Obesity speeds up cartilage loss

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Boston: Obesity, among other factors, is strongly associated with an increased risk of rapid cartilage loss, according to a study published in the August issue of the magazine Radiology.

“We have isolated demographic and MRI-based risk factors for progressive cartilage loss,” said the study’s lead author, Frank W. Roemer, M.D., adjunct associate professor at Boston University and co-director of the Quantitative Imaging Center at the Department of Radiology at Boston University School of Medicine.

“Increased baseline body mass index (BMI) was the only non-MRI-based predictor identified.”

As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss. Weight loss is probably the most important factor to slow disease progression.
Risk Factors for MRI-detected Rapid Cartilage Loss of the Tibio-femoral Joint over a 30-month Period: the MOST Study.

Tibio-femoral cartilage is a flexible connective tissue that covers and protects the bones of the knee. Cartilage damage can occur due to excessive wear and tear, injury, misalignment of the joint or other factors, including osteoarthritis.

Osteoarthritis is the most common form of arthritis, affecting 27 million Americans, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. In osteoarthritis, the cartilage breaks down and, in severe cases, can completely wear away, leaving the joint without a cushion. The bones rub together, causing further damage, significant pain and loss of mobility.

The best way to prevent or slow cartilage loss and subsequent disability is to identify risk factors early.

“Osteoarthritis is a slowly progressive disorder, but a minority of patients with hardly any osteoarthritis at first diagnosis exhibit fast disease progression,”

Dr. Roemer said. “So we set out to identify baseline risk factors that might predict rapid cartilage loss in patients with early knee osteoarthritis or at high risk for the disease.”

The researchers recruited patients from the Multicenter Osteoarthritis (MOST) Study, a prospective study of 3,026 people, age 50 – 79, at risk for osteoarthritis or with early x-ray evidence of the disease. The study is funded by the National Institute on Aging.

Dr. Roemer’s study consisted of 347 knees in 336 patients. The patient group was comprised of 65.2 percent women, mean age 61.2, with a mean BMI of 29.5, which is classified as overweight. Recommended BMI typically ranges from 18.5 to 25. Only knees with minimal or no baseline cartilage damage were included. Of 347 knees selected for the study, 20.2 percent exhibited slow cartilage loss over the 30-month follow-up period and 5.8 percent showed rapid cartilage loss. Rapid cartilage loss was defined by a whole organ magnetic imaging score of at least 5, indicating a large full thickness loss of 75 percent in any subregion of the knee during the follow-up period.

The results showed that the top risk factors contributing to rapid cartilage loss were baseline cartilage damage, high BMI, tears or other injury to the meniscus (the cartilage cushion at the knee joint) and severe lesions seen on MRI at the initial exam. Other predictors were synovitis (inflammation of the membrane that lines the joints) and effusion (abnormal build-up of joint fluid).

Excess weight was significantly associated with an increased risk of rapid cartilage loss. For a one-unit increase in BMI, the odds of rapid cartilage loss increased by 11 percent. No other demographic factors–including age, sex and ethnicity–were associated with rapid cartilage loss.

“As obesity is one of the few established risk factors for osteoarthritis, it is not surprising that obesity may also precede and predict rapid cartilage loss,” Dr. Roemer said. “Weight loss is probably the most important factor to slow disease progression.”

AT A GLANCE

* Researchers using MRI have identified risk factors for rapid cartilage loss in the knee.
* People with a high body mass index (BMI) may be at increased risk for rapid cartilage loss and osteoarthritis.
* Osteoarthritis affects 27 million Americans.

“Risk Factors for MRI-detected Rapid Cartilage Loss of the Tibio-femoral Joint over a 30-month Period: the MOST Study.” Collaborating with Dr. Roemer were Yuqing Zhang, D.Sc., Jingbo Niu, M.D., John A. Lynch, Ph.D., Michel D. Crema, M.D., Monica D. Marra, M.D., Michael C. Nevitt, Ph.D., David T. Felson, M.D., M.P.H., Laura Hughes, Georges El-Khoury, M.D., Martin Englund, M.D., Ph.D., and Ali Guermazi, M.D., for MOST study investigators.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc. (http://radiology.rsnajnls.org/)

RSNA is an association of more than 43,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. www.RSNA.org

For patient-friendly information on MRI, visit www.RadiologyInfo.org

Exercise trial for arthritis pain

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Toronto : Certain types of exercise can help reduce the pain and symptoms of knee arthritis.

Now a $5million study of the benefits of exercise is looking to recruit Canadians with osteo-arthritic knee pain for further research to be carried out at the University of Calgary’s Sport Medicine Centre.

Andrew Marsh, a master’s student co-ordinating the active aspect of the study, says the project will further test the theory that exercise aids in the treatment of the condition.

The is being funded by the Alberta Heritage Fund for Medical Research, and is a free, supervised, three-month exercise program open to individuals over the age of 40. Those who are younger and living with osteoarthritic pain due to past surgeries may also qualify.

Over six per cent of Canadian adults over 30 experience osteoarthritis, and by age 65, that number jumps to 11 per cent.

Co-ordinators and specialists will follow the activity and personal experiences by participants, who must be committed to exercising over the 12 weeks, most of which can be conducted at home. No heavy weights are involved and everyone will receive the necessary training and equipment.

The exercises will focus on various areas of the lower body, including the hips and thighs, which lend support to knees.

Since osteoarthritis is a gradual progression with often subtle signs of pain or immobility, and key to reducing pain is to increase strength around the joint and within the core so the body is better able to move.

The potential for this study to branch out into other areas of health care is exciting and far reaching, adds Ferber.

“This is unique because we’re doing a whole body study and that’s ever been done before,” he says. “Once the results are published, the knowledge can then be used to help patients and inform physicians, and therapists.”

