Location of plantar ulcerations in diabetic patients referred to a Department of Veterans Affairs podiatry clinic, pg. 421
We described the location of foot ulcers through a chart review of diabetic patients in a Department of Veterans Affairs podiatry clinic and looked for connections between ulcer location and specific medical features. We hypothesized that individuals with diabetes rarely have heel ulcers but that heel ulcers are directly related to peripheral neuropathy and diminished vascular function. We found that patients with reduced vascular function were five times more likely to have heel ulcers than patients with adequate vascular function. The importance of understanding the risk factors for heel ulcers stems from a lack of available treatments. Further research should study the effectiveness of interventions for patients with reduced vascular status.
Effects of footwear on medial compartment knee osteoarthritis, pg. 427
This pilot study investigated whether lateral-wedge insoles inserted into shock-absorbing walking shoes relieved pain and stiffness and improved walking in people with painful knee osteoarthritis. People with knee pain in the medial knee compartment were asked to wear lateral-wedge insoles in lightweight cushioned walking shoes for 4 weeks. They answered questions about the amount of pain, stiffness, and problems with activity they had before wearing the insoles and after wearing them for 4 weeks. The results of this study showed that the lateral-wedge insoles decreased pain and stiffness and improved functional status in people with knee osteoarthritis. Pain was especially decreased for stair-climbing activities.
Isometric performance following total hip arthroplasty and rehabilitation, pg. 435
We examined differences in strength between total hip arthroplasty (THA) patients and community-dwelling older adults to provide comparative data for therapists who treat THA patients. Studies based on self-report data indicate that THA surgery successfully alleviates pain and improves function relative to presurgical levels. However, studies based on objective performancebased measures indicate that despite postoperative improvements, THA patients continue to exhibit deficits in strength, postural stability, and gait. Average hip strength during flexion (pushing upward) was significantly less for hip patients (in both their replaced and nonreplaced hip) compared with community-dwelling older adults. These deficits indicate that rehabilitation is not restoring THA patients to a level similar to their peers. Clinicians and therapists can use these results to improve current rehabilitation protocols.
Influence of a 6-week arm exercise program on walking ability and health status after hip arthroplasty: A 1-year follow-up pilot study, pg. 445
This follow-up study of elderly patients after total hip arthroplasty (THA) examined the effect of our arm exercise program on health status and walking ability. Though THA had a major effect on our patients' physical fitness and functional status, the added effects of the training were significant on those outcomes at both 2 months and 1 year after surgery. In a 6-minute walk test, the training group (TG) walked significantly longer distance than the normal rehabilitation group with a faster speed, longer stride length, and higher step cadence. Therefore, besides an improvement in fitness, the TG also might have improved gait efficiency. These preliminary results suggest the importance of endurance-type upper-body aerobic training after THA.
Are patient ratings of chronic pain services related to treatment outcome? pg. 451
We examined the relationships between ratings of services and outcomes of patients who received pain treatment at a teaching hospital. A group of 122 patients who completed a multidisciplinary pain-management program rated their satisfaction with and the effectiveness of services as well as changes in their pain condition and quality of life. The results indicated improvement on ratings of pain severity, pain interference, and depression. The patients' service ratings were significantly related to their outcomes; however, we found no significant change in disability. The results support the importance of assessing not only patients' satisfaction with treatment but also their perceived changes in disability, pain, and quality of life after pain-management services.
Using cranial electrotherapy stimulation to treat pain associated with spinal cord injury, pg. 461
Cranial electrotherapy stimulation (CES) sends microcurrents to the brain via electrodes clipped to the ears. CES can effectively treat spinal, head, dental, and muscle pain and control conditions associated with pain (anxiety, depression, insomnia, and stress). We studied how daily 1-hour active CES or sham CES treatment for 21 days affected pain in 38 males with spinal cord injury (SCI). The active CES group reported significantly greater decreases in daily pain intensity than the sham CES group. Our results suggest that CES can effectively treat chronic pain in people with SCI. We also found that people with SCI can and will use the CES device at home for a 3-week period.
Race/ethnicity: Who is counting what? pg. 475
We examined the racial/ethnic classifications of 1,084 veterans with stroke in Florida who received inpatient and outpatient services within the Department of Veterans Affairs (VA) healthcare system. We compared the reliability of racial/ethnic classifications from the VA inpatient data with the VA outpatient data and the VA data with Medicare data. Misclassification of race/ethnicity in research data may produce spurious conclusions if overlooked or ignored. Our results showed that the rate of unknown racial/ethnic classification in VA outpatient and inpatient data was high. We also found that black and white classifications in the VA data had stronger agreement with Medicare data and Medicare data may underrepresent Hispanic patients. Minimizing the unknowns by substituting known values from other data when available would greatly enhance the overall and individual classification reliability.
