Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals

Sunday, 20 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Diet

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

Polymyalagia Arthritis (Rheumatica)

Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which causes pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdle as a result of the presence of a synovitis in proximal joints and periarticular structures.

The diet

Dietary consumption plays an important part in reduce or increase risk of chronic inflammatory diseases. A typical American diet with high amount of red meat, fat and trans fat, processed, meat, artificial ingredients, refined products are associated to promote the expression of pro inflammatory cytokines, leading to all kinds of diseases including chronic inflammatory, cardiovascular diseases and diabetes.

1. Organic Soy
Dietary rich in organic soy was associated to decrease risk of chronic inflammatory diseases through attenuation of inflammatory marker such as C-reactive protein (CRP) in related to risk of Polymyalgia Rheumatica(PMR)(103).
Dr. Nasca MM and the research team at the Beth Israel Deaconess Medical Center suggested, Soy nuts were associated with a trend toward reduction in C-reactive protein in normotensive women, improved over all inflammatory process(104).

2. Green tea
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world.
Green tea polyphenols (GTP) was effective against chronic inflammation through attenuating the deterioration of bone microarchitecture, according to the Texas Tech University Health Sciences Center, in animal study(105).

Also in rat study, alcoholic extracts of green tea (AE) exhibited analgesic and anti-inflammatory properties, through inhibited carrageenan-induced cell migration(106).
Decaffeinated green tea also expressed the immunomodulatory effects through enhancing the immune system against inflammatory disease in rainbow trout(107).

3. Olive oil
Olive is belongs to the the family Oleaceae, native to the coastal areas of the eastern Mediterranean Basin and south end of the Caspian Sea. Its fruit, is also called the olive and the source of olive oil.
Consumption of extra virgin olive oil (EVOO) was found to decrease joint edema, cell migration, cartilage degradation and bone erosion throguh attenuate the levels of proinflammatory cytokines and prostaglandin E2(108). according joint study by the University of Seville.

In adult male Balb/C mice study, olive oil decreased the second phase of formalin-induced pain through its antinociceptive and anti-inflammatory activity(109).

The Chemistry and health of olive oil phenolics study also found the the positive effects of olive oil phenolics on certain physiological parameters, such as plasma lipoproteins, oxidative damage, inflammatory markers, platelet and cellular function, etc,.....(110).

4. Salmon
Salmon with rich in Omega 3 fatty acids reduce risk of expression of markers and attenuate the inflammatory response of the immune system, according to the study by the Tufts University(111).

High saturated fat diets with low omega 3 fatty acid intake increased omega-6:EPA+DHA ratio diets causing some measures of inflammation(112).

5. Circuit fruits
Circuit fruits containing high amount of Quercetin can reduce risk of chronic inflammatory diseases through anti inflammatory(113) and antioxidant effects(114).

(103) Effect of soy nuts and equol status on blood pressure, lipids and inflammation in postmenopausal women stratified by metabolic syndrome status by Acharjee S1, Zhou JR2, Elajami TK1, Welty FK3.(PubMed)

(104) Effect of soy nuts on adhesion molecules and markers of inflammation in hypertensive and normotensive postmenopausal women by Nasca MM1, Zhou JR, Welty FK.(PubMed)

(105) Green tea polyphenols attenuate deterioration of bone microarchitecture in female rats with systemic chronicinflammation. by Shen CL1, Yeh JK, Samathanam C, Cao JJ, Stoecker BJ, Dagda RY, Chyu MC, Dunn DM, Wang JS.(PubMed)

(106) Evaluation of the anti-inflammatory and analgesic effects of green tea (Camellia sinensis) in mice by Mota MA1, Landim JS1, Targino TS1, Silva SF1, Silva SL1, Pereira MR1(PubMed)

(107) Immunomodulatory effects of decaffeinated green tea (Camellia sinensis) on the immune system of rainbow trout (Oncorhynchus mykiss). by Sheikhzadeh N1, Nofouzi K, Delazar A, Oushani AK.(PubMed)

(108) Anti-inflammatory and joint protective effects of extra-virgin olive-oil polyphenol extract in experimental arthritis by Rosillo MÁ1, Alcaraz MJ2, Sánchez-Hidalgo M1, Fernández-Bolaños JG3, Alarcón-de-la-Lastra C1, Ferrándiz ML4.(PubMed)

(109) Antinociceptive and anti-inflammatory effects of olive oil (Olea europeae L.) in mice. by Eidi A1, Moghadam-kia S, Moghadam JZ, Eidi M, Rezazadeh S.(PubMed)

(110) Chemistry and health of olive oil phenolics by Cicerale S1, Conlan XA, Sinclair AJ, Keast RS.(PubMed)

