consuming seven glasses of fat-free or low-fat milk per week can keep knee arthritis at bay in women. "Milk consumption plays an important role in bone health," said Dr. Bing Lu, lead author of the study from Brigham & Women's Hospital in Boston. "Our study is the largest study to investigate the impact of dairy intake in the progression of knee OA,” he said. To achieve greater muscle strength, improvement in physical functioning, and preservation of cartilage, adults between the ages of 19 to 70 must have 600 to 800 International Units (IU) of vitamin D a day. Skim milk or one percent low-fat milk is one of the best foods to consume to meet the daily requirement. Lu and colleagues sought to examine the possible association of milk consumption with radiographic progress of knee OA in a large cohort from the Osteoarthritis Initiative. A total of 2,148 participants (888 men and 1,260 women) were recruited for the study. At the start, dietary data was collected and joint space width was measured by X-ray to evaluate OA progression. The participants were followed up at 12, 24, 36, and 48 months throughout the duration of the study. The researchers used quantitative joint space width (JSW) between the medial femur and the tibia of the knee based on plain radiographs to examine the progression of OA in the participants. The findings revealed as the intake of milk increased, the JSW in women decreased. As milk intake increased from none to less than three, four to six, and more than seven glasses per week, the JSW in women also decreased. In men, the researchers did not find an association between milk consumption and JSW. "Our findings indicate that women who frequently drink milk may reduce the progression of osteoarthritis. Further study of milk intake and delay in osteoarthritis progression are needed," Lu said.

Comment: Just like mom said…

Umbilical cord stem cells may be useful in the treatment of rheumatoid arthritis.

Cord stem cells have enormous potential in the ever expanding field of regenerative medicine. Animal and in vitro experiments have shown that MSCs taken from umbilical cord blood can suppress inflammation and attenuate collagen-induced arthritis. Study leader professor Zhanguo Li said, “Very little is known about umbilical cord MSCs, and there has been no previous report about their use in the treatment of rheumatoid arthritis. MSCs can exert profound immunosuppression, which encourages their use in the treatment of autoimmune diseases, such as rheumatoid arthritis. At present, the most common source of MSCs has been bone marrow. However, aspirating bone marrow is an invasive procedure and the number and the differentiating potential of bone marrow MSCs decrease with age. In contrast, the collection of umbilical cord MSCs does not require any invasive procedure”. The researchers took immune cells from rheumatoid arthritis patients and showed that the umbilical MSCs were able to suppress the cells’ proliferation, invasive behavior and inflammatory responses. Systemic infusion of the umbilical MSCs into mice was shown to significantly reduce the severity of collagen-induced arthritis. Speaking about the results, Professor Li said, “rheumatoid arthritis imparts a massive burden on health services worldwide and none of the currently used agents reaches long term drug-free remission. Therefore, a new and more effective therapy for rheumatoid arthritis will be very welcome”.

Comment: Interesting concept.

Prolotherapy… an option to knee surgery?

Reported in Science Codex, an interesting article that may be of interest to knee arthritis sufferers. A new nonsurgical approach to treating chronic pain and stiffness associated with knee osteoarthritis has demonstrated significant, lasting improvement in knee pain, function, and stiffness. This safe, two-solution treatment delivered in a series of injections into and around the knee joint is called prolotherapy, and is described in The Journal of Alternative and Complementary Medicine.. David Rabago, MD, and a team of researchers from the University of Wisconsin School of Medicine and Public Health, and Meriter Health Services, Madison, WI, report substantial improvement among participants in the one-year study who received at least three of the two-solution injections. Symptom improvement ranged from 19.5-42.9% compared to baseline status.

Comment: Prolotherapy is actually an old treatment first reported by Hippocrates. Platelet-rich plasma is actually a form of prolotherapy.

Heather Kathryn Ross writing in Healthline reported on a British study which she cleverly headlined as “Putting Humpty Dumpty Together Again, Using Stem Cells and Plastic”

In the article she described how British scientists outfit a lightweight, durable plastic implant with stem cells to repair shattered bones. Researchers tested hundreds of plastic blends before settling on one that is “robust, lightweight, and able to support bone stem cell growth.” They’ve shown success by re-growing bone in the laboratory and during animal tests using the plastic implant, and they hope to begin clinical trials in humans in five to seven years. Their test results were published last week in the journal Adsvanced Functional Materials.. The cleverly designed device is made of a blend of three commercially available plastic polymers, formed into a honeycomb “scaffold” by freeze-drying. Making the implant porous allows blood to flow through it, encouraging the patient’s bone marrow stem cells to attach to it and mature into new bone. The plastic gradually degrades, leaving healthy bone in its wake, with no risk of rejection from a donor bone graft procedure. "We are confident that this material could soon be helping to improve the quality of life for patients with severe bone injuries, and will help maintain the health of an ageing population," Professor Mark Bradley of the University of Edinburgh's School of Chemistry said in a press release.