Treadmill training with harness support: Selection of parameters for individuals with poststroke hemiparesis, pg. 485
Locomotor training with a treadmill and harness support is a promising, task-oriented approach to restoring gait function in individuals with poststroke hemiparesis. Considerable latitude exists in the application of locomotor training, and training protocols vary widely between experimenters and clinical settings. Recent studies indicate that the prescription of certain parameters, including body-weight support and treadmill speed, can affect treatment outcome in hemiparetic individuals. We reviewed the literature for studies that quantified the immediate effects of adjusting body-weight support, treadmill speed, support stiffness, and handrail hold during treadmill walking in hemiparetic and nondisabled subjects. We then summarized results from personal investigations of these parameters. Based on the currently available evidence, we discuss the scientific rationale for selecting certain training parameters for individuals with poststroke hemiparesis and outline future directions for research.
Caregiver distress in parkinsonism, pg. 499
We examined the frequency and degree of caregiver burden in persons with parkinsonism (PWP). Supporting the functioning of caregivers is vital for the successful medical management of individuals with chronic illness and disability. Associations between perceived caregiver burden and physical, cognitive, and functional impairments were assessed with well-established tools for PWP. Caregiver burden was significantly negatively associated with activities of daily living and motoric difficulties, self-reported sleep, and caregiver coping ability. Results did not demonstrate an association among mentation, behavior, and mood or between patients' self-reported pain and caregiver burden. An improved understanding of the severity and correlates of caregiver burden in PWPs may allow clinicians to better prioritize treatment strategies for PWP and be more aware of the caregivers' needs.
A noncontact sensor for measurement of distal residual-limb position during walking, pg. 509
We developed a noncontact means of measuring position of the residual-limb surface relative to the distal prosthetic socket during walking in a transtibial amputee so the amount of slip, or pistoning, between a limb and socket with different suspension systems for different activities could be evaluated. Results showed an average of 41.7 mm of displacement during swing phase relative to stance phase. A rest period caused the limb to displace in the socket approximately 4.8 mm during subsequent walking trials, possibly reflecting limb enlargement and thus a more proximal position in the socket after the rest period. This sensor could be used to identify systems that decrease limb-socket movement since excessive pistoning might detrimentally affect socket fit.
Acclimatization in wide dynamic range multichannel compression and linear amplification hearing aids, pg. 517
We studied acclimatization in hearing-impaired patients with no previous hearing aid (HA) experience who were fit bilaterally with either wide dynamic range multichannel compression (WDRMCC) or linear amplification (LA) HAs. Throughout 32 weeks of normal HA use, we monitored changes in nonsense syllable perception in speechspectrum noise. Syllable recognition for WDRMCC users improved by 4.6% over the first 8 weeks, but the 2.2% improvement for LA users was complete in 2 to 4 weeks. Consonant confusion analyses indicated that WDRMCC experience facilitated consonant identification, while LA users primarily changed their response biases. These results provide evidence for acclimatization in new users of WDRMCC HAs but not in new users of LA HAs. Acclimatization depended on the type of amplification and on the previous amplification experience.
Perceptual training improves syllable identification in new and experienced hearing aid users, pg. 537
We investigated the effects of perceptual training on speech processing in new and experienced hearing aid (HA) users with sensorineural hearing loss. New HA users were randomly assigned to immediate training (IT) or delayed training (DT) groups. IT subjects underwent 8 weeks of syllable identification training and in-laboratory testing, whereas DT subjects underwent identical in-laboratory testing without training. Training produced large improvements in syllable identification in the IT group, whereas untrained DT group showed minimal improvement. DT group then underwent training and showed performance improvements comparable with IT subjects. We also tested experienced HA users using identical training and testing procedures as those used for new HA users. The experienced users also showed significant performance improvements. Perceptual training appears to be a promising tool for improving speech perception in all HA users.
Interface pressure and cutaneous hemoglobin and oxygenation changes under ischial tuberosities during sacral nerve root stimulation in spinal cord injury, pg. 553
We studied how neuromuscular stimulation through a magnetic coil and a sacral anterior root stimulator (SARS) implant (used for bladder emptying) affects pressure and skin blood circulation under the ischial tuberosities (ITs) of participants with spinal cord injury (SCI). The ITs are the most common site for pressure ulcers among wheelchair users with SCI. With optimal stimulation through a magnetic coil, average IT peak pressure and gradient at peak pressure decreased significantly in five seated participants with SCI. Similar results were achieved in six seated participants with SCI during sacral nerve stimulation through their SARS implants. Results indicated that stimulation caused enough gluteal muscle contraction to significantly change the participants' pressures while they sat. In addition, long-term stimulation through a SARS implant may build up the gluteal muscles and help prevent or reduce pressure ulcers in people with SCI.
