Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: Medication and Surgical Treatment in Conventional Medicine Perspectively

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).


                            The Treatment

A. In conventional medicine 

2. Medication

Medication or combined medication are used to stop the progression and relieve the symptoms of the diseases may include
2.1. Medication for reduced symptoms
Nonsteroidal anti-inflammatory drugs (NSAIDs)can be bought as over counter medicine for reduced pain and inflammation for patient with rheumatoid arthritis with an incidence of significant upper GI toxic effects, according to a total of 8059 patients (>/=18 years old) with osteoarthritis (OA) or rheumatoid arthritis (RA)(186). Dr. Wienecke T and Dr. Gøtzsche PC. in the comparison of NSAIDs and Paracetamol for treatment of RA said " There is a need for a large trial, with appropriate randomisation, double-blinding, test of the success of the blinding, and with explicit methods to measure and analyse pain and adverse effects"(187) due to favorable of onsteroidal anti-inflammatory drugs (NSAIDs) in general population.

2.2. Medication for interfering the disease progression
a. Corticosteroids

Corticosteroid, a class a class of chemicals including the steroid hormones medication prednisone, prednisolone and methyprednisolone have been used in conventional medicine for quick treatment of inflammatory diseases such as rheumatoid arthritis, through reduced in activity and expression as a result of oxidative/nitrative stress(188). The University de Montréal joint study of 838 patient indicated the effectiveness of corticosteroids for treatment of inflammation of RA may accompany with increased hazard of infection(189), risk for the development of secondary osteoporosis(190) and dyslipidemia and hypertension(192). adrenal suppression, bone loss, skin thinning, increased cataract formation, decreased linear growth in children, metabolic changes, and behavioral abnormalities(191).

b. DMARDs, (Disease-modifying antirheumatic drugs)

DMARDs,  a disease-modifying antirheumatic drug such as methotrexate, hydroxycholorquine, sulfasalazine, leflunomide used by conventional doctor to modify the course of the disease(RA in this case) by releasing 4 h later to coincide with the rise of nocturnal inflammatory cytokines associated with development of symptoms of RA(192). According to the report of Dr. Sitzia J and Dr. Huggins L. the adverse effects of DMARDs may include  alopecia, fatigue, weight gain with fatigue and nausea to be the "most troublesome" problems, followed by difficulty sleeping and sore eyes(193), as well as other incidences of gastrointestinal side effects(194).

c. Biologics 

Biologics  including abatacept, adalimumab, anakinra, certolizumab pegol, etanercept, infliximab, golimumab and rituximab works with similar effects as DMARDs but more quickly in blocking  a specific step in the inflammation process, such as blocking the activation of T cells(197), B cells(198), pro inflammatory cytokines(199),...... have found significantly improved outcomes for patients with rheumatoid arthritis(195), through reducing the signs and symptoms of RA, slowing radiographic progression of joint destruction, and improving physical function and quality of life in patients with RA(196).

d. JAK inhibitors 
JAK inhibitors, the medication used in conventional doctors for inhibition of the activity of one or more of the Janus kinase family of enzymes, involving function in cytokine receptor signalling pathway, through interaction with signal transducers(transmission of molecularsignals from a cell's exterior to its interior) and activators of transcription proteins(a sequence-specific DNA-binding factor in controlling the rate of transcription of genetic information from DNA to messenger RNA)(200) is also known as a new subcategory of DMARDs. Dr. Norman P. said" JAK inhibitors differ in isoform specificity profiles, with good efficacy achievable by selective inhibition of either JAK1 (filgotinib or INCB-039110) or JAK3 (decernotinib)' of that contrite to the effective treatment of patient with rheumatoid arthritis)(201). According to the University of Occupational and Environmental Health, use of Tofacitinib, a new class of DMARDs orally available exhibited a strong clinical efficacy similar to biologic DMARDs through inhibited multiple cytokines and signaling pathways at clinical doses that are in contrast to biological DMARDs(202).

Here, we quoted the criteria of medication or combined medication is used to stop the progression and relieve the symptoms of RA by Dr. da Mota LM, and scientists at the Universidade de Brasília
1) The therapeutic decision should be shared with the patient;
2) Immediately after the diagnosis, a disease-modifying antirheumatic drug (DMARD) should be prescribed, and the treatment adjusted to achieve remission;
3) Treatment should be conducted by a rheumatologist;
4) The initial treatment includes synthetic DMARDs;
5) Methotrexate is the drug of choice;
6) Patients who fail to respond after two schedules of synthetic DMARDsshould be assessed for the use of biologic DMARDs;
7) Exceptionally, biologic DMARDs can be considered earlier;
8) Anti-TNF agents are preferentially recommended as the initial biologic therapy; 9) after therapeutic failure of a first biologic DMARD, other biologics can be used;
10) Cyclophosphamide and azathioprine can be used in severe extra-articular manifestations;
11) Oral corticoid is recommended at low doses and for short periods of time;
12) Non-steroidal anti-inflammatory drugs should always be prescribed in association with a DMARD; 13) clinical assessments should be performed on a monthly basis at the beginning of treatment;
14) Physical therapy, rehabilitation, and occupational therapy are indicated;
15) Surgical treatment is recommended to correct sequelae;
16) Alternative therapy does not replace traditional therapy;
17) Family planning is recommended;
18) The active search and management of comorbidities are recommended;
19) The patient’s vaccination status should be recorded and updated;
20) Endemic-epidemic transmissible diseases should be investigated and treated.