(111) In vitro fatty acid enrichment of macrophages alters inflammatory response and net cholesterol accumulation by Wang S1, Wu D, Lamon-Fava S, Matthan NR, Honda KL, Lichtenstein AH.(PubMed)

(112) Reduction in dietary omega-6 polyunsaturated fatty acids: eicosapentaenoic acid plus docosahexaenoic acid ratio minimizes atherosclerotic lesion formation and inflammatory response in the LDL receptor null mouse by Wang S1, Wu D, Matthan NR, Lamon-Fava S, Lecker JL, Lichtenstein AH.(PubMed)

(113) In vivo quercitrin anti-inflammatory effect involves release of quercetin, which inhibits inflammation through down-regulation of the NF-kappaB pathway by Comalada M1, Camuesco D, Sierra S, Ballester I, Xaus J, Gálvez J, Zarzuelo A.(PubMed)

(114) Health effects of quercetin: from antioxidant to nutraceutical by Boots AW1, Haenen GR, Bast A.(PubMed)

Saturday, 19 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Do and do not’s list

The Prevention and management

The Do and do not’s list
People may want to know what they can do to protect themselves against the early onset.

1. Reduce intake of saturated and trans fat and increase intake of omega 3 fatty acids

Limited studies have conform the effectiveness of dietary fatty acids (ie, oleic acid and alpha-linolenic acid) in reduced biomarkers of inflammation(91).
Dr. Li Z and the research team at the Jilin University showed that ω3-polyunsaturated fatty acids (ω3-PUFAs) not only have beneficial effects on cardiiovascular function but also promoted the docosahexaenoic acid (DHA) in reduced inflammative risk(93).

The results of over 13 double-blind, placebo-controlled studies involving a total of more than 500 people suggest that omega-3 fatty acids may improve symptoms of rheumatoid arthritis. It appears to work is by decreasing the production of inflammatory chemicals(94).

2. Increasing the ratio of (n-3) : (n-6) PUFA
The industrial elocution induced Western style diet in over consumption of ω6 polyunsaturated fatty acids (PUFA) over many decades has been found to distort the ratio of ω3:ω6 fatty acids, one of the leading cause of chronic inflammatory diseases, including Polymyalgia Rheumatica(PMR)(92).
Increased ratio of (n-6) : (n-3) PUFA are found to promote chronic inflammatory diseases such as nonalcoholic fatty liver disease (NAFLD), cardiovascular disease, obesity, inflammatory bowel disease (IBD), rheumatoid arthritis, and Alzheimer’s disease (AD)(95).

3. Increase intake of fruit and vegetable
Consumption of fruit and vegetable is found to associate in reduced the over expression of inflammation and oxidative stress of that have found to induced chronic inflammatory diseases risk of stroke, coronary heart disease, etc,...(96)

A cross-sectional study of ≈1200 Puerto Rican adults aged 45-75 y, in assessed FV intake with a food-frequency questionnaire, suggested, but not quantity, appears to be important in reducing inflammation(97).

3. Avoid high glycemic index diets
High glycemic index diets with low fiber content are rich in trans fat has showed to induce over activation of the immune system, causing excessive production of pro-inflammatory cytokines of that promoting inflammatory diseases(98).

4. Reduced intake of pro inflammatory foods, such as sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc,.... According to the study by University of Hertfordshire Over consumption of fat content, especially from saturated fat, and cholesterol and reduced the intake of whole-grain foods, fruits, and vegetables, accompanied with the high amount of sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc. in Western diet are found to be the leading causes of metabolic syndrome(99) inducing risk of chronic inflammatory diseases(100).

5. Increase in take of anti inflammatory foods, such as fresh vegetables and fruits, seeds and sprouts whole grain, fish, turkey, chicken, legumes, etc(98).

6. Stop smoking
Smoking is associated with 39% of risk of Polymyalgia Rheumatica(101), according to the study of 28 patients with RS3PE and 123 with pure PMR by the Kameda Medical Center.

7. Moderate exercise
Moderate exercise enhances immune function in fighting against inflammation and and reduced inflammatory (interleukin-6 [IL-6], C-reactive protein [CRP]) markers in attenuated risk of
Polymyalgia Rheumatica(PMR)(102).