Antinociceptive effect of linear polarized 0.6 to 1.6 ?¬m irradiation of lumbar sympathetic ganglia in chronic constriction injury rats, pg. 565
Linear polarized near-infrared light has been used to treat various painful disorders. We examinedthe effects of irradiation applied to an area near the lumbar sympathetic ganglia on the ligated side in a chronic constriction injury model in rats, which is believed to be an animal model of complex regional pain syndrome (CRPS). We believe the results of this study are relevant to the effect of irradiation for patients with upper-limb CRPS: that irradiation near the lumbar sympathetic ganglia of the rat is effective for thermal, but not mechanical, pain.
Skin and bone integrated prosthetic pylon: A pilot animal study, pg. 573
Direct skeletal attachment of limb prostheses is an alternative to traditional techniques based on a socket-residuum attachment. We investigated cell adhesion and penetration into the pores of a porous titanium pylon in rats. We hypothesized that the risk of skin infection during direct attachment of limb prostheses might be reduced with this type of pylon. Electronic scanning and morphological analysis showed that the porous titanium pylon integrated with the surrounding skin. Therefore, developing a natural barrier against the infection associated with direct skeletal attachment of limb prostheses may be possible. We preliminarily conclude that the experimental porous pylon provided an inviting environment for the surrounding tissues.
Contact: Stacieanne C. Yuhasz, PhD
VA Research Communications Service
среда, 12 октября 2011 г.
воскресенье, 9 октября 2011 г.
Patients Taking Cymbalta(R) Reported Reduced Pain Severity Of Osteoarthritis Of The Knee In New Study
New data suggest that
patients with osteoarthritis pain of the knee treated with 60 mg and 120 mg
Cymbalta (duloxetine HCl) once daily experienced significant pain
reduction. Patients taking duloxetine reported significant pain improvement
compared to placebo within the first week of treatment that lasted
throughout the 13-week trial.(1) Results from the study of 231 patients
were presented today at the annual congress of the European League Against
Rheumatism (EULAR) in Paris, France.
Duloxetine showed statistically significant improvement in pain
associated with osteoarthritis of the knee according to the primary
efficacy measure of mean 24-hour average pain scores. Fifty-nine percent of
duloxetine-treated patients experienced a 30 percent improvement in pain
compared with 45 percent of patients taking placebo. Forty-seven percent of
duloxetine-treated patients experienced a 50 percent improvement in pain
compared with 29 percent of placebo-treated patients.
Treatment with duloxetine also was associated with improved patient
outcomes compared with placebo as measured by the Patient Global
Impressions of Improvement (PGI-I) and physical functioning as measured by
the Western Ontario and McMaster Universities (WOMAC) physical functioning
subscale.
In this study, the most common adverse events (occurred at a rate of
greater than or equal to 3 percent and at least twice the rate of placebo)
were nausea, fatigue, somnolence, dizziness, hypertension, constipation and
decreased libido.
"These data are important because it's the first time duloxetine has
been studied in a large, placebo-controlled trial in what's classified as
an inflammatory disease state," said Amy Chappell, M.D., lead study author
and medical fellow II, Eli Lilly and Company. "Although the exact mechanism
of action is unknown, this study may provide important insights into the
treatment of pain in the central nervous system."
It is estimated that 27 million adults in the United States have
osteoarthritis and the prevalence increases with age.(2) Osteoarthritis of
the knee is a common type of this disorder, impacting the lives of
approximately 10 million Americans.(2) Other symptoms of osteoarthritis in
addition to pain include aching, stiffness and limited range of motion of
the joint.(3)
Additional Study Highlights:
- Compared with patients receiving placebo, patients receiving duloxetine
experienced significant improvement in symptom severity associated with
osteoarthritis pain of the knee, including:
Significantly greater reduction in Brief Pain Inventory (BPI)
average pain severity (p
patients with osteoarthritis pain of the knee treated with 60 mg and 120 mg
Cymbalta (duloxetine HCl) once daily experienced significant pain
reduction. Patients taking duloxetine reported significant pain improvement
compared to placebo within the first week of treatment that lasted
throughout the 13-week trial.(1) Results from the study of 231 patients
were presented today at the annual congress of the European League Against
Rheumatism (EULAR) in Paris, France.
