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Insider Arthritis Tips September and October 2016
September 15, 2016
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“Challenges are what make life interesting and overcoming them is what makes life meaningful.” – Joshua J. Marine


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"The Greatest Danger For Most Of Us Is Not That Our Aim Is Too High And We Miss It But That It Is Too Low And We Reach It."  Michelangelo

 


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Fatigue… a real problem for patients with rheumatoid arthritis… is there hope?   Next

Biologics and Fatigue in Rheumatoid Arthritis

Dr. Jack Cush writing in Rheumnow reported researchers from Bristol, UK have published a Cochrane review studying the effects of biologic therapies on fatigue. Based on a review of the electronic literature and randomised controlled trials they found that biologic interventions in patients with active RA can lead to a small to moderate improvement in fatigue.

Fatigue is a common and bothersome symptom for patients with rheumatoid arthritis (RA) and other inflammatory disorders.  Despite its importance to patients, there is no known best approach to managing fatigue, other than to control the underlying disorder.

Researchers identified 20 studies of the anti-TNF agents (adalimumab, certolizumab, etanercept, golimumab and infliximab), and 12 studies focused on non- TNF biologics (abatacept, canakinumab, rituximab, tocilizumab and an anti-interferon gamma monoclonal antibody). These studies added either biologics or placebo to background DMARD therapy.

These studies included 9946 participants in the intervention groups and 4682 participants in the control groups.

Overall treatment by biologic agents led to statistically significant reduction in fatigue.

Despite these modest findings, it is unclear whether the improvement results from a direct action of the biologics on fatigue or indirectly through reduction in inflammation, disease activity or other mechanisms.

Comment: Fatigue is a real issue for patients with rheumatoid arthritis.  Newer biologic agents appear to help with this debilitating problem.

 

 

Wow… a new development that may help erase osteoarthritis… next

Unique gel combats inflammation

Jessa Gamble writing for the Atlantic reported researchers have created a gel that can attach to inflammation sites and slowly deliver drugs to combat a wide variety of ailments—ulcerative colitis, arthritis and mucositis, to name a few. Inflammation is part of the body’s immune response, bringing extra blood to an injured area, but in cases of chronic inflammation, the heat, pain, and swelling become a problem. Developed at the Laboratory for Accelerated Medical Innovation at the Brigham and Women’s Hospital, the hydrogel—a solid material with high water content—can carry a combination of drugs, and matches its drug release to the level of inflammation around it.

When the gel is injected into the joint of an arthritis patient, for example, it will only release its anti-inflammatory payload when the patient is experiencing a flare, a spike in pain and swelling. When it encounters healthy tissue, it stays intact and does not release its payload.

“There are lots of enzymes present in inflammation that can degrade the gel,” explains Jeff Karp, the principal investigator. That breakdown of the gel releases the drug it carries.

Comment:  This looks promising… Stay tuned.

 

 

Fibromyalgia… it’s more than just minor aches and pains

Fibromyalgia Worsens Psoriatic Arthritis Outcomes

Caitlyn Fitzpatrick writing in MD reported on a recent study. Published in The Journal of Rheumatology, the researchers looked at 73 patients with psoriatic arthritis. Forty-two participants (57.5%) were females and the average age was nearly 52. Clinical disease activity was measured using multiple different scales.

Also, using the American College of Rheumatism criteria, fibromyalgia was diagnosed in 13 patients (17.8%) – 12 of which were female.

Twenty-six patients (43.3%) with just psoriatic arthritis met the criteria for minimal disease activity, however, none of the participants who had fibromyalgia did.

The big takeaway here is that the presence of fibromyalgia worsened all psoriatic arthritis disease activity scores.

Comment: Not surprising.  The association of fibromyalgia with all forms of inflammatory arthritis is not a good combination.

 

 

 

Could diet cure your ailments?  Maybe… next

Mediterranean diet may reduce incidence of certain diseases, study suggests

Jacqueline Howard writing for CNN reported new research suggests that a Mediterranean diet rich in “healthy” fats may reduce the risk of incidence of “heart disease, breast cancer and type 2 diabetes.” For the meta-analysis, researchers reviewed 332 previous studies and analyzed around 56 of them, “taking a close look at the health benefits of a Mediterranean diet that included a lot of fat.” The findings, published in the Annals of Internal Medicine, “showed that even though such a diet may not affect overall mortality, it may be effective at reducing incidences of certain diseases.”

