Other Medical Research Updates from Dr. Jarret Morrow
2007-11-05 20:28:00
Hello everyone,My other blog site for premenstrual syndrome research updates can be found at:http://pmsresearch.blogspot.com/
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Whether or not weather affects your arthritis pain?
2007-11-02 09:23:00
Whether or not weather
affects
your arthritis pain?Does weather really affect your the severity of your joint pain? Though, I've often wondered this myself, intuitively I've often felt quite sure that there is a relationship between weather conditions and my own joint pain. In fact, most people with arthritis assert with conviction that weather conditions do influence the severity of their pain (Laborde et al, 1986).Despite our strongly held convictions with respect to the question as to whether or not weather impacts the severity of joint pain, I recently read a clinical trial which tested this hypothesis. In a recent article published in the American Journal of Medicine (McAlindon et al, 2007), they studied 200 geographically isolated individuals with osteoarthritis of the knee. Not surprisingly, their study results confirmed that both cold weather as well as increases in atmospheric pressure are both associated with an increase in joint pain severity.In addition to these recent fi
Balneotherapy for osteoarthritis.
2007-11-01 10:30:00
Balneotherapy for osteoarthritis.I certainly hope that the first question that you are asking yourself is the very same question that I asked myself when I came across this very recent study... The question that came to my mind was, "what on earth is balneotherapy?"Balneotherapy, to my recent understanding is a broadly defined term encompassing the various types of therapy pertaining to spas. In this recent cochrane review, they attempted to review various clinical trials which were conducted on varying forms of mineral bath treatments for arthritis.One challenge with randomized clinical trials that evaluate unconventional treatment forms is that it is often difficult to create an adqueate placebo. For example, with a clinical trial involving tablet type medication, you can make a placebo tablet that looks, tastes, and feels exactly the same as the medication tablet. However, whether the clinical trial is attempting to evaluate a treatment method such as tai chi, spa baths, or meditati
Questions section of this site
2007-10-31 15:43:00
Hello blog readers,Please feel free to post questions in regard to any of the posts on the site. If you have a question that is unrelated to the topics already posted, please post new questions that you have right here. Cheers,Jarret Morrow, MD
Byetta (Exenatide) from Eli Lilly for Type 2 diabetes
2007-10-31 09:26:00
In some of my earlier posts, you can read about the association between diabetes and osteoarthritis risk. One of the common risk factors for both type II diabetes as well as osteoarthritis is obesity. Not only does obesity put added strain on one's joints, but it increases the risk of insulin resistance. For patients that have both of these conditions, an important treatment option to discuss with your health care provider is the drug Byetta (Exenatide). It is a new diabetes treatment from Eli Lilly
and Amylin that is extracted from the saliva of the Gila monster received approval from the Food and Drug Administration.Unfortunately, many patients with type II diabetes will not like the route of administration for Byetta. However, I heard on the news just this morning that three pharmaceutical companies are developing a once a week type of dosing for the drug which they anticipate being available in 2008/9.In terms of patients with both type II diabetes and osteoarthritis, one importan
Glucosamine use in pregnancy: an evaluation of pregnancy outcome.
2007-10-29 10:06:00
"CONCLUSIONS: These limited data suggest no increased risk for major malformations or other adverse fetal effects following the use of GLS during pregnancy. "Sivojelezova A, Koren G, Einarson A. Glucosamine use in pregnancy: an evaluation of pregnancy outcome
. J Womens Health (Larchmt). 2007 Apr;16(3):345-8.
S-adenosylmethionine for osteoarthritis
2007-10-26 09:48:00
"CONCLUSION: SAMe has a slower onset of action but is as effective as celecoxib in the management of symptoms of knee osteoarthritis. Longer studies are needed to evaluate the long-term effectiveness of SAMe and the optimal dose to be used" (Najm et al, 2004)Najm WI, Reinsch S, Hoehler F, Tobis JS, Harvey PW. S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. [ISRCTN36233495]. BMC Musculoskelet Disord. 2004 Feb 26;5:6.SAMe is found in the patent-pending Arthroleve formulation. For a free sample box, visit: www.arthroleve.com
Relationship between arthritis pain and sleep disturbance
2007-10-26 09:40:00
Here's the conclusions of another recent study regarding adequate pain control on sleep disturbances in patients with osteoarthritis which underscores the importance of adequate pain control to improve quality of sleep."In patients with chronic osteoarthritis pain, pain reduction is associated with decreased pain-related sleep disturbance" (Kosinski et al, 2007).Kosinski M, Janagap C, Gajria K, Schein J, Freedman J. Pain relief and pain-related sleep disturbance with extended-release tramadol in patients with osteoarthritis. Curr Med Res Opin. 2007 Jul;23(7):1615-26.
