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Insider Arthritis Tips March 2013
March 15, 2013

"A pound of pluck is worth a ton of luck." -- James Garfield, 20th President of the United States

March Arthritis News

3-D Printing To Make Stem Cells

Naik writing in the Wall Street Journal reported biotech labs are exploring the feasibility of using 3-D printers to create human embryonic stem cells. Wenmiao Shu, a bioengineer at Heriot-Watt University in Scotland and co-author of the study published in the journal Biofabrication, says that by utilizing 3-D printing techniques, scientists could print cells without damaging them. The field of 3-D printing is still growing, and scientists have so far printed several body parts, including heart valves, bone implants, kidney cells, and more.

Comment: Wow!

Steroid Shots May Worsen Tennis Elbow In The Long Run

Lindsay tanner writing in the AP reported that "commonly used steroid shots may worsen tennis elbow in the long run and increase chances that the painful condition will reappear, a small study found." The article points out that "by contrast, patients who got dummy injections alone or with physical therapy were more likely to completely recover after a year and much less likely to have a recurrence than those given steroids." The results of the Australian study were published in the Journal of the American Medical Association. They are similar to findings reported elsewhere that injections of cortisone can provide short-term pain relief but are detrimental in the long run.

Comment: Steroids weaken tendon tissue. Over the long run, they make things worse. Platelet rich plasma given using ultrasound-guided tenotomy technique is far superior and more a much better treatment.

Joint lubrication treatment might help OA in the ankle

Lynda Williams writing in Medwire reported on a study published in the Journal of Foot and Ankle Surgery that "demonstrated significant improvements in function and pain in the 6 months after three sodium hyaluronate 10 mg injections over 3 weeks." According to Omer Mei-Dan, Meir University Hospital, Kfar-Sabar, Israel, "Viscosupplementation with [hyaluronic acid] injection is a valuable addition to the current nonsurgical options for the treatment of subtalar- meaning ankle joint- OA."

Comment: Lubricants work if they are injected properly using ultrasound guidance.

UVB Exposure May Reduce Risk Of RA In Women

Nancy Walsh writing in MedPage Today reported that “more intense sunlight exposure was linked with a decreased incidence of rheumatoid arthritis among women in the original Nurses' Health Study," though "the more common use of sunscreen likely attenuated the association in a later cohort." In support of this conclusion, other "epidemiologic studies have found a correlation between an increased incidence of RA and other autoimmune diseases with higher latitude of residence." UVB has also been shown to have immunosuppressive effects, as well as increasing vitamin D synthesis.

Comment: good news for sun worshippers but be careful. We all know the risks of too much sunlight!

Calcium Supplements Linked To Increased Risk Of Death From Heart Disease In Men

Nanci Hellich writing in USA Today reported on a study published in JAMA Internal Medicine that showed " high intake of calcium from supplements is correlated with an increased risk of death from heart disease, such as heart attacks, for men, but not for women." According to the study's lead author Qian Xiao, of the National Cancer Institute, "Although we observed an increased risk of death from heart disease in men, we cannot say for sure that it was a result of using supplements containing calcium." Xiao added, "We need more studies to clarify this possible relationship and the underlying mechanisms."

Comment: Eyebrow lifting a bit. I wonder why? Is this for real?

Ayurvedic Medicine Good for OA

Lynda Williams writing in MedWire reported, "Ayurvedic medicine may offer osteoarthritis (OA) relief, say Indian researchers who found traditional formulations to be equal to conventional drugs for the improvement of pain and knee function." These findings come from "a 6-month randomized, double-blind, clinical trial comparing celecoxib (200 mg/day) or glucosamine sulfate (2 g/day) with one of two Ayurvedic 400 mg/day formulations containing extracts of Zingiber officinale, Tinospora cordifolia, and Phyllanthus emblica alone (SGC) or with Boswellia serrata (SGCG)." The study was published in the journal Rheumatology.

Comment: More data corroborating the benefits of complementary therapies.

New strategy prevents rheumatoid arthritis in mice

Eureka Alert reported the results of a striking finding. Dana-Farber Cancer Institute scientists have demonstrated a new strategy for treating autoimmune disease that successfully blocked the development of rheumatoid arthritis in a mouse model. They say it holds promise for improved treatment of arthritis and other autoimmune disorders in people. The scientists report in the Journal of Clinical Investigation that infusing a highly specific type of cell that regulates immune responses into arthritis-prone mice shut down the cascade of inflammation that damages tissues and joints. The method worked best when the infusions of CD8+ Treg cells were given at the same time that the animals were injected with a protein that triggered the arthritis-causing autoimmune reaction. "We found we could almost completely inhibit the disease in this setting," said Harvey Cantor, MD, chair of the Department of Cancer Immunology and AIDS at Dana-Farber and the study's senior author.