Duloxetine showed statistically significant improvement in pain
associated with osteoarthritis of the knee according to the primary
efficacy measure of mean 24-hour average pain scores. Fifty-nine percent of
duloxetine-treated patients experienced a 30 percent improvement in pain
compared with 45 percent of patients taking placebo. Forty-seven percent of
duloxetine-treated patients experienced a 50 percent improvement in pain
compared with 29 percent of placebo-treated patients.
Treatment with duloxetine also was associated with improved patient
outcomes compared with placebo as measured by the Patient Global
Impressions of Improvement (PGI-I) and physical functioning as measured by
the Western Ontario and McMaster Universities (WOMAC) physical functioning
subscale.
In this study, the most common adverse events (occurred at a rate of
greater than or equal to 3 percent and at least twice the rate of placebo)
were nausea, fatigue, somnolence, dizziness, hypertension, constipation and
decreased libido.
"These data are important because it's the first time duloxetine has
been studied in a large, placebo-controlled trial in what's classified as
an inflammatory disease state," said Amy Chappell, M.D., lead study author
and medical fellow II, Eli Lilly and Company. "Although the exact mechanism
of action is unknown, this study may provide important insights into the
treatment of pain in the central nervous system."
It is estimated that 27 million adults in the United States have
osteoarthritis and the prevalence increases with age.(2) Osteoarthritis of
the knee is a common type of this disorder, impacting the lives of
approximately 10 million Americans.(2) Other symptoms of osteoarthritis in
addition to pain include aching, stiffness and limited range of motion of
the joint.(3)
Additional Study Highlights:
- Compared with patients receiving placebo, patients receiving duloxetine
experienced significant improvement in symptom severity associated with
osteoarthritis pain of the knee, including:
Significantly greater reduction in Brief Pain Inventory (BPI)
average pain severity (p
четверг, 6 октября 2011 г.
RA Individuals From Lower GDP Countries Keep Working Despite Worse Symptoms Than Richer Countries
Individuals diagnosed with rheumatoid arthritis (RA) in lower gross domestic product (GDP) countries (GDP below $11,000) are more likely to continue working despite higher disease activity and functional disability scores compared to their counterparts in higher GDP countries (GDP >$24,000) according to a new multinational study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark.
Among 1,650 individuals from 30 countries whose symptoms had begun during the 2000's and who remained working after RA diagnosis, disability levels according to the Health Assessment Questionnaire (HAQ*) were 0.25 vs. 0.82 in men and 0.50 vs. 0.94 in women (p
Among 1,650 individuals from 30 countries whose symptoms had begun during the 2000's and who remained working after RA diagnosis, disability levels according to the Health Assessment Questionnaire (HAQ*) were 0.25 vs. 0.82 in men and 0.50 vs. 0.94 in women (p
понедельник, 3 октября 2011 г.
Risk Of Heart Attacks And Strokes Reduced By Arthritis Medications
Patients prescribed drugs to treat rheumatoid arthritis could be at a reduced risk of heart attacks and strokes, according to a study published in the open access journal Arthritis Research & Therapy.
An international team of researchers led by Antonio Naranjo of the University of Las Palmas de Gran Canaria, Spain, and colleagues in Argentina, Europe, and the USA have analyzed data from the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) study. From this study, including 4,363 patients from 48 sites in 15 countries, the team has examined the causes and effects of rheumatoid arthritis, as well as the potential benefits of medications.
Rheumatoid arthritis is a known risk factor for hardening of the arteries and so can lead to stroke and heart attacks occurring in sufferers ten years earlier than in people without the condition. However, earlier studies have shown that treating rheumatoid arthritis with disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, may reduce this risk. The current research quantifies this risk reduction in thousands of patients in the QUEST-RA study.
Naranjo and colleagues found that risk, when adjusted for age, sex, disease activity, and traditional risk factors such as lack of exercise, smoking, diabetes, and high cholesterol levels, correlated strongly with the use of drugs to treat rheumatoid arthritis. Taking methotrexate - the most widely used DMARD - for just one year for example was found to be associated with an 18% reduction in risk of heart attack and an 11% decrease in risk of stroke, the researchers say.
"Our study provides further support of the influence of both traditional and RA specific risk factors in the development of cardiovascular events, especially heart attack" the researchers conclude, "As assessed by this study, the risk was lower with the prolonged use of methotrexate, sulfasalazine, glucocorticoids, leflunomide and TNF-?± blockers."