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The Longitudinal Examination of Arthritis Pain (LEAP) Study
2007-10-26 09:36:00
A recent study (LEAP study) highlights the impact on arthritis pain on patients daily lives including work absenteeism, sleep interference, and daily activities:"Weekly fluctuations in pain levels and other health outcomes were identified among adults with OA. Decreases in patient-reported pain were associated with improvements in daily activities/functioning and decreases in work absenteeism, sleep interference, and healthcare resource use" (Hutchings et al, 2007).Hutchings A, Calloway M, Choy E, Hooper M, Hunter DJ, Jordan JM, Zhang Y, Baser O, Long S, Palmer L. The Longitudinal Examination of Arthritis
Pain (LEAP) Study
: Relationships Between Weekly Fluctuations in Patient-Rated Joint Pain and Other Health Outcomes. J Rheumatol. 2007 Oct 15;
Cell-based cartilage repair: illusion or solution for osteoarthritis.
2007-10-24 12:29:00
One treatment option for osteoarthritis which is not widely used yet, but may offer hope for people who suffer from osteoarthritis in the near future, is cell-based cartilage repair. I will keep my blog readers up to date on recent developments in stem-cell therapies for osteoarthritis.Richter W. Cell-based cartilage repair: illusion
or solution for osteoarthritis. Curr Opin Rheumatol. 2007 Sep;19(5):451-6.
Osteoarthritis: a comorbid marker for longer life?
2007-10-24 10:44:00
Interestingly, a recent study compared the mortality rate of different chronic conditions in patients with or without osteoarthritis. In the various disease groups, lower mortality rates were observed in the patients who additionaly had osteoarthritis. Further research is required to confirm and better understand this association."Diseases are often described and studied as if they occur in isolation of other disease states, yet many individuals have multiple chronic conditions" (Lee et al, 2007)."In summary, osteoarthritis was remarkably consistent in its association with a 20% to 35% reduction in 5-year mortality rates in U.S. veterans when present with different combinations of chronic conditions, whereas COPD unsurprisingly increased the risk of mortality. Given that positive spillover effects of osteoarthritis on mortality have not been previously reported in the literature, further research is warranted to confirm or refute these findings and to examine possible reasons for the o
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Glucoamine Sulfate for Knee Osteoarthritis
2007-10-23 15:18:00
•In this study, 318 patients were enrolled in this randomized control trial for patients with Knee osteoarthritis (OA) during a six month treatment course.•Findings: glucosamine sulfate is more effective than placebo in treating knee OA symptoms. Reached the level of statistical significance over 6 month period.•What’s interesting about this study is that Acetaminophen actually failed to show a statistically significant effect compared to placebo for treating OA pain. -Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007 Feb;56(2):555-67.
Of the vegetables and fruit food group, which component may bemore important for your joint health--Vegetables or Fruit?
2007-10-20 15:54:00
The consumption of both vegetables and fruit are both very important to maintain our overall health. However, in terms of the health of our joints, a recent study suggests that fruit consumption may play a more important role than vegetables (Wang et al, 2007). "Intake of vegetables and other carotenoids was not significantly associated with cartilage or bone measures. The present study suggests a beneficial effect of fruit consumption and vitamin C intake as they are associated with a reduction in bone size and the number of bone marrow lesions, both of which are important in the pathogenesis of knee osteoarthritis" (Wang et al, 2007). If you suffer from arthritis, make sure that you maintain an adquate intake of fruit!As I am Canadian, here's a link for a free copy of the Canada Food Guide for a reference:http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/view_eatwell_vue_bienmang_e.pdfWang Y, Hodge AM, Wluka AE, English DR, Giles GG, O'sullivan R, Forbes A,
Could folic acid fortication of food affect patients with Rheumatoid Arthritis?
