Sunday, October 9, 2011

Role of Diet and Arthritis

It is well-recognized that a healthy diet is important for everyone. Arthritis patients, however, sometimes look beyond this notion of healthy eating and look to diet for a cure. The link between diet and arthritis is complex.

There is evidence that diet can influence some types of arthritis, but to fully understand this, the type of arthritis and the kind of diet must be considered. One example is gout, which is affected by high uric acid levels. A diet which is low in alcohol and purine-rich foods can lower blood uric acid levels and lessen the likelihood of a gout attack. Purines are natural substances found in certain foods. Alcohol is known to alter purine metabolism. Dietary changes may decrease the severity or frequency of gout attacks. Dietary modifications may also be preferred by people who cannot tolerate gout medications.

Excess body weight influences arthritis by putting extra strain on already burdened joints. Clinical experience has shown researchers that people who are 20 percent or more over normal body weight have more problems with their arthritis. Seemingly the weightbearing joints are most affected by carrying the extra weight. The extra load placed on the weightbearing joints (more specifically the knees, hips, ankles, feet, and spine) can increase the pain in those joints.

The increased pain, resulting sedentary lifestyle, and further weight gain can become a vicious cycle. Osteoarthritis patients commonly deal with this problem of battling weight gain. Rheumatoid arthritis patients who are on corticosteroid therapy (i.e. prednisone) are warned about increased appetite, fluid retention and unavoidable weight gain as side effects of the therapy.

It is believed by some people that particular foods act as allergens which can trigger arthritis flares. Although no specific food has been implicated as a cause of arthritis it is known that foods can alter the function of the immune system. Examples of immune-mediated reactions include:

In regard to arthritis, these are often viewed as possible offenders:

caffeinedairy productsnightshade vegetables (tomatoes, peppers, etc.)sugaradditives and preservativeschocolatered meatssalt

Even if food allergy was a cause of arthritis, not every person would be found to be allergic to the same food. The way to test for a food allergy is to employ an elimination diet, whereby it is observed if the arthritis improves when the suspect food is removed from the diet.

Seven Dietary Guidelines originally published by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services:

Eat a variety of foods: Eat from all 4 basic food groups (breads and cereals, fruits and vegetables, meats, and dairy) to obtain the needed forty-plus essential nutrients to maintain good health.Maintain your ideal weight: Less weight equates with less strain on weightbearing joints. Less strain equates with less pain.Avoid too much fat, saturated fat, cholesterol: Increased amounts of fat contribute to weight gain and obesity.Eat adequate amounts of starch and fiber: Starches such as bread, rice, beans, pasta, and potatoes give the body energy. Fiber, the undigested portion of the plants we eat, adds bulk and helps with the process of elimination.Avoid too much sugar: Sugar provides empty calories and little nutrition, contributing to excess weight gain.Avoid too much sodium: Excess salt can contribute to high blood pressure and water retention.Avoid alcohol: Alcohol can deplete the body of vitamins and minerals besides being high in calories. It also potentially can interact with medications for arthritis.

Well-balanced nutritious meals are important for the overall good health of everyone. Maintain as close to your ideal body weight as possible. Avoid fad diets and unproven diet claims that may end up robbing your body of essential nutrients.

Sources:

The Duke University Medical Center Book of Arthritis, by David S. Pisetsky, M.D., Ph.D. with Susan Flamholtz Trien (1995).

Arthritis: What Works, by Dava Sobel and Arthur C. Klein

Related Resources - Diet and ArthritisRelated Resources - Diet and ArthritisRelated Resources - Diet and Arthritis

View the original article here

Saturday, October 8, 2011

Rheumatoid Factor Significance

Diagnosing rheumatoid arthritis involves a physical examination, the patient's clinical history, and diagnostic tests. The rheumatoid factor test is among the diagnostic tests commonly ordered to help diagnose rheumatoid arthritis. What is the significance of the rheumatoid factor blood test in diagnosing rheumatoid arthritis?What is the significance of higher levels of rheumatoid factor?How is it possible that people who are negative for rheumatoid factor can still have rheumatoid arthritis?Answer:

Patients are often times fearful, when their doctor tells them that a rheumatoid factor (RF) was found on routine laboratory testing. Immediately, they assume that they have developed rheumatoid arthritis (RA). This is simply not the case.

