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Insider Arthritis Tips March 2014
March 16, 2014
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When you are courting a nice girl an hour seems like a second. When you sit on a red-hot cinder a second seems like an hour. That's relativity.

Albert Einstein





March Arthritis News

Anxiety and depression were linked to poorer recovery outcomes after hip replacement

The Daily Rx News reported that although total hip replacement is often an effective treatment option for osteoarthritis, some factors may affect how well patients recover from the surgery. A recent study looked at the physical and mental health factors that influenced total hip replacement recovery in osteoarthritis patients. The researchers found that higher levels of anxiety, depression and pain before surgery were linked to poorer outcomes in the year after the hip replacement. These researchers suggested that these patients may need more support after surgery to help ensure a successful recovery.

Comment: Certainly not surprising.



Exercise May Delay or Prevent Hip Surgery

Alice Goodman writing in Arthritis Today reported the findings of a Norwegian study. People with mild to moderate hip osteoarthritis (OA) may be able to avoid hip surgery if they exercise, according to a study published recently online in Annals of the Rheumatic Diseases. The study showed that people who participated in an exercise program for one hour at least twice a week for 12 weeks were 44 percent less likely to need hip replacement surgery six years later compared with a similar group of people who did not exercise. Also, those who exercised reported improved flexibility and ability to perform physical activities compared with those who did not exercise.

Comment: Good news.



Camels to the Rescue for Arthritis?

Dr. Sanjay Gupta writing for Medpage Today reported a novel antibody derived from alpacas -- significantly reduced cartilage erosion and inflammatory cell infiltration in two mouse models of rheumatoid arthritis, Chinese researchers reported on Arthritis Research & Therapy. The antibody targets a specific protein, which has been implicated in the pathogenesis of rheumatoid arthritis through its recruitment of destructive cells and enzymes into the joint. Camelids produce a unique type of antibody can be easily and inexpensively produced, unlike most conventional antibodies.

Comment: There was an old commercial for Camel cigarettes. The catchphrase was, I’d walk a mile for a camel.



Stress management in RA patients helped to reduce IL-8 levels



Patients with rheumatoid arthritis who participated in stress management training had lower levels of stress-induced interleukin-8 levels at follow-up compared with a control cohort, according to recent study results. Researchers in the Netherlands randomly assigned 74 patients with rheumatoid arthritis (RA) to a control group or to receive a short stress management training course. Blood samples were collected during the stress tests, and assessment was made of stress-induced changes in levels of cytokines involved in stress and inflammatory processes, including interleukin (IL)-6 and IL-8, as well as tumor necrosis factor-alpha. At 1 week after treatment, the intervention and control groups did not display significantly different levels of basal and stress-induced cytokine levels. Patients in the stress management group, however, had lower levels of stress-induced IL-8 than controls at follow-up. “This is the first study to explore the response of circulating cytokines to a psychosocial stress test after stress management training in patients with RA,” the researchers concluded. “Stress management training might prove to be beneficial as adjunct to standard therapy to control arthritis symptoms.”

Comment: They needed a study to show that stress makes RA worse?



Anti-TNF-naive RA patients with periodontitis history likely to discontinue Enbrel



Reported in Healio, a study from Taiwan disclosed a fascinating finding. Patients with rheumatoid arthritis who were anti-tumor necrosis factor drug -naive and had a history of periodontitis within 5 years of beginning Enbrel therapy had an increased risk for treatment discontinuation, according to recent study results. The findings were published in the Journal of Clinical Rheumatology.

Comment: Hmmm… where do they come up with these studies?



New compound reduces joint inflammation in arthritis



Researchers have developed an oral compound that can significantly reduce joint inflammation in animal models of rheumatoid arthritis.

Scientists from The Scripps Research Institute (TSRI) in Florida developed the compound, SR2211, that blocked development of virtually all symptoms of rheumatoid arthritis in mice within the first eight to ten days of treatment.

The mice also showed significantly reduced bone and cartilage erosion compared to animals that did not receive treatment.

The experimental compound targets the nuclear receptor RORy, a key regulator of TH17 cells, one of a family of white blood cells that play a role in the immune system.

Comment: Many compounds look good in mice. Unfortunately, what counts is how they do with humans.



Gout Risk Has Genetic Component

Jennifer Davis writing in Arthritis Today reported on a new study that showed for the first time on a large scale that gout does indeed run in families. The study, published in the journal Annals of the Rheumatic Diseases, also shows gender differences in gout risk from the impact of genetic and environmental factors.