For more information about participating in the study, call + 1 403-220-3523 or e-mail kneeoa@ucalgary.ca

New drug relieves rheumatoid arthritis

San Francisco: A new ‘smart drug’ which halts pain and disability for almost half of rheumatoid arthritis patients could go on sale in months.

The drug, called Tocilizumab, has not yet been licensed in Europe, contains a laboratory-made anti-body that blocks interleukin-6, an immune system messenger involved in the inflammation process of the disease. Drug maker Roche hopes to get a licence for sales next year.

The latest results from a trial carried out in 15 countries are to be presented to the American College of Rheumatology meeting in San Francisco.

It looked at the effects of Tocilizumab prescribed with the standard drug treatment, Methotrexate, compared to Methotrexate alone in 1,190 patients with moderate to severe rheumatoid arthritis.

The combination treatment slowed structural damage of joints in patients with rheumatoid arthritis by 85 per cent, compared with 67 per cent in those on standard treatment.

Researchers found 47 per cent of patients on combination treatment achieved remission – where the disease stops advancing – compared with just eight per cent of those treated with methotrexate alone.

Frankincense found to ease arthritis pain

Los Angeles: Francincense contains an extract that may ease the symptoms of oesteoarthritis.

Results of a human trial published in the Journal of Arthritis Research and Therapy compared the extract to a dummy drug in patients with mild to moderate arthritis. Those taking the treatment reported less pain and better mobility after just seven days.

Indian frankincense is the resin which leaks out of the Boswellia Serrata tree and has been used in ancient Hindu medicine for centuries. It comes from a slightly different tree to the biblical frankinsence but this also has been found to have anti-inflammatory properties.

The research involved randomly giving 70 people a high dose, low dose, or dummy drug each day for 90 days. Their pain and physical function was evaluated before the trial began and at intervals using standard and accepted methods.

The treatment was well tolerated and the authors concluded it was safe.

Lead author Siba Raychaudhuri, a faculty member of the University of California, Davis, in America. According to Raychaudhuri, said: “The high incidence of adverse affects associated with currently available medications has created great interest in the search for an effective and safe alternative treatment.”

The study was funded by Laila Impex Research and Development Centre in India which is connected to Lalia Nutraceuticals which have created the drug and the study authors are consultants for the company.

Drinking more water helps prevent arthritis

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London: Drink more water, it helps prevent arthritis and other conditions, according to new research from the UK’s Arthritis Association.

In addition, Baroness Greengross, founder of the charity Action on Elder Abuse, has this week called for a set of minimum standards on hydration across the UK. However, it’s not just the elderly who should drink more water.

According to arthritis pioneer Charles de Coti-Marsh, we could all stay a lot healthier for longer if we looked after our gut, and staying hydrated is the first step.

Nutritional therapist Elizabeth Hartland explains: “Many people will have heard about the benefits of healthy bacteria and the pro-biotic drinks you can now buy, but symptoms of an unhealthy digestive system, such as constipation, are less talked about. Charles de Coti-Marsh believed that a constipated state creates toxins which stay in the bowel, enter the blood stream and poison the body, the long term effects of which can be diseases such as arthritis. Drinking plenty of water can help avoid constipation.”

About The Arthritic Association
Founded in 1942, The Arthritic Association www.thearthriticassociation.org.ukis a registered charity dedicated to helping relieve people from the pain of arthritis through natural methods.

Sugary drinks put men at increased risk of gout

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London: Recent research reported in the British Medical Journal found that consuming sugary drinks can increase the risk of men developing gout, a form of arthritis.

These findings support claims made over 50 years ago by arthritis pioneer Charles de Coti-Marsh, states the UK’s Arthritic Association.

A twelve year study of nearly 50,000 men found a strong association between sugar sweetened soft drinks, usually containing fructose, and gout. Consuming two servings a day of a sugary soft drink increased the risk of developing gout by 85%.

Some sufferers of gout already know to avoid sweetened drinks, thanks to a little-known publication of 1957, ‘Rheumatism and Arthritis – The Conquest’, in which author Charles de Coti-Marsh states that gout sufferers can alleviate the condition by drinking plenty of fresh fruit and vegetable juices every day.

Bruce Hester of The Arthritic Association comments: “Charles de Coti-Marsh advocated drinking water, herbal teas and natural fruit juices. This new research demonstrates that his theories were in many respects sound. Although progress in the field of arthritis and nutrition is slow, we fully expect to see further justification of his theories as medical science progresses.”

Further information is containced in the report: ‘Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study’ which can be read online at www.bmj.com

About The Arthritic Association:

Founded in 1942, The Arthritic Association is a registered charity dedicated to helping relieve people from the pain of arthritis through natural methods.

Publications by Charles de Coti-Marsh, including ‘Rheumatism and Arthritis, The Conquest’, can be viewed online at
www.arthriticassociation.org.uk

Younger skin restored with collagen, reveals patient trial

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London: A new range of collagen based supplements, proven in tests to thicken the skin, has been launched in the UK.

The new range, ‘Skin Deep’ includes ‘Skin Deep 100% Pure Collagen Capsules’ which were originally developed to alleviate joint and arthritic conditions, but patients also reported remarkable improvements in their skin at the same time. It appeared healthier and firmer, while fine lines diminished. Other benefits also included healthier looking hair and stronger nails. The results were visible in as little as three weeks.

The principal ingredient of is Collagen — a word derived from the Greek meaning to produce glue — its function within our body is similar, holding and supporting tissues. As we age collagen production diminishes.

The Skin Deep range differs from other collagen products available as it uses a superior patented brand of hydrolysed collagen produced to make it purer than other collagen supplements. It has a lower molecular weight which enables the collagen to be absorbed more quickly into the system. Skin Deep Collagen is 95% absorbed in the body within the first 12 hours of being taken. Once in the body it seems to perform the same function as our own collagen and the body’s natural collagen base is restored to that of a younger person. Skin Deep Collagen has received FDA approval and has been confirmed as GRAS (Generally Regarded as Safe).

