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Insider Arthritis Tips December 2012
December 15, 2012

"You make the world a better place by making yourself a better person." -- Scott Sorrell

December Arthritis News

Inflatable Bouncer Injuries In Children

Janice Lloyd writing in USA Today reported, "The rate of injuries to children on inflatable bouncers increased fifteen-fold from 1995 to 2010," according to a report published today in the journal Pediatrics. "In 2010 alone, 30 children a day were treated for these injuries in hospital emergency departments, the report says. The number of injuries increased from 702 in 1995 to 11,311 in 2010."

Comment: Pretty soon we’ll have to wrap our kids in bubble wrap

Too many knee replacements?

An article in JAMA by Cram and colleagues cited a 161% and 106% increase in primary and revision total knee replacements, respectively, in Medicare patients during the last 20 years. “The growth in these procedures should prompt consideration of whether too many of these procedures are being performed,” the authors stated.

Comment: The increase is fueld by the Baby Boomer demographic coupled by the epidemic in obesity as well as expanded indications because of improvement in technique and design. Nonetheless, it makes you wonder doesn’t it?

Sugary Soda May Be Linked To Progression Of Knee Osteoarthritis In Men

Charlene Laino writing in WebMD reported that consumption of sugary soda may be linked to progression of knee osteoarthritis in men, according to research presented at the American College of Rheumatology l meeting. Investigators found, "after taking into account BMI and other risk factors for knee osteoarthritis," that "men who drank five or more soft drinks a week had twice as much narrowing of joint space compared with men who did not drink sugary soda." However, "no such link was found in women in the study of more than 2,000 people with knee osteoarthritis."

Comment; Sugary sodas are no good.

Hospitalizations For RA Patients Decline Use Of TNF Inhibitors

Nancy Walsh writing in MedPage Today reported "As disease-modifying tumor necrosis factor (TNF) inhibitor use increases, the number of rheumatoid arthritis patients who require hospitalization has decreased , researchers from Ireland said" at the annual meeting of the American College of Rheumatology. Investigators found that "rheumatoid arthritis inpatient days for any reason was about 49,000 per year in the pre-2002 era, but that was reduced about 13% a year, to 31,000 hospitalizations in 2010 ."

Comment: No cure yet but getting there.

Osteoporosis Drug May Reduce Progression Of Knee OA

Nancy Walsh writing in MedPage Today reported on as study where researchers found that during "a 3-year study, patients with mild-to-moderate knee OA who were randomized to either 1 g or 2 g per day of strontium ranelate had significantly less joint space narrowing, compared with placebo." The investigators reported that "this represented differences of 0.14 mm for the 1-mg dose and 0.10 for the 2-g dose, with no significant difference between the two doses."

Comment: Encouraging news for a supplement with few side effects.

Exercise Programs Ease Arthritis Pain

The Daily Mail reported, "Having a waltz around the room or enjoying a yoga class can work wonders for millions of people suffering from arthritis," according to research presented at the American College of Rheumatology's meeting. After examining "the effectiveness of exercise programs run by the Hospital for Special Surgery in New York City," researchers "found hospital-based exercise programs such as Pilates, yoga or dance fitness can relieve the pain of the disease." The study included about 200 participants.

Comment: Exercise is key.

Visible Signs Of Aging May Predict CV Disease

The Associated Press reported on a study presented at the American Heart Association meeting finding that "people who look old...have a greater chance of developing heart disease than younger-looking people the same age." Study author Dr. Anne Tybjaerg-Hansen, University of Copenhagen, summed up the findings, "Looking old for your age marks poor cardiovascular health." Specifically, "Those with three to four of these aging signs - receding hairline at the temples, baldness at the crown of the head, earlobe creases or yellowish fatty deposits around the eyelids - had a 57% greater risk for heart attack and a 39% greater risk for heart disease compared to people with none of these signs." Yet "wrinkles elsewhere on the face and gray hair seemed just ordinary consequences of aging and did not correlate with heart risks."

Comment: Is it better to look good and feel bad or look bad and feel good?

Researchers make cartilage from induced pluripotential stem cells

Science Codex reported that a team of Duke Medicine researchers has engineered cartilage from induced pluripotent stem cells that were successfully grown and sorted for use in tissue repair and studies into cartilage injury and osteoarthritis. The finding is reported in the journal the Proceedings of the National Academy of Sciences, and suggests that induced pluripotent stem cells, or iPSCs, may be a viable source of patient-specific articular cartilage tissue.

Comment: One danger with induced pluripotential cells is cancer.

Carotid Ultrasound study suggests biologic use indicated in RA

Andrew Czyzewski writing in Medwire reported, "A trial of radiofrequency ultrasound in patients with rheumatoid arthritis) has shown that carotid intima-media thickness (IMT) is significantly greater in patients treated only with synthetic drugs compared with those who are also taking biologics." After assessing "carotid IMT using radiofrequency ultrasound in 94 patients with RA and 94 gender- and age-matched controls," researchers in the journal Rheumatology that "biologic therapy may have a protective effect on the increased carotid IMT and atherosclerotic process widely described in the literature on RA patients."

Comment: More data indicating that biologics reduce the incidence of cardiovascular events such as heart attack and stroke in RA patients.

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Wei’s World December 2012

Every year, the American College of Rheumatology holds a meeting. This year, the meeting was in Washington, D.C., not far from where I live and work.

Washington D.C. was laid out by the French engineer Pierre L’Enfant. It is a beautiful city with wonderful museums, great restaurants, and a crummy Metro system. The Metro was actually modeled after the Paris Metro system. The Washington Metro is one-tenth the size but breaks down ten times more often.

The convention center is nice and easy to get around in. Some convention centers like Orlando’s are so huge, they should give every attendee a golf cart. The convention center is located near Washington’s Chinatown so all the stores have signs in both Chinese as well as in English.

It’s also located near the Verizon Center where the professional basketball team, the Washington Wizards, play. To paraphrase a saying about the first president of the United States… “Washington… first in war and peace… first in the hearts of his countrymen… and last in the NBA…

That being said, the convention was nice. There were many good presentations and it was a chance to see old friends whom I rarely see any more except at these meetings.

Approximately three years ago, the American College of Rheumatology meeting, for the first time, had more international attendees than US attendees. That trend has progress to the point where it appears that perhaps it’s 60-40 in favor of international guests. What that offers is an opportunity for more dissemination of knowledge. Also, there are many more women than there used to be. Rheumatology is attractive to women because it offers a cerebral approach to medicine and also a somewhat less stressful existence than a surgical specialty.

I would have to admit though that there was no real earth-shaking news or major breakthroughs at this meeting. Some interesting things were apparent such as the FDA approval of a new oral rheumatoid arthritis drug (Xeljanz), the use and possible effectiveness of strontium for both osteoporosis as well as osteoarthritis, and new developments in the science behind psoriatic arthritis, to name a few.

I was kept busy during the convention with various meetings. I, also, as the Medscape rheumatology blogger, had to chase down attendees and video interview them. Some were camera-shy, some were rude, and some women thought I might have ulterior motives. In any event, next year’s meeting is going to be out west. I think San Diego if I’m not mistaken.

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