Knee effusion, colloquially known as water on the knee, occurs when excess fluid accumulates in or around the knee joint. There are many common causes for the swelling, including arthritis, injury to the ligaments or meniscus, or when fluid collects in the bursa. This condition is known as prepatellar bursitis.
According to Medilexicon's medical dictionary:
Knee effusion is a large bursa between the inferior part of the femur and the tendon of the quadriceps femoris muscle. It usually communicates with the cavity of the knee joint and is pathologically distended with blood or synovial fluid in suprapatellar bursitis ("water on the knee").
A small amount of fluid exists in normal joints. When a joint is affected by arthritis, particularly an inflammatory arthritis such as rheumatoid arthritis (RA), increased abnormal amounts of fluid buildup, the knee appears swollen. The fluid is produced by the tissues that are affected by the arthritis and that line the joint.
What are the symptoms of Knee Effusion?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.
Signs and symptoms of water on the knee depend on the cause of excess fluid build-up in the knee joint. With osteoarthritis, pain occurs when bearing weight. The pain typically subsides with rest and relaxation.
One knee may appear larger than the other. Puffiness around the bony parts of the knee appears prominent when compared with the other knee.
When the knee joint contains excess fluid, it may become difficult to bend or straighten the knee in certain cases.
If an individual has injured his or her knee, he or she may note bruising on the front, sides or rear of the knee. Bearing weight on the knee joint may be impossible and the pain unbearable.
What are the causes of Knee Effusion?
Causes of the swelling can include arthritis, injury to the ligaments of the knee or an accident after which the body's natural reaction is to surround the knee with a protective fluid.
There could also be an underlying disease or condition. The type of fluid that accumulates around the knee depends on the underlying disease, condition or type of traumatic injury that caused the excess fluid. The swelling can, in most cases, be easily cured.
Having osteoarthritis or engaging in high-risk sports that involve rapid cut-and-run movements of the knee, football or tennis for example, means an individual is more likely to develop water on the knee.
In overweight or obese individuals the body places more weight on the knee joint. This causes more wear in the joint. Over time, the body will produce excess joint fluid.
Diagnosing Knee Effusion
An understanding of knee pathoanatomy is an invaluable part of making the correct diagnosis and formulating a treatment plan. Taking a thorough medical history is the key component of the evaluation.
The most common traumatic causes of knee effusion are ligamentous, osseous and meniscal injuries, and overuse syndromes. Atraumatic etiologies include arthritis, infection, crystal deposition and tumor. It is essential to compare the affected knee with the unaffected knee.
Systematic physical examination of the knee, using specific maneuvers, and the appropriate use of diagnostic imaging studies and arthrocentesis establish the correct diagnosis and treatment.
Joint aspiration, also known as arthrocentesis, is a procedure that includes withdrawal of fluid from inside the knee for analysis such as cell count, culture for bacteria, and examination for crystals, such as uric acid or calcium pyrophosphate dihydrate crystals found in gout or pseudogout.
An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma and may show signs of osteoarthritis.
An MRI (Magnetic Resonance Imaging) detects abnormalities of the bone or knee joint, such as a tear in the ligaments, tendons or cartilage.
If the knee is swollen, red and warm to the touch when compared to the other knee, a doctor may be concerned about inflammation due to rheumatoid arthritis or a crystalline arthritis, such as gout or pseudogout, or joint infection. Besides sending the joint fluid to a laboratory for analysis, he or she may request blood tests to determine a white blood cell count, erythrocyte sedimentation rate, and perhaps the level of C-reactive protein or uric acid. If blood tests reveal Lyme's disease antibodies forming, the condition may be attributed to it.
Psoriatic arthritis often undiagnosed cause of joint conditions. Patients with the skin condition psoriasis can also have the related arthritis subtype called psoriatic arthritis. This arthritic condition tends to be overlooked, even in patients with diagnosed psoriasis.
What are the treatment options for Knee Effusion?
Along with any sort of medical care, knee joint effusion responds well to simple self-care measures, such as rest and elevation as well as icing and exercise. As with any sort of injury, ice should be applied to the affected area only for 15 to 20 minutes at a time. With exercise, a series of fitness activities are established by a physical therapist to strengthen the area to support the weakened knee.
Most treatments for knee joint effusion are based on the cause of the condition, making a "standard" approach to care nonexistent. However, many people with water on the knee need to have the excess fluid removed, so one may undergo a procedure known as aspiration.
Finally, one may need a series of corticosteroid injections, non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics to reduce inflammation or treat an infection. For others, knee surgery or even joint replacement may be necessary.
Preventing Knee Effusion
Avoiding sudden jolting movements and rough running surfaces can help prevent knee injuries. Obesity adds pressure to the vulnerable knee joint, so weight reduction may help.
Exercises considered better for the knees include small (not deep) knee bends and straightening motions done while in supination with most weight on the outside of the foot.
Sports that are easier on the knees include walking, swimming (flutter kicks, knees straight), skating, baseball, cross-country skiing, and, depending on the state of the knee, cycling (seat high, low gear, avoiding hills).
Choose activities to suit your own knee strength and capacity, and remember that sports especially hard on the knees include football, sprinting, soccer, rugby, hockey, squash, volleyball, basketball, downhill skiing, tennis and jogging or anything that pounds, jolts, or twists the knees.
Written by Sy Kraft (B.A.)
пятница, 30 сентября 2011 г.
вторник, 27 сентября 2011 г.
Flexcin Arthritis Remedy Proves Worthy Substitution For Acetaminophen
An advisory panel for the Food and Drug Administration (FDA) recently recommended limiting sales of acetaminophen products like Tylenol and also recommended banning prescription pain medications Vicodin and Percocet. This recommendation will prompt more people to change their habits and focus on joint pain remedy and pain relievers found in the natural vitamin supplements industry for arthritis treatment.
Acetaminophen, along with prescription pain medications like Vicodin and Percocet, have all recently made headlines attracting consumers' attention because the FDA panel believes the drugs pose a risk of liver failure. The headlines underscore why 32 percent more people are now choosing arthritis remedy supplements like Flexcin, which offers the only joint pain treatment with the CM8TM ingredient.
"Like millions of others, I have little interest in taking prescription pain medications because of the uncomfortable and dangerous side effects that can possibly do even more harm to my body," said Lisa Sharron, who takes Flexcin arthritis remedy regularly. "Additionally, I don't want to just put a mask over my pain, I want to repair my arthritis so I can get back to living a normal life, which Flexcin joint pain remedy allows me to do."
Unlike prescription pain medications that work to mask pain, Flexcin with CM8 (cetyl myristoleate) is a natural vitamin supplement that instead works to repair joint damage. Flexcin with CM8 works as an arthritis remedy, joint pain treatment and arthritis treatment for hip pain, shoulder, knee, elbow, hand or foot pain, and muscle pain. Cetyl myristoleate is clinically proven to promote optimal joint health by helping to stimulate the lubricating fluid in the joints, support stronger cartilage and increase total mobility.
Source
Flexcin International, Inc.
Acetaminophen, along with prescription pain medications like Vicodin and Percocet, have all recently made headlines attracting consumers' attention because the FDA panel believes the drugs pose a risk of liver failure. The headlines underscore why 32 percent more people are now choosing arthritis remedy supplements like Flexcin, which offers the only joint pain treatment with the CM8TM ingredient.
"Like millions of others, I have little interest in taking prescription pain medications because of the uncomfortable and dangerous side effects that can possibly do even more harm to my body," said Lisa Sharron, who takes Flexcin arthritis remedy regularly. "Additionally, I don't want to just put a mask over my pain, I want to repair my arthritis so I can get back to living a normal life, which Flexcin joint pain remedy allows me to do."
Unlike prescription pain medications that work to mask pain, Flexcin with CM8 (cetyl myristoleate) is a natural vitamin supplement that instead works to repair joint damage. Flexcin with CM8 works as an arthritis remedy, joint pain treatment and arthritis treatment for hip pain, shoulder, knee, elbow, hand or foot pain, and muscle pain. Cetyl myristoleate is clinically proven to promote optimal joint health by helping to stimulate the lubricating fluid in the joints, support stronger cartilage and increase total mobility.
Source
Flexcin International, Inc.
суббота, 24 сентября 2011 г.