Skin Deep Collagen capsules are available in pots containing 90 capsules (1 month supply – 3 to be taken per night) and contains 100% pure collagen. These are ideal for anyone looking to maintain a healthy skin and reduce the signs of ageing.

Skin Deep Collagen capsules cost £24.95 on-line at www.thevitalityshopuk.com

Moderate exercise relieves arthritis symptoms

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Adults with arthritis tend to be less fit than their peers, but a new study from the University of Carolina has found that moderate exercise increases fitness.

Lead researcher Leigh F. Callahan of the University of North Carolina at Chapel Hill, N.C., said the study examined 346 patients with an average age of 70 who had self-reported arthritis.

The participants were divided into an intervention group that took part in the Arthritis Foundation Exercise Program – exercise classes at basic and advanced levels that met for one hour twice a week for eight weeks – and a control group that was offered the program after eight weeks.

The intervention group completed self-report assessments at three months and six months after completing the program.

The study, published in Arthritis Care & Research, showed that the intervention group had significant improvements in pain, fatigue and managing arthritis at eight weeks, and maintained improvements in pain and fatigue at six months.

Arthritis and rheumatism – a top consultant answers your questions

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London: Is it arthritis? Is it rheumatism? What can I do to help it, or stop it getting worse? These are common questions – and not just for the elderly.
by Dr Charles Mackworth-Young, Consultant Rheumatologist, King Edward VII’s Hospital Sister Agnes London.

There are many kinds of arthritis. While osteoarthritis – which involves loss of cartilage within joints – tends to occur in older individuals, active inflammation of joints, such as rheumatoid arthritis, can strike people of any age. All forms of arthritis can eventually lead to joint damage. Most are partly genetic in origin: the majority of individuals with arthritis have probably inherited genes that have made them more susceptible to the condition. Other factors may contribute to arthritis – for instance certain infections, or even direct damage to joints, such as fractures.

“Rheumatism” is a rather vague term, but is generally used to mean pain in “soft” tissues in the back or limbs, such as muscles, tendons or ligament. This can be due to a number of causes, including strain and overuse. Examples include tendonitis at the wrist, tennis elbow, and heel pain due to “plantar fasciitis”. While many of these conditions are localised and may ultimately get better, they can be painful and debilitating while they last.

Most forms of arthritis cannot be cured by medical therapy. However the good news is that the majority can be improved considerably by treatment which reduces symptoms and may help prevent progression or damage. Therefore for symptoms that persist it is important to have an accurate diagnosis of what the problem is. This can be provided by a general practitioner or, if necessary, a specialist such as a rheumatologist.

There are a number of things that an individual with arthritis can do for him or herself. A lot is written about diet, much of it poorly supported by good evidence. However, for most people simple weight reduction is valuable, since it can result in less physical strain on joints in the back and legs. A diet low in animal fat – e.g. a “Mediterranean” diet – may help reduce joint inflammation, as may the addition of fish oil. Supplements, such as glucosamine, chondroitin and “MSM”, are available without prescription. They are widely used for osteoarthritis, and appear to be harmless: whether they genuinely help remains controversial. Various complementary therapies can be tried, including
chiropracticand acupuncture.

For most people with arthritis or rheumatism, orthodox professional help is needed. This is best given in a clinic or hospital where many different specialities and treatments are available. There are many good NHS hospitals that offer this. An outstanding unit in the private sector is King Edward VII’s Hospital Sister Agnes in Beaumont Street, London. Located in the Harley Street area of London, this remarkable hospital offers a wide range of services covering most disciplines. A unique feature is that each member of its consultant staff is hand-picked after a rigorous selection process, thus ensuring the highest standards of care. There is notable expertise in the area of arthritis and rheumatism, with an extensive range of medical, surgical and other specialities.

Many people with arthritis or rheumatism will need the advice of a rheumatologist. He or she may arrange tests at the hospital, including X-rays and scans; give advice about lifestyle and exercise; and prescribe drugs to help pain and tackle the disease. The rheumatologist may also recommend the opinion of other specialists. For instance there are orthopaedic surgeons who specialise in different areas, and carry out procedures ranging from keyhole surgery to joint replacement. Hand surgeons perform delicate work on tendons and joints. And spinal surgeons operate on the neck and back to release trapped nerves.

Supporting all of these activities are physiotherapists and occupational therapists who have particular expertise in arthritis and rheumatism. The physiotherapy department at King Edward VII’s Hospital is also lucky to have one of the few hydrotherapy pools in London: treatment in the water can be especially valuable for joint and muscle conditions, and in speeding up recovery after surgery.

Besides medical, surgical and physiotherapy approaches, direct control of discomfort can be important. At King Edward VII’s Hospital there is a specialised pain control team, who use a variety of injection and other techniques. They are supported by psychologists, who have particular experience in treating painful disorders.

This is an exciting time for the management of arthritic and rheumatic conditions. Many new and effective treatments are emerging, including “biological” therapies. Gene therapy may be the next great step.

For more information on treatments and specialists go to www.kingedwardvii.co.uk

Arthritis drug banned from sale in UK and Germany

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London: The drug Prexige (lumiracoxib), used to treat osteoarthritic pain has been suspended from sale by health regulators in the UK and Germany over liver damage fears.

Manufacturer, Novartis, is informing regulatory agencies around the world of these changes, which come after similar actions in other countries in recent months.

Novartis will also comply with a request from the Austrian health authority to suspend sales pending a final decision by the Committee for Medicinal Products for Human Use (CHMP), which reviews medicines in the European Union.

Patients taking Prexige in the UK, Germany, and Austria are advised to consult their medical practitioner.

