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April 17, 2009, 5:12 AM CT

New drug for fibromyalgia

New drug for fibromyalgia
For Tara Campbell, the onset of her fibromyalgia began slowly with repeated sore throats, fevers and fatigue. By the time she was diagnosed, a year later, she had become so debilitated by flulike symptoms and exhaustion that she often couldn't get off the couch all day.

"Fall, a year ago, I hit my very, very worst," said Campbell, 39, of Walnut Creek, Calif. "I felt overall pain to the point that even when my children or husband just touched me it hurt".

Campbell's symptoms still linger, but since taking part in a Stanford University School of Medicine clinical trial in the spring of 2008, she's improved enough that she's gone back to working again as an interior decorator and even headed up the fundraising auction at her daughters' school.

"I am really, really good," Campbell said. "Having said that, I'm not yet 100 percent. I'm not yet that person I was before".

Campbell was one of 10 women with fibromyalgia to take part in a small pilot study at Stanford over a 14-week period to test the new use of a low dose of a drug called naltrexone for the therapy of chronic pain. The drug, which has been used clinically for more than 30 years to treat opioid addiction, was found to reduce symptoms of pain and fatigue an average of 30 percent over placebo, as per the results of the study to be published April 17 online in the journal Pain Medicine........

Posted by: Mark      Read more         Source


April 9, 2009, 4:45 AM CT

Vitamin D may make autoimmune disease worse

Vitamin D may make autoimmune disease worse
Deficiency in vitamin D has been widely regarded as contributing to autoimmune disease, but a review appearing in Autoimmunity Reviews explains that low levels of vitamin D in patients with autoimmune disease appears to be a result rather than a cause of disease and that supplementing with vitamin D may actually exacerbate autoimmune disease.

Authored by a team of scientists at the California-based non-profit Autoimmunity Research Foundation, the paper goes on to point out that molecular biologists have long known that the form of vitamin D derived from food and supplements, 25-hydroxyvitamin D (25-D), is a secosteroid rather than a vitamin. Like corticosteroid medications, vitamin D may provide short-term relief by lowering inflammation but may exacerbate disease symptoms over the long-term.

The insights are based on molecular research showing that 25-D inactivates rather than activates its native receptor - the Vitamin D nuclear receptor or VDR. Once associated solely with calcium metabolism, the VDR is now known to transcribe at least 913 genes and largely control the innate immune response by expressing the bulk of the body's antimicrobial peptides, natural antimicrobials that target bacteria.

Written under the guidance of professor Trevor Marshall of Murdoch University, Western Australia, the paper contends that 25-D's actions must be considered in light of recent research on the Human Microbiome. Such research shows that bacteria are far more pervasive than previously thought 90% of cells in the body are estimated to be non-human increasing the likelihood that autoimmune diseases are caused by persistent pathogens, a number of of which have yet to be named or have their DNA characterized.........

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March 30, 2009, 5:02 AM CT

Why mostly women get lupus?

Why mostly women get lupus?
In an international human genetic study, scientists at UT Southwestern Medical Center have identified a gene associated with the autoimmune disease lupus, and its location on the X chromosome might help explain why females are 10 times more susceptible to the disease than males.

Identifying this gene, IRAK1, as a disease gene may also have therapeutic implications, said Dr. Chandra Mohan, professor of internal medicine and senior author of the study. "Our work also shows that blocking IRAK1 action shuts down lupus in an animal model. Though a number of genes appears to be involved in lupus, we only have very limited information on them," he said.

The study appears online this week in the Proceedings of the National Academy of Sciences.

Locating IRAK1 on the X chromosome also represents a breakthrough in explaining why lupus seems to be sex-linked, Dr. Mohan said. For decades, scientists have focused on hormonal differences between males and females as a cause of the gender difference, he pointed out.

"This first demonstration of an X chromosome gene as a disease susceptibility factor in human lupus raises the possibility that the gender difference in rates may in part be attributed to sex chromosome genes," Dr. Mohan said.

Systemic lupus erythematosus, or lupus for short, causes a wide range of symptoms such as rashes, fever or fatigue that make it difficult to diagnose.........