NIH GAIT Study Supports Use Of Glucosamine And Chondroitin For Osteoarthritis Treatment
Arthritis experts and orthopaedic surgeons are discussing the
results of the NIH study that shows a supplement to be as effective as the
most expensive NSAIDs for moderate and severe pain from arthritis.
Dr. Kevin R. Stone, Chairman of the Stone Foundation for Sports Medicine
and Arthritis Research in San Francisco pioneered the use of glucosamine in a
beverage form for athletes and arthritis sufferers and is vocal about the
results of this new study.
"The supplements glucosamine and chondroitin together, which are
inexpensive and have zero negative side effects, performed as well as the very
expensive and somewhat risky Celebrex," said Stone. "I believe the standard
of care in medicine will now be to prescribe the supplements first and if they
are not enough then to add additional medications," Stone said.
The GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) study
funded by the National Institutes for Health (NIH)) evaluates the use of
glucosamine and chondroitin in treating and preventing osteoarthritis.
(nccam.nih/news/19972000/121100/qa.htm#12)
Published study results indicate that the combination of glucosamine and
chondroitin sulfate might be most effective in osteoarthritis patients who had
moderate to severe knee pain.
As a physician treating patients with glucosamine and chondroitin for more
than a decade, Dr. Stone says, "We recommend it for all our patients, both
athletes and those with arthritis. Many of our patients with arthritis have
given up using nonsteroidal anti-inflammatories because glucosamine has been
effective for them." Stone prescribes 1,500 milligrams a day, taken all at
once in beverage form.
WHO: Harvard- and UNC at Chapel Hill-educated Dr. Kevin R. Stone, founder
of the Stone Clinic and chairman of the Stone Foundation for Sports Medicine
and Arthritis Research (stoneclinic), and inventor and founder of
Joint Juice, the first glucosamine beverage. Dr. Stone has provided
commentary for media ranging from The Wall Street Journal and Newsweek to
USAToday and CBSNews, is the author of numerous scientific articles, and is a
frequent lecturer at leading forums and symposia. He is passionate and
objective about the role of supplements in medical practice.
WHEN: Dr. Stone is available for phone and in-person interviews now.
WHERE: Dr. Stone is based in San Francisco.
Background
Initiated in 1998, GAIT is the first multicenter clinical trial in the
United States to test the effects of the dietary supplements glucosamine and
chondroitin for treatment of knee osteoarthritis.
The study tests whether glucosamine and chondroitin used separately or in
combination are effective in reducing pain in patients with knee
osteoarthritis. GAIT includes an additional study (or sub-study) that will
assess whether glucosamine and chondroitin can reduce or halt the progression
of knee osteoarthritis.
GAIT was designed to rigorously assess the effectiveness and safety of
these supplements when taken separately or in combination. Almost 1,600
patients with painful knee osteoarthritis were recruited from 16 U.S. academic
rheumatology centers for the study.
Results of previous studies in the medical literature have yielded
conflicting results on the effectiveness of glucosamine and chondroitin as
treatments for osteoarthritis. This study tested the short-term (6 months)
effectiveness of glucosamine and chondroitin in reducing pain in a large
number of patients with knee osteoarthritis.
The sub-study will also evaluate the impact of glucosamine and chondroitin
on progression of knee osteoarthritis following an additional 18-month
treatment regimen.
Stone Research Foundation
stoneclinic
results of the NIH study that shows a supplement to be as effective as the
most expensive NSAIDs for moderate and severe pain from arthritis.
Dr. Kevin R. Stone, Chairman of the Stone Foundation for Sports Medicine
and Arthritis Research in San Francisco pioneered the use of glucosamine in a
beverage form for athletes and arthritis sufferers and is vocal about the
results of this new study.
"The supplements glucosamine and chondroitin together, which are
inexpensive and have zero negative side effects, performed as well as the very
expensive and somewhat risky Celebrex," said Stone. "I believe the standard
of care in medicine will now be to prescribe the supplements first and if they
are not enough then to add additional medications," Stone said.
The GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) study
funded by the National Institutes for Health (NIH)) evaluates the use of
glucosamine and chondroitin in treating and preventing osteoarthritis.
(nccam.nih/news/19972000/121100/qa.htm#12)
Published study results indicate that the combination of glucosamine and
chondroitin sulfate might be most effective in osteoarthritis patients who had
moderate to severe knee pain.
As a physician treating patients with glucosamine and chondroitin for more
than a decade, Dr. Stone says, "We recommend it for all our patients, both
athletes and those with arthritis. Many of our patients with arthritis have
given up using nonsteroidal anti-inflammatories because glucosamine has been
effective for them." Stone prescribes 1,500 milligrams a day, taken all at
once in beverage form.
WHO: Harvard- and UNC at Chapel Hill-educated Dr. Kevin R. Stone, founder
of the Stone Clinic and chairman of the Stone Foundation for Sports Medicine
and Arthritis Research (stoneclinic), and inventor and founder of
Joint Juice, the first glucosamine beverage. Dr. Stone has provided
commentary for media ranging from The Wall Street Journal and Newsweek to
USAToday and CBSNews, is the author of numerous scientific articles, and is a
frequent lecturer at leading forums and symposia. He is passionate and
objective about the role of supplements in medical practice.
WHEN: Dr. Stone is available for phone and in-person interviews now.
WHERE: Dr. Stone is based in San Francisco.
Background
Initiated in 1998, GAIT is the first multicenter clinical trial in the
United States to test the effects of the dietary supplements glucosamine and
chondroitin for treatment of knee osteoarthritis.
The study tests whether glucosamine and chondroitin used separately or in
combination are effective in reducing pain in patients with knee
osteoarthritis. GAIT includes an additional study (or sub-study) that will
assess whether glucosamine and chondroitin can reduce or halt the progression
of knee osteoarthritis.
GAIT was designed to rigorously assess the effectiveness and safety of
these supplements when taken separately or in combination. Almost 1,600
patients with painful knee osteoarthritis were recruited from 16 U.S. academic
rheumatology centers for the study.
Results of previous studies in the medical literature have yielded
conflicting results on the effectiveness of glucosamine and chondroitin as
treatments for osteoarthritis. This study tested the short-term (6 months)
effectiveness of glucosamine and chondroitin in reducing pain in a large
number of patients with knee osteoarthritis.
The sub-study will also evaluate the impact of glucosamine and chondroitin
on progression of knee osteoarthritis following an additional 18-month
treatment regimen.
Stone Research Foundation
stoneclinic
среда, 21 сентября 2011 г.
Pain Is Not A Symptom Of Arthritis, Pain Causes Arthritis: New Study
Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, according to a study published today in journal Arthritis and Rheumatism. More specifically, the study revealed that pain signals originating in arthritic joints, and the biochemical processing of those signals as they reach the spinal cord, worsen and expand arthritis. In addition, researchers found that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again, causing disease at both ends.
Technically, pain is a patient's conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.
Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips.
"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," said Stephanos Kyrkanides, D.D.S., Ph.D., associate professor of Dentistry at the University of Rochester Medical Center. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect," said Kyrkanides, whose work on genetics in dentistry led to broader applications. The common ground between arthritis and dentistry: the jaw joint is a common site of arthritic pain.
Study Details
Past studies have shown that specific nerve pathways along which pain signals travel repeatedly become more sensitive to pain signals with each use. This may be a part of ancient survival skill (if that hurt once, don't do it again). Secondly, pain has long been associated with inflammation (swelling and fever).
In fact, past research has shown that the same chemicals that cause inflammation also cause the sensation of pain and hyper-sensitivity to pain if injected. Kyrkanides' work centers around one such pro-inflammatory, signaling chemical called Interleukin 1-beta (IL-1??), which helps to ramp up the bodies attack on an infection.
Specifically, Kyrkanides' team genetically engineered a mouse where they could turn up on command the production of IL-1?? in the jaw joint, a common site of arthritis. Experiments showed for the first time that turning up IL-1?? in a peripheral joint caused higher levels of IL-1?? to be produced in the dorsal horns of the spinal cord as well.
Using a second, even more elaborately engineered mouse model, the team also demonstrated for the first time that creating higher levels of IL-1?? in cells called astrocytes in the spinal cord caused more osteoarthritic symptoms in joints. Past studies had shown astrocytes, non-nerve cells (glia) in the central nervous system that provide support for the spinal cord and brain, also serve as the immune cells of CNS organs. Among other things, they release cytokines like IL-1?? to fight disease when triggered. The same cytokines released from CNS glia may also be released from neurons in joints, possibly explaining how crosstalk carries pain, inflammation and hyper-sensitivity back and forth.