2007-10-20 15:27:00
Folic acid is a B vitamin which is found in green, leafy vegitables. Pregnant women are often advised to take folic acid during their pregnancy to reduce the risk of neural tube defects such as spina bifida. Some evidence also suggests that folic acid supplementation may reduce the risks of heart disease, stroke, and cancer. Moreover, some clinical trials have found that low levels of folic acid are associated with clinical depression. Dietary fortification with folic acid has been used in the United States since 1997 to reduce the risk of neural tube defects in newborn babies. Rheumatoid
arthritis is a debilitating condition which has a world wide distribution with an estimated incidence of 1-2% of the population. Disability is very high amoungst patients
with rheumatoid arthritis with approximately 60% being unable to work ten years after the onset of the disease. However, folic acid supplementation could theoretically reduce the effectiveness of anti-folate medications such as metho
Read more: Arthritis
, Rheumatoid Arthritis
Results of a study just published links diet with osteoarthritis risk
2007-10-18 14:42:00
Monounsaturated Fatty Acids (MUFA):A study just recently published
in the medical journal, Osteoarthritis Cartilage, found a link between higher intakes of monounsaturated fatty acids and bone marrow lesions. Bone marrow lesions are important in the pathogenesis of osteoarthritis (Wang et al, 2007).What does this mean?When I was in medical school, one type of diet gaining popularity was the Mediterranean diet (Spain, Italy, and Greece). This particular diet was of interested as people in this region were noted to have lower levels of cholesterol and a lower incidence of cardiovascular disease. People in this region consume reasonably large quantities of Olive Oil, which has a high MUFA content. Not surprisingly, there is a high content of MUFAs in this Mediterranean diet. A diet high in MUFA (versus a high-carbohydrate diet) improves glycemic control in individuals with adult onset diabetes (NIDDM) who maintain body weight. Individuals with elevated triglycerides or insulin levels also
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Question about myalgia (muscle pain)
2007-10-17 08:02:00
*Please refer to disclaimer text."Dr Morrow,In was pleased to respond to your email of October 13 and filling out the customer satisfaction survey. As I have indicated, I'm delighted with Arthroleve. It is affording me relief from joint pain that I was unable to find anywhere else.I do have a question for you, however: Do you know of any product that will successfully elevate pain in my arm muscle
s?I have tried Co Enzyme A-10, I have temporarily discontinued Cholesterol-lowering medications like Lipitor for up to 3 weeks but I still have really bad pain in my biceps. Any thoughts or suggestions?Perhaps University [Health Industries] produce a product that I should try.Thank you for ant thoughts on my problem."Thank you for your question. I would first strongly advise you to visit your doctor about these concerns. The most important thing is for your doctor to determine the cause of your myalgia. Muscle pain or myalgia can have a wide variety of causes, some of which can be serious, an
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Gout Information Links
2007-10-16 09:28:00
Medicinet:http://www.medicinenet.com/gout/article.htmWebMD:http://www.webmd.com/a-to-z-guides/gout-topic-overviewMayoclinic:http://www.mayoclinic.com/health/gout/DS00090
Rheumatoid Arthritis Information Links
2007-10-16 09:22:00
Medicinet: http://www.medicinenet.com/rheumatoid_arthritis/article.htmMayo Clinic:http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020WebMD:http://www.webmd.com/rheumatoid-arthritis/default.htm
Read more: Arthritis
, Rheumatoid
, Rheumatoid Arthritis
Osteoarthritis Information links
2007-10-16 09:16:00
Mayoclinic:http://www.mayoclinic.com/health/osteoarthritis/DS00019Medicinet.com:http://www.medicinenet.com/osteoarthritis/article.htmWeb MD:http://www.webmd.com/osteoarthritis/default.htm
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Clinical Trial recruiting participants--Yoga for Rheumatoid Arthritis
2007-10-16 09:02:00
If you suffer from rheumatoid or an inflammotry type of arthritis, you may be interested in participating in this study.Study sponsors: National Center for Complementary and Alternative Medicine (NCCAM)National Institute of Neurological Disorders and Stroke (NINDS)Primary outcome measure: Quality of LifeLink for further information:http://clinicaltrials.gov/ct/show/NCT00349869;jsessionid=A0D67642B7E386977DCC0A637186F2D4?order=4
Read more: Trial
, recruiting
, Rheumatoid
, Arthritis
, Rheumatoid Arthritis
New smoking cessation treatment from Pfizer
2007-10-15 10:32:00
Two recent studies were published in the Journal of American Medical Association about a new drug for smoking cessation (Gonzales et al, 2006; Jorenby et al 2006). Unlike other approved treatments for smoking cessation including nictotine replacement therapy, or selectively inhibit the reuptake of dopamine (Bubrorpion), Chantix is a partial agonist of the alpha 4 Beata 2 nictotinic acetylcholine receptor.In the study both of these studies, Chantix's efficacy exceeded buproprion SR and placebo (Jorenby et al, 2007). During the last four weeks of treatment, 43.9% of participants in the varenicline group were abstinent from smoking compared with 17.6% and 29% in the placebo and buprioprion SR groups respectively.Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, Watsky EJ, Gong J, Williams KE, Reeves KR; Varenicline Phase 3 Study Group. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessa
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Does enteric-coated aspirin result in a lower incidence of gastrointestinal complications compared to normal aspirin?
