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Arthritis Treatment Today

Starfish Slime Could Hold Key To New Treatment For Asthma, Arthritis

A non-stick slime made by starfish may lead to new treatments for asthma, arthritis, hay fever and other inflammatory conditions, say marine biologists in Scotland.

The scientists, from the Scottish Association for Marine Science (SAMS) in Oban, Argyll, have been studying the slime produced by the spiny starfish, Marthasterias glacialis, commonly found in the waters around Scotland and other parts of the British Isles, and say it could be vital for treating human infections.

Lead researcher Dr Charlie Bavington, founder and managing director of Glycomar, a marine biotechnology company based at SAMS, has been talking to the media about their work.

In an interview with the BBC aired on Thursday 9 December, he demonstrated how the starfish produced the slime: he took a starfish with a span of about 30 cm or 12 in out of a tank, held it, after a few seconds the slime began visibly to ooze from the creature’s spiny body.

The slime is a defence mechanism and also prevents debris from sticking to the starfish.

Bavington said the compound they were interested in was only part of the starfish’s “goo”; he showed BBC reporter Rebecca Morelle the purified compound, which looks like a white powder, and explained that they are planning to work with chemists to produce a man-made version.

They are hoping that the compound can do for blood vessels what it does for the starfish: stop things sticking to them.

Inflammatory conditions like asthma and arthritis are what happens when the body’s natural immune response to infection overreacts and white blood cells stick to and build up on the inside walls of blood vessels, damaging tissue.

Starfish are continually bathed in micro-organisms, bacteria, larvae, and viruses looking to set up camp on their spiny skin. But the slime that they secrete protects them from this continual onslaught by making their skin too slippery:

“… starfish are better than Teflon: they have a very efficient anti-fouling surface that prevents things from sticking,” said Bavington, according to a report in The Scotsman.

He said they want to see if the compounds they have isolated from the starfish slime could be developed into a drug that coats blood vessels to create the same effect and allow white blood cells to flow through without sticking to the sides.

“In humans cells stick from a flowing medium to a blood vessel wall, so we thought we could learn something from how starfish prevent this so we could find a way to prevent it in humans,” explained Bavington.

Clive Page, professor of pharmacology at King’s College London, is working with Bavington on this. He said discovering this substance in the starfish slime has dramatically shortened the usual timescale for developing a new treatment:

“The starfish have effectively done a lot of the hard work for us,” said Page, explaining that normally scientists have to screen hundreds of compounds before they find such a lead.

The starfish has had “billions of years in evolution to come up with molecules that do specific things,” he added.

The field of research that this kind of discovery belongs to is called glycobiology, a branch of biology that studies the structure, biosynthesis and function of sugar chains or saccharides, for which there is increasing interest because of the important role they play in cells.

Saccharides exist on cell surfaces, they mediate interaction between cells, and also between cells and the extracellular matrix and effector molecules.

Studies in this field are opening up possibilities for the discovery of new drugs made from saccharides or other molecules that target the biosynthesis and function of saccharides.

Managing inflammatory arthritis treatment for adults and children

Dr David Kane provides an update from the Irish Society for Rheumatology Annual Scientific Meeting, where delegates heard about advances in biological therapy and other care developments

The Irish Society for Rheumatology Winter Meeting was held at Killiney Castle on September 23-24 last. The theme of the meeting was ‘The Management of Inflammatory Arthritis in Adults and Children’. The meeting highlighted the major advances that have been made in the care of adults and children with inflammatory arthritis, particularly as a result of novel developments in biological therapy.

Importance of early treatment
Rheumatoid arthritis (RA) is estimated to affect 45,000 people in Ireland, with 2,250 new cases diagnosed each year. Some 75 per cent of these patients are of working age; 30 per cent of patients stop work within one year due to the effects of rheumatoid arthritis, with this increasing to 50 per cent at three years.

Dr Patrick Kiely of St George’s Hospital in London outlined the new paradigm of early, aggressive therapy in RA. Two pivotal studies published by Lard and Nell confirmed that there is an early window of opportunity to treat patients within the first three months of symptoms.

These patients should be commenced at the earliest opportunity on immunomodulatory therapy (disease modifying anti-rheumatic drugs) and/or steroids to obtain control of joint inflammation.

The benefits of early control of joint inflammation in preventing joint damage will persist for many years. However, in patients who have a delay in obtaining treatment for rheumatoid arthritis, there is clear evidence that they will have worse outcomes in terms of function, disability and radiological damage. There are three factors in the delay in obtaining treatment for rheumatoid arthritis.

In the early rheumatoid arthritis network in the United Kingdom, patients waited an average of four months before they sought a GP opinion for their joint pains. There was a second delay from the initial consultation with their GP before a referral to a rheumatologist was made. There was a third delay from referral to achieving the appointment with a rheumatologist.

Clearly, if strategies can be implemented to make patients aware to consult their GPs earlier, and if GPs can access the early arthritis referral pathways present in most Irish hospitals, then the possibility of treating people within the first three months of symptoms could be attainable. Most Irish hospitals now have early inflammatory arthritis referral criteria and designated rapid-access clinics or appointments.

The Fin-RACo study showed the treatment of RA within the first four months of diagnosis led to remission of 40 per cent, but treatment after four months led to remission of just 10 per cent. With remission, the new target of rheumatoid arthritis therapy, the consensus was that more work must be focused not just on earlier rheumatology appointments, but also on patient education.

The choice of treatment is also critical. Immunomodulatory treatment with disease-modifying, anti-rheumatic drugs should be started immediately on making the diagnosis of rheumatoid arthritis.

EULAR guidelines suggest the use of methotrexate, while recent NICE guidelines recommend a combination of methotrexate and sulfasalazine or another DMARDs.
Both EULAR and NICE guidelines recommend initial use of corticosteroids, either oral or intramuscular, to obtain rapid symptom control and to maintain patients at their usual level of social function.

Treat to target: remission
In addition to early treatment with immunomodulatory drugs, there is clear evidence that patients should be seen very frequently at the early stages of the disease and treated according to standardised protocols to obtain remission of joint symptoms. This requires practice change, whereby formal disease activity scores are recorded in patients at each visit, with therapy escalated until the disease activity score is less than 2.6 in early disease and 3.2 in established disease.

The optimal frequency in the TICORA study was one-monthly review of patients until they had obtained remission. Recent data from the RAISE study in Ireland suggest that most patients get an appointment on average of every six months, probably due to issues of capacity within the current system. The consensus was that any service reconfiguration in the future must accommodate frequent visits for patients with new or unstable rheumatoid arthritis until therapeutic target has been obtained.