In both mouse models, experimental techniques that shut down IL-1?? signaling reversed the crosstalk effects. Specifically, researchers used a molecule, IL-1RA, known to inhibit the ability of IL-1?? to link up with its receptors on nerve cells. Existing drugs (e.g. Kineret® (anakinra), made by Amgen and indicated for rheumatoid arthritis) act like IL-1RA to block the ability IL-1?? to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is exploring a new use for them as osteoarthritis treatment.
The implications of this process go further, however, because the cells surrounding sensory nerve cell pathways too can be affected by crosstalk. If 10 astrocytes secrete IL-1?? in response to a pain impulse, Kyrkanides said, perhaps 1,000 adjacent cells will be affected, greatly expanding the field of inflammation. Spinal cord astrocytes are surrounded by sensory nerve cells that connect to other areas of the periphery, further expanding the effect. According to Kyrkanides' model, increased inflammation by in the central nervous system can then send signals back down the nerve pathways to the joints, causing the release of inflammatory factors there.
Among the proposed, inflammatory factors is calcitonin gene related peptide (CGRP). The team observed higher levels calcitonin-gene related peptide (CGRP) production in primary sensory fibers in the same regions where IL-1?? levels rose, and the release of IL-1?? by sensory neurons may cause the release of CGRP in joints. Past studies in Kyrkanides reveal that CGRP can also cause cartilage-producing cells (chondrocytes) to mature too quickly and die, a hallmark of osteoarthritis.
Joining Kyrkanides in the publication from the University of Rochester School of Medicine and Dentistry were co-authors M. Kerry O'Banion, M.D., Ph.D., Ross Tallents, D.D.S., J. Edward Puzas, Ph.D. and Sabine M. Brouxhon, M.D. Paolo Fiorentino was a student contributor and Jennie Miller was involved as Kyrkanides' technical associate. Maria Piancino, led a collaborative effort at the University of Torino, Italy. This work was supported in part by grants from the National Institutes of Health.
"Our study results confirm that joints can export inflammation in the form of higher IL-1?? along sensory nerve pathways to the spinal cord, and that higher IL-1?? inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints," Kyrkanides said. "We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Kineret.
Technically, pain is a patient's conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides strong evidence that two-way, nociceptive "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.
Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis. Armed with the results, researchers have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips.
"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, and inevitable part of aging," said Stephanos Kyrkanides, D.D.S., Ph.D., associate professor of Dentistry at the University of Rochester Medical Center. "Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect," said Kyrkanides, whose work on genetics in dentistry led to broader applications. The common ground between arthritis and dentistry: the jaw joint is a common site of arthritic pain.
Study Details
Past studies have shown that specific nerve pathways along which pain signals travel repeatedly become more sensitive to pain signals with each use. This may be a part of ancient survival skill (if that hurt once, don't do it again). Secondly, pain has long been associated with inflammation (swelling and fever).
In fact, past research has shown that the same chemicals that cause inflammation also cause the sensation of pain and hyper-sensitivity to pain if injected. Kyrkanides' work centers around one such pro-inflammatory, signaling chemical called Interleukin 1-beta (IL-1??), which helps to ramp up the bodies attack on an infection.
Specifically, Kyrkanides' team genetically engineered a mouse where they could turn up on command the production of IL-1?? in the jaw joint, a common site of arthritis. Experiments showed for the first time that turning up IL-1?? in a peripheral joint caused higher levels of IL-1?? to be produced in the dorsal horns of the spinal cord as well.
Using a second, even more elaborately engineered mouse model, the team also demonstrated for the first time that creating higher levels of IL-1?? in cells called astrocytes in the spinal cord caused more osteoarthritic symptoms in joints. Past studies had shown astrocytes, non-nerve cells (glia) in the central nervous system that provide support for the spinal cord and brain, also serve as the immune cells of CNS organs. Among other things, they release cytokines like IL-1?? to fight disease when triggered. The same cytokines released from CNS glia may also be released from neurons in joints, possibly explaining how crosstalk carries pain, inflammation and hyper-sensitivity back and forth.
In both mouse models, experimental techniques that shut down IL-1?? signaling reversed the crosstalk effects. Specifically, researchers used a molecule, IL-1RA, known to inhibit the ability of IL-1?? to link up with its receptors on nerve cells. Existing drugs (e.g. Kineret® (anakinra), made by Amgen and indicated for rheumatoid arthritis) act like IL-1RA to block the ability IL-1?? to send a pain signal through its specific nerve cell receptor, and Kyrkanides' group is exploring a new use for them as osteoarthritis treatment.
The implications of this process go further, however, because the cells surrounding sensory nerve cell pathways too can be affected by crosstalk. If 10 astrocytes secrete IL-1?? in response to a pain impulse, Kyrkanides said, perhaps 1,000 adjacent cells will be affected, greatly expanding the field of inflammation. Spinal cord astrocytes are surrounded by sensory nerve cells that connect to other areas of the periphery, further expanding the effect. According to Kyrkanides' model, increased inflammation by in the central nervous system can then send signals back down the nerve pathways to the joints, causing the release of inflammatory factors there.
Among the proposed, inflammatory factors is calcitonin gene related peptide (CGRP). The team observed higher levels calcitonin-gene related peptide (CGRP) production in primary sensory fibers in the same regions where IL-1?? levels rose, and the release of IL-1?? by sensory neurons may cause the release of CGRP in joints. Past studies in Kyrkanides reveal that CGRP can also cause cartilage-producing cells (chondrocytes) to mature too quickly and die, a hallmark of osteoarthritis.
Joining Kyrkanides in the publication from the University of Rochester School of Medicine and Dentistry were co-authors M. Kerry O'Banion, M.D., Ph.D., Ross Tallents, D.D.S., J. Edward Puzas, Ph.D. and Sabine M. Brouxhon, M.D. Paolo Fiorentino was a student contributor and Jennie Miller was involved as Kyrkanides' technical associate. Maria Piancino, led a collaborative effort at the University of Torino, Italy. This work was supported in part by grants from the National Institutes of Health.
"Our study results confirm that joints can export inflammation in the form of higher IL-1?? along sensory nerve pathways to the spinal cord, and that higher IL-1?? inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints," Kyrkanides said. "We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Kineret.
воскресенье, 18 сентября 2011 г.
Geisinger Rheumatology Experts To Present At National Conference
The Geisinger Department of Rheumatology has been selected to present six abstracts at the 2009 American College of Rheumatology (ACR)/Association of Rheumatology Health Professionals (ARHP) Annual Scientific Meeting in Philadelphia Oct. 16-21.
In addition, Rheumatology Director Eric Newman, M.D., will present a workshop on Practical Approaches to Redesigning Your Rheumatology Practice, and chair and moderate a podium session, Quality Measures and Innovations in Practice Management and Delivery of Care. Rheumatologist Thomas P. Olenginski, M.D., FACP, will participate in a Meet the Professor session on Osteoporosis-Applying FRAX Methodology and moderate a clinical symposium regarding Osteoporosis Care in 2010.
"All six of the abstracts submitted by our department were selected for the scientific meeting," said Dr. Newman. "This level of acceptance speaks to the high caliber of work being done at Geisinger. It is an honor for the rheumatology department to be recognized by such esteemed professional organizations."
Podium presentations and presenters at the scientific meeting include: Rheumatology Touch Screen Questionnaire to Improve Efficiency and Patient-centric Care with Successful Development and Implementation Using Process Redesign (Dr. Newman); Closing Osteoporosis Care Gaps through Process Redesign-The Primary Care/Rheumatology DXA Partnership (Dr. Newman); and Glucocorticoid-Induced Osteoporosis Program (GIOP)-A Highly Successful Care Program with Improved Clinical Outcomes After Two Years (Cynthia Matzko, RN, MSN, clinical nurse specialist.
Poster presentations and presenters include: High-Risk Osteoporosis Clinic (HiROC)-Closing the Loop in Clinical Osteoporosis Care (Dr. Olenginski); DXA Testing in Women Older than 65-Closing the Osteoporosis Quality Care Gap at the Point of Service Using an Electronic Health Record Best Practice Alert (Dr. Newman); and Hydroxychloroquine Use-Significant Improvement of Lipid Profile in Rheumatoid Arthritis Patients (Stephanie Morris, D.O., fellow).
