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Insider Arthritis Tips January 2013
January 15, 2013
"Don't be afraid to take a big step if needed. You can't cross a chasm in two small jumps." -- Anonymous
January Arthritis NewsRituxan Added To Methotrexate Slows Joint Damage In RA
Nancy Walsh writing in MedPage Today reported, "Adding the B-cell depleting agent rituximab (Rituxan) to methotrexate slowed joint damage progression in patients with rheumatoid arthritis (RA) regardless of the level of disease activity," according to research published in the Annals of the Rheumatic Diseases. Researchers found that "at 1 year, patients with low disease activity receiving rituximab in combination with methotrexate had a change in joint damage scores of 0.38." Patients with moderate disease activity and high disease activity experienced similar changes in scores.
Comment: Interesting but not surprising. Most biologics added to methotrexate seem to work.
Pill Color Changes Leads To Medication Non-Adherence
Ben Tinker reporting on CNN quoted Dr. Aaron Kesselheim, assistant professor of medicine at Brigham and Women's Hospital in Boston, who conducted a study, published in the journal Archives of Internal Medicine, that found "changes in pill color significantly increase the odds that a patient will fail to take their medication as prescribed by their doctor." Researchers found when patients with epilepsy "refilled their prescriptions and received a different color pill than they were used to, they were 53% more likely to take a break from taking their drugs as prescribed. Twenty-seven percent of patients taking antiepileptic drugs for other reasons also took a break from their prescribed drug regimen."
Comment: Interesting how a simple change can cause a patient’s prescription taking habits.
The Aromatase musculoskeletal syndrome
An article appearing in Arthritis Care and Research looked at the peculiar syndrome of aches and pains found in women who take aromatase inhibitors for breast cancer. The authors found that the musculoskeletal symptoms occurred in more than 50 per cent of treated women generally by 8 weeks. Focal areas of inflammation affecting tendons and joints in the hands and feet were the major findings. Later stage cancer and poorer quality of life were predictors of symptom development.
Comment: Some light shed on this fairly common problem..
Unsafe Injection Practices Still Exist In US
Peter Eisler writing in USA Today reported in an article, "As drug-resistant superbugs and increasingly virulent viruses menace the medical community, health officials still face a quiet threat that was supposed to die with the advent of the disposable syringe 150 years ago: dirty needles." USA Today adds, "Since 2001, more than 150,000 patients nationwide have been victims of unsafe injection practices, and two-thirds of those risky shots were administered in just the past four years, according to data from the U.S. Centers for Disease Control and Prevention."
Comment: Hard to believe and very scary
Brain Activity Associated With Response To TNF Inhibition In RA
Lynda Williams writing in Medwire reported, "How well a patient responds to tumor necrosis factor (TNF) inhibitor therapy may depend on brain activity reflecting the individual's perception of their rheumatoid arthritis (RA)," according to a functional MRI study published in Arthritis and Rheumatism. Investigators found that "patients who responded to TNF inhibition showed significantly greater baseline brain volume activity in the thalamic, limbic, and associative areas of the brain than nonresponders."
Comment: The most powerful organ system in the body is the brain.
Hospital Patients Being OD’d on acetaminophen
According to an article in Rheumatology News authored by Mary Ann Moon, 4 per cent of hospitalized adolescents and adults in 2 academic hospitals received excessive doses of acetaminophen. Nearly half received more than 5 gms a day and 40% received excessive dosing for 3 or more days. These doses put the patients at increased risk of liver damage and death. The findings were published in the Archives of Internal Medicine.
Comment: Pretty sobering data.You should have a family member with you if you’re in the hospital.
Lyme … is it a relapse or is it new?
Mary Ann Moon writing in Rheumatology News reported that when erythema chronicum migrans recurs a year or more after standard antibiotic therapy, it most likely represents a reinfection from another tick bit and not a relapse from the first infection. These findings were from a study conducted at the New York Medical College and published in the New England Journal of Medicine.
Comment: Lyme can be a bad disease if not treated aggressively.
As reported in Medscape Medical News, the EMA – the European equivalent of the US FDA, began reviewing cardiovascular and cutaneous toxicity in patients who received strontium ranelate.
The review was prompted by publication of a study in France that identified 199 severe adverse reactions reported with strontium ranelate from January 2006 to March 2009. Of those, 52% were venous thromboembolism and 26% were cutaneous reactions.
Comment: These are ultra severe side effects.
Standing Test Strong Indicator Of Musculoskeletal Fitness
Healthday reported that, according to a study, "The ability to sit and then rise from the floor is a strong predictor of the risk of death in middle-aged and elderly people." The study "included more than 2,000 men and women, aged 51 to 80, who were told to sit on the floor and then try to rise, using only the minimum amount of support," and the "participants were followed for an average of about six years;" those patients who scored well on the test were less likely to die than those who performed poorly. HealthDay adds, "The test is safe, takes less than two minutes and does not require any special equipment, which makes it ideal for primary-care physicians who want a quick way to assess patients' musculoskeletal fitness," according to author Dr. Claudio Gil Araujo.
Comment: Seems like everybody I know is fit… but maybe not.
Knee Replacement Surgery May Increase Risk Of Weight Gain
Hip Dislocation After Replacement Surgery More Common With RA
Robert Preidt writing in Healthday reported, "Patients with rheumatoid arthritis are more likely to suffer hip dislocation after hip replacement surgery than those with osteoarthritis," according Dr. Bheeshma Ravi, of the University of Toronto and Women's College Research Institute, and published the journal Arthritis & Rheumatism. "For the study, the investigators analyzed the findings of 40 studies published between January 1990 and December 2011. The studies included arthritis patients aged 18 or older who had hip or knee replacements."
Does running help you live longer… or shorter?
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Wei’s World January 2013Today, I’m going to write about time. One of our long term employees, Susan Rock, the manager of our laboratory, is retiring this month after working for more than twenty years.
During that time she has been meticulous in her duties, securing our lab some of the highest marks in the country on the Commission on Laboratory Office Accreditation (COLA) inspections.
She and her husband enjoy traveling so this will give them the time to do it and “other chores around the house” as well.
I’m writing about time because time speeds up as one gets older.
What used to take forever- for example the night before Christmas- is over in an instant. What used to feel like months, now seem to pass in a few minutes.
I’m constantly amazed about the contrast I see when I’m driving. For example, I will get behind the car of a senior citizen and he’s going 30 miles per hour in a 45 mile per hour zone. Then, when I’m on a highway a young 19 year old tailgates then flies past me on my right doing 85. What’s wrong with this picture?
It drives me crazy because it just doesn’t make sense. The elderly person should be in a rush because he probably doesn’t have much time left and the young guy could slow down because he has his whole life ahead of him, probably (although if he continues to drive that way, that may not be the case).
Now let’s not get confused about two subjects. There’s “age” and there’s “time.” Age is really what you make of it. If you exercise, eat healthy, and take care of yourself, age is something that can be altered. Time is different. We all have the same 1440 minutes a day.
And productivity- what we do with that time- is a function of how hard we work and how much. But the length of time doesn’t change whether you’re Bill Gates or you’re homeless in Cleveland.
But that still doesn’t make me feel any better because no matter what I do, however productive I try to be, it feels like time is going faster and faster.
Which is why you won’t see me doing 30 in a 45 mile per hour zone any time soon.
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