“The composition of risk is different in men and women, but both genders are at higher risk if they have family history [of the disease],” explains the study’s lead author Chang-Fu Kuo, a PhD candidate at the University of Nottingham in the United Kingdom and a practicing rheumatologist in Taiwan. “And genes determine part of the risk but environmental factors shared by families – like diet habits – determine much more.”

Comment: Another thing to blame your parents for…



Age, rheumatoid factor among risks for metabolic syndrome in RA patients



Reported in Healio was a study from Argentina that evaluated the risk of metabolic syndrome occurrence in patients with rheumatoid arthritis. Metabolic syndrome consists of the combination of obesity, hypertension, diabetes, and elevated blood lipids. Patients with rheumatoid arthritis did not experience a greater prevalence of metabolic syndrome compared with controls, although the patients’ age and rheumatoid factor positivity were risk factors, according to study results.

Comment: Sort of interesting I guess but not the greatest study.



Pores in cell membranes trigger RA.

Reported in the Almagest, Experiments by scientists at Johns Hopkins and in Boston have Discovered that pore-forming pathways in cell membranes are associated with a process called “abnormal citrullination” in rheumatoid joints. The pathways are normally used by the immune system to fight pathogens. Researchers say such disruptions in cell membranes by these pores leads to enzyme-activating imbalances of calcium ions and set off the inflammatory immune response that is rheumatoid arthritis’ hallmark.

Comment: Isn’t that what those acne treatments are supposed to fight… abnormal pores… oh well…



An inexpensive high BP pill can treat arthritis

An inexpensive pill that treats high blood pressure and heart failure could also help ease pain in people with arthritis without causing any side-effects, scientists say. Recent research suggests the drug called spironolactone could provide a breakthrough in the treatment of osteoarthritis for people with aching, ageing joints. It is believed spironolactone suppresses a hormone called aldosterone, which has also been linked to inflammation in the joints, Daily Express reported. It is also thought that the drug boosts cortisol, a hormone which reduces the body’s sensitivity to pain. Scientists at Dundee University turned to spironolactone, in their hunt for a safer, cheaper painkiller, the report said. After an initial study highlighted the drug’s painkilling powers, scientists are now setting up a larger trial to assess its full potential.

Comment: This is the first time I’ve heard about this. I’m eager to hear more.



Gout increases 7 fold in the last 50 years

Bruce Jancin writing in Rheumatology News reported on a study presented by Dr. Eswar Krishnan at the Amercan College of Rheumatology meeting. According to data compiled by the National Health and Nutrition Examination Survey or NHANES as it is referred to, the number of Americans with gout has climbed sevenfold during the last 50 years. The increase was most striking in men older than 65 years.

Comment: Gout is becoming an increasingly common problem that is a real public health issue.



Low serum uric acid slows kidney disease

Doug Brunk writing in Rheumatology News reported on a study presented by Dr. Gerald Levy at the American College of Rheumatology meeting. Data showed that patients who achieve a serum uric acid less than 6 mg/dl showed a 37% reduction in kidney disease progression.

Comment: Good news in that gout treatment will salvage kidney function.



Soft drinks increase RA risk

Bruce Jancin writing in Rheumatology News reported on a study compiled from data in the Nurses Health Study. The numbers showed that women who regularly drink one or more sugar-sweetened soft drinks per day are at increased risk of developing rheumatoid arthritis.

Comment: Soft drinks and cigarettes… risk factors that can be modified.



TNF therapy reduces heart attack risk

Bruce Jancin writing in Rheumatology News reported on a Swedish study involving more than 7,000 rheumatoid arthritis patients. While those patients with no response or only a moderate response had the expected increase in incidence of coronary events seen in rheumatoid arthritis, those with a good response had an incidence similar to age matched controls.

Comment: This study confirms that patients who respond to anti-TNF therapy also benefit from fewer heart attacks as well.



Psoriasis linked to fatty liver

A Dutch study from Erasmus University in Rotterdam, the Netherlands, showed that the prevalence of psoriasis was significantly greater in patients with nonalcoholic liver disease by a margin of 7% to 4.2%. The study involved more than 4,000 individuals.

Comment: An unexpected finding worth noting.