Guide to Rheumatoid Arthritis

The rheumatoid factor is an immunologic marker in the body, found in low titer in a number of diseases, including infectious mononucleosis and other viral diseases, chronic bacterial infections, and other acute and chronic conditions. Rheumatoid factor is also found in approximately 5 percent of healthy elderly persons. Then why worry? The concern is that when found in higher titer, it does suggest rheumatic disease.

What is Rheumatoid Factor?

The highest levels of rheumatoid factor are usually found in rheumatoid arthritis. Clinically, higher titers tend to correlate with more severe and sustained disease, joint deformities, rheumatoid nodules, and other extraarticular features of the disease.

Rheumatoid Arthritis: Explained With Pictures

The presence of this marker is not, however, needed to make the diagnosis of rheumatoid arthritis. In fact 15-25 percent of all patients with rheumatoid arthritis do not have rheumatoid factor in their serum. There is no conclusive laboratory test which confirms the diagnosis of rheumatoid arthritis.

Do Normal Blood Test Results Rule Out Rheumatoid Arthritis or Other Rheumatic Diseases?Diagnostic Tests / Diagnosing ArthritisEarly Diagnosis of Arthritis - Is it Important?An In-Depth Report: Blood Tests For Evaluating Arthritis

(Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)


View the original article here

What Is Arthritis Rheumatoid?

Arthritis literally means joint inflammation. Arthritis is not a single disease. Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that can cause pain, stiffness and swelling in the joints.

Any part of your body can become inflamed or painful from arthritis. Some rheumatic conditions can result in debilitating, even life-threatening complications or may affect other parts of the body including the muscles, bones, and internal organs.

The two most common types of arthritis are osteoarthritis and rheumatoid arthritis. Arthritis can affect anyone at any age, including children. The incidence of arthritis increases with age, but nearly three out of every five sufferers are under age 65.

If left undiagnosed and untreated, many types of arthritis can cause irreversible damage to the joints, bones, organs, and skin.

Osteoarthritis, also known as degenerative joint disease, results from wear and tear. The pressure of gravity causes physical damage to the joints and surrounding tissues, leading to:

paintendernessswellingdecreased function

Initially, osteoarthritis is non-inflammatory and its onset is subtle and gradual, usually involving one or only a few joints. The joints most often affected are the:

Risks of osteoarthritis increase with age. Other risk factors include joint trauma, obesity, and repetitive joint use.

Rheumatoid arthritis is an autoimmune disease that occurs when the body's own immune system mistakenly attacks the synovium (cell lining inside the joint). Rheumatoid arthritis is a chronic, potentially disabling disease which causes:

joint painstiffnessswellingloss of joint function

While the cause remains elusive, doctors suspect that genetic factors are important. Rheumatoid arthritis can be difficult to diagnose early because it can begin gradually with subtle symptoms.

Juvenile arthritis is a general term for all types of arthritis that occur in children. Juvenile rheumatoid arthritis is the most prevalent type of arthritis in children. There are three major types:

Signs and symptoms of juvenile rheumatoid arthritis vary from child to child. No single test can conclusively establish a diagnosis. Juvenile arthritis must be present consistently for six or more consecutive weeks before a correct diagnosis can be made.

Psoriatic arthritis is similar to rheumatoid arthritis. About 5 percent of people with psoriasis, a chronic skin disease, also develop psoriatic arthritis. In psoriatic arthritis, there is inflammation of the joints and sometimes the spine.

Fibromyalgia syndrome is a painful condition characterized by:

The name fibromyalgia means pain in the muscles, ligaments and tendons. Fibromyalgia is a type of soft tissue or muscular rheumatism and does not cause joint deformities.

Gout is a painful type of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in the joints, especially the big toe. The pain and swelling associated with gout are caused by uric acid crystals that precipitate out of the blood and are deposited in the joint.