2007-10-11 13:28:00
Does enteric coating actually reduce the risk of gastrointestinal bleeding in patienst who take aspirin?"Five randomised controlled trials of healthy volunteers undergoing endoscopy after a period of either enteric-coated aspirin or plain aspirin administration all demonstrated a clear reduction of gastric mucosal injury. However, these trials on healthy volunteers taking short-term aspirin have not been supported by clinical studies in older age-group adults taking lower doses of aspirin for long periods. No clinical benefits in terms of reduction of gastrointestinal bleeding or ulceration with enteric coating have, therefore, been successfully demonstrated, although the endoscopic studies show that potentially these benefits could exist."Walker J, Robinson J, Stewart J, Jacob S. Does enteric-coated aspirin result in a lower incidence of gastrointestinal complications compared to normal aspirin? Interact Cardiovasc Thorac Surg. 2007 Aug;6(4):519-22. Epub 2007 Apr 6.
How to advise aspirin use in patients who need NSAIDs.
2007-10-11 13:05:00
Many patients
who suffer from osteoarthritis taken prescription NSAIDS to treat their condition. NSAIDs carry a significant risk of gastrointestinal bleeding. Selective Cox-2 inhibitors are believed to have a lower risk of GI bleeding, but carry a risk of serious thrombotic events. Low dose Aspiring is used by many patienst fr the prevention of cardiovascular events. At present, it is STILL UNKONWN whether aspririn lowers the risk of cardiovascular events in patients who are taking selective COx-2 inhibitors..."NSAIDs are widely used all over the world. NSAID use is rising due to increasing availability without a prescription, use of aspirin for prevention of thrombotic disorders and the ageing population. Aspirin is used as an analgesic drug in many countries, but the main current indication is low-dose aspirin for the prevention of cardiovascular events. However, NSAIDs and aspirin use account for approximately 20-25% of all reported drug adverse events. Most of those are gastrointes
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Efficacy and safety of willow bark extract?
2007-10-11 13:00:00
"OBJECTIVE: To investigate the efficacy and safety of a standardized willow bark extract
in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). ""CONCLUSION: The OA study suggested that the willow bark extract showed no relevant efficacy in patients with OA. Similarly, the RA trial did not indicate efficacy of this extract in patients with RA."Biegert C, Wagner I, Lüdtke R, Kötter I, Lohmüller C, Günaydin I, Taxis K, Heide L.Efficacy and safety of willow bark extract in the treatment of osteoarthritis and rheumatoid arthritis: results of 2 randomized double-blind controlled trials. J Rheumatol. 2004 Nov;31(11):2121-30.
Steroid injection for osteoarthritis of the hip: a randomized, double-blind, placebo-controlled trial.
