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Medicineworld.org: Archives of rheumatology news blog
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Archives Of Rheumatology News Blog From Medicineworld.Org
Heat Wrap Therapy Reduces Low Back Pain
"With recent concerns around the safety of oral pain medications, both patients and physicians are considering alternative therapy options for acute low back pain," said Edward J. Bernacki, M.D., M.P.H., associate professor of medicine at The Johns Hopkins University School of Medicine and the study's principal investigator. "The dramatic relief we see in workers using CLHT shows that this treatment has clear benefits for low back pain and that it plays an important role in pain management. Physicians and other health care providers in an occupational environment can tell patients that CLHT is a safe and effective alternative for treating acute low back plain". In the study, 43 patients (age 20 to 62) who visited an occupational injury clinic for low back pain were randomized into one of two intervention arms: 18 patients received education regarding back treatment and pain management alone, while 25 received education regarding back treatment and pain management combined with three consecutive days of CLHT for eight hours continuously (ThermaCare- HeatWraps). The heat wrap is a wrap worn over the lower back, under the clothing. It uses an exothermic chemical reaction to deliver a low level of topical heat for at least eight continuous hours. All groups were assessed for measures of pain intensity and pain relief levels four times a day during the three therapy days, followed by measures for pain intensity and pain relief levels obtained in three follow-up visits on days 4, 7, and 14 from the beginning of the therapy. In addition, other measures were obtained and assessed by the Roland-Morris Low Back Disability Questionnaire and the Lifeware Musculoskeletal Abbreviated Assessment Form......... Posted by: Mark Permalink January 26, 2006, 12:52 AM CT 'Vioxx like' drugs may still be best option for arthritis
They argue that eventhough this class of drugs, which includes Vioxx, has been associated with an increase in the risk of cardiovascular events such as heart attacks and strokes in some patients, the same may be true for traditional non-steroid anti-inflammatory drugs (NSAIDs). All NSAIDs, including COX-2 inhibitors, work by blocking the actions of both COX-1 and COX-2 enzymes. Blocking COX-2 relieves inflammation and pain, but blocking COX-1 can increase the risk of gastric ulcers and bleeds. For this reason COX-2 selective drugs were developed with the simple aim that they would retain the therapeutic actions of NSAIDs (linked to inhibition of COX-2) but lose the gastric side effects (linked to inhibition of COX-1). The scientists reviewed over one hundred papers on the subject and looked at the latest recommendations from organisations such as the American Federal Drugs Administration on the use of COX-2 inhibitors and NSAIDs. The scientists point out that the calls for the removal of COX-2 inhibitors, and a return to using NSAIDs, may cause additional problems. Eventhough NSAIDs have been marketed for many years, they have never been mandatory to meet the clinical trial standards now set for COX-2 inhibitors, meaning they may not be any safer......... Posted by: Mark Permalink January 23, 2006, 9:30 PM CT A Robot That Follows Patients As They Move
A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities - and maybe even athletic ones like swinging a bat. UF mechanical and aerospace engineer Scott Banks' goal is to augment static images of patients' bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate therapys and get a clearer idea of post-operative successes and failures, he said. "Our goal is come up with a way to observe and measure how joints are moving when people are actually using them," Banks said. "We think this will be tremendously powerful, not only for research but also in the clinical setting as well". Complaints about orthopedic injuries are among the most common reasons people visit the doctor, as per the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually......... Posted by: Mark Permalink December 27, 2005 How To Make Cox-2 Inhibitors Safer
In a paper published in the Dec. 23 issue of Science, a Johns Hopkins team led by Solomon H. Snyder, M.D., said the iNOS (inducible nitric oxide synthase)-based inflammation pathway has now been found to cross-link with the more well-known COX-2 pathway that is the target of COX-2 inhibitor drugs such as Vioxx. Until now, these two major inflammatory mechanisms were assumed to be unrelated and independent of each other, the scientists say. "The fundamental significance of this work is that it demonstrates a totally unsuspected connection between the two most important inflammatory systems in the body," says Snyder, professor and director of neuroscience in Johns Hopkins' Institute for Basic Biomedical Sciences. "The therapeutic significance is that drugs which block the binding of iNOS and COX-2 might represent novel anti-inflammatory agents or reduce the dosage needed and side effects of this family of drugs". COX-2 is an enzyme that makes prostaglandins, molecules that cause inflammation and pain. iNOS is an enzyme that makes NO (nitric oxide), a molecule that acts as a signal for a variety of cellular functions throughout the body, including the triggering of inflammation, dilating of blood vessels and penile erection. The site on the iNOS protein that binds to COX-2 is close to the active or business end of the iNOS, the scientists found. As a result, it should be possible to design drugs that do double duty by inhibiting iNOS while also blocking iNOS binding to COX-2. This would decrease the formation of both NO and prostaglandins, Snyder said......... Mark Permalink December 26, 2005 Arthritis Drug Effective for Depression
High concentrations of pro-inflammatory substances called cytokines, such as tumor necrosis factor-alpha (TNF-alpha), have been associated with major depression. According to Ranga Krishnan, M.D., the study author based at Duke, scientists have long hypothesized that reducing the effects of the cytokines may reverse depressive symptoms. Until now, no research team has examined the effects of a tumor necrosis factor receptor on depression in humans. The phase III clinical trial was primarily designed to test the effectiveness of etanercept in improving the clinical symptoms of psoriasis, a chronic skin disease characterized by silvery, scaling bumps and raised patches of very dry skin. In severe cases, people can experience joint pain similar to that of rheumatoid arthritis. Psoriasis sufferers frequently experience problems with both depression and fatigue as a result of their disease. "It has been shown that when you are sick or depressed, tumor necrosis factor concentration increases," said Krishnan, chief of psychiatry and behavioral sciences at Duke. "When TNF-alpha goes up, the symptoms are very similar to what is termed 'sickness behavior' and prior studies have shown that when a person is depressed, TNF-alpha levels are increased in blood"......... JoAnn Permalink December 25, 2005, 10:32 AM CT Merry Christmas To All Our Readers