Pseudogout, which is also known as Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD), is caused by deposits of calcium phosphate crystals (not uric acid) in the joints. CPPD is often mistaken as gouty arthritis. Since CPPD is a different disease than gout, treatment is not the same as gout.

Scleroderma is a disease of the body's connective tissue that causes thickening and hardening of the skin. It can also affect the:

jointsblood vesselsinternal organs

There are two types of scleroderma: localized and generalized.

Systemic lupus erythematosus (SLE) is an autoimmune disease that can involve the:

skinkidneysblood vesselsjointsnervous systemheartother internal organs

Symptoms vary, but may include a skin rash, arthritis, fever, anemia, fatigue, hair loss, mouth ulcers, and kidney problems. Symptoms usually first appear in women of childbearing age, but, can occur in children or older people. About 90 percent of those affected are women.


View the original article here

Friday, October 7, 2011

Arthritis Medications

Arthritis Medications - Test Your Knowledge

There are several different classes of arthritis medications, and often many drugs within each class. In recent years, new arthritis drugs have become available. More are in the product pipeline. How much do you know about arthritis medications? Take Arthritis Medications - Test Your Knowledge.

Related Resources

Have You Missed A Quiz?

Arthritis-Related Quizzes (alphabetical)

Screening Quizzes

Knowledge Quizzes

Risk Factor Quizzes

Arthritis Medication or Treatment Quizzes

Arthritis and Lifestyle Quizzes

More Information About Arthritis

Sign Up For Free Newsletters and E-Courses


View the original article here

Risk of cardiac arrhythmias with anti-inflammatory drugs

AppId is over the quota
AppId is over the quota

The study suggests that the use of non-steroidal anti-inflammatory drugs (NSAIDs) – and in particular a type of NSAID called Cox-2 inhibitors – could be linked to an increased risk of irregular heart rhythm (atrial fibrillation).

It has been known for some time that NSAIDs – which include drugs such as ibuprofen and celecoxib – are associated with an increased risk of heart attack and stroke in people with a history of heart problems, but the effect on heart rhythm has not been looked at. Atrial fibrillation is associated with an increased long-term risk of stroke, heart failure and death.

Researchers in Denmark studied over 32,000 people with atrial fibrillation compared with those who did not have it, and found that use of NSAIDs was linked with an increased risk of atrial fibrillation.

In those who had recently started taking NSAIDs, there was a 40 per cent increased risk of atrial fibrillation, whilst those taking Cox-2 inhibitors had a 70 per cent increased risk, compared with people not taking the drugs.

The researchers estimated that there would be approximately four extra cases per year of atrial fibrillation per 1,000 new users of NSAIDs and seven extra cases per year of atrial fibrillation per 1,000 new users of Cox-2 inhibitors.

The study also found that the risk of atrial fibrillation was highest in older people and in those with chronic kidney disease or rheumatoid arthritis. The research was published online in the British Medical Journal.

Dr Chris Deighton, rheumatologist in Derby and member of Arthritis Care’s medical advisory board said that people with arthritis needed to carefully weigh up the risks and benefits of taking NSAIDs. ‘These drugs should be taken in the lowest dose for the shortest period of time, and only then of course if the person feels they are definitely helping the symptoms of their arthritis.’

Anyone with questions about arthritis or treatments can call Arthritis Care’s helplines free on 0808 800 4050 or email Helplines@arthritiscare.org.uk


View the original article here

Sunday, October 2, 2011

NSAIDs Plus PPIs May Cause Serious Problems for Arthritis Patients

It has long been known that nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen and ibuprofen, are associated with an increased risk of gastrointestinal complications (ulcers and bleeding). Some arthritis patients have been prescribed proton pump inhibitors (PPIs) with their NSAID to reduce stomach acid. PPIs include drugs like Nexium, Prevacid, and Prilosec. But this may be a problem, according to researchers from the Farncombe Family Digestive Health Research Institute.


Study results published online July 11, 2011 in the journal Gastroenterology suggest that, while PPIs do protect the stomach from damage caused by NSAIDs, the problem is shifted to the small intestine. The problem may even be greater in the small intestine because ulcers located in that area are more difficult to detect and more difficult to treat.


View the original article here

Saturday, October 1, 2011

What Are Rheumatoid Nodules?