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February 26, 2009, 6:20 AM CT

Physical therapy effective for low-back ache

Physical therapy effective for low-back ache
A new review article reported in the Journal of the American Academy of Orthopaedic Surgeons should help convince a number of patients with low back pain to consider physical treatment as a first line of therapy for their condition, as per the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective therapy is physical treatment combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.1.

Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.

The review details the different therapy methods for symptomatic lumbar degenerative disc disease, including physical treatment with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and concludes that, in most patients with low back pain, symptoms resolve without surgical intervention. The review also concludes that physical treatment and nonsteroidal anti-inflammatory drugs are the "cornerstones" of non-surgical therapy.........

Posted by: Mark      Read more         Source


January 26, 2009, 11:32 PM CT

Gene therapy for rheumatoid arthritis

Gene therapy for rheumatoid arthritis
Scientists have reported the first clinical evidence that gene treatment reduces symptoms in patients with rheumatoid arthritis, an important milestone for this promising therapy which has endured a sometimes turbulent past. Described in the recent issue of the journal Human Gene Therapy the findings stem from a study of two patients with severe rheumatoid arthritis conducted in Gera number of and led by an investigator at Beth Israel Deaconess Medical Center (BIDMC).

Originally conceived as a means of treating genetic diseases, such as cystic fibrosis and hemophilia, gene treatment involves implanting a normal gene to compensate for a defective gene in the patient. The first clinical trial to test gene treatment was launched in 1990 for the therapy of a rare, genetic immunodeficiency disease.

"This study helps extend gene treatment research to nongenetic, nonlethal diseases," explains principal investigator Christopher Evans, PhD, Director of the Center for Advanced Orthopaedic Studies at BIDMC. "Rheumatoid arthritis [RA] is an extremely painful condition affecting multiple joints throughout the body. Arthritis is a good target for this therapy because the joint is a closed space into which we can inject genes," adds Evans, who is also the Maurice Muller Professor of Orthopaedic Surgery at Harvard Medical School.........

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January 8, 2009, 9:06 PM CT

For fats, longer may not be better

For fats, longer may not be better
Scientists have uncovered why some dietary fats, specifically long-chain fats, such as oleic acid (found in olive oil), are more prone to induce inflammation. Long-chain fats, it turns out, promote increased intestinal absorption of pro-inflammatory bacterial molecules called lipopolysaccharides (LPS). This study appears in the recent issue of JLR

While dietary fats that have short chains (such as those found in milk and cheese products) can be absorbed directly into the bloodstream from the intestines, long-chain fats need to be first packaged by the intestinal cells into particles known as chylomicrons (large complexes similar to HDL and LDL particles). Erik Eckhardt and his colleagues at the University of Kentucky wondered whether some unwanted LPS particles, routinely shed by the bacteria that inhabit the human gut, might also be sneaking in the chylomicrons.

Their hypothesis turned out to be correct; when they treated cultured human intestinal cells with oleic acid they observed significant secretion of LPS together with the chylomicron particles, a phenomenon that was not observed when the cells were treated with short-chain butyric acid. Similar findings were found in mouse studies; high amounts of dietary oleic acid, but not butyric acid, promoted significant absorption of LPS into the blood and lymph nodes and subsequent expression of inflammatory genes.........

Posted by: Mark      Read more         Source


January 7, 2009, 11:22 PM CT

How skeletal muscle stabilizes the spine?

How skeletal muscle stabilizes the spine?
The novel design of a deep muscle along the spinal column called the multifidus muscle may in fact be key to spinal support and a healthy back, as per scientists at the University of California, San Diego School of Medicine. Their findings about the potentially important "scaffolding" role of this poorly understood muscle has been published on line in advance of the recent issue of the Journal of Bone and Joint Surgery

"The multifidus muscle was formerly believed to be relatively unimportant based on its fairly small size," said Richard L. Lieber, Ph.D., Professor and Vice Chair of UC San Diego's Department of Orthopedic Surgery and Director of the National Center for Skeletal Muscle Rehabilitation Research, based at UC San Diego. Lieber is also Senior Research Career Scientist at the Veterans Affairs San Diego Health System. "Our research shows that it's actually the strongest muscle in the back because of its unique design. It's like a long, skinny pencil packed with millions of tiny fibers".