Oh, jingle bells, jingle bells Jingle all the way Oh, what fun it is to ride In a one horse open sleigh Jingle bells, jingle bells Jingle all the way Oh, what fun it is to ride In a one horse open sleigh........ Daniel Permalink December 21, 2005 Chronic Disability in Older Americans
"Our projections yielded about two million fewer chronically disabled older Americans in 1999, relative to the published estimate of seven million," said Thomas M. Gill, M.D., who co-authored the study with Evelyne A. Gahbauer, M.D. Gill, associate professor of medicine/geriatrics, obtained his findings using data from the "Yale PEP Study," which seeks to better understand how older persons manage day-to-day activities and remain independent at home. Titled "Epidemiology of Disability and Recovery in Older Persons," the PEP study includes 754 participants age 70 or older from the Greater New Haven area. Over the last eight years, participants have shared their experiences during a series of home assessments and monthly telephone interviews focusing on essential activities of daily living, such as bathing, dressing and walking. Patients were classified as having chronic disability based on the presence of disability during consecutive monthly interviews immediately before or after the fourth comprehensive assessment. Of the 552 participants, 16.1 to 17.2 percent met criteria for chronic disability, leading to a national estimate ranging from 4.9 to 5.3 million chronically disabled older Americans. Gill said accurate estimates of chronic disability are important for a variety of reasons. From a policy perspective, these estimates are often used to inform decisions regarding the current and future health care needs of older persons and to forecast the likely demand for long-term care. From an epidemiologic perspective, the causes of chronic disability, including pre-disposing risk factors and subsequent precipitants, may differ from those of short-term disability......... Janet Permalink December 21, 2005 Links Between Kidney Function And Bone
Keith A. Hruska, MD
The organs of the human body, for example, all have their well-known primary specialties, but a number of of them also play secondary roles in support of each other. One such moonlighter is the human kidney, which purifies waste from the blood, but also has a more recently identified role as a contributor to the structural integrity of the human skeleton. Keith A. Hruska, MD, professor of pediatrics, medicine and of cell biology and physiology at the School of Medicine and head of pediatric nephrology at St. Louis Children's Hospital, has developed several new insights into the connections between the kidney and the skeleton and hopes to put them to use soon in new therapys for kidney patients that will ease the harmful effects their condition inflicts on both the skeleton and the heart. To recognize the connections between the kidney and the skeleton, doctors first had to understand that the skeleton isn't the dry and unchanging place it . was once thought to be. "In the past, the skeleton has been viewed as mostly a dead structure, but that's not the case at all," Hruska explains. "The adult skeleton is very active tissue that is continually remodeling, dismantling damaged bone and replacing it with new bone". Cells inside the bone marrow accomplish this task, regularly destroying and rebuilding bone structure to adjust for wear, injury and changes in the mechanical loads and pressures placed on the bones. Kidney disease's direct connection to bone health was initially masked by a complication of chronic kidney disease (CKD) known as secondary hyperparathyroidism. This complication, which afflicts about 100,000 new patients with kidney disease each year, raises bloodstream levels of the parathyroid hormone......... Daniel Permalink December 19, 2005 The Best Way To Cope With The Flu
These are some of the best weapons you may have in your arsenal to help you avoid getting - and giving - the flu this year. Daniel Havlichek, a Michigan State University doctor and chief of the College of Human Medicine's Infectious Disease Section, said coughing or sneezing into a tissue, rather than your hand, is one of the best ways to avoid spreading germs. "Coughing into your hand and then shaking someone else's hand or touching them or a doorknob is a great way to spread influenza or the viruses that cause the common cold," said Havlichek, an associate professor in the Department of Medicine. "A tissue will do a much better job of keeping germs from spreading. Then you just throw it away and then wash your hands. It is also important to rest and take time off if you become ill so that you don't spread infection to others". Hand washing remains one of the most effective, and easiest, ways to avoid illness. "Winter in particular is a time when hand washing can be effective in preventing the spread of illness," said Vincent Young, an MSU doctor who specializes in infectious diseases. Havlichek is also a strong proponent of the use of hand sanitizers, those waterless cleaners that are popping up everywhere. "These are as effective as washing your hands," he said. "In some respects they are even more effective at killing bacteria and viruses than soap and water, eventhough you still need to wash your hands with soap and water regularly to prevent build up of the sanitizer, which can make it less effective". Paula Guss, a nurse with the MSU Office of the University Physician, said other ways to help avoid the flu, and other infectious illnesses, include eating right, drinking plenty of water and getting enough sleep......... Mark Permalink Study on Temporomandibular Joint (December 11, 2005) The National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institutes of Health, announced today the launch of a seven-year clinical study that could accelerate research on better pain-controlling therapys for a jaw condition called temporomandibular joint and muscle disorders (TMJDs).
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.
Medicineworld.org: Archives of rheumatology news blog
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