Prexige was precribed as 100 mg once-daily treatment for osteoarthritic pain following EU approval through the Mutual Recognition Procedure (MRP) in October 2006. Itis also marketed and sold in Belgium, Cyprus, Hungary, Malta, Portugal, and Sweden.

Other EU countries may decide to independently suspend the marketing authorization or sale of Prexige ahead of a decision by the CHMP, which is expected in December.

Prexige is part of a class of drugs known as a COX-2 inhibitors and liver enzyme changes are a known side effect of these and traditional non-steroidal anti-inflammatory drugs (NSAIDs).

The ban comes The actions in Europe come after an Urgent Safety Restriction was initiated in August 2007 for the Prexige 100 mg dose. Prexige was first withdrawn in August 2007 in Australia where a number of liver side effects were reported, including two deaths, associated with the use of Prexige at doses higher than 100 mg. No deaths have been reported worldwide with the 100 mg dose.

Older adults suffering increase in disabilities

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Older adults are suffering from increasing levels of disability as a result of obesity, according to new research by the University of Pennsylvania School of Medicine.

The research, published in the Journal of the American Medical Association is the first to track effects of obesity on disability over time.

“Obesity is more hazardous to the health of the elderly than we previously suspected,” says Dawn Alley, PhD, lead author, and Robert Wood Johnson Health and Society Scholar at the University of Pennsylvania School of Medicine. “For an older person, suffering from obesity means they are much less likely to be able to walk to the front door or pick up a bag of groceries.”

The study reveals that obesity, which has become more common among older Americans, is having an increasingly profound impact on their day-to-day activities and overall health.

The researchers examined health data from 1988-1994 to data from 1999-2004, the researchers found that the odds of suffering from functional impairment have increased 43 percent among obese adults age 60 years and older. This means they are less able to do things like walk a quarter of a mile, climb 10 steps, pick up a 10-pound weight, and bend over.

“We believe that two factors are likely contributing to the rise in disability among older, obese people,” says Virginia Chang, MD, PhD, Assistant Professor of Medicine at Penn; Attending Physician, Philadelphia Veterans Affairs Medical Center; and senior study author.

“First, people are potentially living longer with their obesity due to improved medical care, and second, people are becoming obese at younger ages than in the past. In both instances, people are living with obesity for longer periods of time, which increases the potential for disability.”

The study evaluated health survey data from 9,928 Americans age 60 years and over from the National Heath and Nutrition Examination Surveys (NHANES) conducted from 1988 to 1994 and from 1999 to 2004. Researchers estimated the risk of functional and activities of daily living (ADL) impairment – the inability to move from a bed, dress, or eat – for normal weight, overweight, and obese populations for both time periods, and evaluated trends in the relationship between obesity and disability over time. Results revealed that obesity increased by 8.2% among the population over 60 during this time period, and that the disability gap between obese and non-obese groups widened.

Researchers also found that obese people are not benefiting from some of the health improvements that the rest of the population is experiencing. For example, although the odds of ADL impairment decreased by 34 percent among the general population, no such improvements were seen in the obese population.

Other recent studies have suggested that obese populations have actually become healthier since the 1960s. While other obesity-related risk factors — such as high blood pressure and elevated cholesterol — have declined, this new research suggests that quality of life for obese older people may be deteriorating.

“Preventing disability should be another motivation for health care providers, policymakers and the public to take obesity seriously in the elderly population. Spending time and resources to prevent obesity now may reduce the need to treat disabilities later,” says Dr Alley.

The study was supported by the Robert Wood Johnson Foundation Health and Society Scholars Program and by a grant from the National Institute of Child Health and Human Development.

Knee arthritis may be sign of lung cancer in smokers

Rome: Arthritis of the knee may be the first sign of a type of lung cancer that is hard to treat in heavy smokers, suggests research published ahead of print in the Annals of the Rheumatic Diseases.

The Italian researchers reviewed the case notes of all patients with rheumatic disorders, diagnosed at one tertiary referral centre over six years.

Between 2000 and 2005, more than 6500 new patients attended the clinic. Of these, 296 (4.4%) were cases of monoarthritis—inflammation in just one joint—of the knee.

Among this group of patients, the knee arthritis, which was very mild, was the first sign of as yet undiagnosed non-small cell lung cancer in just under 2%.

All the patients were middle aged men, who had been heavy smokers for most of their lives.

But in every case, the lung cancer was operable, and once the cancerous tissue had been removed, the knee symptoms subsided.

Non-small cell lung cancer is linked to other conditions, which feature abnormal growths, in up to 20 per cent of cases, say the authors. And spread to the bones occurs in around one in five cases.

But the authors note that it has not so far been linked to arthritis.

Non-small cell lung cancer is particularly difficult to treat unless caught early, and in over half the cases diagnosed, the disease is already advanced.

Features that could act as early warning signs are therefore especially important, say the authors.

Pet arthritis – advice from pet longevity vet Dr Carol Osborne

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By Dr Carol Osborne

Arthritis is a degenerative joint disease which causes painful inflammation of the joints and affects dogs and cats as well as humans. Recent research reveals that arthritis manifests itself in 95% of dogs even at the age two, and 99% of people at age 35, even if there are no visible signs. Twenty percent of all dogs two years of age and older are afflicted.

Symptoms include limping, lameness, decreased activity, stiffness, reluctance to stand, climb stairs, run and jump. In the case of cats they become reluctant to move and often have accidents outside the litter box.

Although arthritis is more common in large dogs, small dogs and cats are also vulnerable to this condition which destroys the cartilage and connective tissue, which normally act as a cushion and absorbs the shock between bones and joints.

But medical management, weight control and moderate exercise can help many pets to live a relatively pain free life even with this condition. This has traditionally consisted of anti-inflammatory drugs and steroids, which are effective in relieving pain but can carry serious side effects. But new, natural remedies are able to offer similar benefits without the risks. Moderate exercise helps maintain joint mobility and muscle strength for joint support. Weight control also helps reduce the burden of excess soft tissue the joints must support.