 

Comment: diet is often overlooked when it comes to disease treatment.  It is extremely important… maybe more than we think.

 

 

Hope for young people with bad osteoarthritis of the hips… next

Stem Cells Could Replace Hip Replacements

Christopher Wanjek writing for Live science reported scientists have coaxed stem cells to grow new cartilage on a scaffold shaped like the ball of a hip joint. This is a major step toward being able one day to use a patient's own cells to repair a damaged joint, thus avoiding the need for extensive joint-replacement surgery.

In addition, the scientists used gene therapy to grant this new cartilage the ability to release anti-inflammatory molecules when needed. If done in patients, this technique could help prevent a return of arthritis, if that was what damaged the joint in the first place.

The new technique may be ready to test in humans within three to five years and may ultimately work with other joints, such as knees, said Farshid Guilak, a professor of orthopedic surgery at Washington University School of Medicine in St. Louis, who co-led the project.

Comment:  We stopped doing stem cell procedures for hips at our center because we weren’t getting the results we wanted. While this approach looks like it might work I’m reserving judgement.  The hip has a unique mechanical structure that makes any type of stem cell procedure problematic..

 

 

Did you know your nose could help your knees.  Find out how next…

Aching knee? Surgeons pioneer groundbreaking new operation taking tissue from the NOSE to grow cartilage 

Roger Dobson writing for the Daily Mail reported surgeons are taking tissue from the nose to grow cartilage to fix knee-joint pain.

The operation sees cartilage harvested from the nose, which is then used to grow patches of tissue to be transplanted on to knee joints.

The procedure is regarded as particularly beneficial for osteoarthritis patients, or those at risk of the joint disease, and doctors carrying out the operation say it could help thousands of people.

The most widely used procedure to repair the injury involves trimming any remaining damaged tissue and drilling holes in the bone beneath the defect to trigger bleeding and scar tissue that, it is hoped, can work as a substitute tissue.

But according to the NHS, results are variable, with studies suggesting that it offers only short-term benefits and does not lead to the formation of new cartilage.

Comment: The procedure is a bit risky for only short term relief but maybe it will improve.

 

 

Is there an effective treatment for c diff.?  Found out next.

Fecal transplants effective against C. difficile infections, study finds

Carl Zimmer writing in the New York Times  reported that fecal transplants appear to be “remarkably effective” against “potentially fatal infections of bacteria known as Clostridium difficile.” In a study, investigators “isolated the spores of about 50 different species of bacteria found in stool samples donated by healthy people.” Next, researchers put “the spores” into capsules, “which they gave to 30 patients with C. difficile infections.” Notably, 29 of those 30 patients recovered. While no one knows for sure how fecal transplants work, experts theorize that bacteria from a healthy donor’s GI tract may “be able to gobble up nutrients that competing invaders like C. difficile need to survive.” The findings were published July 15 in the Journal of Infectious Diseases.

 

Comment: C diff is an awful disease to have and is responsible for many deaths, particularly among older individuals.  This is welcome news.

 

A common activity that may stunt your growth… next

TV Watching Stunts Bone Growth, Study Finds

Megan Daily writing in MD reported long periods of television watching could have the same negative effects on kids' bone growth as total bed rest, an Australian study found. 

Australian research presented in the Journal of Bone and Mineral Research shows decreased bone mass in young adults who spent more of their childhood hours in front of a television set.  
Of more than1,000 young men and women scanned at age 20 those who had watched 14 or more hours of TV each week as children and adolescents had less bone mineral content than their peers.

 

Comment: Wow… that’s pretty alarming.

 

 

 

 

 

Stick a needle in for pain.  Huh?

“Dry needling” therapeutic technique receiving praise and criticism

Kim painter writing in USA Today reported on the controversial practice of “dry needling,” a technique that “involves the insertion of non-medicated solid needles at certain points in the body,” and which “has caught on with some physical therapists, athletes and other patients.” The article explains that some claim the practice is a type of acupuncture that can help people heal, while others argue the practice is not supported by scientific evidence and is just a “theatrical placebo.”

 

Comment: This is something that needs a controlled study to find out if it really works.

 

 

 

 

 

Brrrr.  It’s cold.  And the FDA doesn’t like it… next

FDA Says Cryotherapy Lacks Evidence, Poses Risks

Dr. Jack Cush in RheumNow reported cryotherapy is a non-FDA approved treatment that has been promoted to treat post-athletic injury, osteoarthritis, rheumatoid arthritis, fibromyalgia, alzheimers, migraines, asthma, multiple sclerosis, etc. Cryotherapy may be as simple as ice packs on a localized portion of the body, such as the lower back, or may involve whole body cryotherapy exposing the body to vapors that reach ultra-low temperatures ranging from minus 200 to minus 300 degrees Fahrenheit, typically for 2-4 minutes at a time.