Surgical Infection Rate Higher with RA Drugs

Marianne Wait writing in Arthritis Today reported that people with inflammatory forms of arthritis, such as rheumatoid arthritis who take more than one traditional disease modifying antirheumatic drug (DMARD), or a type of biologic drug known as a TNF inhibitor, have an increased risk of infection following orthopaedic surgery, according to a new study published in Arthritis Care & Research in December. It is not a new theory that drugs taken for inflammatory arthritis conditions, which in many cases work by suppressing the immune system, might increase post-surgical infections. Over the years, a host of studies has looked at which drugs might elevate the risk and by how much. The results have not been clear. But this study “is one of the best out there regarding this topic,” says Tim Bongartz, MD, associate professor of rheumatology at Mayo Clinic in Rochester, Minn. Dr. Bongartz was not involved in the study. Based on their results, senior study author Inès A. Kramers-de Quervain, MD, of the department of rheumatology at the Schulthess Clinic in Zurich, Switzerland, suggests “it may be advisable to consider stopping TNF inhibitors more than one administration interval before surgery, since the risk of postoperative infection appears to be higher if the operation occurs within this period.” An administration interval is the length of time between one injection and the next.

Comment: Not anything I didn’t suspect sooner.



Side Effects of Methotrexate Experienced Even Before Treatment Starts

Nancy Walsh writing in Medpage Today reported that the gastrointestinal side effects that commonly accompany treatment with methotrexate aren't limited to post-treatment nausea and vomiting, but also include anticipatory, associative, and behavioral symptoms, Dutch researchers found. In a group of 291 adults with rheumatoid or psoriatic arthritis, one-third reported nausea following methotrexate administration -- but 8.6% also experienced nausea while awaiting treatment and 11% felt nauseous when just thinking about the treatment, according to Maja Bulatovic Calasan, MD, of University Medical Center Utrecht, and colleagues.

Comment: The mind has a powerful influence in how we feel about upcoming events. Definitely an interesting study.



Intestinal bugs to blame for RA?

Reported in the Almagest, researchers have linked a species of intestinal bacteria known as Prevotella copri to the onset of rheumatoid arthritis, the first demonstration in humans that the chronic inflammatory joint disease may be mediated in part by specific intestinal bacteria. The new findings by laboratory scientists and clinical researchers in rheumatology at NYU School of Medicine add to the growing evidence that the trillions of microbes in our body play an important role in regulating our health. Using sophisticated DNA analysis to compare gut bacteria from fecal samples of patients with rheumatoid arthritis and healthy individuals, the researchers found that P. copri was more abundant in patients newly diagnosed with rheumatoid arthritis than in healthy individuals or patients with chronic, treated rheumatoid arthritis. Moreover, the overgrowth of P. copri was associated with fewer beneficial gut bacteria belonging to the genera Bacteroides.

Comment: With RA, it’s not all in your head… it’s in your gut.



Flu shots a must for arthritis patients

Marianne Wait writing in Arthritis Today reported on treatment guidelines published by the Infectious Diseases Society of America in December which remind doctors and patients that people with a chronic inflammatory disease, even those who take immune-suppressing medications, should not shy away from getting flu and pneumonia vaccine shots. People with rheumatoid arthritis (RA), lupus, psoriatic arthritis and other autoimmune forms of arthritis face an elevated risk of infections, including influenza and pneumonia. The increased risk may be due to the disease, which changes how the immune system functions, as well the medications used to control the disease, many of which suppress the immune system.

Comment: I always recommend flu vaccination for my arthritis patients.



Foot osteoarthritis affects one in six over 50s

A n article in The Press Association highlighted a painful form of arthritis in the foot affects one in six people over 50 - more than previously thought, research suggests. Experts at Keele University’s Arthritis Research UK Primary Care Centre studied more than 5,000 people with painful foot osteoarthritis. The study found that foot osteoarthritis affects more women than men, while those who have spent a lot of time in manual work are more likely to develop it. Three-quarters of people with the condition reported having difficulty with simple day-to-day activities such as walking, standing, housework and shopping. Dr Edward Roddy, clinical senior lecturer in rheumatology at Keele University, said the research had focussed on “midfoot” joints, which previous studies have neglected to do. “The study tells us that if we want to keep our over- 50s active and healthy we should be similarly serious about ‘arch’ or midfoot pain.”

Comment: A neglected cause of foot pain.