More than 5,000 abstracts are submitted worldwide for the ACR/ARHP Annual Scientific Meeting; however, only about 5 percent are accepted for podium presentations and 30 percent for poster presentations. More than 13,000 health professionals from around the world are expected to attend this year.
ABOUT GEISINGER HEALTH SYSTEM
Founded in 1915, Geisinger Health System is one of the nation's largest integrated health services organizations. Serving more than two million residents throughout central and northeast Pennsylvania, the physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger is comprised of two medical centers, a children's hospital, 740-member group practice, a not-for-profit health insurance company and the Henry Hood Center for Health Research dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes.
Source: Geisinger Health System
In addition, Rheumatology Director Eric Newman, M.D., will present a workshop on Practical Approaches to Redesigning Your Rheumatology Practice, and chair and moderate a podium session, Quality Measures and Innovations in Practice Management and Delivery of Care. Rheumatologist Thomas P. Olenginski, M.D., FACP, will participate in a Meet the Professor session on Osteoporosis-Applying FRAX Methodology and moderate a clinical symposium regarding Osteoporosis Care in 2010.
"All six of the abstracts submitted by our department were selected for the scientific meeting," said Dr. Newman. "This level of acceptance speaks to the high caliber of work being done at Geisinger. It is an honor for the rheumatology department to be recognized by such esteemed professional organizations."
Podium presentations and presenters at the scientific meeting include: Rheumatology Touch Screen Questionnaire to Improve Efficiency and Patient-centric Care with Successful Development and Implementation Using Process Redesign (Dr. Newman); Closing Osteoporosis Care Gaps through Process Redesign-The Primary Care/Rheumatology DXA Partnership (Dr. Newman); and Glucocorticoid-Induced Osteoporosis Program (GIOP)-A Highly Successful Care Program with Improved Clinical Outcomes After Two Years (Cynthia Matzko, RN, MSN, clinical nurse specialist.
Poster presentations and presenters include: High-Risk Osteoporosis Clinic (HiROC)-Closing the Loop in Clinical Osteoporosis Care (Dr. Olenginski); DXA Testing in Women Older than 65-Closing the Osteoporosis Quality Care Gap at the Point of Service Using an Electronic Health Record Best Practice Alert (Dr. Newman); and Hydroxychloroquine Use-Significant Improvement of Lipid Profile in Rheumatoid Arthritis Patients (Stephanie Morris, D.O., fellow).
More than 5,000 abstracts are submitted worldwide for the ACR/ARHP Annual Scientific Meeting; however, only about 5 percent are accepted for podium presentations and 30 percent for poster presentations. More than 13,000 health professionals from around the world are expected to attend this year.
ABOUT GEISINGER HEALTH SYSTEM
Founded in 1915, Geisinger Health System is one of the nation's largest integrated health services organizations. Serving more than two million residents throughout central and northeast Pennsylvania, the physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger is comprised of two medical centers, a children's hospital, 740-member group practice, a not-for-profit health insurance company and the Henry Hood Center for Health Research dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes.
Source: Geisinger Health System
четверг, 15 сентября 2011 г.
Plexxikon Initiates Phase 1 Clinical Trial For Oral Rheumatoid Arthritis Agent PLX5622
Plexxikon Inc. announced that dosing began in the first of two Phase 1 clinical trials with PLX5622, a novel, oral and highly selective Fms inhibitor, targeted for the treatment of rheumatoid arthritis (RA). PLX5622 has been shown in preclinical arthritis models to reduce inflammation, reduce cartilage damage and prevent bone resorption. Fms-related inflammatory mediators and cells, including macrophages, osteoclasts and T-cells, have been validated as key players in RA, other autoimmune diseases and osteoarthritis.
The initial Phase 1 trial is a single-ascending dose study in 32 healthy volunteers. The second trial is a multiple-ascending dose study in 32 RA patients that will begin once the first cohort of healthy volunteers has been cleared for safety, with continued enrollment in a staggered fashion relative to the single-ascending dose study.
"PLX5622 is an important and differentiated candidate among Plexxikon's portfolio of Fms inhibitors that are being developed for multiple indications, and yet another first-in-class compound from Plexxikon," said K. Peter Hirth, CEO of Plexxikon. "By targeting key drivers of the inflammatory process, we are hopeful that PLX5622 may provide relief to patients with rheumatoid arthritis and other autoimmune disorders, with the convenience of a pill."
PLX5622 is expected to provide therapeutic benefit by modulating macrophage proliferation, inhibiting production of pro-inflammatory cytokines, and preventing the formation of osteoclasts. Osteoclasts' bone resorptive activity is responsible for excessive bone destruction in several diseases.
In preclinical models of arthritis, PLX5622 demonstrated substantial disease suppression, including in advanced models of collagen-induced arthritis. PLX5622 significantly improved grip strength and clinical scores, as well as improved knee joint range-of-motion scores.
Plexxikon is completing a Phase 1 trial with PLX3397, another Plexxikon Fms inhibitor that selectively targets Fms, Kit and the Flt-3-ITD mutation. This study has provided validation of Fms-specific biomarkers, which will be directly applicable to the development of PLX5622 in defining a dose response. The company plans to initiate several proof-of-concept clinical trials with PLX3397, including in Hodgkin lymphoma, glioblastoma, acute myelogenous leukemia (AML) and metastatic breast cancer in 2011.
About Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, and swelling primarily in the joints, and affects more than 1.3 million Americans.
RA occurs when the body's immune system malfunctions and attacks healthy tissue. This malfunction causes inflammation which leads to pain, swelling in the joints and may eventually cause permanent joint damage, bone erosion and deformation, and painful disability.
Source:
Plexxikon
The initial Phase 1 trial is a single-ascending dose study in 32 healthy volunteers. The second trial is a multiple-ascending dose study in 32 RA patients that will begin once the first cohort of healthy volunteers has been cleared for safety, with continued enrollment in a staggered fashion relative to the single-ascending dose study.
"PLX5622 is an important and differentiated candidate among Plexxikon's portfolio of Fms inhibitors that are being developed for multiple indications, and yet another first-in-class compound from Plexxikon," said K. Peter Hirth, CEO of Plexxikon. "By targeting key drivers of the inflammatory process, we are hopeful that PLX5622 may provide relief to patients with rheumatoid arthritis and other autoimmune disorders, with the convenience of a pill."
PLX5622 is expected to provide therapeutic benefit by modulating macrophage proliferation, inhibiting production of pro-inflammatory cytokines, and preventing the formation of osteoclasts. Osteoclasts' bone resorptive activity is responsible for excessive bone destruction in several diseases.
In preclinical models of arthritis, PLX5622 demonstrated substantial disease suppression, including in advanced models of collagen-induced arthritis. PLX5622 significantly improved grip strength and clinical scores, as well as improved knee joint range-of-motion scores.
Plexxikon is completing a Phase 1 trial with PLX3397, another Plexxikon Fms inhibitor that selectively targets Fms, Kit and the Flt-3-ITD mutation. This study has provided validation of Fms-specific biomarkers, which will be directly applicable to the development of PLX5622 in defining a dose response. The company plans to initiate several proof-of-concept clinical trials with PLX3397, including in Hodgkin lymphoma, glioblastoma, acute myelogenous leukemia (AML) and metastatic breast cancer in 2011.
About Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, and swelling primarily in the joints, and affects more than 1.3 million Americans.
RA occurs when the body's immune system malfunctions and attacks healthy tissue. This malfunction causes inflammation which leads to pain, swelling in the joints and may eventually cause permanent joint damage, bone erosion and deformation, and painful disability.
Source:
Plexxikon
понедельник, 12 сентября 2011 г.
Hit Back At Pain, Says Arthritis Care, England
A shocking 90% of calls to Arthritis Care's helpline in the last 12 months have been cries for help over pain - so this year, the charity is marking its awareness week by urging doctors, nurses and allied health professionals to support people with arthritis in making a special challenge to pain and the constraints it imposes on their lives.