Comment: Prevention is better than cure!

TKR Quantified

Liam Davenport writing in Medwire reported, "Research highlights the growing use of total knee replacement (TKR) in the USA among patients with osteoarthritis and the associated healthcare burden." Researchers estimated "the overall prevalence of TKR in adults aged 50 years and be 4.2%, at 4.8% in females and 3.4% in males." Meanwhile, "the prevalence of TKR increased with each additional decade in age for both males and females." The researchers "estimate that 4,007,400 US adults currently live with TKR, of whom 536,100 have a revised TKR." The findings were published in the Journal of Bone and Joint Surgery.

Comment: Pretty soon the majority of Americans will be bionic.

What’s a hip replacement cost?

Elizabeth Rosenthal writing in the New York Times reported on a study published in JAMA. OF more than 100 hospitals, including top-ranked orthopedic centers and community hospitals, only half could provide any sort of price estimate, despite repeated calls. Those that could gave quotes that varied by a factor of more than 10, from $11,100 to $125,798.

Comment: Hmmm… So what’s all this hub-bub about reining in healthcare costs?

Piroxicam-Ultrasound Together Help With Knee OA

Helen Albert writing in Medwire reported, "Phonophoresis of the non steroidal anti-inflammatory drug (NSAID) piroxicam – also known as Feldene- with ultrasound is more effective than ultrasound alone for improving pain and other symptoms of mild-to-moderate knee osteoarthritis (OA)," according to a study published in the Archives of Physical Medicine and Rehabilitation. Researchers arrived at that conclusion after comparing "treatment with ultrasound alone plus standard gel (controls; n=23) with ultrasound plus piroxicam gel (n=23; approximately 20 mg per application) for patients with mild-to-moderate knee OA aged 59 years on average."

Comment: Feldene is an old drug. Who says you can’t teach an old dog new tricks?

Diclofenac's Heart Risk Hasn't Led To Reduced Use

Richard Know writing for NPR reported that the non-steroidal anti-inflammatory drug, diclofenac, sold under the trade names of Cambia, Voltaren, Zipsor, and Cataflam, "is just as likely to cause a heart attack as Vioxx, which was pulled from the US market in 2004." However, " the drug's cardiovascular risk hasn't translated to a reduction in use, an article in the journal PLoS Medicine found. Diclofenac far outsells ibuprofen, naproxen, and other NSAIDs in 15 countries around the world."

Comment: All anti-inflammatory drugs increase the risk of heart attack and stroke. Beware.

PFCs Linked To Osteoarthritis In Women

Alan Mozes writing in Healthday reported, "In what researchers are calling a first, a new analysis suggests that the greater a woman's exposure to a type of common chemical compound called PFCs, the greater her risk for developing osteoarthritis." Researchers "found 'significant associations' between osteoarthritis incidence and exposure to PFOA or PFOS among women but not men." The investigators reported that "women exposed to the highest levels of either chemical seemed to face up to nearly double the risk for developing osteoarthritis, compared to women exposed to the lowest levels." The research was published in Environmental Health Perspectives.

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Wei’s World March 2013

As you know we skipped a month. Sometimes that happens because it’s a lot of work getting this newsletter out. We don’t want to slap together some nonsense. We want to make sure this is a newsletter worthy of your time.

Last month I started to write about digestion because I had had my second colonoscopy. I wanted to write about my experience with that since it was very different from the situation I had ten years earlier. But my wife nixed my draft saying it was “not very good.” I think it was her way of telling me it was not an appropriate topic. I was hurt.

So this month I’m going to talk about George Bernard Shaw’s quote about “youth being wasted on the young.” At least I hope it was George Bernard Shaw.

If you never saw the movie, ‘The Curious Case of Benjamin Button”, you should. Though it isn’t one of my favorite movies, it was well done. It described a situation I found very interesting.

What if we were born really old and got younger over the years? Just think about how much more we would enjoy life, particularly those youthful years of vigor and energy. You know…”If I knew then what I know now…”

Even though my wife and I remain active, exercise regularly, and eat a healthy diet, we still find ourselves driving to doctors’ appointments much more than we would like. And often we drive each other to the other’s appointment.

We use these pill containers that can hold a week’s worth of pills. And we now realize we have become our parents.

I think the person who recently described it best was Mick Jagger. I believe he is now close to 70 years of age.

He said, and I hope I’m getting this right, “When we were young, we did rock and roll so we could do drugs and have sex. Now we do drugs so we can do rock and roll and have sex.”

Of course this is the same Jagger who said, I’d rather be dead than singing ‘Satisfaction’ when I’m forty-five.” But added, “People have this obsession. They want you to be like you were in 1969. They want you to, because otherwise their youth goes with you. It's very selfish, but it's understandable.”

Rock on Mick!

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