8. Etc.

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You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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REFERENCES
(91) The effect of weight loss and dietary fatty acids on inflammation by Devaraj S1, Kasim-Karakas S, Jialal I.(PubMed)
(92) Effects of the Dietary ω3:ω6 Fatty Acid Ratio on Body Fat and Inflammation in Zebrafish (Danio rerio). by Powell ML1, Pegues MA2, Szalai AJ2, Ghanta VK3, D'Abramo LR4, Watts SA3.(PubMed)
(93) ω3-polyunsaturated fatty acids suppress lipoprotein-associated phospholipase A2 expression in macrophages and animal models vt Li Z1, Ren W1, Han X1, Liu X1, Wang G1, Zhang M1, Pang D1, Ouyang H1, Tang X1.(PubMed)
(94) Overview of Omega-3 Fatty Acid Therapies by J. Chris Bradberry, PharmD and Daniel E. Hilleman, PharmD(PubMed)
(95) Health implications of high dietary omega-6 polyunsaturated Fatty acids by Patterson E1, Wall R, Fitzgerald GF, Ross RP, Stanton C.(PubMed)
(96) Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents by Holt EM1, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, Hong CP, Sinaiko AR.(PubMed)
(97) Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults. by Bhupathiraju SN1, Tucker KL.(PubMed)
(98) [Role of diet on chronic inflammation prevention and control - current evidences].[Article in Portuguese] by Geraldo JM1, Alfenas Rde C.(PubMed)
(99) [Dietary factors and metabolic syndrome].[Article in Portuguese] by Steemburgo T1, Dall'Alba V, Gross JL, Azevedo MJ.(PubMed)
(100) A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolicsyndrome by Xiao S1, Fei N, Pang X, Shen J, Wang L, Zhang B, Zhang M, Zhang X, Zhang C, Li M, Sun L, Xue Z, Wang J, Feng J, Yan F, Zhao N, Liu J, Long W, Zhao L.(PubMed)
(101) Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica by Kimura M1, Tokuda Y, Oshiawa H, Yoshida K, Utsunomiya M, Kobayashi T, Deshpande GA, Matsui K, Kishimoto M.(PubMed)
(102) A Systematic Review of the Acute Effects of Exercise on Immune and Inflammatory Indices in Untrained Adults by Brown WM1, Davison GW1, McClean CM1, Murphy MH1.(PubMed)

Most Common Disease of 50 plus: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): Misdiagnosis and delay diagnosis

The Misdiagnosis and delay diagnosis

Polymyalgia rheumatica (PMR) is a very painful inflammatory disease, affecting the shoulder region and the pelvic girdle region in people over 50 year of age. But according to Dr, Talke M and Dr. Schmidt WA. said" the misdiganosis is common, .....taking a structured medical history and performing a thorough clinical examination are crucial" and "patient with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels should be investigated particularly in patients who present with new onset bilateral shoulder pain and pronounced general impairment of movement"(84).

1. Spondyloarthropathy

Late onset of pondyloarthropathy, a disease characterized as a joint disease of the vertebral column is often misdiagnosed as Polymyalgia Rheumatica(PMR). According to the centre hospitalier d'Aulnay-sous-Bois, eight patients with spondyloarthropathy with poor response to corticosteroids and multiple flares,were misdiagnosed as PMR(85). The Gaziantep University study also showed the similarities of pondyloarthropathy and PMR in a patient of 50 year of age(86).

2. Osteoarthritis of the shoulders

Osteoarthritis of the shoulders in some case may be wrongly diagnosis as PMR due to the relapse of the symptoms of similarity in both diseases(87), According to the Istituto di Ricovero e Cura a Carattere Scientifico, patients with PMR and pain in the shoulder is alo hound in 2 patients with spinal osteoarthritis(88).

3. Calcifying tendinitis of the rotator cuff
Calcifying tendinitis is disease characterized by a building-up of calcium in the rotator cuff (calcific deposit) in some case may be misdianosed as PMR(87).

4. Bursitis
Bursitis is an inflammation of a bursa of the knee, elbow or shoulder in some cases may be misdiagnosed as PMR(87). According to Asklepios Clinic, in the investigation of 54 consecutive patients with recent-onset PMR, over 30% with Subdeltoid bursitis(89).

5. Rheumatoid arthritis
Rheumatoid arthritis, a chronic inflammatory rheumatic diseases, found most often in the people age of 50 and over may be misdiagnosed as PMR(87). According to the Università di Pavia, the percentage of patient diagnosed with RA and PMR often change in first and during follow up diagnosis(90) due to like onset of patient with PMR.

(85) [Late onset spondyloarthropathy misdiagnosed as polymyalgia rheumatica].[Article in French] by Kouassi Djaha JM1, Jenvrin C, Dupont MP, Steiner J, de Bandt M.(PubMed)

(86) Late onset spondyloarthropathy mimicking polymyalgia rheumatica by Aydeniz A1, Altındağ O, Oğüt E, Gürsoy S.(PubMed)

(87) [Polymyalgia rheumatica in daily routine practice].[Article in German] by Talke M1, Schmidt WA(PubMed)

(88) Lumbar interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Boiardi L, Pipitone N, Bajocchi GL, Macchioni PL, Catanoso M, Pazzola G, Valentino M, De Luca C, Hunder GG.(PubMed)