Pain is the chief reason people give for visiting their GP - and arthritis and musculoskeletal disorders are the commonest cause of that pain. That's why the charity has chosen 'Take control of pain' as the theme for this year's Arthritis Care Awareness Week, and is also calling for more investment in vital pain management services across the country.
Arthritis Care's chief executive Neil Betteridge said: "Most people with chronic pain have some form of arthritis, and when you are stuck with debilitating pain year in, year out, you may be unaware of new developments in treatment - some available on prescription, but many that don't require a doctor's signature. We want to remind people that something can always be done, and that if you can take control of your pain, you really can reclaim great tracts of your life.
Our message during this year's Arthritis Care Awareness Week is simple: nobody with arthritis should be struggling alone with pain. We want people to take a fresh look at how they are managing it. There's plenty of support out there. For example, people with arthritis can ask their pharmacist about any new drugs or products on the market, request a medication review, keep a pain diary, and speak to their GP about referral to a pain specialist, to physiotherapy, hydrotherapy, or to an ergonomist, or occupational therapist."
Arthritis Care believes that if pain were regarded as the 'fifth vital sign', it would be managed more holistically and effectively. Chronic pain has a major impact on people's lives, causing sleeplessness and depression and interfering with everyday activities. It can destroy physical mobility and mental concentration, and undermine all aspects of social, family and work life. People with chronic pain are seven times more likely to quit their jobs due to ill health than the general population. Overall, 25% of people with chronic pain eventually lose their jobs4.
"Drugs and surgery have an obvious place in pain management but GPs and nurses can also think about 'information prescriptions' - perhaps pointing people with arthritis to services like Arthritis Care's website, with its free, downloadable resources on living with arthritis, and its free-to-enter peer-support forums. They can also direct patients to the free professionally-staffed Helplines, or prescribe one of the free-to-user Arthritis Care courses like 'Challenging Pain' where patients learn pain-cheating techniques and develop a step-by-step plan to take control of their condition,"said Neil Betteridge.
65-year-old Muriel Weisz from Nottingham, was diagnosed with rheumatoid arthritis two years ago - a month before retiring from her work as a social care manager. Muriel, who recently formed a self help group for people with arthritis, said: "I'm in some level of pain everyday and where it is in my body changes often. One of the worst things is waking up not knowing which part of you is going to hurt most that day - at the moment it's my feet and wrists. For example, there's sometimes a pain that's so paralyzing - I go to swing my legs out of bed in the morning and the pain is so intense that I have to stop and prepare myself for making any smaller movement to test out what going to be possible.
"Walking outside the house is just too painful. Sometimes I use a wheelchair to help me get around, but I'm just not very mobile - it's so strange to think that 6 months before I was diagnosed, I'd walked the Cumbrian Way!
"It's taking a lot to get used to not being able to do the things that I used to, but learning about my condition and how to deal with the pain means that I have some kind of control and that's crucial. I keep a pain diary so that when I see my doctor I can tell him exactly how many days of the month I've been in severe pain or too tired to get out of bed. I've also just started on a trial for a new medication and it's working wonders for me - the pain and inflammation has reduced considerably and my friends keep telling me how much better and less tired I look.
"When I was first diagnosed, reading Arthritis Care's magazine, which had information about rheumatoid arthritis, appropriate treatments and also the experiences of other people with arthritis, was incredibly helpful.
"My advice to anyone out there struggling with arthritis is : don't try to pretend to the outside world that the pain isn't there - make sure you're honest with your family and friends about the support you need. Have the confidence to say how you're experiencing the pain to your GP, so they know exactly what's going on. There might be a solution out there that could really help you, but you won't know if you stay silent."
Neil Betteridge added: "As well as encouraging people with arthritis to take control of their own pain we also call on all national governments in the UK to improve the services available to people with arthritis. In his recent report, Sir Liam Donaldson the Chief Medical Officer for England, concludedthat a major initiative to widen access to high-quality pain services was needed to improve the lives of millions of people in the UK3. We know that there are people with arthritis who struggle for years in pain before they get any kind of specialist support. Arthritis Care believes that pain services in the UK are under-funded and urgently in need of investment. We want to see GPs more committed to assessing and monitoring people's pain, a better network of specialist pain clinics, and more accessible services like physiotherapy and hydrotherapy to help people to reduce their pain levels."
Arthritis Care will mark the week by extending its Helplines service, offering a free 'Pain Pack', and running its free-to-user 'Challenging Pain' courses in venues around the UK. To order a free 'Pain Pack' or for information about arthritis go to arthritiscare.uk or call Arthritis Care's Helpline on 0808 800 4050.
Take control of arthritis pain - Ten Arthritis Care Tips
1. Lighten Up: Shed excess pounds to reduce stress on weight-bearing joints, like back, hips, and knees.
2. Be a Poser: Use good posture to protect your back and the joints of your legs and feet. Alter position often, take a break from the desk, and sit down to do some tasks instead of bending awkwardly.
3. Don't suffer in silence: Your GP needs to know that you are in pain, and what kind in order to find you an effective treatment or refer you to a pain management specialist.
4. Mix it up: Different pain can be eased by different drugs and treatments. Discuss with your doctor and pharmacist the best combination for your condition.
5. The Ex Factor: Exercise releases the body's own natural 'morphine' in the form of endorphins so appropriate exercise really can make you feel better.
6. Chuck out the chintz! Have a look at your furniture and decide if your bed and chairs are helping your pain or making it worse.
7. Listen to pain: Don't force already damaged, painful, or stiff joints into an activity that puts strain on them. But remember joints are supposed to move, so do not be afraid of persevering with gentle exercise recommended by your clinician.
8. Have an Exit Strategy: Plan how to leave before you arrive if you can't stand or walk for long. Plot your ways of lifting, carrying, pulling, pushing, or carrying objects before starting the action.
9. Big it up: Make your strongest joints and muscles work harder to cut stress on smaller joints - e.g. use a backpack instead of a briefcase or handbag, sparing fingers and wrist. Lift heavy objects in your arms instead of with your hands
10. Doctor Gadget: Look in Arthritis News and catalogues for self-help products - designed to make everyday tasks easier. Occupational therapists, physiotherapists, ergonomists and doctors can suggest helpful work or home devices.
Notes
1. Arthritis Care exists to support people with arthritis. We are the UK's largest organisation working with and for all people who have arthritis. We are a user led organisation which means people with arthritis are at the heart of our work - they form our membership, are involved in all of our activities and direct what we do.
2. Arthritis is the biggest single cause of physical disability in the United Kingdom, affecting people of all ages, including 12,000 children .Arthritis means inflammation of the joints. Most people with arthritis will experience pain and difficulty moving around. Over nine million people in the UK have arthritis. There are over 200 kinds of rheumatic diseases - the word rheumatic means aches and pains in joints, bones and muscles. Two of the most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA).
Arthritis is not just a disease of older people - it can affect people of all ages, including babies and children. It is not clear what causes arthritis and there is no cure at present. However, there is plenty you can do to manage your condition and lead a full and active life.
3. The Chief Medical Officer's Annual Report 2008
4. The Chief Medical Officer's Annual Report 2008
- 7.8 million people live with chronic pain
- ??3.8 billion cost of adolescent pain
- ??584 million spent on prescriptions for pain
- 49% of people with chronic pain experience depression
- 25% of people with chronic pain lose their jobs
- 16% of people feel their chronic pain is so bad that they sometimes want to die
Source
Arthritis Care
Pain is the chief reason people give for visiting their GP - and arthritis and musculoskeletal disorders are the commonest cause of that pain. That's why the charity has chosen 'Take control of pain' as the theme for this year's Arthritis Care Awareness Week, and is also calling for more investment in vital pain management services across the country.
Arthritis Care's chief executive Neil Betteridge said: "Most people with chronic pain have some form of arthritis, and when you are stuck with debilitating pain year in, year out, you may be unaware of new developments in treatment - some available on prescription, but many that don't require a doctor's signature. We want to remind people that something can always be done, and that if you can take control of your pain, you really can reclaim great tracts of your life.
Our message during this year's Arthritis Care Awareness Week is simple: nobody with arthritis should be struggling alone with pain. We want people to take a fresh look at how they are managing it. There's plenty of support out there. For example, people with arthritis can ask their pharmacist about any new drugs or products on the market, request a medication review, keep a pain diary, and speak to their GP about referral to a pain specialist, to physiotherapy, hydrotherapy, or to an ergonomist, or occupational therapist."