The gains highlighted were clear, with a change from previous remission rates of approximately 10 per cent to a potential remission rate of 70 per cent using these. Dr Andrew Oster of Addenbrooke’s Hospital, Cambridge, reviewed the data on anti-TNF therapy. There are now five licensed anti-TNF therapies: adalimumab, etanercept, infliximab, golimumab and certolizumab.

All have proven efficacy in not just rheumatoid arthritis but also in psoriatic arthritis, ankylosing spondylitis and other inflammatory conditions. Dr Oster reviewed data from the ATTRACT, PREMIER and ARMADA studies, all of which demonstrate superiority to traditional disease-modifying, anti-rheumatic drugs. The Quinn study also suggests that the earlier these are introduced, the greater the potential to induce remission in patients with rheumatoid arthritis. Further data from the Irish RAISE study demonstrated the beneficial effects of these drugs in Irish patients.

In addition to the anti-TNF therapies, rheumatologists have the option to use anti-IL6 therapy (tocilizumab), anti-B cell therapy (rituximab) and anti-T cell therapy (abatacept).

Dr Oster reviewed the data from the REFLEX, ATTAIN and RADIATE studies demonstrating that all of these agents were effective when used in rheumatoid arthritis, with equivalent efficacies. Selection of optimal therapy for the patient depends on specific features of their disease activity and co-morbidities. There has been a revolutionary change in the management of RA now that eight novel, extremely efficacious biologic agents exist.

Managing co-morbidity and preventing premature mortality
Rheumatoid arthritis causes inflammation and damage of the joints. Most doctors, however, are unaware that most patients with RA will have a reduced life expectancy if the disease is inadequately controlled. It is expected that with the newer therapeutic approaches that the standard of treatment will improve and the frequency of co-morbidities of osteoporosis and coronary disease will diminish. At present, however, established rheumatoid arthritis patients must be viewed as being at significantly increased risk of coronary artery disease and osteoporotic fractures.

Advances in osteoporosis therapy
Prof Eugene McCloskey of the University of Sheffield reviewed the treatment of rheumatoid arthritis-related osteoporosis fractures. It is essential that doctors now recognised that patients with rheumatoid arthritis have an increased risk for osteoporotic fractures. The FRAX score has been developed for clinical diagnosis of osteoporosis within a primary care setting. It is available from www.shef.ac.uk/frax. By entering clinical data, the 10-year risk of all fractures and the 10-year risk of hip fracture can be calculated, allowing a decision on osteoporosis treatment.

Rheumatoid arthritis is an independent risk in the FRAX model, highlighting the strong association between rheumatoid arthritis and osteoporotic fractures.

Treatment for rheumatoid
arthritis-related osteoporosis
1. Antiresorptive: Oestrogen/SERMS; Bisphosphonate; Calcitonin
2. Calcium/vitamin D/calcitriol
3. RANK ligand targeted therapy
4. Anabolic therapy: Parathyroid hormone
5. Novel action: Strontium ranelate

Prof McCloskey outlined all of the available therapies for osteoporosis, particularly in the setting of rheumatoid arthritis. Currently, bisphosphonates, calcium and vitamin D are the mainstay of therapy. However, he presented data on a novel agent denosumab, which acts by inhibiting osteoclast formation.

Data in the FREEDOM trial demonstrated that three years of denosumab therapy produced a reduced risk of vertebral fracture (68 per cent), non-vertebral fracture (20 per cent) and hip fracture (40 per cent). The therapy is administered by two six-monthly subcutaneous injections, which were felt to improve patients’ compliance.
Added benefits may exist in rheumatoid arthritis where inhibition of osteoclast function has been shown to reduce the development of bone erosion, a key feature of rheumatoid joint damage.

Managing cardiovascular disease
Dr Vincent Maher of the Adelaide and Meath Hospital, Dublin, reviewed the increased risk of coronary heart disease and sudden death that exists in rheumatoid arthritis. Patients with rheumatoid arthritis have had a threefold increase in the incidence of acute myocardial infarction and a twofold increase in the incidence of sudden death. This appears to be related to therapy in the pre-biologic age and there is much hope from initial studies that more effective biological therapy may reduce the risk of coronary artery disease. This remains to be proven.

At present, rheumatoid arthritis patients must be viewed at a high risk for coronary artery disease and should have regular cardiovascular assessment, including lipid profile and blood pressure. Dr Maher pointed out that the patient with rheumatoid arthritis may not present with the usual angina pectoris symptoms due to their reduced capacity for exercise.

Thus, traditional tests such as stress ECG may be limited, while newer modalities – such as CT coronary angiography – are likely to become more widely available, given the combination of high accuracy and the non-invasive nature of the test.

Economic and social impact
Prof Carol Black, the National Director for Health and Work in the UK, presented an overview of work and musculoskeletal diseases. Musculoskeletal disease is the second-leading cause of sickness absence and long-term incapacity in Ireland, with an estimated 14,000,000 working days lost last year due to ill health overall.
It is estimated that the direct cost of musculoskeletal disease due to sickness absence and disability is € 750,000,000 per annum in Ireland.

Rheumatoid arthritis in particular is a serious concern to rheumatologists, as only 22 per cent of rheumatoid arthritis patients in Ireland remain in full-time employment. There is now clear evidence that intervention in the first few months of disease has a major impact on maintaining rheumatoid arthritis patients in the workforce.

While there are obvious economic benefits to this, it is important to realise that work is also a strong social determinant of health. It is imperative that the patients with all musculoskeletal disorders have early intervention to maintain them in the workforce.

Replacing the sick note
In the UK, the ‘sick note’ is being replaced with the ‘fit note’. This has resulted in the Fit for Work Services, which provide early interventions to actively manage the return of patients with musculoskeletal disorders back to work. The fit note was designed to create a management plan for a return to work, rather than an all-or-nothing scenario practised under the old sick note system.

The fit note outlines directions for a graded return to work, in addition to guidance on hours of work, change of duties and adaptations in which the employer needs to engage. The roll-out of this new scheme has been underpinned with planned changes within undergraduate and postgraduate training so that GPs can play a more active role in managing work disabilities.

Prof Black advocated a fit-for-work programme for Ireland that would involve a national plan for musculoskeletal disorders led by a national clinical director. She recommended a change from our current sick-note system to a fit note, with early diagnosis and management of sickness absence due to musculoskeletal disorders.

Arthritis in children
Prof Helen Foster outlined the current state of managing inflammatory arthritis in children. The commonest condition is juvenile inflammatory arthritis which, like many adult diseases, was previously thought to be relatively benign. It is estimated that there are 1,000 juvenile inflammatory arthritis patients in paediatric services in Ireland and 700 adult patients with juvenile inflammatory arthritis.

It is now clear that juvenile inflammatory arthritis is a chronic disorder that is not benign. Joint damage occurs early and it is recognised that early aggressive treatment provides a window of opportunity to obtain tight control and better outcome in terms of overall health and functioning for children with inflammatory arthritis. Methotrexate is the drug of choice in juvenile inflammatory arthritis, but all of the biologic agents used in adults are currently being used in juvenile inflammatory arthritis with good results.