But according to the FDA, cryotherapy may pose serious health risks and does not have the evidence to substantiate many of its claims. Whole body cryotherapy (WBC) is starting to pop up in a number of gyms, spas and wellness centers. 

Despite the growing availability of WBC, cryotherapy hasn't been cleared or approved by the FDA to treat any conditions. An FDA scientific reviewer said potential hazards of cryotherapy include asphyxiation, frostbite and burns.

Comment: I still advocate ice for acute injuries and for some soft tissue problems as well as osteoarthritis.  It works but be cautious.

 

 

A breakthrough in rheumatoid arthritis prediction and prevention… next

Gut bacteria can cause, predict and prevent rheumatoid arthritis

Reported in Eureka from the Mayo Clinic… this item. The bacteria in your gut do more than break down your food. They also can predict susceptibility to rheumatoid arthritis, suggests Veena Taneja, Ph.D., an immunologist at Mayo Clinic's Center for Individualized Medicine. Dr. Taneja recently published two studies -- one in Genome Medicine and one in Arthritis and Rheumatology -- connecting the dots between gut microbiota and rheumatoid arthritis.

Their studies indicate that testing for specific microbiota in the gut can help physicians predict and prevent the onset of rheumatoid arthritis.

"These are exciting discoveries that we may be able to use to personalize treatment for patients," Dr. Taneja says.

After further research in mice and, eventually, humans, intestinal microbiota and metabolic signatures could help scientists build a predictive profile for who is likely to develop rheumatoid arthritis and the course the disease will take, Dr. Taneja says.

Comment: Interesting and provocative.

 

A novel method for detection and treatment in rheumatoid arthritis… next

Rheumatoid Arthritis Effectively Diagnosed and Treated with Biodegradable Nanoparticles in Early Study

Dr. Patricia Inacio writing in Rheumatoid Arthritis News reported biodegradable polymer nanoparticles (BNPs), tiny particles made of a biodegradable polymer, appear to be quite useful for the early detection and for long-term, effective treatment of rheumatoid arthritis (RA) with minimal side effects, according to a study presented at the recent . These particles, once coated with a molecule that specifically targets inflamed joint tissues, ensure a high degree of efficacy in delivering both diagnostic probes and drugs to arthritic joints.

Dr. Paolo Macor, the study’s lead investigator from the Department of Life Sciences, University of Trieste, Italy said “There is a need to develop a new tool to enable early diagnosis, and also to develop tissue-specific agents able to reduce systemic side effects. This would increase the potency of drugs with lower doses, and also potentially reduce the cost of treatment,” Dr. Macor said.

Comment: Exciting and I look forward to hearting more.

 

 

Here’s an interesting twist on rheumatoid arthritis treatment… next

Nerve stimulation 'eases symptoms' of chronic condition rheumatoid arthritis

Olivia Lerche writing in the Express reported scientists believe stimulating the vagus nerve, which controls electrical signals to the stomach, heart and lungs, can significantly reduce pain and swelling caused by chronic joint inflammation.

The nerve can be stimulated with an electrical device surgically implanted into the body to send pulses through the vagus at various intervals.

Clinical trial data published in the Proceedings of the National Academy of Sciences (PNAS) revealed stimulating the vagus nerve with a bioelectronic device significantly improved the level of disease in patients with rheumatoid arthritis (RA).

Comment: Wow.  This is unreal … I really am excited about this one.

 

 

An old drug with a new use… next

Low-dose spironolactone seen as safe, effective treatment for patients with OA-related knee effusion

Reported in Healio… “Low dose spironolactone is a safe, effective and noninvasive treatment for osteoarthritis-related effusion. It is effective in mild and moderate cases and, to a lesser extent, in severe cases,” Sarah Ohrndorf, MD, specialist in internal medicine/rheumatology in the Department of Rheumatology and Clinical Immunology at Charité University Hospital in Berlin.

Researchers categorized 200 patients with unilateral knee effusion related to osteoarthritis (OA) into four groups with 50 patients in group 1 receiving spironolactone for 2 weeks, 50 patients in group 2 receiving ibuprofen for 2 weeks, 50 patients in group 3 using cold compresses twice daily for 2 weeks and 50 patients in group 4 receiving placebo for 2 weeks.  Group 1 outperformed all other groups.