In an accompanying editorial, Dr Ronald van Vollenhoven of Karolinska Institute, Sweden, reviews the research article. "The possibility that antirheumatic therapy decreases the risk for cardiovascular complications is tantalizing," writes the author. "The current study, while not exactly proving this point, adds a further measure of support to the concept, and suggests that it must now be formally addressed.
1. Cardiovascular disease in patients with rheumatoid arthritis. Results from the QUEST-RA study Antonio Naranjo, Tuulikki Sokka, Miguel A Descalzo, Jaime Calvo-Alen, Kim Horslev-Petersen, Reijo K Luukkainen, Bernard Combe, Gerd R Burmester, Joe Devlin, Gianfranco Ferraccioli, Alessia Morelli, Monique Hoekstra, Maria Majdan, Stefan Sadkiewicz, Miguel Belmonte, Ann-Carin Holmqvist, Ernest Choy, Recep Tunc, Aleksander Dimic, Martin Bergman, Sergio Toloza and Theodore Pincus
Arthritis Research & Therapy (in press)
Article available at journal website: arthritis-research/
All articles are available free of charge, according to BioMed Central's open access policy.
2. Arthritis Research & Therapy is an international, peer-reviewed online and print journal, publishing original research, reviews, commentaries and reports. Studies relate to the rationale and treatment of arthritis, autoimmune disease and diseases of bone and cartilage. The journal is edited by Prof Peter E Lipsky (USA) and Prof Sir Ravinder N Maini (UK) and has an Impact Factor of 3.8.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Charlotte Webber
BioMed Central
An international team of researchers led by Antonio Naranjo of the University of Las Palmas de Gran Canaria, Spain, and colleagues in Argentina, Europe, and the USA have analyzed data from the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis) study. From this study, including 4,363 patients from 48 sites in 15 countries, the team has examined the causes and effects of rheumatoid arthritis, as well as the potential benefits of medications.
Rheumatoid arthritis is a known risk factor for hardening of the arteries and so can lead to stroke and heart attacks occurring in sufferers ten years earlier than in people without the condition. However, earlier studies have shown that treating rheumatoid arthritis with disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate, may reduce this risk. The current research quantifies this risk reduction in thousands of patients in the QUEST-RA study.
Naranjo and colleagues found that risk, when adjusted for age, sex, disease activity, and traditional risk factors such as lack of exercise, smoking, diabetes, and high cholesterol levels, correlated strongly with the use of drugs to treat rheumatoid arthritis. Taking methotrexate - the most widely used DMARD - for just one year for example was found to be associated with an 18% reduction in risk of heart attack and an 11% decrease in risk of stroke, the researchers say.
"Our study provides further support of the influence of both traditional and RA specific risk factors in the development of cardiovascular events, especially heart attack" the researchers conclude, "As assessed by this study, the risk was lower with the prolonged use of methotrexate, sulfasalazine, glucocorticoids, leflunomide and TNF-?± blockers."
In an accompanying editorial, Dr Ronald van Vollenhoven of Karolinska Institute, Sweden, reviews the research article. "The possibility that antirheumatic therapy decreases the risk for cardiovascular complications is tantalizing," writes the author. "The current study, while not exactly proving this point, adds a further measure of support to the concept, and suggests that it must now be formally addressed.
1. Cardiovascular disease in patients with rheumatoid arthritis. Results from the QUEST-RA study Antonio Naranjo, Tuulikki Sokka, Miguel A Descalzo, Jaime Calvo-Alen, Kim Horslev-Petersen, Reijo K Luukkainen, Bernard Combe, Gerd R Burmester, Joe Devlin, Gianfranco Ferraccioli, Alessia Morelli, Monique Hoekstra, Maria Majdan, Stefan Sadkiewicz, Miguel Belmonte, Ann-Carin Holmqvist, Ernest Choy, Recep Tunc, Aleksander Dimic, Martin Bergman, Sergio Toloza and Theodore Pincus
Arthritis Research & Therapy (in press)
Article available at journal website: arthritis-research/
All articles are available free of charge, according to BioMed Central's open access policy.
2. Arthritis Research & Therapy is an international, peer-reviewed online and print journal, publishing original research, reviews, commentaries and reports. Studies relate to the rationale and treatment of arthritis, autoimmune disease and diseases of bone and cartilage. The journal is edited by Prof Peter E Lipsky (USA) and Prof Sir Ravinder N Maini (UK) and has an Impact Factor of 3.8.
3. BioMed Central (biomedcentral/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.
Source: Charlotte Webber
BioMed Central
пятница, 30 сентября 2011 г.
What Is Water On The Knee (Knee Effusion)? What Causes Water On The Knee?
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.)
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.)
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
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