There are many challenges for these children as they grow up, with 1/3 continuing to have active disease and 1/3 having disability problems, despite eventually going into remission of inflammation. Adult patients with JRA are best managed by a transition model run by paediatric and adult rheumatologists. It was highlighted that there is only one paediatric rheumatologist through the whole of Ireland, which makes provision of these services extremely difficult.

The lack of services for children prevents implementation of modern standards of therapy, thus exposing paediatric patients to irreversible loss of joint damage and function, with consequent high risk of permanent disability.

Joint replacement might be best arthritis treatment

December 8, 2010 — Arthritis is a group of conditions involving damage to the joints of the body. There are more than 100 different forms of arthritis.

The most common form, osteoarthritis, is a result of trauma to the joint, infection of the joint – or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and autoimmune disease.

Arthritis is the most common cause of disability in the United States. More than 20 million people with arthritis have severe limitations that affect their function on a daily basis. Each year, arthritis results in nearly 1,000,000 hospitalizations and close to 45,000,000 outpatient visits to health care centers.

Causes of arthritis include injury metabolic abnormalities, hereditary factors, the direct and indirect effect of infections and a misdirected immune system with autoimmunity. Symptoms of arthritis include pain, limited function of joints, and inflammation of the joints, which is characterized by joint stiffness, swelling, redness, and warmth. (SOURCE: The Arthritis Foundation)

MYTHS: How much do you really know about arthritis? Did you know it’s a two billion dollar a year business?

Many medications promise miracle cures, but doctors say a quick fix with unproven pills, devices, and minimally invasive surgery may be a waste of money if you have an advanced form of arthritis.

The best option: joint replacement surgery.

When joint replacement surgery occurs, the artificial surfaces of the joint replacement are shaped in such a way as to allow joint movement similar to that of a healthy natural joint.

MYTH # 1: ARTHRITIS ONLY AFFECTS OLDER PEOPLE!

The truth: Some forms of arthritis do mainly affect elderly people, including the most common, osteoarthritis. Yet many types can affect younger people, and joint injuries at any age can lead to osteoarthritis. Currently more than half of the population with arthritis is under 65.

MYTH # 2: WEATHER AFFECTS ARTHRITIS SYMPTOMS!

The truth: Many people with arthritis believe that cold and dampness can set off joint symptoms. Indeed, according to the Arthritis Foundation, nearly half of arthritis patients think their flare up happens when they have to take their sweaters out off the closet.

MYTH # 3: EXERCISE BOOSTS ARTHRITIS PAIN!

The truth: Regular moderate exercise can help prevent and treat arthritis. Exercise promotes function and mobility, controls weight and strengthens the muscles that support the joints. Though you may want to avoid high-impact exercises if your knees bother you, low-impact exercises such as walking, tai chi or aquatics are all beneficial. Talk to your physician about the best exercise regimen for you. Pool therapy has been shown to cause improvement in mobility in arthritic joints.

Mental Health News

Nova Scotia to factor Hyde inquiry report into new mental health strategy

HALIFAX – Nova Scotia’s health minister says she will direct her department’s mental health policy working group to look at recommendations from a fatality inquiry into the jail cell death of Howard Hyde.

Maureen MacDonald says provincial court Judge Anne Derrick used some very specific language regarding mental health issues in her report on Howard Hyde’s death.

Hyde, a 45-year-old musician diagnosed with schizophrenia, died while in custody in a Halifax jail in November 2007 after he was restrained by guards.

MacDonald says she will review the directions she has already given department officials to make sure the parameters outlined by Derrick are covered.

She says a direct response to the concerns raised by Hyde’s death will follow shortly.
Mexican online pharmacy
MacDonald expects to deliver government’s new mental health strategy next year.

Secondhand smoke tied to childrens’ poor mental health

(Reuters Life!) – The evidence is piling up that parents who smoke really should quit — or at least not smoke at home, a study said.

Children who breathe secondhand smoke are more likely to struggle with mental health problems, especially hyperactivity and “bad” behavior, according to the study, published in the Archives of Pediatrics and Adolescent Medicine.

While the findings add urgency to the push for parents to quit smoking or at least smoke outside the home, it remains unclear whether tobacco fumes actually take a toll on childrens’ brains or if something else is at play, said researchers led by Mark Hamer of University College London.

“We know that exposure to secondhand smoke is associated with a lot of physical health problems in children, although the mental health side has not been explored,” Hamer told Reuters Health in an e-mail.

In the United States, two of every three children between the ages of three and 11 are exposed to secondhand smoke. Meanwhile, one in five children aged nine to 17 have been diagnosed with some kind of mental or addictive disorder, according to the U.S. department of Health and Human Services.

Hamer and his colleagues studied 901 nonsmoking British children between the ages of 4 to 8, measuring levels of a byproduct of cigarette fumes in the childrens’ saliva to gauge smoke exposure and having parents fill out a questionnaire about the childrens’ emotional, behavioral and social problems.

The more secondhand smoke a child took in, on average, the poorer their mental health — particularly for hyperactivity and conduct disorder, or so-called “bad” behavior, the study said.

Overall, about three percent of all children received “abnormal” scores of 20 or more on the Strengths and Difficulties Questionnaire, a 40-point scale with the highest scores representing the poorest mental health.

Compared to the 101 children who breathed in the least secondhand smoke, the 361 with the most exposure scored an average of 44 percent higher on the questionnaire — 9.2 versus 6.4. Children were most likely to breathe secondhand smoke in their own homes.

The gap remained after researchers accounted for other factors that could affect mental health such as asthma, physical activity and the families’ income and housing situations, although they noted that some unmeasured factor also couldn’t be ruled out.

It also isn’t yet clear how secondhand smoke might trigger mental troubles, though researchers suggested it could be due to genetics or possibly related to smoke’s effects on chemicals in the brain such as dopamine, and Hamer noted further research is needed.

But Michael Weitzman at New York University Medical Center, who was not involved in the study, said the results strengthen the evidence that secondhand smoke, and possibly prenatal exposure to tobacco, causes mental health problems in children.

“Many people now recognize that childrens’ secondhand smoke exposure increases their risk for Sudden Infant Death Syndrome, ear infections and asthma,” he told Reuters Health in an e-mail.

“But secondhand smoke also poses a huge burden on the quality of life of children, their families and the larger society due to increased child mental health problems.”

SOURCE: http:/link.reuters.com/xev29q

(Reporting by Lynne Peeples at Reuters Health; editing by Elaine Lies)

Report: Growing mental health problems in military

Washington (CNN) — Mental problems send more men in the U.S. military to the hospital than any other cause, according to a new Pentagon report.