Like humans pets can benefit from taking supplements that provide relief from pain while increasing joint lubrication and flexibility and enhancing the joints ability to absorb shock. These should contain a range of ingredients including glucosamine, methylsulfonylemethane (MSM, Green Lipped Mussel, glycosaminoglycans, hyaluronic acid, natural chelated minerals, Ester C, enzymes and polypeptides.

Since age, breed, diet, lifestyle, injury and stress can affect the health and function of joints in different ways it is always wise to seek the advice of a professional vet.

Dr Carol can be contacted toll free in the US at 1-866 DR CAROL or by email at drcarol@drcarol.com For more information visit www.drcarol.com

Pet Arthritis – advice from leading vet Carol Osborne

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By Dr Carol Osborne

Arthritis is a degenerative joint disease which causes painful inflammation of the joints and affects dogs and cats as well as humans. Recent research reveals that arthritis manifests itself in 95% of dogs even at the age two, and 99% of people at age 35, even if there are no visible signs. Twenty percent of all dogs two years of age and older are afflicted.

Symptoms include limping, lameness, decreased activity, stiffness, reluctance to stand, climb stairs, run and jump. In the case of cats they become reluctant to move and often have accidents outside the litter box.

Although arthritis is more common in large dogs, small dogs and cats are also vulnerable to this condition which destroys the cartilage and connective tissue, which normally act as a cushion and absorbs the shock between bones and joints.

But medical management, weight control and moderate exercise can help many pets to live a relatively pain free life even with this condition. This has traditionally consisted of anti-inflammatory drugs and steroids, which are effective in relieving pain but can carry serious side effects. But new, natural remedies are able to offer similar benefits without the risks. Moderate exercise helps maintain joint mobility and muscle strength for joint support. Weight control also helps reduce the burden of excess soft tissue the joints must support.

Like humans pets can benefit from taking supplements that provide relief from pain while increasing joint lubrication and flexibility and enhancing the joints ability to absorb shock. These should contain a range of ingredients including glucosamine, methylsulfonylemethane (MSM, Green Lipped Mussel, glycosaminoglycans, hyaluronic acid, natural chelated minerals, Ester C, enzymes and polypeptides.

Since age, breed, diet, lifestyle, injury and stress can affect the health and function of joints in different ways it is always wise to seek the advice of a professional vet.

Dr Carol can be contacted toll free in the US at 1-866 DR CAROL or by email at drcarol@drcarol.com. For more information visit www.drcarol.com

Arthritis more likely for women smokers

San Francisco: Smoking increases the chance of developing rheumatoid arthritis in women who otherwise lack genetic risk factors for the disease, according to new published in the Annals of the Rheumatic Diseases.

Rheumatoid arthritis is a chronic, inflammatory disease in which the patient’s immune system attacks the joint linings. It is the most serious and debilitating form of arthritis.

Interaction between genes and environmental factors is considered to be fundamentally important in complex autoimmune diseases, such as rheumatoid arthritis.

The authors base their findings on a comparison of 115 postmenopausal women with the disease and 466 women without.

All the women were taking part in the Iowa Women’s Health Study, a long term research project tracking participants’ lifestyles, such as smoking, and included the ages at which a woman started and gave up smoking and how many cigarettes she smoked every day.

The results showed that smoking almost doubled the odds of developing rheumatoid arthritis in women who had not inherited the most well established genetic risk factor for the disease, HLA-DRB1 SE.

However, among those women who had inherited the genetic risk factor HLA-DRB1 SE, exposure to tobacco smoke was not associated with an increased risk of the disease.

The authors point out that this research was limited to older white women, so it is not yet clear if other age groups and ethnicities would be similarly affected.

Rose-hip – a new hope for sufferers of joint pain and osteoarthritis

London: Rose-hip can help alleviate joint pain in patients with knee, hip, and hand osteoarthritis, according to latest research.

In the study, a randomized, double-blind, placebo-controlled clinical trial published in the Scandinavian Journal of Rheumatology (Aug 2005)1, 82% of patients reported a reduction in pain after 3 weeks of active treatment with GOPO – the active compound isolated from Rosa canina, a type of rose-hip.

The research could give new hope to the 9 million people in the UK who suffer from painful joints2 due to arthritis and related conditionsbut who are keen to maintain an active life. In comparison, one of the largest long-term studies on glucosamine3, currently the most popular supplement for joint health, showed only a 40% response rate to treatment and that it took up to 12 weeks before the subjects reported feeling improvement.

The research also found that GOPO alleviated pain to an extent that therewas a significant reduction in the consumption of traditional painkillers such as paracetamol, ibuprofen, and non-steroidal anti-inflammatory drugs(NSAID’s) – a key benefit not observed in studies on glucosamine. Although typical treatments for the pain and inflammation caused by arthritis, NSAID’s can cause serious side effects if used over a prolonged period including abdominal pain, heartburn, nausea, and vomiting.

“I was very interested to see the results of this research, which show
rose-hip extract to have a very quick effect in reducing osteoarthritic pain in the hip, knee, and hand. This study suggests that rose-hip extract offers potential relief from pain for osteoarthritis sufferers, without theside effects that are often found with conventional anti-inflammatorydrugs or pain killers”, says Dr Rod Hughes, Consultant Rheumatologist at St Peter’s Hospital in Surrey.

The study, recently presented at the 10th World Congress on Arthritis in December 2005, is a continuation of extensive research into anti-inflammatory efficacy of GOPO in osteoarthritis. The Scandinavian Journal of Rheumatology is one of the leading international journals in the field of arthritis and rheumatology. Unfortunately due to the drying process that is needed to isolate the active anti-inflammatory compound from the sub-species of rose-hip, GOPO is not available in a normal diet and can only be taken in the form of a food supplement. LitoZin Joint Health, from Lanes, is the only supplement containing GOPO and is specifically formulated for maintaining joint health.

