Degenerative Meniscus Tears Rarely Require Surgery

And your surgeon says you need surgery… maybe not… next

Meniscal Tears May Not Need Surgery

Jack Cush reporting in RheumNow cited a study published in the British Medical Journal examines whether knee surgery or conservative medical management benefits those with degenerative meniscal tears. Patients with knee pain from a degenerative meniscal tear were randomized to either arthroscopic surgery (followed by daily exercises at home) or physical therapy (neuromuscular and strength exercises) two to three times a week for 12 weeks.

Over the next 2 years both groups improved. Muscle strength had improved more, on average, in the physical therapy group at the three-month checkup, but at the final two-year checkup, there was essentially no difference between the surgery and therapy groups, including in pain, ability to function in sports and recreation activities, and quality of life. The researchers noted that 19 percent of the therapy group opted to have surgery at some point but had achieved “no additional benefit” by the end of the study.

Conservative exercise therapy was equal to arthroscopic intervention overall, but also showed positive effects over surgery short-term muscle strength.  Clinicians should consider conservative management and physical therapy in middle-aged patients with degenerative meniscal tears.

Comment: Degenerative meniscus tears are secondary to the arthritis. Surgery is not generally warranted.

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TV Watching Increases Risk of Blood Clots

A popular method of relaxation is deadly. Found out which one next

Watching TV Longer Increases Risk Of Fatal Blood Clot, Study Finds

Nicholas Bakalar writing in the New York times reported a new study published in the journal Circulation by Japanese researchers analyzing “86,024 generally healthy people who filled out questionnaires with items about health and lifestyle, including time spent watching television,” found that more time watching television increases the risk for a fatal blood clot. Researchers estimated that, after adjusting for other factors, “watching for two and a half to five hours increased the risk for a fatal clot by 70 percent, and watching more than five hours increased the risk by 250 percent,” compared to watching for less than two and half hours each day.

Comment: Better grab that remote, turn the TV off and get moving…

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Nanoparticles Rheumatoid Arthritis

A novel method for detection and treatment in rheumatoid arthritis… next

Rheumatoid Arthritis Effectively Diagnosed And Treated With Biodegradable Nanoparticles In Early Study

Dr. Patricia Inacio writing in Rheumatoid Arthritis News reported biodegradable polymer nanoparticles (BNPs), tiny particles made of a biodegradable polymer, appear to be quite useful for the early detection and for long-term, effective treatment of rheumatoid arthritis (RA) with minimal side effects, according to a study presented at the recent. These particles, once coated with a molecule that specifically targets inflamed joint tissues, ensure a high degree of efficacy in delivering both diagnostic probes and drugs to arthritic joints.

Dr. Paolo Macor, the study’s lead investigator from the Department of Life Sciences, University of Trieste, Italy said “There is a need to develop a new tool to enable early diagnosis, and also to develop tissue-specific agents able to reduce systemic side effects. This would increase the potency of drugs with lower doses, and also potentially reduce the cost of treatment,” Dr. Macor said.

Comment: Exciting and I look forward to hearing more.

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T Cells Cancer Treatment

The future of cancer therapy? Next

Cell Therapy Uses Genetically Redesigned T-Cells To Fight Some Types Of Cancer

Andrew Pollack writing in the New York Times reported in 4,400-word feature piece as part of its “Cell Wars” series on immunotherapy, on the technique of cell therapy, which extracts T-cells from a patient’s blood, which are “then genetically engineered to recognize and destroy cancer.” The “souped-up” cells are “multiplied in the laboratory, and millions or billions of them are put back into the patient’s bloodstream.” Each killer cell, which are “genetically engineered to produce a complex protein,” can destroy up to 100,000 cancer cells. Cell therapy has only treated a few hundred patients, and for “now it works only for certain types of blood cancers, not common malignancies like breast and lung cancer.” However, the technique has “produced complete remissions in some patients who were out of treatment options,” exciting physicians and patients “and setting off a race among companies to bring the treatments to market.”

Comment: Maybe we can’t get away from using those horrendous chemotherapies we now use.

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Americans More Obese

This next item falls into the , “Duh…. No kidding” category…

Americans heavier than they were two decades years ago, report says

Alexandra Sifferlin writing in Time reported the CDC’s National Center for Health Statistics found that US men and women “weigh about 15 pounds more than they did 20 years ago.” According to the report, the average 5’9” man now weighs 195.7 pounds and the average 5’4” woman weighs 168.5 pounds. Time noted “men and women’s heights were about the same two decades ago.” The study also found that average 11-year-old boys and girls now weigh about 13 and 7 pounds more, respectively, in comparison to 1988-94. Boys have grown about an inch on average since then, while girls this age have remained the same height.