And they are the second highest reason for hospitalization of women military personnel, behind conditions related to pregnancy.

The Defense Department’s Medical Surveillance report from November examines “a large, widespread, and growing mental health problem among U.S. military members.”

The 31-page report says mental disorders are a problem for the entire U.S. population, but that sharp increases for active duty military reflect the psychological toll of wars in Iraq and Afghanistan.

“Most notably in this regard, the rate of incident diagnoses of post-traumatic stress disorder (PTSD) increased nearly six-fold from 2003 to 2008,” the report says.

And new outreach and screening, as well as the military’s efforts to reduce the stigma attached to seeking treatment also contributed to higher numbers, according to the report.

The Army was hit hardest by the most common and long-lasting problems — post-traumatic stress disorder, major depression, bipolar disorder, alcohol dependence and substance dependence, according to the report.

“The Army was relatively most affected (based on lost duty time) by mental disorder-related hospitalizations overall; and in 2009, the loss of manpower to the Army was more than twice that to the Marine Corps and more than three times that to the other Services,” the report says.

“The Army has had many more deployers to Afghanistan and Iraq and many more combat-specific casualties; it is not surprising, therefore, that the Army has endured more mental disorder-related casualties and larger manpower losses than the other services.”

While most new diagnoses of mental illness were in the Army, the fewest were in the Air Force.

“The only exceptions to this observation were in 2007, 2008, and the first two quarters of 2010 when the incidence rates of new diagnoses of alcohol dependence in the Marine Corps were the highest of all the Services,” the report said.

But overall, the Marines were found to have fewer overall mental problems than the Army, Air Force and Navy with 4.3 percent of Marines versus 6.4-percent of the overall pool of active duty military.

Researchers call for additional study, and admit that tracking mental problems can be a moving target, as treatment and attitudes change.

“There are real and perceived barriers to seeking and accessing care for mental health disorders among military members. These barriers include shortages of mental health professionals in some areas and the social and military stigmas associated with seeking or receiving mental health care,” the report says. “The nature and effects of these barriers to care have likely changed.”

Sleep Disorders News

Graymark Healthcare to Focus on Treatment of Sleep Disorders with Completed Sale of Independent Pharmacy Business Assets to Walgreens

OKLAHOMA CITY, Dec. 7, 2010 /PRNewswire-FirstCall/ — Graymark Healthcare, Inc. (Nasdaq: GRMH) has closed the previously announced sale of substantially all the assets of its ApothecaryRx’s retail pharmacy business to Walgreens Co. (NYSE: WAG, Nasdaq: WAG). ApothecaryRx operated 18 pharmacies across five states.

The transaction allows Graymark to focus on its core business of providing comprehensive care for sleep disorders, primarily obstructive sleep apnea, including diagnosis, therapy, and ongoing clinical and product support.

“Millions of Americans suffer from obstructive sleep apnea, and many aren’t aware they have a problem or that treatment is available in their communities,” said Stanton Nelson, chairman and CEO of Graymark Healthcare. “As a pure-play sleep disorders company focused primarily on obstructive sleep apnea, we believe Graymark is better able to help people sleep better.”

Graymark launched the nation’s first comprehensive care model for patients with obstructive sleep apnea in 2009 and has grown into one of the nation’s largest aggregators of sleep therapy providers.

“Given our substantially improved balance sheet as a result of this sale, we are ideally positioned to execute on our plans to grow through the acquisition of treatment centers, as well as through developing alliances with hospitals and other health care providers,” added Nelson. “The rapidly growing sleep apnea marketplace offers us an opportunity for significant growth and margin expansion.”

The sale to Walgreens was comprised of substantially all of the assets of ApothecaryRx for $25.5 million, plus approximately $3.8 million for inventory. Graymark expects to realize net proceeds of approximately $33 million from the completed divestiture, including collection of retained accounts receivable, and proceeds from the liquidation of remaining ApothecaryRx assets.

The Healthcare Investment Banking Group of Morgan Joseph LLC served as the financial advisor to Graymark in this transaction, with Greenberg Traurig LLP and Commercial Law Group, P.C. serving as Graymark’s legal advisors.

About Graymark Healthcare

Graymark Healthcare, Inc. is the nation’s second largest provider of sleep medicine diagnosis and treatment. Graymark owns and operates diagnostic sleep centers that treat a wide range of sleep disorders, and operates a medical equipment supply company that provides disposable and durable medical equipment. For more information, please visit www.graymarkhealthcare.com.

This press release may contain forward-looking statements that are based on the company’s current expectations, forecasts and assumptions. Forward-looking statements involve risks and uncertainties that could cause actual outcomes and results to differ materially from the company’s expectations, forecasts and assumptions. These risks and uncertainties include risks and uncertainties not in the control of the company, including, without limitation, the current economic climate and other risks and uncertainties, including those enumerated and described in the company’s filings with the Securities and Exchange Commission, which are available on the SEC’s Web site (www.sec.gov). Unless otherwise required by law, the company disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.

Weird Things That Happen When We Fall Asleep: REM Behavior Disorder

Recently, on the NPR show “This American Life,” comedian Mike Birbiglia talked about how he nearly killed himself while he slept—more than once. It seems that he has a disorder called REM Behavior Disorder, which makes a person act out his dreams. Normally the body is paralyzed (or nearly so) during sleep so this sort of thing doesn’t happen. But, in people with REM Behavior Disorder, the “sleep paralysis” mechanism fails.

As a comedian, Birbiglia makes jokes about climbing high onto a bookcase in his sleep——in his dream he was on a podium receiving an Olympic medal for vacuuming—and then falling off of it. Another time, he jumped through a second-story hotel window in his underwear “to escape a missile.” Since he survived, we can marvel (and, perhaps, laugh) at this escapade, but I’m guessing these events weren’t funny at the time—he ended up bruised and needing emergency medical attention.

REM Behavior Disorder is one of several uncommon sleep disorders–it affects about half of 1% of the population. Maybe it’s the rareness of these “extreme” sleep behaviors that makes them so interesting. Or maybe it’s just that these sleep-related experiences are so bizarre. They’re certainly not the usual series of events we anticipate when lying down for a good night’s sleep. In any case, here’s a brief roundup of some interesting—and, often, frightening—sleep disorders.

REM Behavior Disorder

The name REM Behavior Disorder comes from the stage of sleep when the eyes move rapidly (Rapid Eye Movement), and dreaming occurs. In most people, the brain is extremely active during REM sleep, but the body is paralyzed, except for some occasional muscle twitches. And, of course, the muscles needed to keep you alive—the breathing muscles and the heart – are still active and so are your eyes. While the body is quiet, the brain is racing along. Although most of us are blissfully unaware, deep sleep is actually a time of active brain activity.