LitoZin Joint Health is available in Boots, independent pharmacies and
health food stores, and is priced at £19.99 for 120 capsules. For more
information on LitoZin Joint Health, please see www.litozin.co.uk For more information on arthritis, please see Arthritis Care
(www.arthritiscare.org.uk ) and Arthritis Research Campaign (www.arc.org.uk)

About Lanes G R Lane Health Products Ltd (Lanes) is one of the major natural medicine companies in the UK and manufactures well-known products such as Olbas,Kalms, Quiet Life and Aquaban. Established in the 1930’s by Gilbert Lane – an early supporter of the ideathat we can improve our health through diet and the use of carefully selected plants and nutrients – Lanes remains a family owned business and is chaired by Gilbert’s grand-daughter, Janet Lane. References 1 A powder made from seeds and shells of a rose-hip subspecies (Rosa canina l.) reduces symptoms of knee and hip osteoarthritis: A randomized, double-blind, placebo-controlled clinical trial, Scand J Rheumatol 34:302-308, July – August 2005 by Winther, K. Apel, K and Thomsborg,G., 2 Statistics from the Arthritis Research Campaign 3 Long term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled clinical trial JY. Reginster , R. Deroisy , LC. Deroisy, et al., Lancet , 2001, vol. 357, pp. 251—256)

New arthritis drug fears

London: There are health concerns over a new arthritis drug which comes from the same drug family as Vioxx, which is at the heart of a US class action against the manufacturers.

The new drug Prexige, is a Cox-2 inhibitor, an anti-inflammatory, the best-known of which is Vioxx. A law suit against Vioxx manufacturer Merck Sharpe & Dohme, is currently ongoing in which 7,000 Americans claim they suffered heart attacks or strokes after taking it. The drug was removed from the market in 2004.

Prexige’s maker, Novartis, has carried out its biggest-ever trial involving 34,000 patients to prove that the drug is no more likely to cause heart attacks or strokes than standard painkillers such as ibuprofen or naproxen.

Prexige has now been licensed for use in the Britain by the Medicines and Healthcare products Regulatory Agency, the government agency responsible for making sure drugs are safe.

But following the scandal over Vioxx, many GPs are expected to be reluctant to prescribe it.

When Cox-2s became available in the late 1990s, they were seen to reduce the rate of stomach ulcers caused by existing painkillers such as aspirin. Thousands of patients end up in hospital each year because of ulcers linked to painkilling drugs and it is estimated up to 2,500 Britons a year die as a result.

Patients with heart disease or at high risk of a stroke have been advised not to take Cox-2s since Vioxx was taken off the market.

Trials on Prexige show it reduces pain as successfully as some other Cox-2s and nonsteroidal anti-inflammatory drugs. But it reduces the rate of stomach problems, including ulcers, by up to 79 per cent compared with two other commonly-used drugs.

There was no difference in the cardiovascular risk in patients taking the new drug compared with the painkillers ibuprofen or naproxen.

Selenium may cut risk of arthritis

New York: Researchers in the US believe that low levels of the mineral selenium could increase the risk of osteoarthritis in the knees.

Levels of selenium were measured in the toenail clippings and those with high levels were found to have half the risk of developing severe osteroarthritis in their knees.

The conclusion is that the mineral acts as a protective antioxidant but more research is necessary to prove this.

Red wine may help osteoarthritis

San Diego: Scientists have discovered that resveratrol, a powerful antioxidant found in red wine, appears to stop the damage caused to cartilage in osteoarthritis.

During laboratory experiments, tissue was taken from patients undergoing knee replacement surgery and cells were exposed to small doses of resveratrol. The results,presented at a recent American College Of Rheumatology meeting in San Diego, showed the wine chemical protected cells in the knee joint against further damage.

Osteoarthritis develops when cartilage becomes roughened and thin. In a healthy joint, the cartilage acts as a cushion, spreading forces evenly when pressure is applied. Its smooth, slippery surface also allows the bones to move freely. The cartilage stays slippery and smooth thanks to a thick fluid — called synovial fluid — produced by a membrane that surrounds the joint.

But if the cartilage breaks down, usually through wear and tear, the bone underneath starts to thicken and the joint becomes inflamed. In severe cases, the bones grind together, which can be extremely painful.

Treatments range from painkilling creams and pills to steroid injections, designed to curb the swelling inside the joint. But many people end up on a waiting list for replacement joints.

The latest findings from the New York University of Medicine may have found a new treatment based on red wine, although the research is still at a very early stage.

In the new study into resveratrol’s effects on osteoarthritis, tiny samples of cartilage taken from damaged knee joints were combined with the antioxidant compound.

The results showed it slashed production of chemicals that cause inflammation in the joints by between 50 and 90 per cent.

It also stimulated production of key proteins that make up an important part of the connective tissue in the joints.

Red wine also contains polyphenrols which reduce the amount of bad LDL cholesterol in the arteries and increase the levels of protective HDL cholesterol. This means blood is less likely to clot, which can lead to a stroke or heart attack.

The anti-oxidants in red wine -tannin and resveratrol – also help guard against cancer and slow tumour growth.

Studies have shown that a glass a day could be effective against lung cancer.

Joint supplement better at fighting arthritis than drugs, reveals US research

San Diego: A supplement taken by athletes is better at fighting osteoarthritis pain than prescription drugs, research by the American College of Rheumatologyhas revealed.

Sportsmen have been using glucosamine sulphate and chondroitin – basic building blocks in cartilage tissue – for years because of the enormous pressure on their joints.

Now a study funded by the U.S. government says over-the-counter supplements significantly reduce pain as joints naturally wear with increasing age.