Comment: Wow! Great news!

Glucosamine might be the magic pill for long life

Rhodi Lee writing for Tech Times reported on this gem. Although glucosamine is popularly used for treating arthritis, scientists conducting experiments with mice and worms have found out that it has more benefits that previously known. A new study suggests the drug may actually have another use that could have potential implications in extending life span. In the study "D-Glucosamine supplementation extends life span of nematodes and of ageing mice" published in Nature Communications , researchers experimented with two groups of mice whose age was the equivalent of 65-years old in humans. The mice in the first group were given glucosamine as supplement to their normal diet, while those in the second group did not receive glucosamine. The researcher found that the mice that received glucosamine lived 10 percent longer than the mice that were not given glucosamine, a stretch in longevity that translates to eight years in humans. The researchers also observed mice that received the glucosamine supplement did not also just lived longer, they also had improved glucose metabolism which could mean protection from diabetes, a chronic disease that commonly affects obese individuals and the elderly. The researchers have likewise studied the effects of glucosamine on a nematode's mitochondria, the parts of the cell responsible for energy conversion. They observed that glucosamine can boost the breakdown of amino acids and fatty acids, which is similar to the effects of consuming low-carbohydrate diet. Low-carbohydrate diets are known to reduce blood pressure and harmful blood fats.

Comment: OK… this is exciting isn’t it?

Study: NSAIDs Linked to Increased AFib Risk

Reported in MPR, a look at research in BMJ Open has found that use of NSAIDs may be associated with an increased risk of atrial fibrillation (AFib). Data from the population-based Rotterdam Study was utilized and 8,423 participants without AFib at baseline were included. After a mean follow-up of 12.9 years, current use of NSAIDs was associated with increased risk for AFib, compared to those who never took NSAIDs, as well as recent use (within 30 days post-discontinuation of NSAIDs). Future research should explore the underlying mechanism behind this association, the authors emphasize.

Comment: Another possible complication. They just keep coming and coming.

'Revolutionary' new laser scanner to detect arthritis before symptoms startM

Reported in Business Standard this item… A new laser scanner has been developed to detect arthritis even before the symptoms start. The revolutionary new scanner created by British scientists could help start arthritis treatment by spotting signs of the crippling disease before it has done painful and irreversible damage to cartilage in the joints, the Daily Express reported. Professor Allen Goodship, of University College London said that the research is at an early stage but the results are promising and possibly in the future, the technique, called Spatially Offset Raman Spectroscopy, could be effective as a screening tool.

Comment: Interesting but obviously more data is needed.

Smoking Tied to Worse Lupus, Arthritis

Nancy Walsh writing in MedPagwe Today reported worse patterns of disease for both rheumatoid arthritis and systemic lupus erythematosus were seen among patients who were smokers, and the risks actually increased after quitting for those with lupus, Swedish researchers reported. Patients with rheumatoid arthritis who were current smokers had more than twice the risk of x-ray disease progression over 1 year, according to Saedis Saevarsdottir, MD, PhD, of the Karolinska Institute in Stockholm, and colleagues. And among patients with lupus, more former than current smokers had the most dangerous types of the disease-associated antiphospholipid antibodies, reported Johanna T. Gustafsson, MD, also of the Karolinska Institute, and colleagues.

Comment: If you smoke and have either of these conditions, stop.

Chinese Herb Shows Promise As Rheumatoid Arthritis Treatment; Could Be Cheaper Than Methotrexate

Anthony Rivas writing for Medical Daily reported on a study where researchers used “Tripterygium wilfordii Hook F (TwHF), component of traditional Chinese medicine for the treatment of joint pain, and local inflammation. The herb is sometimes called the Thundergod vine and is recognized for its anti-inflammatory properties, as well as the ability to suppress the immune system and possibly fight cancer. Its ability to remedy these ailments, according to researchers of the new study, come from its chloroform-methanol extract. Known as the Thunder God Vine, tripterygium wilfordii Hook F might be better at treating rheumatoid arthritis than current medications. The researchers split a group of 207 patients with RA into three groups. Some took the RA medication methotrexate (12.5 milligrams once a week), while another group took 20 milligrams of TwHF three times a day, and the last group took a combination of both. The treatment period lasted 24 weeks — 84 percent of participants got to the end. Of these participants, the researchers found that 46.5 percent of patients treated with methotrexate reached ACR 50, a level of response defined by the American College of Rheumatology indicating that symptoms were relieved by 50 percent. By comparison, 55 percent of patients who took the TwHF supplements, and 77 percent of patients who took both reached ACR 50.