REM Behavior Disorder was first described in cats and was only recently reported in humans—the first human case was described in 1986. Scientists don’t know why the bodies of people with REM Behavior Disorder aren’t paralyzed as they should be during REM sleep. Experts believe the acting out of dreams is a problem with neurotransmitters (chemicals in the brain), but different studies point to different neurotransmitters. It may be that different neurotransmitters are to blame in different people.

REM Behavior Disorder may be accompanied by a number of brain diseases including Parkinson’s disease, dementia, and multiple system atrophy (a degenerative brain disease). In nearly half of cases, REM Behavior Disorder may be related to alcohol withdrawal or withdrawal from a sedative or antidepressant medication. But it can occur for no apparent reason in otherwise healthy people.

There are many medications that can help people with REM Behavior Disorder. However, since so few people are affected by the disorder, we don’t have large, high quality studies to tell us which medications are best. As a result, it can take some trial and error to find a medication that’s right for an individual with this condition. A sleep specialist can help.

It’s important to make the bedroom of people with REM Behavior Disorder as safe as possible until they can get their nighttime behavior under control. It may be a good idea to put the mattress directly on the floor, pad the corners of furniture in the room, remove anything fragile or dangerous from the room, and have bed partners sleep in another room.

Sleep paralysis

In a way, sleep paralysis is the opposite problem of REM Behavior Disorder: instead of acting out dreams while asleep, a person with sleep paralysis is awake but cannot move. It’s common, affecting up to 40% of the population. It can be associated with sleep deprivation, other sleep disorders, psychological stress, or certain medications. Fortunately, it lasts only a few seconds or minutes and usually requires no treatment. Still, it can be scary.

The teenager who sleeps for 10 days

Trying to wake Louisa during one of her episodes is difficult
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While most teenagers struggle to get out of bed in a morning, Louisa Ball might take 10 days to fully wake from her slumber, due to a very rare neurological disorder. So what’s it like living with Kleine-Levin Syndrome?

Louisa has slept through holidays, friends’ birthdays and half of her GCSEs.

In 2008, aged 14, she had been suffering from flu-like symptoms. She was at her school in Sussex when she started nodding off in class and behaving strangely.

“I didn’t know what I was doing, what I was saying, everyone thought ‘hey this isn’t right,'” she recalls.

“I was hallucinating and after that I don’t remember anything. All of a sudden it just went blank and I just slept for 10 days. I woke up and I was fine again.”

Her parents Rick and Lottie watched their daughter becoming fidgety and with unusual facial expressions as she sank into sleep. The first time was a frightening experience for them, although Louisa herself says she wasn’t scared by the episode, more puzzled.

“It was really weird, no one knew what was wrong, we just thought it wasn’t going to happen again. And then four weeks later it happened again.”

She was finally diagnosed with Kleine-Levin Syndrome (KLS). There is no known cause or cure but Louisa says it was good to know what it was and that it wasn’t life threatening.

The average time it takes to diagnose the condition is four years, because there is no test and so it requires a process of elimination of other disorders.

The disease was named after Willi Kleine, a neurologist from Frankfurt, and Max Levin, a psychiatrist from New York, who identified patients with similar symptoms in 1925 and 1936.

Louisa is unusual as KLS usually affects teenage boys, who can also exhibit hypersexuality and inappropriate behaviour.

As well as excessive sleeping, symptoms include behaviour changes, irritability, feeling in a dream-like state and binge eating, symptoms that can be mistaken for normal teenage behaviour. There are no drugs that have conclusively shown to alleviate symptoms.

‘No dreams’

People with the sleep disorder narcolepsy fall asleep immediately, but people with KLS might sleep more and more over a number of days before falling into sleep mode.

Louisa says she remembers very little when she wakes up from an episode: “It’s just blank – no dreams. Now I’ll remember a lot more that’s gone on. Before I wouldn’t remember anything at all. My dad thinks my brain is learning to cope with it more.”

So how do you deal with a disorder that takes over your life so much?

It nearly ruined Louisa’s career ambitions, because she slept through most of her GCSEs but her college allowed her to enrol and she is studying sport performance and excellence, with dreams of being a dancer.

At first, her school teachers didn’t understand, she says. “They’d give work to my brother for me to do and when I went back to school they expected me to have done it but I’d have slept for 10 days.”

Some people with KLS have complained they have lost their friends because they suddenly disappear for weeks on end but Louisa has a close knit group of girlfriends. Some even visit her when she’s sleeping, just to check she’s ok.

When she wakes up, it takes her a few days to fully come round, and her body is quite stiff so her dancing is affected for while.

“I’ve never really got upset about it but I sometimes do think ‘why me’, because I’ve always been a normal healthy person. But all of a sudden it happened and there’s no reason why it happened and that sometimes frustrates me.

“But I’ve got used to it now and learnt to live with it. I’m a special kid.”

The change in behaviour before and during a sleep episode is one of the most upsetting things for Louisa’s parents, who take it in turns to remain with her. Doctors have told the family it’s crucial to wake Louisa once a day to feed her and get her to the bathroom.

But Lottie admits it can take a while to get her to come round. “I’ve tried before to literally force her to wake up but she just starts swearing and gets so agitated and aggressive.”

After watching a video the family made of her while sleeping, Louisa says: “I look scary, it doesn’t look like me, it’s like I’m on drugs.”

Frustrated by the lack of information in the UK, Louisa was taken by her parents to the Hospital Pitié-Salpétrière in Paris, where researchers are looking into whether it is caused by a defective gene.

Many sufferers have abnormalities in their temporal lobe, the area of the brain involved in behaviour and memory. A scan of Louisa’s brain function revealed she does have abnormalities in her frontal lobe but there are no signs that this has affected her behaviour or memory.

The good news is the disease can also disappear just as suddenly as it came on. This normally happens after 10 to 15 years.

But Louisa is currently going through a good period. She was out doing Christmas shopping with her best friend this week and has not had an episode in 13 weeks. A few weeks ago she won yet another dance competition.

“It’s almost as if I’ve forgotten about it because I haven’t had one in so long.”

Louisa’s parents, however, are still watching her constantly for signs she could be heading into a sleep state.

“It’s weird – now I’ve left school I haven’t actually had an episode, they probably think I was faking it,” she jokes.

Acne Treatment News

Simpler Treatments Often Mean Better End Results

Having trouble sticking to your acne treatment regimen? Maybe a simpler routine is needed.

A recent study published in the medical journal Cutis found that people were more likely to stick with, and consistently, use a simpler acne treatment routine. This consistency lead to better clearing clearing of the skin.