It is thought they decrease the inflammation caused by the disorder and stimulate the production of cells needed to make new cartilage. Supplements helped four out of five people and had negligible side effects.

Arthritis link to lack of vital mineral

New York: US researchers have shown that shortage of a mineral is linked to knee arthritis.

Selenium, which occurs naturally in the soil and found in brazil nuts, shellfish, tuna, wholegrains and eggs, is believed to have anti-ageing properties and has been shown to protect men against prostate cancer.

The US study of 940 volunteers found that even tiny amounts of the mineral could protect against knee arthritis. For every additional tenth of a part per million of selenium in participants’ bodies, there was a 15% to 20% reduction in risk.

Those who had less of the mineral than normal in their systems faced a higher risk of osteoarthritis in one or both knees. The severity of disease was related to how low the selenium levels were.

Study leader Dr Joanne Jordan, of the University of North Carolina at Chapel Hill, said: “We are very excited about these findings because no one had ever measured body selenium in this way in relationship to osteoarthritis.

“Our results suggest that we might be able to prevent or delay osteoarthritis of the knees and possibly other joints in some people if they are not getting enough selenium. That’s important because the condition, which makes walking painful, is the leading cause of activity limitation among adults in developed countries.”

Volunteers were enrolled into the Johnston County Osteoarthritis Project, a continuing investigation of the disabling condition that was launched 15 years ago. It was the experience of people in severely selenium-deficient areas of China that led Dr Jordan to suspect that the mineral might play a role in preventing osteoarthritis.

In those regions, people frequently develop Kashin-Beck disease, which causes joint problems relatively early in life. Dr Jordan’s team compared the extent of knee osteoarthritis shown on X-rays with the amount of selenium in each volunteer’s body. Selenium was measured in toenail clippings taken from the participants. “We found that when we divided the participants into three groups, those with the highest selenium levels faced a 40% lower risk of knee osteoarthritis than those in the lowest-selenium group,” said Dr Jordan.

Too much red meat may cause rheumatoid arthritis, say researchers

London: Eating lots of red meat increases the risk of rheumatoid arthritis, say researchers at Manchester University. And smoking increases the risk of chronic ageing diseases.

Epidermiologists from the university researched 25,000 people aged between 45 and 75. They compared the diets of the 88 diagnosed with rhumatoid arthritis, the condition causes membranes lining the joints to become inflamed, leading to pain and swelling, with those in a control group of 175 others. The findings are published in the Arthritis and Rheumatism journal.

They discoverd that those who ate large mounts of red meat and who smoked were more likely to have inflammatory arthritis.

Only 35 per cent of those who suffered from arthritis had never smoked, compared with 85 per cent of the control group.

The researchers concluded that the eating of red meat would likely only affect those predisposed to the condition.

‘It may be that the high collagen content of meat leads to collagen sensitisation and consequent production of anticollagen antibodies, most likely in a subgroup of susceptible individuals,’ the team said.

‘Meat consumption may be linked to either additives or even infectious agents, but again there is no evidence as to what might be important in relation to rheumatoid arthritis.’

Experts said last night that while people who eat large quantities of red meat should consider cutting down, they should not panic.

A spokesman for the Arthritis Research Campaign, which funded the study, said: ‘This provides further evidence that environmental factors can help to trigger rheumatoid arthritis.

‘In the light of this new evidence, we would suggest that, as part of a healthy lifestyle, people should cut down the amount of red meat they eat.’

But he added: ‘We wouldn’t want people to think that if they eat four burgers a week they are going to develop rheumatoid arthritis the following week, because there are other risk factors that come into play – genetic susceptibility, smoking and low intake of Vitamin C.

‘Red meat in itself is not dangerous to health, but should be eaten in moderation as part of a balanced, healthy diet.’

Arthritis

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There are two types of arthritis (rheumatoid and osteo) and about eight million sufferers of the disease.

Rheumatoid arthritis is caused by inflammation in the lining of the joints and is a chronic progressive disease that causes swelling in the joints, resulting in deformity and immobility especially in the fingers, wrists, feet and ankles.

Osteoarthritisis affects the cartilage and bone, causing pain and stiffness. It usually occurs in weight-bearing joints such as the hips, knees, spine, back and neck, but can also affect finger joints, toe joints and the spine.

In the case of rheumatoid arthritis an early warning blood test may help sufferers in the future. Doctors have discovered a link in the blood of those likely to develop the disease – two kinds of anti-bodies – one to a substance called anti-cyclic citrullinated peptide and another called rheumatoid factors.

There is a drug which is able to block a chemical called tumour necrosis factor (TNF) which causes the swelling and tissue damage in rheumatoid arthritis. It is available on the NHS but expensive it costs about £10,000 a year but helps those who do not respond to any other treatment. – about ten per cent of people with the disease. Another is Enbrel is a twice-weekly injection for rheumatoid arthritis.

Recent discoveries that may help are:

New joints

Surgeons in Finland have managed to create new joints using tissue-engineering techniques and a specially designed mould or scaffold. In the operation, a small round scaffold full of tiny holes is fitted in the gap between the two pieces of bone at either side of what was the joint. Once in place, the job of the scaffold is to create and maintain a space between the bone ends.

The idea is that the surrounding tissue invades the mould through the tiny pores of the scaffold and fills the empty space, effectively creating a living, working joint. The Finnish surgeons who carried out the operations on 80 individual joints at the Medical University of Tampere said they found that during the first ten days, when the hand is in a splint, the cells migrated into the mould and almost filled it. As the cells grow, the mould itself starts to degenerate.

Almost two years after the first joint was implanted, doctors found that all patients had less pain and had a wider range of movements in their hands. The surgeons say that although this group of patients had very poor joints because of previous repeated operations, the results were at least as good as those reported for the best conventional implants.