(89) Joint involvement in patients with early polymyalgia rheumatica using high-resolution ultrasound and its contribution to the EULAR/ACR 2012 classification criteria for polymyalgia rheumatica by Weigand S1, Ehrenstein B, Fleck M, Hartung W.(PubMed)

(90) Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: a prospective study by Caporali R1, Montecucco C, Epis O, Bobbio-Pallavicini F, Maio T, Cimmino MA.(PubMed)

Friday, 18 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Diagnosis

The Diagnosis

There is no specific test to diagnose polymyalgia rheumatica. If you are over age of 60 with some of the symptoms mentioned above without joint swelling, Joint tenderness, decreased range of motion in joints, Visible joint damage, etc., you may be already on the early onset of Polymyalgia Rheumatica(PMR)
Dr. Loeslie V said, ..." diagnosis of rheumatologic disorders in the elderly is often complicated " (due to) "clinician’s inability to differentiate among similar manifestations of rheumatologic disorders, the presence of comorbid conditions, and symptoms attributed simply to aging"(76).

1. Blood test
a. Erythrocyte sedimentation rate (ESR) is the blood test to exam the red blood cells in a test tube. he higher the ESR value is an indication of inflammation. Requisite indication of erythrocyte sedimentation rate (ESR)>40 mm/h is considered an important for the diagnosis of polymyalgia rheumatica (PMR)(78). Error reading may occur, normal erythrocyte sedimentation rate (ESR) reading has found to presence to approximately one-fifth of all PMR patients, more commonly in men(77). A patient with PMR with an ESR lower than 40 mm/h is rare but has happened to men of that represent a clinically less severe than the classic form of PMR(78).

b. C-reactive protein (CRP)
Blood test measures the levels of C-reactive protein (CRP) produced by the liver in response to an injury or infection and people with polymyalgia rheumatic.Patient with PMR are associated to elevation of levels of both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)(79).

c. Blood test for thrombocytes
Patient with polymyalgia rheumatica have an unusually high number of thrombocytosis. On the other hand, People with anemic polymyalgia rheumatica have a lower number of red blood cells than normal. The associated of thrombocytosis acted as an inflammation parameter to rheumatic diseases such as Rheumatic Polymyalgia is found to be correlated to disease activity(81)

d. Rheumatoid factor (RF)
RF is an antibody, a protein made by the immune system presented in the blood of people with rheumatoid arthritis, but not in the blood of people with polymyalgia rheumatica(82).

2. Biopsy
Polymyalgia rheumatica is often associated with giant cell arteritis with biopsy by taking a small sample from the scalp artery in the emporal artery and examined under a microscope in a laboratory(83). The biopsy would be helpful to rule the presence of giant cell arteritis through observation of abnormal cells in the artery walls

The Southend University Hospital diagnosed criteria of PMR include "patients ≥50 years old presenting with bilateral shoulder pain, not better explained by an alternative pathology, can be classified as having PMR in the presence of morning stiffness >45 minutes, elevated C-reactive protein and/or erythrocyte sedimentation rate, and new hip pain"(80).

(76) Pain in the elderly: polymyalgia rheumatica by Loeslie V1.(PubMed)

(77) Polymyalgia rheumatica in patients with a normal erythrocyte sedimentation rate by Helfgott SM1, Kieval RI.(PubMed)

(78) Polymyalgia rheumatica without significantly increased erythrocyte sedimentation rate. A more benign syndrome by González-Gay MA1, Rodríguez-Valverde V, Blanco R, Fernández-Sueiro JL, Armona J, Figueroa M, Martínez-Taboada VM.(PubMed)
(79) Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica by Nothnagl T1, Leeb BF.(PubMed)
(80) 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative by Dasgupta B1, Cimmino MA, Kremers HM, Schmidt WA, Schirmer M, Salvarani C, Bachta A, Dejaco C, Duftner C, Jensen HS, Duhaut P, Poór G, Kaposi NP,Mandl P, Balint PV, Schmidt Z, Iagnocco A, Nannini C, Cantini F, Macchioni P, Pipitone N, Del Amo M, Espígol-Frigolé G, Cid MC, Martínez-Taboada VM,Nordborg E, Direskeneli H, Aydin SZ, Ahmed K, Hazleman B, Silverman B, Pease C, Wakefield RJ, Luqmani R, Abril A, Michet CJ, Marcus R, Gonter NJ, Maz M,Carter RE, Crowson CS, Matteson EL.(PubMed)

Thursday, 17 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Complications(2)

The Complications(2)

The Most common complications for people with Polymyalgia Rheumatica(PMR)
1. Ischemic complications
Patient with Polymyalgia Rheumatica(PMR) are found to have an lower risk of developing ischemic events, according to University of Barcelona(63). Dr. Narváez J and the research team at the joint study lead by Hospital Universitario de Bellvitge-IDIBELL said," Patients with GCA presenting with apparently isolated PMR have a significant risk of developing transient or permanent disease-related ischemic complications" and "these complications occurred in 50% of the cases"(64). Some patient of PMR with thrombocytosis also are found to at greatest risk for the development of stroke as well(65).