Maybe instead of buying and using a bunch of different acne treatments, we’d be better off streamlining our treatment routine into a regimen that’s quick and simple to use. Some ideas:
Instead of buying several cleansers (or toners, creams, etc.) buy one and use it consistently. If you see results, no need to spend more money on another product.
Ask your doctor about combination treatments that contain more two acne medications in one tube (this may be a more expensive option, though, and some may not be covered by your insurance.)
Cut the guesswork and buy a complete acne treatment skin care system like Proactiv, AcneFree, or The Pimple Clinic. This is a good option if walking into the skin care aisle makes your head spin with too many choices.

Remember, anything that makes it easier for your to use your acne treatments correctly and consistently will ultimately help you get clearer skin.

Natural ways help clear up acne

(NaturalNews) Acne is a problem that doesn’t just affect teenagers, but also affects millions of adults as well. Drugs used to be the preferred method to clear up acne, but there are many natural methods that work very well. Natural methods are preferred, since the most common drugs prescribed to fight acne are antibiotics.

Long term antibiotic exposure can have serious consequences for your entire digestive system. It has also been linked to breast cancer in some studies. For this reason, it is strongly preferable that natural methods are used to attain clear, blemish free skin.

The first and most important aspect of naturally healing and clearing acne is your diet. This is no shock, since the phrase “you are what you eat” applies to just about every facet of your life. The food you put in your mouth has a direct impact on the appearance of your skin.

Diets that are high in saturated fats, salt, and sugar are especially harmful to your hormonal balance. Since almost all cases of acne are strongly linked to hormonal imbalances, it is vital that you eat a balanced diet.

Some of the best foods to eat for acne free skin are deeply colored fruits such as berries, citrus fruits such as lemons and oranges, fish, almonds, walnuts, and leafy green vegetables.

Avoid deep fried foods, all fast food, candy, cake and other sugary baked goods, and processed foods, and your skin will respond by clearing up over time.

Supplements, which help to maintain clear skin, can also be taken in addition to a hormone-balancing diet. Some of the supplements which are useful for maintaining clear, acne free skin are fish oil, vitamin B5, vitamin A, and vitamin C.

These vitamins and nutrients all have either anti-inflammatory or antioxidant properties. Both antioxidants and anti-inflammatory foods and vitamins are beneficial to acne prone skin. Antioxidants help to eliminate free radicals. Free radicals can damage the skin cells and hinder healthy new tissue growth, resulting in longer recovery after breakouts.

Anti-inflammatory foods and supplements help the inflammation caused by excess sebum production. By addressing both hormonal imbalance and inflammation through diet, you deal a powerful blow to this embarrassing skin condition.

Unfortunately for those that look forward to a caffeine pickup in the morning or throughout the day, coffee and other heavily caffeinated beverages can make acne worse. It is best to avoid any stimulants which stimulate the central nervous system. These types of stimulants often throw the hormones off balance and lead to more severe acne.

There are some excellent topical products that are all natural and can be used to help treat acne externally. One of the best and most effective is tea tree oil. Tea tree oil has a distinct scent to it, and that is because it is a very potent antibacterial agent.

It is very helpful in the treatment of acne because acne lesions are partly caused by bacteria, which causes infection underneath the skin. When you take away the bacterial component, you have a much better chance at not breaking out and getting large, infected and painful acne lesions.

There are also some excellent natural acne soaps and cleansers that use pine tar and sulfur, both of which are excellent deep cleansing and astringent agents. Naturally derived topical acne care products are preferable to chemical products since they do not irritate and dry the skin.

Back Pain News

St Jude Medical reports positive results from chronic low back pain study

St. Jude Medical, Inc., a medical device company, has announced two-year results in a post-market clinical study evaluating neurostimulation for the management of chronic low back pain.

The study found that 70 percent of neurostimulation patients reported overall pain relief of 50 percent or better at their final two-year visit. Additionally, 88 percent of these patients reported that their quality of life was improved or greatly improved.

“This study is the largest neurostimulation study conducted to date and is specifically designed to gather more information about the effectiveness of spinal cord stimulation for low back pain,” said Dr Eugene Mironer, presenter of the results and managing partner of the Carolina Center for Advanced Management of Pain in Spartanburg, S.C. “Our findings at the two-year mark indicate that the therapy is sustainable long-term. In addition to reporting an improvement in their quality of life, 89 percent of patients were satisfied or very satisfied with their results.”

Neurostimulation therapy uses an implantable medical device to deliver mild electrical pulses to the epidural space to mask or interrupt pain signals as they travel to the brain. St. Jude Medical is sponsoring this research to continue to build on the published data supporting the long-term sustainability of the therapy.

“There is a growing body of evidence that confirms the effectiveness of neurostimulation for the management of chronic pain, especially for those patients who have tried multiple therapies only to continue to suffer with pain,” said Chris Chavez, president of the St. Jude Medical Neuromodulation Division. “Over the course of the past decade, physician training, technology improvement and patient selection criteria have advanced greatly. Our study validates the significant impact of these advances in further improving the effectiveness of neurostimulation therapy.”

Low back pain patients’experiences of work modifications; a qualitative study

Research indicates that work modifications can reduce sickness absence and work disability due to low back pain. However, there are few studies that have described modified work from the perspective of patients.

A greater understanding of their experiences may inform future workplace management of employees with this condition.

Methods: Individual semi-structured interviews were conducted with twenty-five employed patients who had been referred for back pain rehabilitation. All had expressed concern about their ability to work due to low back pain.

Data was analysed thematically.

Results: Many participants had made their own work modifications, which were guided by the extent of control they had over their hours and duties, colleague support, and their own beliefs and attitudes about working with back pain. A minority of the participants had received advice or support with work modifications through occupational health.

Access to these services was limited and usually followed lengthy sickness absence. Implementation largely rested with the manager and over-cautious approaches were common.

Conclusions: There was little evidence of compliance with occupational guidance on modified work.

There appears to be insufficient expertise among managers and occupational health in modifying work for employees with low back pain and little indication of joint planning. On the whole, workers make their own modifications, or arrange them informally with their manager and colleagues, but remain concerned about working with back pain.

More effective and appropriate application of modifications may increase employees’confidence in their ability to work.

Lower back pain is a very common problem

Lower back pain is a very common problem and the chances of having it reoccur are likely, but why is this? Low back pain can be caused from many different tissues and pathologies, but the lumbar multifidus muscles (LMM) are one cause that is often overlooked and neglected.

The lumbar multifidus muscles (LMM) stabilize the spine when in a neutral position. When the spine is injured, a reflex occurs that can inhibit the activation of the lumbar multifidus muscles (LMM). When this inhibition persists, atrophy and fatty invasion of the muscle will ensue and often persist after the pain is gone. When the lumbar multifidus muscles (LMM) atrophies, it causes instability within the lower back which can lead to prolonged pain. Assessment of the lumbar multifidus muscles (LMM) as a source of pain with reoccurring low back pain is often overlooked. If the LMMs are the cause of pain, rehabilitation is essential if longterm resolution is to be achieved.