2007-10-11 10:10:00
"CONCLUSION: This placebo
-controlled trial confirms that corticosteroid injection can be an effective treatment of pain in hip OA, with benefits lasting up to 3 months in many cases. Future studies should address questions related to the benefits of repeated steroid injection and the effects of this treatment on disease modification" (Lambert et al, 2007).Lambert RG, Hutchings EJ, Grace MG, Jhangri GS, Conner-Spady B, Maksymowych WP. Steroid
injection for osteoarthritis of the hip: a randomized, double
-blind, placebo-controlled trial. Arthritis Rheum. 2007 Jul;56(7):2278-87.
Glucosamine and Diabetes
2007-11-06 13:40:00
Many joint health products (including Arthroleve) which contain glucosamine caution use in people who have diabetes as glucosamine is type of sugar which could theoretically affect blood sugar levels. However, a recent study concluded, "oral glucosamine at standard doses for 6 weeks does not cause or significantly worsen insulin resistance or endothelial dysfunction in lean or obese subjects" (Muniyappa et al, 2006).References1. Muniyappa R, Karne RJ, Hall G, Crandon SK, Bronstein JA, Ver MR, Hortin GL, Quon MJ. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes
. 2006 Nov;55(11):3142-50.
Different Types of Glucosamine
2007-11-06 12:43:00
I recently came across an interesting article which was published in the medical journal, Osteoarthritis and Cartilage, in 2006 (Hopman et al). The authors of the study had noted that glucosamine use was increasing dramatically in Canada and they sought to find our which factors were associated with glucosamine use. The noted that glucosamine is often used by people that suffer from arthritis, back pain, or simply seek to maintain their joint health.Not surprsingly, they found that glucosamine use was higher among the elderly. The incidence of arthritis increases dramatically with age. The also noted that glucosamine use was higher among people who take calcium supplements, engage in physical activity, and who have a prior history of glucosamine use. Many of these factors seem to fit the pattern of people who are taking proactive measures to maintain their joint health.How many types of glucosamine are commonly taken by consumers?There are three main types of glucosamine currently on t
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Which type of exercise is best for knee osteoarthritis?
2007-11-14 12:07:00
The results of a very recent study concluded that water-based exercises were superior to land based exercises for patients with osteoarthritis (OA) of the knee. If you suffer from OA of the knee, you may want to talk your healthcare provider about approrpriate water-based exercises. "Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee" (Silva et al, 2007).References:1. Silva LE, Valim V, Pessanha AP, Oliveira LM, Myamoto S, Jones A, Natour J. Hydrotherapy Versus Conventional Land-Based Exercise for the Management of Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial. Phys Ther. 2007 Nov 6;
Does Tomato lycopene extract reduce cancer risk?
2007-11-26 12:28:00
The results of a recent clinical trial support the assertion that consuming tomato lycopene extract
may prevent certain types of cancer:"Epidemiological studies have shown that high serum levels of insulin-like growth factor-I are associated with an increased risk of colon and other types of cancer. The aim of this study was to determine whether short intervention with dietary tomato lycopene extract will affect serum levels of the insulin-like growth factor system components in colon cancer patients. The study had a double-blind, randomized, placebo-controlled design.....Given that high plasma levels of insulin-like growth factor-I have been suggested as a risk factor for various types of cancer including colon cancer, the results support our suggestion that tomato lycopene extract has a role in the prevention of colon and possibly other types of cancer" (Walfisch et al, 2007)Reference:Walfisch S, Walfisch Y, Kirilov E, Linde N, Mnitentag H, Agbaria R, Sharoni Y, Levy J. Tomato
lyco
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Are you taking the wrong type of glucosamine?
2007-11-26 09:24:00
Glucosamine is a ubiquitous and widely studied ingredient in many joint health products. I've written previous articles on the different types of glucosamine used in joint health products (sulfate, hydrochloride, and n-acetyl glucosamine). A recent article (Vlad et al, 2007) supports my previous conclusions on the ingredient glucosamine hydrochloride. In this recent article, published in the medical journal, Arthritis and Rheumatism, the study others sought to explain the heterogeneity of clinical trial results on glucosamine. Essentially, they endeavored to explain why many randomized clinical trials on glucosamine have found that it works, yet some clinical trials have conflicting results. Essentially, part of the reason for this discrepancy is that the clinical trials on glucosamine products include trials on glucosamine sulfate and glucosamine hydrochloride. Among their explanations was the simple conclusions that "glucosamine hydrochloride is not effective." Make sure that y
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