The scientists discovered that the multifidus has a unique packing design consisting of short fibers arranged within rods, and that these fibers are stiffer than any other in the body. Using laser diffraction methods that they developed to measure muscle internal properties during back surgery, they demonstrated that the multifidus' unique design serves a critical function as a stabilizer of the lumbar spine. These findings could have implications for surgery, as per Steven R. Garfin, M.D., Professor and Chair of UCSD's Department of Orthopaedic Surgery.........

Posted by: Mark      Read more         Source


December 1, 2008, 5:47 PM CT

New treatment eliminates heel pain

New treatment eliminates heel pain
Image courtesy of Foothealthcare.com
Combining an ultrasound-guided technique with steroid injection is 95 percent effective at relieving the common and painful foot problem called plantar fasciitis, as per a research studypresented today at the annual meeting of the Radiological Society of North America (RSNA).

"There is no widely accepted treatment or standard of care for patients when first-line therapys fail to relieve the pain of plantar fasciitis," said the study's lead author, Luca M. Sconfienza, M.D., from Italy's University of Genoa. "Our new technique is an effective, one-time outpatient procedure".

Plantar fasciitis, the most common cause of heel pain, is an inflammation of the connective tissue called the plantar fascia that runs along the bottom of the foot, from the heel to the ball of the foot. The condition accounts for 11 percent to 15 percent of all foot symptoms requiring professional care and affects one million people annually in the U.S.

Conservative therapys, which may take up to a year to be effective, include rest, exercises to stretch the fascia, night splints and arch supports.

When the condition does not respond to conservative therapys, patients may opt for shockwave treatment, in which sound waves are directed at the area of heel pain to stimulate healing. Shockwave treatment is painful, requires multiple therapys and is not always effective. Complications may include bruising, swelling, pain, numbness or tingling and rupture of the plantar fascia. In the most severe cases of plantar fasciitis, patients may undergo invasive surgery to detach the fascia from the heel bone.........

Posted by: Mark      Read more         Source


September 29, 2008, 10:35 PM CT

Pain is not a symptom of arthritis, pain causes arthritis

Pain is not a symptom of arthritis, pain causes arthritis
Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, as per a research studypublished recently 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, scientists observed 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 good 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, scientists 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.........

Posted by: Mark      Read more         Source


September 29, 2008, 9:28 PM CT

Supplements no better than placebo in slowing cartilage loss

Supplements no better than placebo in slowing cartilage loss
In a two-year multicenter study led by University of Utah doctors, the dietary supplements glucosamine and chondroitin sulfate performed no better than placebo in slowing the rate of cartilage loss in the knees of osteoarthritis patients.

This was an ancillary study concurrently conducted on a subset of the patients who were enrolled in the prospective, randomized GAIT (Glucosamine/chondroitin Arthritis Intervention Trial). The primary objective of this ancillary study was to investigate whether these dietary supplements could diminish the structural damage of osteoarthritis. The results, reported in the recent issue of Arthritis & Rheumatism, show none of the agents had a clinically significant effect on slowing the rate of joint space width loss the distance between the ends of joint bones as shown by X-ray.

However, in line with other recent studies, the scientists found that all the study's participants had a slower rate of joint space width loss than expected, making it more difficult to detect the effects of the dietary supplements and other agents used in the study.

Rheumatologist Allen D. Sawitzke, M.D., associate professor of internal medicine at the University of Utah School of Medicine, was lead investigator. "At two years, no therapy achieved what was predefined to be a clinically important reduction in joint space width loss," Sawitzke said. "While we found a trend toward improvement among those with moderate osteoarthritis of the knee in those taking glucosamine, we were not able to draw any definitive conclusions".........

Posted by: Mark      Read more         Source



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Did you know?
A recently identified path of inflammation once thought to be wholly independent of other inflammatory systems has now been linked to another major pathway. The findings by neuroresearchers at Johns Hopkins are likely to point researchers to novel drugs that significantly reduce the risks of taking COX-2 inhibitor pain relievers, the researchers report.

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