Health Care News

U.S. Health Department Lays Out Its Health Goals For The Next Ten Years

As 2010 gets closer to its end, the U.S. Department of Health and Human Services (HHS) has posted its latest strategies for promoting public health in over forty categories by the year 2020. The Healthy People 2020 objectives deal with nearly six hundred aspects of health, from decreasing children’s exposure to allergens, to cutting down the use of suntanning beds which cause cancer, to getting more people insured and food poisoning.

One of the goals laid out in the initiative is to lower the number of deaths from stroke and heart disease by twenty percent, and reduce new cases of diabetes, cancer deaths, and obesity rates by ten percent. Specified objectives to fight obesity feature building more neighborhood sidewalks, pressuring schools to keep their tracks and gyms open for after-hours exercising, and offering healthier meals in day care centers and schools.

The Healthy People goals are to some degree a guide for public health organizations, identifying what problems are improvable and which ones to direct resources toward in the next ten years. Since the Healthy People 2010 goals were set, only 19% of the goals have been met, but progress has been made toward 52% of those goals.

Meeting the goals set forth in Healthy People 2020 will depend less on developing new methods, programs and tools than on our commitment to putting the tools and methods we already have to their best use. For example, the medical establishment is convinced that heart disease could be all but eradicated if we fully applied what we already know about the use of tobacco, and the importance of exercise and proper diet.

CMS to Hold Listening Session on Health Care Delivery System Reform

On Tuesday, December 14, the Centers for Medicare and Medicaid Services (CMS) will host an open door forum for Region 2 to discuss health care delivery system reforms established by the Affordable Care Act of 2010. Dr. Richard Gilfillan, Acting Director of the Center for Medicare and Medicaid Innovation (CMMI), and Cheryl Powell, Deputy Director for the Federal Coordinated Health Care Office, will provide a brief overview of the Accountable Care Organization Shared Savings Program, CMMI, and the Federal Coordinated Health Care Office, before opening the discussion for public comment.

Doctors fear health reform

SHREWSBURY — Massachusetts should tread slowly and carefully as it adopts new ways to pay for health care, representatives from medical groups told the state’s top health official yesterday.

Reforms aimed at bringing down costs could unintentionally block patients from their doctors or the care they need, according to some medical professionals and organizations.

“First of all, we need to protect our patients,” said Dr. Barbara Rockett, a general surgeon who practices at Newton-Wellesley Hospital in Newton. “This process should be a very slow process.”

The comments came during a public forum before a committee of the Massachusetts Health Care Quality and Cost Council, a group created as part of the state’s 2006 health care reform law.

About 100 people representing family physicians, registered nurses, anesthesiologists, physical therapists, home health workers and others crowded into a conference room at the University of Massachusetts Medical School’s center at 222 Maple Ave., Shrewsbury, to testify. The committee is preparing recommendations on legislation aimed at reforming health care payments.

Many of the speakers focused on a proposed method of paying for medical care called “global payments.” Insurers generally pay set fees to health professionals for specific procedures. Under global payments, insurers would give set amounts of money to groups of health professionals to manage all the care that patients need. Doctors, nurses, hospitals and others would form groups called “accountable care organizations” or “integrated provider organizations.”

There is no proof that approach will lower costs, said Dr. Bruce S. Auerbach, vice president of Sturdy Memorial Hospital in Attleboro.

“Too much consolidation can result in entities having so much market clout that prices are driven up,” Dr. Auerbach said.

Some patients seeking emergency care ran into barriers under a similar payment method, called capitation, used in the past, according to Dr. Joseph Bergen, past president of the Massachusetts College of Emergency Physicians. “Our fundamental principle is that patients must be protected by some consideration for emergency care,” Dr. Bergen said.

A payment reform commission established by the state has already recommended that any move to global payments take place over at least five years, said Dr. JudyAnn Bigby, state secretary of health and human services, who attended part of the forum. Although a number of speakers urged slow steps toward reform, Dr. Bigby said she has heard others say the state has not moved fast enough.

“I hear anxiety,” she said. “I also hear people say the system is untenable.”

Diabetes News and Treatment

Diabetes Mortality High Despite Better Management

Since management of type 1 diabetes improved markedly in the 1980s, survival rates in those with the disease have improved as well, but mortality is still much higher than that in the general population, according to research published in the December issue of Diabetes Care.

TUESDAY, Nov. 30 (HealthDay News) — Since management of type 1 diabetes improved markedly in the 1980s, survival rates in those with the disease have improved as well, but mortality is still much higher than that in the general population, according to research published in the December issue of Diabetes Care.

Aaron M. Secrest, Ph.D., of the University of Pittsburgh, and colleagues studied data from an Allegheny County registry of childhood-onset type 1 diabetes.

The researchers found the death rate in people with type 1 diabetes to be seven-fold higher than their expectations, though standardized mortality ratios (SMRs) based on local mortality data showed an improving trend by diagnosis cohort at 30 years of diabetes duration (SMRs, 9.3 for 1965 to 1969, 7.5 for 1970 to 1974, and 5.6 for 1975 to 1979). Women with type 1 diabetes had a risk of dying 13 times that of age-matched women in the general population, and African-Americans had a significantly lower 30-year survival rate than Caucasians.

“Although survival has clearly improved, those with diabetes diagnosed most recently (1975 to 1979) still had a mortality rate 5.6 times higher than that seen in the general population, revealing a continuing need for improvements in treatment and care, particularly for women and African-Americans with type 1 diabetes,” the authors write.

Skyrocketing Diabetes Costs Point to Need for More Preventive Care, Largest Insurer Says

With the costs of diabetes care expected to skyrocket in the next 10 years, providers need to develop improved preventive care and early intervention strategies for the condition, according to a release by UnitedHealth Group, the nation’s largest insurer.

If nothing more is done, the annual cost of treatment for diabetes and pre-diabetes would grow from an estimated $194 billion this year to $500 billion in 2020 and the 10-year cost would reach $3.35 trillion, UnitedHealth’s Center for Health Reform & Modernization predicted.

The center said more programs to prevent and control diabetes could save up to $250 billion over the next 10 years. “What is now needed is concerted, national, multi-stakeholder action,” said Simon Stevens, executive vice president at UnitedHealth and chairman of the center. He cited the need to “engage consumers in new ways, while working to scale nationally some of the most promising preventive care models.”

Arthritis News and Treatment

Early treatment ‘best way to get arthritis under control’

Early treatment is the best way to get rheumatoid arthritis under control, it has been claimed.

According to Arthritis Research UK, aggressive early treatment is the best way to get the condition under control before any serious damage to the joints is sustained, however, many people don’t get diagnosed in time for early treatment to start.