Arthritis Care believes that if pain were regarded as the 'fifth vital sign', it would be managed more holistically and effectively. Chronic pain has a major impact on people's lives, causing sleeplessness and depression and interfering with everyday activities. It can destroy physical mobility and mental concentration, and undermine all aspects of social, family and work life. People with chronic pain are seven times more likely to quit their jobs due to ill health than the general population. Overall, 25% of people with chronic pain eventually lose their jobs4.
"Drugs and surgery have an obvious place in pain management but GPs and nurses can also think about 'information prescriptions' - perhaps pointing people with arthritis to services like Arthritis Care's website, with its free, downloadable resources on living with arthritis, and its free-to-enter peer-support forums. They can also direct patients to the free professionally-staffed Helplines, or prescribe one of the free-to-user Arthritis Care courses like 'Challenging Pain' where patients learn pain-cheating techniques and develop a step-by-step plan to take control of their condition,"said Neil Betteridge.
65-year-old Muriel Weisz from Nottingham, was diagnosed with rheumatoid arthritis two years ago - a month before retiring from her work as a social care manager. Muriel, who recently formed a self help group for people with arthritis, said: "I'm in some level of pain everyday and where it is in my body changes often. One of the worst things is waking up not knowing which part of you is going to hurt most that day - at the moment it's my feet and wrists. For example, there's sometimes a pain that's so paralyzing - I go to swing my legs out of bed in the morning and the pain is so intense that I have to stop and prepare myself for making any smaller movement to test out what going to be possible.
"Walking outside the house is just too painful. Sometimes I use a wheelchair to help me get around, but I'm just not very mobile - it's so strange to think that 6 months before I was diagnosed, I'd walked the Cumbrian Way!
"It's taking a lot to get used to not being able to do the things that I used to, but learning about my condition and how to deal with the pain means that I have some kind of control and that's crucial. I keep a pain diary so that when I see my doctor I can tell him exactly how many days of the month I've been in severe pain or too tired to get out of bed. I've also just started on a trial for a new medication and it's working wonders for me - the pain and inflammation has reduced considerably and my friends keep telling me how much better and less tired I look.
"When I was first diagnosed, reading Arthritis Care's magazine, which had information about rheumatoid arthritis, appropriate treatments and also the experiences of other people with arthritis, was incredibly helpful.
"My advice to anyone out there struggling with arthritis is : don't try to pretend to the outside world that the pain isn't there - make sure you're honest with your family and friends about the support you need. Have the confidence to say how you're experiencing the pain to your GP, so they know exactly what's going on. There might be a solution out there that could really help you, but you won't know if you stay silent."
Neil Betteridge added: "As well as encouraging people with arthritis to take control of their own pain we also call on all national governments in the UK to improve the services available to people with arthritis. In his recent report, Sir Liam Donaldson the Chief Medical Officer for England, concludedthat a major initiative to widen access to high-quality pain services was needed to improve the lives of millions of people in the UK3. We know that there are people with arthritis who struggle for years in pain before they get any kind of specialist support. Arthritis Care believes that pain services in the UK are under-funded and urgently in need of investment. We want to see GPs more committed to assessing and monitoring people's pain, a better network of specialist pain clinics, and more accessible services like physiotherapy and hydrotherapy to help people to reduce their pain levels."
Arthritis Care will mark the week by extending its Helplines service, offering a free 'Pain Pack', and running its free-to-user 'Challenging Pain' courses in venues around the UK. To order a free 'Pain Pack' or for information about arthritis go to arthritiscare.uk or call Arthritis Care's Helpline on 0808 800 4050.
Take control of arthritis pain - Ten Arthritis Care Tips
1. Lighten Up: Shed excess pounds to reduce stress on weight-bearing joints, like back, hips, and knees.
2. Be a Poser: Use good posture to protect your back and the joints of your legs and feet. Alter position often, take a break from the desk, and sit down to do some tasks instead of bending awkwardly.
3. Don't suffer in silence: Your GP needs to know that you are in pain, and what kind in order to find you an effective treatment or refer you to a pain management specialist.
4. Mix it up: Different pain can be eased by different drugs and treatments. Discuss with your doctor and pharmacist the best combination for your condition.
5. The Ex Factor: Exercise releases the body's own natural 'morphine' in the form of endorphins so appropriate exercise really can make you feel better.
6. Chuck out the chintz! Have a look at your furniture and decide if your bed and chairs are helping your pain or making it worse.
7. Listen to pain: Don't force already damaged, painful, or stiff joints into an activity that puts strain on them. But remember joints are supposed to move, so do not be afraid of persevering with gentle exercise recommended by your clinician.
8. Have an Exit Strategy: Plan how to leave before you arrive if you can't stand or walk for long. Plot your ways of lifting, carrying, pulling, pushing, or carrying objects before starting the action.
9. Big it up: Make your strongest joints and muscles work harder to cut stress on smaller joints - e.g. use a backpack instead of a briefcase or handbag, sparing fingers and wrist. Lift heavy objects in your arms instead of with your hands
10. Doctor Gadget: Look in Arthritis News and catalogues for self-help products - designed to make everyday tasks easier. Occupational therapists, physiotherapists, ergonomists and doctors can suggest helpful work or home devices.
Notes
1. Arthritis Care exists to support people with arthritis. We are the UK's largest organisation working with and for all people who have arthritis. We are a user led organisation which means people with arthritis are at the heart of our work - they form our membership, are involved in all of our activities and direct what we do.
2. Arthritis is the biggest single cause of physical disability in the United Kingdom, affecting people of all ages, including 12,000 children .Arthritis means inflammation of the joints. Most people with arthritis will experience pain and difficulty moving around. Over nine million people in the UK have arthritis. There are over 200 kinds of rheumatic diseases - the word rheumatic means aches and pains in joints, bones and muscles. Two of the most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA).
Arthritis is not just a disease of older people - it can affect people of all ages, including babies and children. It is not clear what causes arthritis and there is no cure at present. However, there is plenty you can do to manage your condition and lead a full and active life.
3. The Chief Medical Officer's Annual Report 2008
4. The Chief Medical Officer's Annual Report 2008
- 7.8 million people live with chronic pain
- ??3.8 billion cost of adolescent pain
- ??584 million spent on prescriptions for pain
- 49% of people with chronic pain experience depression
- 25% of people with chronic pain lose their jobs
- 16% of people feel their chronic pain is so bad that they sometimes want to die
Source
Arthritis Care
пятница, 9 сентября 2011 г.
Osteoarthritis Initiative Releases First Data
The Osteoarthritis Initiative (OAI), a public-private partnership between the National Institutes of Health (NIH) and private industry that seeks to improve diagnosis and monitoring of osteoarthritis (OA) and foster development of new treatments, has released its first set of data.
Making this information available to researchers worldwide will expedite the pace of scientific studies and identification of biological and structural markers (biomarkers) for OA. Researchers can analyze the data to form new hypotheses for further study of OA, which is the major cause of activity limitation and disability in older people. Images, including x rays and magnetic resonance imaging scans, will also be available to researchers upon request. All data are stored with an anonymous identification number to protect the confidentiality of the participants' information.
"Since its inception, the OAI has been a premier example of how industry, government, and academic sectors might work together to add value to biomedical research," says NIH Director Elias A. Zerhouni, M.D. "This first data release is proof positive that with cooperation, we can achieve results that neither the government nor its private partners is able to reach alone."
Over the next five years, the OAI will provide an unparalleled, state-of-the-art longitudinal database of images and clinical outcome information to facilitate the discovery of biomarkers for development and progression of OA. In this case, a biomarker would be a physical sign or biological substance that indicates changes in bone or cartilage.
Nearly 5,000 people at risk of developing knee OA, in the early stage of the disease or with more advanced knee OA are participating in the OAI at four centers around the United States. Participants in the research study provide biological specimens (blood, urine, and DNA); images (X rays and magnetic resonance scans); and clinical data such as dietary intake, medication use and pain, function, and general health assessments.
Data gathered from participants are available to researchers at oai.ucsf/. The data include symptoms; pain severity; a measure of pain, stiffness, and function known as the WOMAC OA index; walking ability; endurance; balance and strength; nutrition; and prescription medicines and alternative therapies used by the participants.
