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May 20th, 2013
Lynda Williams writing in Medwire reported, “Around a third of elderly patients experience oropharyngeal dysphagia (OD) while recovering from hip fracture surgery, say Australian researchers who have identified markers for the complication.” Investigators found that, “overall, 34% of the 181 patients, aged an average of 83 years old, who were assessed at a specialist orthogeriatric unit within 72 hours of surgery showed clinical signs of reduced swallowing efficiency, such as oral residue or multiple swallows per bolus, or had reduced swallowing safety, defined as coughing or choking after swallowing.” The researchers found that “postoperative OD was significantly more common with increasing age, in patients with neurologic or respiratory comorbidity before surgery than those without, and patients living in a residential aging care facility .” The findings were published in Age and Ageing.
Comment: My patients tell me, getting old is not for sissies.
Tags: arthritis, arthritis treatment, hip fracture, hip fracture surgery, nathan wei, oropharyngeal dysphagia, swallowing issues
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May 17th, 2013
Albertina Torsoli writing in Bloomberg News reported, “Low testosterone levels in men may be an indication of future development of rheumatoid arthritis, a painful inflammatory disorder that primarily affects joints,” according to a study published in the Annals of the Rheumatic Diseases.
Charles Bankhead writing in MedPage Today stated , “Low testosterone raised the odds for subsequent diagnosis of rheumatoid factor (RF)-negative RA by 69% as compared with men who had normal values.” The researchers also found that “men who developed RF-negative RA…had significantly higher levels of follicle-stimulating hormone prior to diagnosis.”
Comment: Hmmm interesting. We know RA is more common in women so obviously hormonal factors play a role.
Tags: arthritis, arthritis treatment, inflammatory disorder, low testosterone, nathan wei, rheumatoid arthritis, testosterone
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May 15th, 2013
Bianca Nogrady writing in Rheumatology News reported that corticosteroid injections may offer short term relief but long term considerations may make one think twice about getting them. She commented on a one year study of 165 patients who were treated with either a steroid injection or physical therapy with a placebo injection. At the end of one year 83% of the steroid group were improved compared with 96% of the sham injection group. In addition the steroid treated group had a higher incidence of recurrence and non-healing.
Comment: I’m not surprised. Ultrasound-guided needle tenotomy with platelet-rich plasma is a much more physiologic treatment since it creates new tendon tissue in addition to relieving pain.
Tags: arthritis, arthritis treatment, nathan wei, steroids, tennis elbow
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May 13th, 2013
Jeff Evans writing for Rheumatology News reported on a recent study which showed transcranial direct current stimulation directed focally to the left primary motor cortex of patients with fibromyalgia
significantly reduced pain compared with sham stimulation. The study involved 18 patients and was published in the journal of Pain.
Comment: Anything that works for fibro is OK with me.
Tags: arthritis, arthritis treatment, fibro, fibromyalgia, nathan wei, transcranial stimulation
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May 9th, 2013
Nancy Walsh writing in MedPage Today reported, “Patients with rheumatoid arthritis (RA) have an increased incidence of diastolic dysfunction, meaning the heart doesn’t fill with blood properly. This may further raise their already high risk for congestive heart failure, a meta-analysis suggested.” Researchers found that “mean left atrial size was larger in RA patients than in controls. The investigators also found that pulmonary artery pressure was higher. The findings were published in Arthritis Care & Research.
Comment: RA patients already are at risk for heart problems. This raises a whole other issue.
Tags: arthritis, arthritis treatment, diastolic dysfunction, heart attack, heart disease, nathan wei, rheumatoid arthritis
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May 8th, 2013
Kathryn Doyle writing in Reuters reported that, according to research published in Arthritis Care and Research, exercising more often may help to reduce certain symptoms of fibromyalgia. The study included 170 fibromyalgia patients who were participating in a larger NIH-funded study.
Comment: Effective fibromyalgia treatment consists of non-impact aerobic exercise, cognitive behavioral therapy, and medication.
Tags: arthritis, arthritis treatment, exercise, fibromyalgia, nathan wei
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May 7th, 2013
We may have a mouse to thank for a new treatment for osteoarthritis. The findings, in a paper by Gregory D. Jay, MD, PhD, of the department of emergency medicine, is published in the journal Proceedings of the National Academy of Sciences. The discoveries were made in part by studying the knees of mice, which genetically lack lubricin, causing an aggressive arthritis in spite of high levels of hyaluronic acid in the synovial fluid. A lack of lubricin, resulting in higher friction, leads to cartilage cell death — even in the presence of high levels of hyaluronic acid, a viscous fluid that cushions the joints. This discovery appears to challenge the practice of injecting hyaluronic acid alone into a patient’s joints.
“The lubricant is a protein, not hyaluronic acid, and currently, there are no disease-modifying treatments for osteoarthritis,” Jay said. “Patients suffering from this degenerative joint disease either go through a total joint replacement, or are forced to live with pain every day. This discovery, however, supports that adding a lubricin replacement to the fluid in joints may in fact prevent osteoarthritis in those who have a genetic predisposition to the illness, or who have suffered significant trauma to the joints.”
Comment: MICKEY MOUSE.
Tags: arthritis, arthritis treatment, degenerative joint disease, Joint Replacement, nathan wei, osteoarthritis, synovial fluid
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May 6th, 2013
Nicholas Bakalar writing in the New York Times reported, “Scientists have turned up ample evidence that consumption of seafood high in omega-3 fatty acids may help protect against cardiovascular disease.” Now, a new analysis published in the Annals of Internal Medicine “confirms that higher blood levels of omega-3 fatty acids may reduce the risk for heart disease and death in people over age
65.” For the analysis, “blood tests were used to track the levels of three different types of omega-3 in 2,692 randomly selected people, average age 74 at the start of the study, for 14 years.”
Comment: Well then… eat your fish!
Tags: arthritis, arthritis treatment, cardiovascular disease, heart attack, heart disease, nathan wei, Omega 3
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May 3rd, 2013
Lynda Williams writing in Medwire reported, “Postmenopausal women with joint pain may benefit from taking estrogen-only hormone therapy,” according to research published in Menopause. Investigators looked at data from the Women’s Health Initiative. The researchers found that “women randomly assigned to receive daily oral conjugated equine estrogen (0.625 mg/day) after hysterectomy were significantly less likely to experience joint pain at 1 year than women given placebo.” The investigators found that “estrogen treatment was also associated with a significant reduction in mean joint pain severity scores at 1 year and both benefits persisted for up to 3 years of follow-up.”
Comment: Whether this will balance out the other risks of estrogen is still not known.
Tags: arthritis, arthritis treatment, estrogen, hysterectomy, joint pain, nathan wei, women with joint pain
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May 2nd, 2013
Nancy Walsh writing in MedPage Today reported, “Highly obese patients can derive similar benefits from total knee replacement surgery as other patients,” according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons. “During nine years of follow-up, highly obese individuals with a body mass index of at least 35 kg/m2 showed an increase of 50 points on Knee Society knee function scores, compared with an increase of 52 and 56 points for mildly obese and nonobese individuals, respectively,” the study found.
Comment: Not what I would have expected… that’s for sure. Still not a license to chow down at the all you can eat buffet.
Tags: arthritis, arthritis treatment, benefits from total knee replacement, nathan wei, obese patients, Obesity, tkr, total knee replacement
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