As part of the rheumatoid process, firm, non-tender, subcutaneous nodules develop in about 25 percent of rheumatoid arthritis patients. These are commonly found at pressure points like the elbow, back of the forearm, and metacarpophalangeal joint. Nodules usually occur in chronic active cases of rheumatoid arthritis, and are commonly associated with more joint deformity and serious extra-articular manifestations including lungs, eyes, and blood vessels. Nodules may vary in size during the course of the disease process, according to Raymond Federman, M.D.

Johns Hopkins claims complications of rheumatoid nodules include:

painlimited joint mobilityneuropathyulcerationfistula formationinfection

Surgical removal is an option, but nodules tend to reoccur in as little as a few months when they are present over an area of repeated trauma. Intranodular steroid injections may reduce the size of the nodule.

Arthritis Hand Photo Gallery
Hand damage and deformity caused by arthritis can include nodules, swelling, stiffness, ulnar drift, contractures, and other problems. Photos of hands damaged by arthritis.

Sources: Interview with Raymond Federman, M.D., Case rounds case report#6 by Andrea Marx, M.D., The Johns Hopkins University

Related Resources - Rheumatoid NodulesRelated Resources - Rheumatoid ArthritisRelated Resources - Rheumatoid Arthritis

View the original article here

What Is Rheumatoid Factor?

Rheumatoid factor is an immunoglobulin (antibody) which can bind to other antibodies. Antibodies are normal proteins found in the blood which function within the immune system. Rheumatoid factor though is not normally found in the general population (only found in about 1-2% of healthy people). The incidence of rheumatoid factor increases with age and about 20% of people over 65 years old have an elevated rheumatoid factor.

A blood test is used to detect the presence of rheumatoid factor. The blood test is commonly ordered to diagnose rheumatoid arthritis. Rheumatoid factor is present in 80% of adults who have rheumatoid arthritis but there is a much lower prevalence in juvenile rheumatoid arthritis. The incidence of rheumatoid factor increases with duration of disease in rheumatoid arthritis: at 3 months the incidence is 33%, while at one year it is 75%. Up to 20% of rheumatoid arthritis patients remain negative for rheumatoid factor (also known as "seronegative rheumatoid arthritis") throughout the course of their disease.

Other autoimmune diseases can also be positive for rheumatoid factor including:

Other infections or conditions which can be associated with positive rheumatoid factor include:

Rheumatic conditions NOT associated with elevated rheumatoid factor include:

High levels or titers of rheumatoid factor are associated with more severe rheumatoid arthritis. The factor also has been associated with a higher tendency to develop the non-joint complications of the disease such as rheumatoid nodules and rheumatoid lung disease.

The amount of rheumatoid factor in blood can be measured by:

Agglutination tests

One method mixes the patient's blood with tiny latex beads covered with human antibodies (IgG). The latex beads clump or agglutinate if rheumatoid factor (IgM RF) is present. Another method mixes the patient's blood with sheep red blood cells that have been covered with rabbit antibodies. The red blood cells clump if rheumatoid factor is present.

A titer is an indicator of how much the agglutination test blood sample can be diluted before rheumatoid factor is undetectable. A titer of 1:20 indicates that rheumatoid factor can be detected when 1 part of blood is diluted by up to 20 parts saline. The lab value for rheumatoid factor of 1:20 or less is considered normal.

Nephlometry test

This method mixes the patient's blood with antibodies that cause the blood to clump if rheumatoid factor is present. A light is passed through the tube containing the mixture and an instrument measures how much light is blocked by the mixture. Higher levels of rheumatoid factor create a more cloudy sample and allow less light to pass through, measured in units. The lab value for rheumatoid factor of 23 or less units is considered normal.

When analyzing lab results the following should be considered:

A rheumatoid factor more than 23 units and a titer more than 1:80 is indicative of rheumatoid arthritis but may also occur in other conditions.False positive results can occur when the blood is high in fats.Inaccurate results can be caused by improper handling of the blood specimen.A negative test result for rheumatoid factor does not exclude the diagnosis of rheumatoid arthritis.

View the original article here