20 Things You Don’t Need To Know

Iwastesomuchtime.com

  1. Rubber bands last longer when refrigerated.
  2. Peanuts are one of the ingredients of dynamite.
  3. There are 293 ways to make change for a dollar.
  4. The average person’s left hand does 56% of the typing.
  5. A shark is the only fish that can blink with both eyes.
  6. There are more chickens than people in the world.
  7. Almonds are a member of the peach family.
  8. A cat has 32 muscles in each ear.
  9. Tigers have striped skin, not just striped fur.
  10. A cockroach can live 9 days without its head before it starves to death.
  11. There are 336 dimples on a regulation golf ball.
  12. More people are killed by donkeys annually than are killed in plane crashes.
  13. If you keep a gold fish in a darkroom it will eventually turn white.
  14. A dragonfly has a life span of one to six months.
  15. A giant squid has the largest eyes in the world.
  16. The average chocolate bar has 8 insect legs in it.
  17. A snail can sleep for three years.
  18. Typewriter is the longest word that can be spelled using the letters on only one row of the keyboard.
  19. The names of the continents all end with the same letter in which they start.
  20. Right-handed people live, on average, nine years longer than left-handed people do.


Arthritis Research Institute

7th Arthritis Symposium

Thursday, May 15, 2014

The Arthritis Research Institute has assembled a brilliant team of elite arthritis experts. The advice and information they provide is bullet-proof. These “Navy Seals” of arthritis are among the most respected names in the field. As an attendee you will be privy to inside information.  You will discover: 

  • The “pickpocket” cure for back pain
  • 5 untapped methods for having fewer gout attacks in just 30 days
  • 5 surefire ways to neutralize your knee pain
  • 3 proven methods to get rid of nerve-shattering arthritis flares, and
  • 5 “savvy” new methods for crushing arthritis

Throughout the day you will receive a steady flow of unexpected, bottom-line, advice to help you manage your arthritis. If you suffer from arthritis, this will be the most valuable experience you will ever have.

This full day event will be held at the Ceresville Mansion, a historic 1888 mansion, surrounded by beautiful grounds with idyllic mountain views. Lunch will be served on the garden terrace (weather permitting).

John A. Goldman, MD
Psoriasis – is More than Just a Rash!
Former Clinical Professor of Medicine,
Emory University School of Medicine, Atlanta, Georgia.
 
N. Lawrence Edwards, MD, FACP, FACR
Gout
Professor of Medicine, Division of Rheumatology
and Clinical Immunology,
as well as Program Director and
Vice Chairman of the Department of Medicine
at the University of Florida in Gainesville.
 
Larry J. Leventhal, MD
Update on the Diagnosis and Management of Fibromyalgia
Chief of Rheumatology at the
Holy Redeemer Medical Center
in Meadowbrook, Pennsylvania,
and Medical Director of  Comprehensive
Arthritis Care Consultants, LLC
in Huntingdon Valley, Pennsylvania
 
Roland Moskowitz, MD
Osteoarthritis
Professor of Medicine and a member of the
Division of Rheumatic Diseases at
University Hospitals Case Medical Center,Cleveland,Ohio
 
Frank R. Wellborne, DO, FACR
Rheumatoid Arthritis
Co-Director of Rheumatic Innovative Therapies
at the Houston Institute for Clinical Research in Houston, Texas.
 
John J. Cush, MD
Clinical Research
Director of Clinical Rheumatology
for the Baylor Research Institute and
Professor of Medicine and Rheumatology
at the Baylor University Medical Center in Dallas, TX

Register at the Early Bird Rate of $50.00 at:
https://aocm.infusionsoft.com/app/form/2014-symposiumregistration
Or, Call us at 301-624-5800 to register by phone.

    REGISTRATION INCLUDES PROGRAM MATERIALS, BREAKFAST, AND LUNCH.


Untitled 1

Pistachio Cake

Recipe from Family Circle

 

Bake this moist cake for a potluck and it will be the talk of the party. Servings: 16 ~ Prep Time: 15 mins

 

Cake Ingredients:

  • 1   box (18.25 ounces) white cake mix

  • 1   package (3.4 ounces) instant pistachio pudding mix

  • 3   eggs

  • 1   cup vegetable oil

  • 1   can (12 ounces) lemon-lime soda (such as 7-Up)

Frosting Ingredients:

  • 1   package (3.4 ounces) instant pistachio pudding mix

  • 1 ½ cups of milk

  • 1   container (8 ounces) frozen whipped topping, thawed

  • 1/4  cup chopped pistachio nuts, to garnish

 Directions:

 

  1. Heat oven to 350 F. Coat two 9-inch round cake pans with nonstick cooking spray. Line bottom of pans with waxed paper and spray again.