2. Vascular events
DR. Staud R. said," Patients with polymyalgia rheumatica had a 2.6-fold increased risk for vascular events at a median 7.8 y"(66). Youngest age groups patient with Polymyalgia Rheumatica(PMR) are associated to the greatest risk of vascular events in comparison to other age group(67).

3. Interspinous bursitis

Interspinous bursitis, a frequent finding in the lumbar spine of patients with PMR is found to have a potential cause of spinal symptoms probably due to the presence of cervical and lumbar bursitis(68). Other study suggested that the complications of low back pain reported by patients with PMR may also be result of Inflammation of lumbar bursae, the Istituto di Ricovero e Cura a Carattere Scientifico study suggested(69).

4. Shoulder inflammation

Shoulder inflammation is found common in 50%patient with PMR(70). But according to the research lead by Dr. Curran JF , shoulder arthritis may be result of inflammatory, degenerative, and septic arthritis and rarely the initial joint involved in rheumatoid arthritis and generally the symptoms is respond to the basic management for rheumatoid arthritis(71).

5. Stress fractures
One of the complication of rheumatic disease, including Polymyalgia Rheumatica(PMR) may often be delayed or missed in diagnosis, leading to improper treatment, the Sourasky Medical Center suggested(72). Dr. Mäenpää HM and the research team at the Rheumatism Foundation Hospital said,"a patient with rheumatic disease experiences sudden and unexplained pain localised in the forefoot, above the ankle, below the knee, or in the pelvis, a stress fracture should be suspected"(73).

6. Infection diseases
Patient with Polymyalgia Rheumatica(PMR) are found to be susceptible to the complications of infectious diseases, such as Chronic Epstein-Barr virus infection(74), Mycoplasma pneumoniae infection(75),........

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

REFERENCES
(63) Development of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica: study of a series of 100 patients by Hernández-Rodríguez J1, Font C, García-Martínez A, Espígol-Frigolé G, Sanmartí R, Cañete JD, Grau JM, Cid MC.(PubMed)
(64) Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica by Narváez J1, Estrada P2, López-Vives L2, Ricse M2, Zacarías A2, Heredia S2, Gómez-Vaquero C2, Nolla JM2.(PubMed)
(65) Thrombocytosis in polymyalgia rheumatica: an additional diagnostic criterion and possible risk factor for ischemic complications?by Harten P, Seyfarth B, Löffler H.(PubMed)
(66) Patients with polymyalgia rheumatica had a 2.6-fold increased risk for vascular events at a median 7.8 y by Staud R.(PubMed)
(67) Risk of vascular events in patients with polymyalgia rheumatica by Hancock AT1, Mallen CD2, Muller S1, Belcher J1, Roddy E1, Helliwell T1, Hider SL1.(PubMed)
(68) Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain by Camellino D, Paparo F, Morbelli S, Cutolo M, Sambuceti G, Cimmino MA.(PubMed)
(69) Lumbar interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Boiardi L, Pipitone N, Bajocchi GL, Macchioni PL, Catanoso M, Pazzola G, Valentino M, De Luca C, Hunder GG.(PubMed)
(70)Shoulder arthritis. Distinguishing among the many causes of inflammation by Ellman MH, Brown NL, Curran JJ.(PubMed)
(71) Rheumatologic aspects of painful conditions affecting the shoulder by Curran JF, Ellman MH, Brown NL.(PubMed)
(72) Insufficiency fractures in rheumatic patients: misdiagnosis and underlying characteristics by Elkayam O1, Paran D, Flusser G, Wigler I, Yaron M, Caspi D.(PubMed)
(73) Insufficiency fractures in patients with chronic inflammatory joint diseases by Mäenpää HM1, Soini I, Lehto MU, Belt EA.(PubMed)
(74) "Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica by Buchwald D1, Sullivan JL, Leddy S, Komaroff AL.(PubMed)
(75) Synchronous variations of the incidence of temporal arteritis and polymyalgia rheumatica in different regions of Denmark; association with epidemics of Mycoplasma pneumoniae infection by Elling P1, Olsson AT, Elling H.(PubMed)

Wednesday, 16 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Diseases associated To

Diseases associated with Polymyalgia Rheumatica(PMR)

1. Giant cell arteritis
Giant cell arteritis shares many similarities with Polymyalgia rheumatica, according to the statistics
Patient with Giant cell arteritis is associated to 50% higher risk of polymyalgia rheumatica. On the other hand, there are 20% risk of development of Giant cell arteritis in patient polymyalgia, rheumatica. But the clinical manifestations, the relationship between GCA and PMR is not yet clearly established(48).
Medication and therapies used for treatment of polymyalgia rheumatica are also found effectively for giant cell arteritis as well, including Corticosteroids and anti-interleukin-6 receptor therapy(50).