Comment: Who would have thunk it?

 

 

Stem cells… a breakthrough… I mean a huge one next.

Researchers use stem cells to restore motor function in stroke patients

Ariana Cha writing in the Washington Post reported that scientists “studying the effect of stem cells injected directly into the brains of stroke patients said...that they were ‘stunned’ by the extent to which the experimental treatment restored motor function in some of the patients.” Although the study “involved only 18 patients and was designed primarily to look at the safety of such a procedure and not its effectiveness, it is creating significant buzz in the neuroscience community because the results appear to contradict a core belief about brain damage – that it is permanent and irreversible.” The findings were published in Stroke.

 

Comment: Wow.  Double wow.

 

So you’re a careful and courteous driver right.  Well you’re in the minority… next

Nearly 8 Out Of 10 US drivers have engaged in aggressive or angry driving in past year, survey finds

 

Joan Lowy writing for the Associated Press reported  almost 80 percent of US drivers “admit expressing anger, aggression or road rage at least once in the previous year, according to a survey” from the AAA Foundation for Traffic Safety. The survey found that male drivers were more likely to engage in road rage than female drivers, especially younger men between the ages of 19 and 39.

 

Comment: I’ve seen it often.  Pretty sad.


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Grilled Tomato Gazpacho

EatingWell Magazine July/August 2007

Original recipe yields 6 servings

 

  • 2 pounds ripe plum tomatoes

  • 1 small red bell pepper

  • Bell Peppers Orange, Red, & Yellow

  • 1 English cucumber, peeled and seeded, divided

  • 1/2 cup torn fresh or day-old country bread, (crusts removed)

  • 1 small clove garlic

  • 2-3 tablespoons red-wine vinegar

  • 1 tablespoon chopped fresh parsley

  • 1/4 teaspoon piment d'Espelette, (see Ingredient Note) or hot Spanish paprika or pinch of cayenne pepper

  • 1/2 teaspoon salt

  • 1/4 teaspoon freshly ground pepper

  • 2 tablespoons extra- virgin olive oil

Preparation

  1. Preheat grill to medium-high.

  2. Grill tomatoes and bell pepper, turning a few times, until they soften and the skins are blistered and charred in spots, about 8 minutes. Transfer the pepper to a plastic bag and let it steam until cool enough to handle. Peel off the skin; cut the pepper in half and discard the stem and seeds. Place one half in a blender. When the tomatoes are cool enough to handle, core and roughly chop. Add the tomatoes, skins and all, to the blender.

  3. Add half the cucumber to the blender along with bread, garlic, vinegar to taste, parsley, piment d'Espelette (or paprika or cayenne), salt and pepper. Blend until smooth. Add oil and blend until well combined. Refrigerate until room temperature or chilled, at least 1 hour.

  4. Before serving, finely dice the remaining cucumber and bell pepper; stir half of each into the gazpacho and garnish with the remaining cucumber and bell pepper.

  5. Make Ahead Tip: Cover and refrigerate for up to 1 day. Stir to recombine and garnish just before serving.

  6. Ingredient Note: Piment d'Espelette is a sweet, mildly spicy pepper, from the French side of the Basque region, ground into powder.


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Sea Gold… It’s the purest form of Omega-3 fish oil available.

Research studies show that the health benefits from Omega 3 fish oil are downright amazing. Omega-3 fish oils have been recommended by more rheumatologists than any other dietary supplement for the control of the inflammation that accompanies rheumatoid arthritis, psoriatic arthritis, and other forms for inflammatory arthritis. Studies show that supplementation with fish oils can markedly reduce morning stiffness and the number of painful joints for people who have rheumatoid arthritis. And Sea Gold is the purest, most effective dietary fish oil manufactured.

Omega-3 supplements may provide the following benefits to make you happier and healthier:

  • Lower blood pressure.
  • Reduce triglycerides.
  • Improve your memory and energy levels.
  • Reduce your stress and fatigue.
  • Reduces breast, colon and prostate cancer.
  • Live a strong healthier life!
  • Reduce your risk of arthritis, heart attack, stroke, and sudden death.

And now it's time to put all these Omega 3 fish oil health benefits to work by eating more oily fish and taking quality fish oil supplements every day.

Buy 2 and Get 1 Free….

This offer is available only thru October 2016. Call our office at 301-694-5800 to speak with our product specialist.


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