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Insider Arthritis Tips March 2012
March 15, 2012

"Character consists of what you do on the third and fourth tries." -- James Michener, Author

J&J knew about Hip replacement failures

Barry Meier writing for the New York Times reported that a year before recalling an artificial hip, an executive at Johnson & Johnson reported in an internal e-mail that the FDA had refused to approve the device, after reviewing company studies that showed it had failed prematurely in “significant” numbers, requiring repeat surgeries for patients. Meier said, “The statements in that e-mail contrast with those made by the company in recent years about the all-metal hip. Before recalling the device amid rising failure rates in 2010, Johnson & Johnson insisted it was safe and maintained that its internal studies refuted complaints by surgeons and regulators abroad that the device was flawed.

Comment: If this is true, it’s an abomination. At one time, J&J was the model of corporate integrity. Remember the tainted Tylenol issue? They’ve fallen far. Think twice about joint replacement!

Novel Microchip Implant Delivers Drug To Osteoporosis Patients

Terapeptide- parathyroid hormone- has been used to treat patients with severe osteoporosis. Unfortunately, it requires a daily injection. Diane Sawyer reporting for BC News discussed a study where "researchers at MIT, Mass General Hospital and Harvard Medical School" implanted "a microchip in seven women battling osteoporosis." The devices "automatically deliver the right amount of drugs, daily," which "can be inserted in your doctor's office." In addition, "the doses are preprogrammed."

Comment: Technology… wow!

Baby Boomers Skyrocketing Knee Replacements

Holt reported on NBC News "The number of baby boomers getting total knee replacements tripled in a ten-year period. And even though there can be complications, nearly one in 20 Americans over 50 is walking around with a new knee." ABC News medical editor Nancy Snyderman, MD, attributed the increase to "America's obesity epidemic, aging athletes not taking care of their aching joints, genetics, and the fact that we're living longer, more active lives."

Comment: I think this trend is worrisome.

Allergy Testing Reduces Complications From Joint Replacements

Charles Bankhead writing in MedPage Today reported, "Preoperative skin patch testing for metal allergy influenced treatment planning in two-thirds of a small group of patients scheduled to receive metal-containing prosthetic devices," according to a study published in the Archives of Dermatology. "All 21 patients with positive tests received allergen-free prostheses and had no complications associated with hypersensitivity."

Comment: A step in the right direction!

Stomach protecting drugs Increase Hip Fracture Risk In Postmenopausal Women

Linda Searing writing in The Washington Post reported that according to a study published in the BMJ, postmenopausal women "who took proton pump inhibitors (PPIs)" such as esomeprazole [Nexium], omeprazole [Prilosec], or lansoprazole [Prevacid], "were 35 percent more likely to have broken their hip than were women who did not use the drugs, increasing to a 51 percent greater risk if the women had ever smoked." In addition, "the longer women had used PPIs, the greater their risk for a broken hip, with six to eight years of use correlating to a 55 percent greater likelihood."

Comment: A worrisome potential problem with commonly used medicines.

Whipworms For Autoimmune Diseases

Shirley Wang writing in the Wall Street Journal reported that according to a number of studies, treatment using whipworm eggs may reduce the symptoms in some autoimmune diseases such as ulcerative colitis. In addition, research is expected to begin on rheumatoid arthriti and allergies. The Journal raised the possibility of the hygiene hypothesis underlying the treatment, which suggests that humans have been reducing exposure to microorganisms that are necessary to strengthen the immune system, resulting in an increase in the incidence of immune system diseases, such as asthma. Whipworms may be ideal for this type of treatment because they can trigger an immune-modulating effect in, but do not infect or colonize, humans.

Comment: I’m not sure about this one…

Stem Cells Regrow Heart Tissue

Diane Sawyer reported in ABC News on a study from Cedars-Sinai hospital and published in the Lancet"heart attack patients were treated with their own stem cells injected directly into their hearts and they grew new heart muscle."

Comment: Yes Yes Yes!

Chinese Herb Targets Immune System

Jennifer Warner writing in WebMD reported a new discovery about a 2,000-year-old Chinese herbal remedy derived from the roots of the blue evergreen hydrangea may pave the way for a new generation of targeted treatments for autoimmune disorders. A new study suggests the Chinese herb known as Chang Shan selectively weakens the runaway immune response implicated in many autoimmune disorders, such as rheumatoid arthritis. Researchers say the active ingredient in the Chinese herbal remedy, halofuginone (HF), blocks the development of a harmful type of immune cell called Th17 cells without disabling the immune system altogether. "HF prevents the autoimmune response without dampening immunity altogether," researcher Malcolm Whitman, PhD, professor of developmental biology at Harvard School of Dental Medicine.

Comment: Tally up another point for herbal remedies.

PRP Injections Help Young Athletes With UCL Tears

John Gever writing in MedPage Today reports, "Young athletes with torn elbow ligaments, where rest and physical therapy were ineffective, quickly returned to play after receiving platelet-rich plasma (PRP) injections, a researcher said" during "the American Orthopaedic Society for Sports Medicine's Specialty Day, part of the American Academy of Orthopaedic Surgeons' annual meeting." Researcher Scott Crow, MD found that "16 of 17 teenage and young adult patients with partial ulnar collateral ligament (UCL) tears were able to return to regular play within 15 weeks of receiving PRP injection."

Comment: Regenerative medicine techniques Will revolutionize not only the treatment of athletic problems but will also change the way we view degenerative situations such as osteoarthritis and tendinosis.

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Wei's World March 2012

My dad died on February 5th at 4AM . He entered the hospital for treatment of a urinary tract infection. Then he lost consciousness. A CAT scan showed he had suffered a massive stroke.

For the past three years or so, he had lived in an assisted living facility and his mental capacity had been declining.

Often times when I called, I had to remind him who I was.

Still… it’s very difficult to lose a parent. It’s particularly hard when I think about the strength and courage he and my mom had to have in order to make a life here in the United States.

They left China and sailed on the Grover Cleveland in 1948. They passed through Ellis Island and settled in New York City where my dad worked during the day while studying for his master’s degree at night at Columbia.

He then moved the family to Norwich, NY, a small farming community with a pharmaceutical company, Eaton Laboratories, where he was hired to do medicinal research. While we were there, the family expanded to include my brother and two sisters. During that time, he taught me how to fish, how to rise above the racist comments of people, and how to push on.

Remember, this was the 1950’s when being Asian elicited much prejudice. I distinctly remember a visit to a barber shop where the barber refused to cut my dad’s hair.

I think my dad’s desire to not make waves was due to his upbringing. He was an orphan raised in a Baptist mission in China. He was quite religious and he and my mom made all of us go to church at least three or four times a week. (That might explain why I stopped going to church after I graduated from high school!)

After all the sacrifices he and my mom made, he was extremely proud of all the accomplishments of his children and grandchildren.

Our mom passed away in 1988 and three years after my mother died, my dad married another woman who took very good care of him until his passing.

I think a lot about the good times we had. About 10 years ago, I took my dad and one of my sons to northern Canada for a fishing trip. That was a wonderful time and one of the memories my dad relished in his later years.

It was very hard to see him in the hospital at the end hooked up to all that machinery. It was comforting when my siblings and I agreed that they should remove those horrible things. The old person lying in bed all shriveled up was not my father. It will take time to get over this. And you actually never do “get over” the death of a parent. I think you just compartmentalize it better. This Wei’s World is, of course, dedicated to the memory of my dad.

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