2. Autoimmune thyroid disease and thyroid diseases
Autoimmune thyroid disease is defined as a condition in which the immune system wrongly viewed the thyroid gland and hormones produced as a foreign substances, thereby, producing antibodies to destroy them. In a study of 250 patients with autoimmune thyroid disease, seven (2.8%) were found to have polymyalgia rheumatica. Female patient with age over 60 are found to have an increased risk of over 9.3% (49). Autoimmune thyroiditis is often related to Rheumatoid Arthritis due to other non-specific autoimmune organ diseases(51)

But according to the Service de Médecine Interne B, there is no evidences in support that the giant cell arteritis or polymyalgia rheumatica patients are at increased risk for hypothyroidism or hyperthyroidism(52)

3. Stroke
Besides cancer and heart diseases, stroke is the third leading cause of death. Approximate 1/4 of all stroke victims die as a direct result of the stroke or it's complications. The study of a total of 781 patients with PMR from the Taiwan Longitudinal Health Insurance Database between 2001 and 2005, patients with PMR are associated to an increased of stroke in comparison to controls(53).
Dr,.Hernández-Rodríguez J and the research team at the University of Barcelona suggested that Patients with GCA with apparently isolated PMR have a significant risk of developing ischemic complication(54).

4. Gastroesophageal reflux disease (GERD)
The prevalence of upper gastrointestinal (GI) diseases is increasing in subjects aged 65 years and over. Pathophysiological changes in esophageal functions that occur with aging may, at least in part, be responsible for the high prevalence of the disease. Use of medication of proton pump inhibitors (PPIs) are found to reduced risk of GERD in patient with polymyalgia rheumatica(55) in comparison to those without.

5. Vasculitis

Vasculitis is diseases associated to the inflammation of blood vessels. Patient with Polymyalgia Rheumatica(PMR) may present together with large vessel vasculitis (LVV) as a result of the inflammatory impact(56). Tocilizumab showed to improve symptoms of disease and inhibit inflammatory markers(57).Methotrexate effectively reduces relapse rate and lowers the cumulative dose of glucocorticoid therapy in patient with Polymyalgia Rheumatica(PMR)(58).

6. Peripheral vascular disease
Patient with Polymyalgia rheumatica, the most common inflammatory rheumatologic conditions in older adults are associated with an excess risk of vascular disease in comparison to the onset of vascular event in patients with and without polymyalgia rheumatica(59). Dr. Warrington KJ and the research team at the Mayo Clinic, Rochester said. "Patients with PMR appear to have an increased risk of PAD" in an inception cohort of all Olmsted County, Minnesota residents diagnosed with PMR between 1 January 1970 and 31 December 1999(60).

7. Renal function impairment
Renal function impairment may associate rarely to patient with Polymyalgia Rheumatica(PMR). Only a few cases of AA amyloidosis secondary to PMR have been described in the literary data bases,according to the King's College Hospital NHS Foundation Trust(61). Dr. Escribá A and the research team at the Hospital Universitario 12 de Octubre, also expressed concerns of several cases of systemic amyloidosis associated with polymyalgia rheumatica (PMR) caused by massive amyloid deposition(62).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