The charity’s Jane Tadman said: “Unfortunately, in the real world, the average length of time that people with rheumatoid arthritis wait before going to their GP after developing symptoms is 12 weeks – and then there is a further wait before they are referred to see a specialist and start treatment.”

She added that more needs to be done to inform people about the symptoms of arthritis so they can get quick access to the help they need.

Ms Tadman’s comments follow research from the Netherlands which shows that patients who are diagnosed early with rheumatoid arthritis are less likely to experience joint damage.

Arthritis: New Treatment Rebuilds Damaged Cartilage

Secret Process Sparks Hope For Joint Pain Sufferers.

Breakthrough joint supplement has demonstrated re-growth in damaged cartilage.

Osteoarthritis (OA) is the most common type of arthritis and it is not confined to the older generations, as many believe. Young people can also develop OA, often as a result of a sports injury or excessive exercise leading to wear and tear on joints.

OA is also surprisingly common among athletes, hardcore training regimes, pressure from peers and the drive to be the best can lead athletes to push themselves too hard and suffer the consequences of joint damage. In the UK alone there are 27,000 people under the age of 25 suffering from arthritis1. A subtle ache, a little pain after exercise or physical work – these could be the warning signs of things to come.

There is no known cure for osteoarthritis, however an innovative natural supplement has emerged as the only product with clinical evidence to indicate it can halt and even rebuild damaged cartilage, potentially improving the lives of millions of OA sufferers and getting injured athletes on the road to recovery much quicker.

Clinical trials have demonstrated that Flexeze Fortify, containing a secret formulation of Collagen Hydrolysate (Fortigel), actually appears to re-grow cartilage, relieving pain and greatly improving mobility.

Dr Andrew Carson, a GP who is Associate Dean, GP Education, Birmingham and Solihull and Medical Advisor to the NHS Executive in the West Midlands said;

“I am not aware of any other product that has been shown to regenerate articular cartilage. The best that other products have achieved in the past is a reduction in the speed of disease progression and a subjective improvement in pain sensation. I would recommend anyone taking glucosamine and Chondroitin to consider this option, which is a natural product with no known side effects.”

Many people don’t realise the importance of looking after your joints and just accept joint pain and stiffness as a part of the aging process. All types of exercise can put pressure on joints, from everyday walking to training for a triathlon. It is therefore essential to take care to protect them, and it’s never too early to start.

Whilst exercise is essential for strong healthy joints, sports injuries can leave you more prone to joint pain and osteoarthritis. There are a few tips to consider that can decease your likelihood of having an injury; never exercise when tired, keep yourself hydrated, always warm-up and down and never push yourself through joint pain, wear supportive shoes and exercise on forgiving surfaces.

Certain activities put your joints under more stress, for example running on concrete, varying these activates with other sports such as swimming, yoga or cycling will build the strength of your joints without putting them under unnecessary pressure.

Professor Alan Silman, medical director at Arthritis Research UK explains:

Despite the overriding benefits of participating in sport and exercise, there are hidden hazards related to sports injury. From the limited research carried out, we know some sport-related injuries will cause osteoarthritis, which is a painful and debilitating condition. 2

It is therefore essential to take preventative action to protect your joints from wear and tear, and keep them strong to prevent injuries. There are many supplements that can aid joint health, however up until now there have been none to actually support the regeneration of cartilage.

Glucosamine and Chondroitin, both popular supplements for sufferers of joint pain and Osteoarthritis, have recently received a lot of criticism. Sales of the two supplements have reached an estimated one billion dollars in just the USA3, despite little scientific evidence to prove they do any more than a placebo.

A study by world expert Professor Juni, from Berne University, Switzerland and published in the British Medical Journal into the effects of Glucosamine and Chondroitin came to the following conclusions;

“Compared with placebo, Glucosamine, Chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.” 4

In comparison Flexeze Fortify, a natural supplement taken once a day, has clinical evidence to suggest that it reduces the deterioration of cartilage, and actually helps to rebuild damaged cartilage. It contains the award-winning ingredient Fortigel, made up of the patented Collagen Hydrolysate – a specially processed form of collagen claimed to be more bioavailable – that is absorbed by our body more easily, than unprocessed collagen.

Clinical trials undertaken in America by Harvard Medical School and Tufts Medical Centre in Boston have shown that where other supplements may simply slow down the deterioration of cartilage, Flexeze Fortify appears to not only stop the deterioration but also reverses the process. When tested on 30 patients, all suffering with arthritis, 15 were given Flexeze Fortify and 15 were given a placebo. The results of the year-long trial demonstrated that patients taking Flexeze Fortify had experienced cartilage re-growth, decreased joint pain and improved mobility. In comparison the patients taking the placebo saw continued deterioration in their cartilage.

Osteoarthritis Treatment

According to a new study announced recently at the yearly meeting of the Radiological Society of North America, people who are susceptible to developing osteoarthritis may postpone its development or possibly arrest the development by becoming more physically active.

“According to the results of our study, participating in a high-impact activity, such as running, more than one hour per day at least three times a week appears associated with more degenerated cartilage and potentially a higher risk for development of osteoarthritis,” said the study’s senior author Thomas M. Link, M.D., professor of radiology and chief of musculoskeletal imaging at the University of California, San Francisco (UCSF). “On the other hand, engaging in light exercise and refraining from frequent knee-bending activities may protect against the onset of the disease.”

Osteoarthritis is a worsening disease of the joints causing severe pain and deficient mobility. The National Institute of Arthritis and Musculoskeletal and Skin Diseases state that it is the most prevalent type of arthritis affecting in excess of 27 million people in the U.S. over 25 years of age.

Researchers examined 132 subjects showing no sign of the disease but at risk for developing osteoarthritis, as well as 33 control subjects. There were 99 female and 66 male study participants between 45 and 55 years of age. The group consisted of 3 sub-groups divided up according to their answers to the Physical Activity Scale for the Elderly or PASE test. Degrees of exercise for each group were labelled sedentary, light, and moderate to strenuous exercise.

MRI tests showed that the light exercise group participants enjoyed the healthiest knee cartilage and those with little strength exercise had healthier cartilage overall than those with no strength exercise and those with frequent strength exercise.

“The results for this group indicate that moderate to strenuous exercise may accelerate cartilage degeneration, putting these women at even greater risk of developing osteoarthritis,” said study coauthor Keegan K. Hovis, B.S., R.N., research associate in the Department of Radiology at UCSF.

“People can reduce their risk for osteoarthritis by maintaining a healthy weight and avoiding risky activities and strenuous exercise,” he said. “Lower-impact sports, such as walking, swimming or using an elliptical trainer are likely more beneficial than high-impact sports, such as running or tennis.”

“Our findings indicate that light exercise, particularly frequent walking, is a safer choice in maintaining healthy cartilage,” Hovis added.