Comment: Overseas, Americans are referred to as the Porkus Americanus species.

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Radiofrequency Neurotomy Efficient In Knee Osteoarthritis

Another promising treatment for osteoarthritis knee pain

Radiofrequency Neurotomy Efficient In Knee Osteoarthritis

Reported in Healthday, this item… For patients with chronic knee osteoarthritis (OA) pain, radiofrequency (RF) neurotomy of genicular nerves is safe and efficient, according to a study published in the International Journal of Rheumatic Diseases.

Sinem Sari, M.D., from Adnan Menderes University in Aydin, Turkey, and colleagues compared the efficacy of intra-articular injection of anesthetic and steroid and RF neurotomy of genicular nerves in 73 patients with chronic knee OA pain. Patients were randomized to the injection group or to the RF neurotomy group.

The researchers observed no statistically significant differences between the groups in terms of pain. “This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA,” the author said.

Comment: Interesting study.

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Rheumatoid Arthritis Gut

Got guts…next?

Searching for Rheumatoid Arthritis in the Gut

A pair of recent studies look in an interesting place to find commonality among rheumatoid arthritis sufferers:

Their guts.

Ryan Black writing for MD reported on a study published in Genome Medicine from the Mayo clinic. Veena Taneja, Ph D of the Mayo Clinic’s Center for Immunized Medicine said they sought to find a biomarker in the form of gut microbiota. Examining fecal samples of (human) RA patients and their first-degree relatives, the researchers noticed that an abundance of collinsella in the gut was linked to increased RA symptoms.

To test this, they administered collinsella to “humanized” mice, and found that “Mice given [Collinsella aerofaciens] developed arthritis with increased incidence and severity compared with non-treated mice (100 % incidence in treated vs 62.5 % in untreated, P = 0.068).” Their findings indicate that collinsella may be a predictive biomarker for RA in humans.

Comment: Maybe I’ll stay away from pepperoni pizza…

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Etanercept Alzheimers

Hope for Alzheimer’s… maybe

Arthritis drug could reduce risk of having Alzheimer’s disease

Nicholas Bakalar writing for Business Standard reported a drug used to treat rheumatoid arthritis may have benefits against Alzheimer’s disease, researchers report.

Rheumatoid arthritis is an autoimmune disease believed to be driven in part by tumour necrosis factor, or TNF, a protein that promotes inflammation. Drugs that block TNF, including an injectable drug called etanercept, have been used to treat rheumatoid arthritis for many years.

TNF is also elevated in the cerebrospinal fluid of Alzheimer’s patients.

Researchers identified 41,109 men and women with a diagnosis of rheumatoid arthritis and 325 with both rheumatoid arthritis and Alzheimer’s disease. In people over 65, the prevalence of Alzheimer’s disease was more than twice as high in people with rheumatoid arthritis, as in those without it. The study is in CNS Drugs.

But unlike patients treated with five other rheumatoid arthritis drugs, those who had been treated with etanercept showed a significantly reduced risk for Alzheimer’s disease.

Comment: Interesting to see what future developments occur.

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Road Rage

So you’re a careful and courteous driver right.  Well you’re in the minority… next

Nearly 8 Out Of 10 US drivers have engaged in aggressive or angry driving in past year, survey finds

Joan Lowy writing for the Associated Press reported  almost 80 percent of US drivers “admit expressing anger, aggression or road rage at least once in the previous year, according to a survey” from the AAA Foundation for Traffic Safety. The survey found that male drivers were more likely to engage in road rage than female drivers, especially younger men between the ages of 19 and 39.

Comment: I’ve seen it often.  Pretty sad.

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Stem Cells for Stroke

Stem cells… a breakthrough… I mean a huge one next.

Researchers use stem cells to restore motor function in stroke patients

Ariana Cha writing in the Washington Post reported that scientists “studying the effect of stem cells injected directly into the brains of stroke patients said…that they were ‘stunned’ by the extent to which the experimental treatment restored motor function in some of the patients.” Although the study “involved only 18 patients and was designed primarily to look at the safety of such a procedure and not its effectiveness, it is creating significant buzz in the neuroscience community because the results appear to contradict a core belief about brain damage – that it is permanent and irreversible.” The findings were published in Stroke.

Comment: Wow.  Double wow.

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