REFERENCES
(48) Polymyalgia Rheumatica by Ehab R Saad, MD, MA, FACP, FASN; Chief Editor: Herbert S Diamond, MD(Medscape)
(49) Autoimmune thyroid disease and the polymyalgia rheumatica-giant cell arteritis syndrome by Dent RG, Edwards OM.(PubMed)
(50) Giant cell arteritis and polymyalgia rheumatica: an update by González-Gay MA1, Pina T.(PubMed)
(51) [Chronic autoimmune thyroiditis and connective tissue system diseases].[Article in Slovak]by Macejová Z1, Benhatchi K, Lazúrová I.(PubMed)
(52) [Prevalence of hypothyroidism and hyperthyroidism in temporal arteritis and rhizomelic pseudopolyarthritis. A controlled study of 104 cases].[Article in French] by Juchet H1, Labarthe MP, Ollier S, Vilain C, Arlet P.(PubMed)
(53) Polymyalgia rheumatica and the risk of stroke: a three-year follow-up study by Kang JH1, Sheu JJ, Lin HC.(PubMed)
(54) Development of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica: study of a series of 100 patients by Hernández-Rodríguez J1, Font C, García-Martínez A, Espígol-Frigolé G, Sanmartí R, Cañete JD, Grau JM, Cid MC(PubMed)
(55) Estimation of the symptoms for GERD by GerdQ in the patients with rheumatic diseases by Nozaki Y1, Kinoshita K1, Ri J1, Sakai K1, Shiga T1, Hino S1, Hirooka Y1, Sugiyama M1, Funauchi M1, Matsumura I1.(PubMed)
(56) (18)F-FDG PET/CT for the detection of large vessel vasculitis in patients with polymyalgia rheumatica by Lavado-Pérez C1, Martínez-Rodríguez I2, Martínez-Amador N1, Banzo I1, Quirce R1, Jiménez-Bonilla J1, De Arcocha-Torres M1, Bravo-Ferrer Z1, Jiménez-Alonso M1, López-Defilló JL1, Blanco R3, González-Gay MA3, Carril JM1.(PubMed)
(57) Tocilizumab for the treatment of large-vessel vasculitis (giant cell arteritis, Takayasu arteritis) and polymyalgia rheumatica by Unizony S1, Arias-Urdaneta L, Miloslavsky E, Arvikar S, Khosroshahi A, Keroack B, Stone JR, Stone JH.(PubMed)
(58) Methotrexate treatment in large vessel vasculitis and polymyalgia rheumatica by Spies CM1, Burmester GR, Buttgereit F.(PubMed)
(59) Risk of vascular events in patients with polymyalgia rheumatica by Hancock AT1, Mallen CD2, Muller S1, Belcher J1, Roddy E1, Helliwell T1, Hider SL1.(PubMed)
(60) Increased risk of peripheral arterial disease in polymyalgia rheumatica: a population-based cohort study by Warrington KJ1, Jarpa EP, Crowson CS, Cooper LT, Hunder GG, Matteson EL, Gabriel SE.(PubMed)
(61) Rapid development of renal failure secondary to AA-type amyloidosis in a patient with polymyalgia rheumatica by Javaid MM1, Kamalanathan M, Kon SP.(PubMed)
(62) Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica by Escribá A1, Morales E, Albizúa E, Herrero JC, Ortuño T, Carreño A, Dominguez-Gil B, Praga M.(PubMed)

Tuesday, 15 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Complications(1)

The Complications(1)

Patient with Polymyalgia Rheumatica(PMR) are limited to number daily physical functions and daily physical activities in most cases, according to Keele University and Mayo Clinic, the primary complications of PMR patients aref pain, stiffness and functioning(33)(34). Other more prevalence of complications of Polymyalgia Rheumatica(PMR) may include

1. Visual loss

Due to the nature of an inflammatory vasculopathy that involves large- and medium-sized arteries, patient with Polymyalgia Rheumatica(PMR) are associated to the complication of visual loss, according to the study by Dr. Schmidt J and Dr. Warrington KJ.(35). Dr.Hart FD. in the study of Visual complications of polymyalgia rheumatica (polymyalgia arteritica) siad," patients with polymyalgia rheumatica (polymyalgia arteritic) developed evidence of cranial arteritis (in one case two years and in one six months) following withdrawal of steroid therapy after apparent cure"(36).

2. Stroke
Polymyalgia rheumatica (PMR), a relatively common rheumatic disease, particularly in the elderly effecting the medium and large arteries causes of stroke(35). According to Taipei Medical University, PMR was associated with a significantly higher risk of stroke in the three-year follow-up period, in a study included 781 patients with PMR from the Taiwan Longitudinal Health Insurance Database between 2001 and 2005(37).

Dr. Narváez J and the research team at the Hospitalet de Llobregat said,"Patients with GCA presenting with apparently isolated PMR have a significant risk of developing transient or permanent disease-related ischemic complications; these complications occurred in 50% of the cases"(38).

3. Low back pain

Interspinous bursitis associated with lower back pain, a frequent finding in the lumbar spine of patients with PMR may be as a result of Inflammation of lumbar bursae, according to Istituto di Ricovero e Cura a Carattere Scientifico in the finding by using magnetic resonance imaging (MRI)(39). The joint study lead by the University of Cantabri said,"The most common clinical manifestations at diagnosis were: PMR features, often with atypical clinical presentation (n=23 patients, 72%); diffuse lower limb pain (n=16 patients, 50%); constitutional symptoms (n=12 patients, 37%), inflammatory low back pain (n=9 patients, 28%) and fever (n=7 patients, 22%)(40).

4. Cervical interspinous bursitis
Cervical interspinous bursitis, an active inflammatory involvement of cervical bursae is likely to cause discomfort in the neck of patients(41) and also a frequent finding in the lumbar spine of patients with PMR(42). Although it is not associated with clinical symptoms, it has been found to associate to the spinal pain reported by the patients(42).

5. Renal failure

Patient with Polymyalgia rheumatica (PMR) may be important of monitoring renal function due to renel failure is found to associate to a few cases of AA amyloidosis(43), the King's College Hospital NHS Foundation Trust suggested.