  2. In a large bowl, beat cake mix, pudding mix, eggs, vegetable oil and soda on medium-high speed for 4 minutes. Scrape down side of bowl after 2 minutes.

  3. Equally divide batter between prepared cake pans. Bake at 350 F for 35 minutes, or until a toothpick inserted in the center comes out clean. Cool cake layers in pans on wire rack for 15 minutes. Turn cake layers out directly onto rack and cool completely.

Frosting:

  1. In a large bowl, beat pudding mix and milk for 2 minutes on medium-high speed. Fold in whipped topping.

  2. Place 1 cake layer on a serving plate and frost top with 1 cup of the frosting. Place remaining layer on top and frost top and sides. Garnish with chopped nuts. Refrigerate for at least 1 hour before serving. Store in refrigerator.


Complete Wellness

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The only missing ingredient is… you!

This 80 ingredient super supplement formula is known as Complete Wellness. This wonderful food based Vitamin/Mineral/Herbal Complex is quickly becoming part of the daily health program for people all across the country. Our family of loyal repeat customers continues to grow.

Complete Wellness gives your body more nutritional support in a single daily formula than you might find in more than a half dozen different products. Stop by our office and see the comparison!

It is highly recommended that you take our food based Complete Nutritional Formula “Super Supplement” every single day. Give your body the optimal nutrition it needs to achieve optimal health.

Dr. Wei is so confident that you will find Complete Wellness the best vitamin – so he’s giving you a special offer…

Buy two months of Complete Wellness and save $20.00. If you haven’t noticed an extra “pep in your step” or difference in your health within three months, we’ll refund your purchase 100 percent. Guaranteed!

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For March and April, we are giving you a Special Offer for a two month(3 bottles) for only $81.70

You Save $20

Call our product specialist at 301-694-5800 for more information.

P.S. Don’t forget about our autoship program. You can have Complete Wellness delivered directly to your home and pay no shipping and handling!


Wei’s World March 2014

One time a patient asked me if I’m happy. The question surprised me because no one had ever asked that question of me before. I had to think about it. I have had moments of happiness in my life. In fact, quite a few moments. But they were just moments. Do I go through a day every day with a silly grin on my face. Not exactly...

I think I’m probably more unhappy than I am happy. And that’s okay. I used to think I was weird. But I realized that because of the type of person I am, it’s not easy to be happy a lot. And here’s the reason why:

First, I didn’t grow up in a happy household. I guess nowadays you would call our family dysfunctional. But from what I gather, many households have their share of dysfunction. But I think ours had even more than the norm.

Second, I have four children. If you have children, you know you’re only as happy as your least happy child. And that means you’re generally unhappy.

Third, I’m a physician. I expect a lot of myself and my staff. I work hard, not only in the office, but after office hours too. I’m constantly trying to get better at what I do. I’m studying constantly. I’m learning about new techniques, new procedures… what can I do to improve outcomes? And here I am in my mid-60’s!

I realize that medicine is also undergoing a lot of changes. Insurance companies, the government, etc… they all want their pound of flesh from me. That doesn’t make for a lot of happiness.

Still, I do have those happy moments… when a patient appreciates what I do for them… when a patient has a good outcome… when my children seem to appreciate what it is that their parents have done for them… when I finish a day and feel happy that I’ve done not only my best but even a little more.

So that may be a reason why I’m not as happy as I probably should be. I don’t really feel happiness if I’ve done an adequate or even a good job. I only feel happy when I’ve extended myself and raised the bar to a new level. Set another record for bettering my best. Whether it’s a procedure or helping a difficult patient through a hard time. Whatever. So imagine a baseball player who hits 300. And doesn’t feel happy until he hits 310… and so on. Or a quarterback who completes 60 per cent of his passes, but doesn’t feel happy until he competes 65%. And then doesn’t feel happy until he completes 70%.

I think you get my drift. It’s a burden. But the way I’m wired I’m not sure I could do it any other way. In a sense, and don’t take this the wrong way, but I feel that those who just settle… who are content with what they’ve accomplished… who feel happy at the end of the day because it’s the end of the day and they’ve made it through… I feel sorry for them. Because in those moments, when I’ve climbed the mountaintop and know I’ve really really excelled, I feel ecstasy.

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