More information on the treatment options available and advice can be obtained from the National Rheumatoid Arthritis Society Helpline, Mon-Fri 9.30am-5.30pm, 01628 670606. www.rheumatoid.org.uk

In cases of osteoporosis one of the most common treatments is the painkiller Inbrufen. Doctors have also discovered that some antibiotics may help to slow down the effects of osteoarthritis of the knee. Doctors who gave the antibiotic doxycycline to patients with the disease found it significantly reduced the loss of cartilage by 33% , as well as cutting pain levels. It is thought that the antibiotic works to relieve arthritic pain by inhibiting chemicals or enzymes that break down joint cartilage. It is thought that doxycycline can slow the progression of structural damage and help reduce pain.

There is a growing list of alternative therapies such as frankincense and myrrh made from the gum of two different trees – boswellia serrata (frankincense) and commiphora molmol (myrrh) has been found to be as successful at reducing pain and inflammation caused by arthritis as conventional painkillers.

Fruity cure

An exotic fruit called Noni, a member of the citrus family from the south sea Pacific islands is attributed with relieving arthritis pain. The juice from the fruit found on the islands of Tahiti and Hawaii has anti-inflammatory chemicals and antibacterial compounds that work to block the causes of joint pain.

Fish Oil

Cod liver oil has long reputed easing aching joints. Now scientists say it is so effective it should be hailed as a natural ‘wonder drug’. In the first clinical study of its kind, cod liver oil was found to be highly effective in slowing the destruction of joint cartilage – the ‘cushion’ between bones – in patients with arthritis. A daily capsule of fish oil could help delay arthritis from developing and people as young as 20 should start taking it to protect their joints. Fish oil cuts the risk of heart attacks and strokes by helping to thin the blood, and contains essential fatty acids – omega- 3s – which are crucial for maintaining brain power and may protect against Alzheimer’s.

Collagen

A laboratory study has also shown that collagen, the most abundant protein in the body, can stimulate the growth of new cartilage tissue. Present in bones, joints, muscle and other connective tissue, scientists believe that in some people, particularly the elderly, its production slows down or stops.

Supplements seem to perform the same role as natural collagen in keeping the tissue in joints healthy and supple. The latter group showed significant reduction in pain and an improvement in joint mobility, with 93 per cent achieving positive results, some after only two weeks.

Glucosamine

Glucosamine is a natural substance in the body which helps form new connective molecules that make vital links between cells and tissue. As people age, they lose the ability to manufacture sufficient levels of glucosamine. Cartilage then loses its gel-like nature and ability to act as a shock absorber. In Spain, Portugal and Italy, glucosamine is the preferred treatment for arthritis. Research shows glucosamine sulphate – a basic building block in cartilage tissue – can combat pain caused by the natural wear of joints that comes with increasing age. Top athletes take the food supplement in pill form to relieve the pain caused by the constant pressure on their joints, especially the knees.

People with joint pain and muscular tension are also getting relief from a skin patch which provides a steady supply of glucosamine. The glucosamine gel patch gives a sustained release through the skin. Glucosamine is combined with the cooling effect of menthol and anti- inflammatory properties of horse chestnut. The patch can be worn day or night on ‘mobile’ areas such as the elbow, knee, ankle or foot, as well as flat areas such as the back.

Never say die….

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In the past physical ageing was inevitable. Now, new scientific discoveries mean we can not only live longer but healthier and more enjoyable lives. Our longevity is not purely genetic – inherited factors account for only 30% of longevity. It is our health behaviour – that is, the choice of food, environment and physical activity that most importantly accounts for 70 percent of living longer. So our longevity is really in our own hands.

Improved healthcare and standards of living also mean we are seeing the growth of an active elderly population over the age of 65, and a new group of 85 years and older. Twenty percent of the world’s elderly population or 61 million people are 85+. By 2020, this group will double to 146 million. So if we are living longer we should all take preventative measures with out diet and exercise to ensure we not only live longer but that we are as happy and healthy as we can be.

So what causes ageing? The main causes of ageing and death are ageing of the heart and blood vessels (cardiovascular system), ageing of the immune system, and ageing caused by accidents and the environment.

Clogging of the arteries from a diet of highly saturated fat causes heart attacks and strokes. A weak immune system and environmental toxins may be the trigger for many forms of cancer and accidents that lead to early death.

But there are a number of factors that accelerate ageing. These are mainly lifestyle choices that we make that cut years off our natural lives and include: overeating and poor nutrition, smoking of whatever form, excessive alcohol intake, lack of exercise, lack of mental challenge, and feeling unloved or uncared for. Which is another reason why we should nurture the older members of our community.

The key to successful ageing is how well we can control these factors. Take control – see a doctor who can determine what measures you should be taking to improve your blood pressure, cholesterol, blood sugar and diet. Whether you need medication, sugery or special supplements. There are lists of experts on our site.

Doctors are learning more about how to extend human life through new discoveries such as stem cells. There are already a number of supplements available that can subsitute for the loss of hormones and other building blocks. One is human growth hormone (HGH) and another sex steroids. In theory, since HGH and testosterone (or estrogen) are responsible for the rapid growth and maturation in adolescence, replenishing them in old age will reverse the effects of ageing.

A recent study (Journal of the American Medical Association, November 2002), stated that combined HGH and sex steroids did just that – increased lean body mass and decreased fat in both men and women subjects. So is this the elixir of youth? Current research has not come up with the answer. There are long term risks and side-effects such as the increased risk of cancer with HGH. There is no one magic pill but there are a number of elixirs – elixir supplements, elixir antioxidents and elixir foods – which we can all take so that we can live life to the optimum. Even with the most serious diseases of ageing described below these elixirs can assist quality of life but their real value is in prevention. The aim of ElixirNews is to report on these new developments to help you make informed choices in living life to the optimum.