A second set of data will be released later in 2006, and a third release will take place early in 2007. Subsequent data will be released at approximately six -- month intervals.
The four centers taking part in the study and their principal investigators include:
* The University of Maryland School of Medicine, Baltimore; Marc Hochberg, M.D., M.P.H., in conjunction with Johns Hopkins Bayview Medical Center; Joan Bathon, M.D.
* The Ohio State University, Columbus; Rebecca Jackson, M.D.
* The University of Pittsburgh; C. Kent Kwoh, M.D.
* Memorial Hospital of Rhode Island , Pawtucket; Charles Eaton, M.D.
The study is coordinated and the data from the study and the Web site are managed by the University of California, San Francisco. The principal investigator for the Data Coordinating Center is Michael Nevitt, Ph.D.
Today, 35 million people -- 13 percent of the U.S. population -- are 65 and older, and more than half of them have radiological evidence of osteoarthritis in at least one joint. By 2030, an estimated 20 percent of Americans -- about 70 million people -- will have passed their 65th birthday and will be at increased risk for OA.
The OAI is a public-private partnership comprised of five contracts funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Aging (NIA), Office of Research on Women's Health (ORWH), National Institute of Dental and Craniofacial Research (NIDCR), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Center on Minority Health and Health Disparities (NCMHD) and National Center for Complementary and Alternative Medicine (NCCAM), all part of the Department of Health and Human Services' National Institutes of Health.Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. Private-sector funding for the OAI is managed by the Foundation for the National Institutes of Health.
The mission of the NIAMS is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at niams.nih/. Information on bone and its disorders can be obtained from the NIH Osteoporosis and Related Bone Diseases - National Resource Center; Phone (toll free) 800-624-BONE (2663) or visit osteo/.
The NIA leads the Federal Government effort conducting and supporting research on the biomedical and social and behavioral aspects of aging and the problems of older people. For more information on aging and aging-related research, please visit the NIA Web site at nia.nih/. The public may also call for publications at 1-800-222-2225, the toll-free number for the National Institute on Aging Information Center.
The Foundation for the National Institutes of Health was established by the United States Congress to support the mission of the National Institutes of Health -- improving health through scientific discovery. The foundation identifies and develops opportunities for innovative public-private partnerships involving industry, academia and the philanthropic community. A nonprofit, 501(c)(3) corporation, the Foundation raises private-sector funds for a broad portfolio of unique programs that complement and enhance NIH priorities and activities. The foundation's Web site address is fnih/.
The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih/.
Contact: Ray Fleming
NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases
Making this information available to researchers worldwide will expedite the pace of scientific studies and identification of biological and structural markers (biomarkers) for OA. Researchers can analyze the data to form new hypotheses for further study of OA, which is the major cause of activity limitation and disability in older people. Images, including x rays and magnetic resonance imaging scans, will also be available to researchers upon request. All data are stored with an anonymous identification number to protect the confidentiality of the participants' information.
"Since its inception, the OAI has been a premier example of how industry, government, and academic sectors might work together to add value to biomedical research," says NIH Director Elias A. Zerhouni, M.D. "This first data release is proof positive that with cooperation, we can achieve results that neither the government nor its private partners is able to reach alone."
Over the next five years, the OAI will provide an unparalleled, state-of-the-art longitudinal database of images and clinical outcome information to facilitate the discovery of biomarkers for development and progression of OA. In this case, a biomarker would be a physical sign or biological substance that indicates changes in bone or cartilage.
Nearly 5,000 people at risk of developing knee OA, in the early stage of the disease or with more advanced knee OA are participating in the OAI at four centers around the United States. Participants in the research study provide biological specimens (blood, urine, and DNA); images (X rays and magnetic resonance scans); and clinical data such as dietary intake, medication use and pain, function, and general health assessments.
Data gathered from participants are available to researchers at oai.ucsf/. The data include symptoms; pain severity; a measure of pain, stiffness, and function known as the WOMAC OA index; walking ability; endurance; balance and strength; nutrition; and prescription medicines and alternative therapies used by the participants.
A second set of data will be released later in 2006, and a third release will take place early in 2007. Subsequent data will be released at approximately six -- month intervals.
The four centers taking part in the study and their principal investigators include:
* The University of Maryland School of Medicine, Baltimore; Marc Hochberg, M.D., M.P.H., in conjunction with Johns Hopkins Bayview Medical Center; Joan Bathon, M.D.
* The Ohio State University, Columbus; Rebecca Jackson, M.D.
* The University of Pittsburgh; C. Kent Kwoh, M.D.
* Memorial Hospital of Rhode Island , Pawtucket; Charles Eaton, M.D.
The study is coordinated and the data from the study and the Web site are managed by the University of California, San Francisco. The principal investigator for the Data Coordinating Center is Michael Nevitt, Ph.D.
Today, 35 million people -- 13 percent of the U.S. population -- are 65 and older, and more than half of them have radiological evidence of osteoarthritis in at least one joint. By 2030, an estimated 20 percent of Americans -- about 70 million people -- will have passed their 65th birthday and will be at increased risk for OA.
The OAI is a public-private partnership comprised of five contracts funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute on Aging (NIA), Office of Research on Women's Health (ORWH), National Institute of Dental and Craniofacial Research (NIDCR), National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Center on Minority Health and Health Disparities (NCMHD) and National Center for Complementary and Alternative Medicine (NCCAM), all part of the Department of Health and Human Services' National Institutes of Health.Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer Inc. Private-sector funding for the OAI is managed by the Foundation for the National Institutes of Health.
The mission of the NIAMS is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at niams.nih/. Information on bone and its disorders can be obtained from the NIH Osteoporosis and Related Bone Diseases - National Resource Center; Phone (toll free) 800-624-BONE (2663) or visit osteo/.
The NIA leads the Federal Government effort conducting and supporting research on the biomedical and social and behavioral aspects of aging and the problems of older people. For more information on aging and aging-related research, please visit the NIA Web site at nia.nih/. The public may also call for publications at 1-800-222-2225, the toll-free number for the National Institute on Aging Information Center.
The Foundation for the National Institutes of Health was established by the United States Congress to support the mission of the National Institutes of Health -- improving health through scientific discovery. The foundation identifies and develops opportunities for innovative public-private partnerships involving industry, academia and the philanthropic community. A nonprofit, 501(c)(3) corporation, the Foundation raises private-sector funds for a broad portfolio of unique programs that complement and enhance NIH priorities and activities. The foundation's Web site address is fnih/.
The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih/.
Contact: Ray Fleming
NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases
вторник, 6 сентября 2011 г.
A shallow hip socket predicts osteoarthritis of the hip
Long-term study suggests moderate acetabular dysplasia, a developmental condition of hip instability, as an independent
risk factor for the disease -
Osteoarthritis (OA) of the hip is one of the leading causes of disability among elderly men and women. This progressive joint
disease involves multiple factors, including genes, age, gender, hormones, as well as body mass index, mechanical stress. In
addition, a developmental condition known as acetabular dysplasia can contribute to disease risk. Often present at birth,
acetabular dysplasia is marked by a shallow hip socket, making the hip unstable and, in extreme cases, prone to dislocation.
Severe acetabular dysplasia has been linked to premature hip OA. The influence of moderate acetabular dysplasia on the
development of hip OA is less clear.
To assess the role of moderate acetabular dysplasia in the onset of hip OA, a research team in the Netherlands conducted a
long-term study on 835 women and men ages 55 years and older. Their results, published in the March 2005 issue of Arthritis &
Rheumatism (interscience.wiley/journal/arthritis), indicate acetabular dysplasia, even when assessed at a mild
degree, as a strong independent risk factor for OA of the hip, even in an elderly population.
Led by Dr. M Reijman and supported by the Dutch Arthritis Association, the research team drew its subjects from The Rotterdam
Study, a comprehensive investigation of the incidence of, and risk factors for, chronic disabling diseases. At baseline, the
participants had no signs of radiographic OA of the hip. Women comprised 57 percent of the sample, whose mean age was 65
years. At baseline, all participants underwent radiographs in order to detect the presence and assess the depth and degree,
using the center-edge angle, of acetabular dysplasia. Participants were also evaluated for current BMI and history of heavy,
physically demanding work.