Comment: Looks promising!

Can osteoarthritis be treated with light?

Michael Hamblin from the Massachusetts General Hospital discussed the results of a recent article. Low-level laser (light) therapy (LLLT) is an alternative approach with no known side effects and with reports of substantial therapeutic efficacy in osteoarthritis. In the journal Arthritis Research & Therapy, Alves and colleagues used a rat model of osteoarthritis produced by intra-articular injection of the cartilage-degrading enzyme papain to test 810-nm LLLT. A single application of LLLT produced significant reductions in inflammatory cell infiltration and inflammatory cytokines 24 hours later. A lower laser power was more effective than a higher laser power. However, more work is necessary before the title question can be answered in the affirmative.

Comment: No apparent side effects but will it work in people?

Bristol researchers developing new blood tests to diagnose osteoarthritis

Reported in domain b. com, researchers at the University of Bristol are hoping to develop new blood tests that would help to diagnose and monitor the common joint condition, osteoarthritis. Osteoarthritis, which occurs when cartilage at the ends of bones wears away, leading to stiff, swollen and painful joints. There is currently little effective treatment other than painkillers and joint replacement for patients with most severe disease. Now a team led by Dr Mohammed Sharif, Senior Lecturer in the School of Clinical Sciences, have been awarded almost £300,000 by medical research charity Arthritis Research UK to find out if two new biomarkers (specific physical traits used to measure or indicate the effects or progress of a disease) found in the blood of patients with osteoarthritis can be used not only to diagnose the condition but also inform doctors which patients are likely to get worse over time, and who is likely to benefit from specific treatments. At present there are no simple tests for the early diagnosis of osteoarthritis, and usually by the time a definitive diagnosis is made using x-rays, the disease is in its advanced stages. Moreover, there are currently no means of predicting how it will develop or respond to therapy. Biomarkers could be used to identify patients in the early stages of osteoarthritis or those who will worsen over time, but current biomarkers are not good enough to perform these tasks reliably. ''There's an urgent need to find new and better biomarkers, and we've now identified two that are likely to prove useful for diagnosis and monitoring of osteoarthritis,'' explained Dr Sharif. ''However, we need to be sure they will be good enough for use in an individual patient. Therefore in this research project we hope to find out whether they can reliably distinguish between a healthy person and a person with osteoarthritis, identify which patients' condition will get worse, and whether a particular drug is working or not.'' Osteoarthritis-specific biomarkers will enable doctor to direct specific treatment options such as physiotherapy towards those patients most likely to benefit, and may also help to identify early who will require a joint replacement.

Comment: I think it looks pretty promising.

Living human cartilage grown on lab chip

Reported in Business Standard, scientists have created the first example of a living human cartilage grown on a laboratory chip, an advance that will help treat patients with osteoarthritis or soldiers with battlefield injuries.

Creating artificial cartilage requires three elements: stem cells, biological factors to make the cells grow into cartilage, and a scaffold to give the tissue its shape.

The 3-D printing approach used by researchers in this study achieves all three by extruding thin layers of stem cells embedded in a solution that retains its shape and provides growth factors.

"We essentially speed up the development process by giving the cells everything they need, while creating a scaffold to give the tissue the exact shape and structure that we want," said Rocky Tuan, director of the Center for Cellular and Molecular Engineering at the University of Pittsburgh School of Medicine, member of the American Association of Anatomists and the study's senior investigator.

The researchers ultimately aim to use their innovative 3-D printing approach to create replacement cartilage for patients with osteoarthritis or soldiers with battlefield injuries.

Comment: Dr. Tuan is doing great work and this is a major step forward.

Wei's World, May 2014

My wife and I have a dog. Her name is Mei-Mei. That means little sister in Chinese. When we got Mei-Mei, our kids were a bit mad at us. They said, “How come you’re getting a dog now instead of when we were kids?”

My wife reminded me of a story… When our oldest child, Becky was about 4, she asked Judy, my wife, about getting a dog. Judy told her, “We can’t. Your dad is allergic to them.” That’s the truth. I had severe asthma as a child. About a year later, Becky asked my wife about getting a computer. And my wife, knowing how technophobic I was, said, “Your dad doesn’t want to get one…” And Becky asked, “Is he ‘lergic to ‘puters too?”

To make a long story short, we got Mei-Mei about five and a half years ago. She’s a Labradoodle so she is hypoallergenic and doesn’t shed very much at all. And she is a terrific dog. Quiet, patient, affectionate, and pretty smart.

Every year in April, in Dewey Beach, Delaware, they hold a Doodle romp. People from all over bring their Doodles (Labradoodles, golden doodles, and so on…) to the beach and the dogs play.

It’s quite a spectacle.

Here’s the link to a video I made about the event...



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