According to the reports of Hospital Universitario 12 de Octubre, "two patients with PMR (one with associated GCA) who developed nephrotic syndrome and end-stage renal failure caused by massive amyloid deposition"(44)

6. Perforated colonic diverticular disease

The association of Polymyalgia Rheumatica(PMR) and perforated colonic diverticular disease may be result of proinflammatory expression and high incidence of other co-morbidities including colonic pathology(45), according to the joint study lead by the James Paget University Hospital.

7. Cancers

The investigation of a total of 185 patients with polymyalgia rheumatica (PMR) and temporal arteritis (TA) diagnosed during 1978-83 and their 925 matched controls with the data files at the Cancer Registry of Norway at the end of 1987, indicated that the malignancy of cancer are found to associate with 24% in patient with PMR(46).

Dr. Ji J and the research team at the Lund University said," Patients hospitalized for PMR and GCA had a marginally increased risk of cancer, with the highest risk noted for the first year after hospitalization. However, for specific cancers, such as skin cancer and leukaemia, the increases were still significant for patients diagnosed later than 1 year after hospitalization"(47).

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REFERENCES
(33) The epidemiology of polymyalgia rheumatica in primary care: a research protocol.by Muller S1, Hider S, Helliwell T, Bailey J, Barraclough K, Cope L, Dasgupta B, Foskett R, Hughes R, Mayson Z, Purcell C, Roddy E, Wathall S, Zwierska I, Mallen CD.(PubMed)
(34) Patient-reported outcomes in polymyalgia rheumatica. by Matteson EL1, Maradit-Kremers H, Cimmino MA, Schmidt WA, Schirmer M, Salvarani C, Bachta A, Dejaco C, Duftner C, Slott Jensen H, Poór G, Kaposi NP,Mandl P, Balint PV, Schmidt Z, Iagnocco A, Cantini F, Nannini C, Macchioni P, Pipitone N, Del Amo M, Espígol-Frigolé G, Cid MC, Martínez-Taboada VM,Nordborg E, Direskeneli H, Aydin SZ, Ahmed K, Hazelman B, Pease C, Wakefield RJ, Luqmani R, Abril A, Marcus R, Gonter NJ, Maz M, Crowson CS, Dasgupta B.(PubMed)
(35) Polymyalgia rheumatica and giant cell arteritis in older patients: diagnosis and pharmacological management by Schmidt J1, Warrington KJ.(PubMed)
(36) Visual complications of polymyalgia rheumatica (polymyalgia arteritica) by Hart FD(PubMed)
(37) Polymyalgia rheumatica and the risk of stroke: a three-year follow-up study by Kang JH1, Sheu JJ, Lin HC.(PubMed)
(38) Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica by Narváez J1, Estrada P2, López-Vives L2, Ricse M2, Zacarías A2, Heredia S2, Gómez-Vaquero C2, Nolla JM2.(PubMed)
(39) Lumbar interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Boiardi L, Pipitone N, Bajocchi GL, Macchioni PL, Catanoso M, Pazzola G, Valentino M, De Luca C, Hunder GG(PubMed)
(40) Non-infectious aortitis: a report of 32 cases from a single tertiary centre in a 4-year period and literature review by Loricera J1, Blanco R1, Hernández JL2, Carril JM3, Martínez-Rodríguez I3, Canga A4, Peiró E1, Alonso-Gutiérrez J2, Calvo-Río V1, Ortiz-Sanjuán F1, Mata C1,Pina T1, González-Vela MC5, Martínez-Amador N3, González-Gay MA6.(PubMed)
(41) Cervical interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Cantini F, Niccoli L, Boiardi L, Valentino M, Pipitone N, Bajocchi G, Macchioni P, Catanoso MG, Olivieri I, Hunder GG.(PubMed)
(42) Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain by Camellino D, Paparo F, Morbelli S, Cutolo M, Sambuceti G, Cimmino MA.(PubMed)
(43) Rapid development of renal failure secondary to AA-type amyloidosis in a patient with polymyalgia rheumatica by Javaid MM1, Kamalanathan M, Kon SP.(PubMed)
(44) Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica by Escribá A1, Morales E, Albizúa E, Herrero JC, Ortuño T, Carreño A, Dominguez-Gil B, Praga M.(PubMed)
(45) Presentations of perforated colonic pathology in patients with polymyalgia rheumatica: two case reports by de Silva P1, Pranesh N, Vautier G.(PubMed)
(46) Cancer in association with polymyalgia rheumatica and temporal arteritis by Haga HJ1, Eide GE, Brun J, Johansen A, Langmark F.(PubMed)
(47) Cancer risk in patients hospitalized with polymyalgia rheumatica and giant cell arteritis: a follow-up study in Sweden by Ji J1, Liu X, Sundquist K, Sundquist J, Hemminki K.(PubMed)