Over a follow-up period averaging six years, participants were examined, through radiographs, for definite signs -
osteophytes and joint space narrowing - of hip OA. Calculating odds ratios, subjects with acetabular dysplasia, from moderate
to mild, had a 4.3 times increased risk for radiographic OA of the hip. Among subjects with acetabular dysplasia, the
incidence and severity of hip OA was greater among women, as well as associated with a high-stress mechanical workload and a
low BMI.
Based on this study's findings, Dr. Reijman concludes that acetabular dysplasia, at any measurable depth or degree, is a
strong, independent indicator for the development of OA of the hip. "Furthermore," he notes, "the associations between
acetabular dysplasia and incident radiographic OA of the hip may even be underestimated because of the relatively high mean
age of the study population. In other words, we assume that in a younger population the association between acetabular
dysplasia and OA may be even higher."
Article: "Acetabular Dysplasia Predicts Incident Osteoarthritis of the Hip: The Rotterdam Study," M. Reijman, J.M.W. Hazes,
H.A.P. Pols, B.W. Koes, and S.M.A. Bierma-Zeinstra, Arthritis & Rheumatism, March 2005; 52:3; pp. 787-793.
John Wiley & Sons, Inc.
interscience.wiley
risk factor for the disease -
Osteoarthritis (OA) of the hip is one of the leading causes of disability among elderly men and women. This progressive joint
disease involves multiple factors, including genes, age, gender, hormones, as well as body mass index, mechanical stress. In
addition, a developmental condition known as acetabular dysplasia can contribute to disease risk. Often present at birth,
acetabular dysplasia is marked by a shallow hip socket, making the hip unstable and, in extreme cases, prone to dislocation.
Severe acetabular dysplasia has been linked to premature hip OA. The influence of moderate acetabular dysplasia on the
development of hip OA is less clear.
To assess the role of moderate acetabular dysplasia in the onset of hip OA, a research team in the Netherlands conducted a
long-term study on 835 women and men ages 55 years and older. Their results, published in the March 2005 issue of Arthritis &
Rheumatism (interscience.wiley/journal/arthritis), indicate acetabular dysplasia, even when assessed at a mild
degree, as a strong independent risk factor for OA of the hip, even in an elderly population.
Led by Dr. M Reijman and supported by the Dutch Arthritis Association, the research team drew its subjects from The Rotterdam
Study, a comprehensive investigation of the incidence of, and risk factors for, chronic disabling diseases. At baseline, the
participants had no signs of radiographic OA of the hip. Women comprised 57 percent of the sample, whose mean age was 65
years. At baseline, all participants underwent radiographs in order to detect the presence and assess the depth and degree,
using the center-edge angle, of acetabular dysplasia. Participants were also evaluated for current BMI and history of heavy,
physically demanding work.
Over a follow-up period averaging six years, participants were examined, through radiographs, for definite signs -
osteophytes and joint space narrowing - of hip OA. Calculating odds ratios, subjects with acetabular dysplasia, from moderate
to mild, had a 4.3 times increased risk for radiographic OA of the hip. Among subjects with acetabular dysplasia, the
incidence and severity of hip OA was greater among women, as well as associated with a high-stress mechanical workload and a
low BMI.
Based on this study's findings, Dr. Reijman concludes that acetabular dysplasia, at any measurable depth or degree, is a
strong, independent indicator for the development of OA of the hip. "Furthermore," he notes, "the associations between
acetabular dysplasia and incident radiographic OA of the hip may even be underestimated because of the relatively high mean
age of the study population. In other words, we assume that in a younger population the association between acetabular
dysplasia and OA may be even higher."
Article: "Acetabular Dysplasia Predicts Incident Osteoarthritis of the Hip: The Rotterdam Study," M. Reijman, J.M.W. Hazes,
H.A.P. Pols, B.W. Koes, and S.M.A. Bierma-Zeinstra, Arthritis & Rheumatism, March 2005; 52:3; pp. 787-793.
John Wiley & Sons, Inc.
interscience.wiley
суббота, 3 сентября 2011 г.
Aerobic Exercise Safe And Effective For Rheumatoid Arthritis Patients
Cardio-Respiratory Aerobic Conditioning Improves Function; Lessens Joint Pain
Researchers from the University of Grenoble Medical School in France determined that cardio-respiratory aerobic exercise is safe for patients with stable rheumatoid arthritis (RA). The team found that RA patients who exercised regularly had improved function, less joint pain, and greater quality of life. Full findings of the study are now available online and will publish in the July print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.
RA, a chronic inflammatory disease characterized by swollen joints, pain, stiffness, fatigue, and general malaise affects up to 1% of the global population, according to the World Health Organization (WHO). The Centers for Disease Control and Prevention (CDC) citing health-related quality of life (HRQL) studies found that RA patients were 40% more likely to report fair or poor general health and twice as likely to have a health-related activity limitation compared with those without arthritis.
The current study led by Athan Baillet, M.D., conducted an abstract search of relative medical journals for studies that researched RA patients and impact of aerobic exercise. The team analyzed 14 studies and meta-analysis included 510 patients in the intervention group and 530 in the control group. Participants in these studies had a mean age of 44-68 years and their RA disease duration was 1-16 years. Researchers compared HRQL, the Health Assessment Questionnaire (HAQ), joint count, and pain using a visual analog scale (VAS) among patients in the studies.
"Our results show that patients with stable RA would benefit from regular aerobic exercise," said Dr. Baillet. "Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function." Researchers assessed the efficacy of exercise on RA symptoms using standardized mean differences (SMDs) which is the difference (between groups) of mean outcome variation from baseline/SD at baseline of aerobic exercises versus non-aerobic rehabilitation. Meta analysis of the research showed that exercise improved the post-intervention quality of life (SMD=0.39), HAQ score (SMD=0.24), and pain VAS (SMD=0.31). The difference in scores between those who exercised and those who had not are considered clinically meaningful by both patients and doctors noted the researchers.
The American College of Rheumatology states that exercise is beneficially for everyone, including those with RA, and currently recommends 150 minutes of moderate intensity aerobic activity each week. Safe forms of aerobic exercise, such as walking, aerobic dance, and aquatic exercise, help arthritis patients to control weight, and improve sleep, mood, and overall health.
"While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA," concluded Dr. Baillet.
Source: Wiley - Blackwell
Researchers from the University of Grenoble Medical School in France determined that cardio-respiratory aerobic exercise is safe for patients with stable rheumatoid arthritis (RA). The team found that RA patients who exercised regularly had improved function, less joint pain, and greater quality of life. Full findings of the study are now available online and will publish in the July print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.
RA, a chronic inflammatory disease characterized by swollen joints, pain, stiffness, fatigue, and general malaise affects up to 1% of the global population, according to the World Health Organization (WHO). The Centers for Disease Control and Prevention (CDC) citing health-related quality of life (HRQL) studies found that RA patients were 40% more likely to report fair or poor general health and twice as likely to have a health-related activity limitation compared with those without arthritis.
The current study led by Athan Baillet, M.D., conducted an abstract search of relative medical journals for studies that researched RA patients and impact of aerobic exercise. The team analyzed 14 studies and meta-analysis included 510 patients in the intervention group and 530 in the control group. Participants in these studies had a mean age of 44-68 years and their RA disease duration was 1-16 years. Researchers compared HRQL, the Health Assessment Questionnaire (HAQ), joint count, and pain using a visual analog scale (VAS) among patients in the studies.
"Our results show that patients with stable RA would benefit from regular aerobic exercise," said Dr. Baillet. "Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function." Researchers assessed the efficacy of exercise on RA symptoms using standardized mean differences (SMDs) which is the difference (between groups) of mean outcome variation from baseline/SD at baseline of aerobic exercises versus non-aerobic rehabilitation. Meta analysis of the research showed that exercise improved the post-intervention quality of life (SMD=0.39), HAQ score (SMD=0.24), and pain VAS (SMD=0.31). The difference in scores between those who exercised and those who had not are considered clinically meaningful by both patients and doctors noted the researchers.
The American College of Rheumatology states that exercise is beneficially for everyone, including those with RA, and currently recommends 150 minutes of moderate intensity aerobic activity each week. Safe forms of aerobic exercise, such as walking, aerobic dance, and aquatic exercise, help arthritis patients to control weight, and improve sleep, mood, and overall health.
"While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group. Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA," concluded Dr. Baillet.
Source: Wiley - Blackwell
Подписаться на:
Сообщения (Atom)