3. Surgery
Surgery in some cases may be necessary to relieve severe pain and extensive joint deformities and with patient do not response to non and medical treatment. According to the Wrightington Hospital NHS Trust, in the study of postoperative infection or surgical complications occurring within one year of surgery in patient with RA found that the surgical procedure induced 27% of infection and complication for patient with  different in the intake of Methotrexate(204), a synthetic compound used for treatment of some forms of cancers.

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
References
(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)

(185) A randomized double-blind sham-controlled trial of the Prosorba column for treatment of refractory rheumatoid arthritis by Gendreau RM1; Prosorba Clinical Trial Group(PubMed)

(186) Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis andrheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study by Silverstein FE1, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, Makuch R, Eisen G, Agrawal NM, Stenson WF, Burr AM, Zhao WW, Kent JD, Lefkowith JB, Verburg KM, Geis GS.(PubMed)

(187) Paracetamol versus nonsteroidal anti-inflammatory drugs for rheumatoid arthritis by Wienecke T1, Gøtzsche PC.(PubMed)

(188) How corticosteroids control inflammation: Quintiles Prize Lecture 2005 by Barnes PJ1.(PubMed)

(189) Use of corticosteroids in patients with rheumatoid arthritis treated with infliximab: treatment implications based on a real-world Canadian population by Haraoui B1, Jovaisas A2, Bensen WG3, Faraawi R3, Kelsall J4, Dixit S3, Rodrigues J5, Sheriff M6, Rampakakis E7, Sampalis JS7, Lehman AJ8, Otawa S8,Nantel F8, Shawi M8.(PubMed)

(190) Adverse effects of corticosteroids on bone metabolism: a review by Mitra R1.(PubMed)

(191) Adverse effects of inhaled corticosteroids by Hanania NA1, Chapman KR, Kesten S.(PubMed)

(191) Adverse effects of corticosteroids on the cardiovascular system by Sholter DE1, Armstrong PW.(PubMed)

(192) Delayed-release prednisone improves fatigue and health-related quality of life: findings from the CAPRA-2 double-blind randomised study in rheumatoid arthritis by Alten R1, Grahn A2, Holt RJ3, Rice P4, Buttgereit F5.(PubMed)

(193) Side effects of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) chemotherapy for breast cancer by Sitzia J1, Huggins L.(PubMed)

(194) Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for rheumatoid arthritis by Shea B1, Swinden MV2, Ghogomu ET2, Ortiz Z2, Katchamart W2, Rader T2, Bombardier C2, Wells GA2, Tugwell P2.(PubMed)

(195) Biologics in rheumatoid arthritis: where are we going? by Fechtenbaum M1, Nam JL, Emery P.(PubMed)

(196) Use of biologics in rheumatoid arthritis: where are we going? by Pucino F Jr1, Harbus PT, Goldbach-Mansky R.(PubMed)

(197) [Efficacy and safety of abatacept in patients with rheumatoid arthritis and no prior treatment with biologics].[Article in Spanish] by Escudero Contreras A1, Castro-Villegas MC, Hernández-Hernández MV, Díaz-González F.(PubMed)

(198) Complement activation and C3b deposition on rituximab-opsonized cells substantially blocks binding of phycoerythrin-labeled anti-mouse IgG probes to rituximab by Beum PV1, Kennedy AD, Li Y, Pawluczkowycz AW, Williams ME, Taylor RP.(PubMed)

(199) Infections and biological therapy in rheumatoid arthritis by Cunnane G1, Doran M, Bresnihan B.(PubMed)

(200) Transcription factors: An overview by David S. Latchman(Science direct)

(201) Selective JAK inhibitors in development for rheumatoid arthritis by Norman P1.(PubMed)

(202) Targeting the Janus kinases in rheumatoid arthritis: focus on tofacitinib by Yamaoka K1, Tanaka Y.(PubMed)

(203) Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery by Grennan DM1, Gray J, Loudon J, Fear S.(PubMed)

(204) 2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis.[Article in English, Portuguese] by da Mota LM1, Cruz BA, Brenol CV, Pereira IA, Rezende-Fronza LS, Bertolo MB, de Freitas MV, da Silva NA, Louzada-Júnior P, Giorgi RD, Lima RA, da Rocha Castelar Pinheiro G; Brazilian Society of Rheumatology.(PubMed)

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: Non Medication Treatment in Conventional Medicine Perspectively

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

                                The Treatment

A. In conventional medicine perspective
The aim of treatment is to stop the progression and relieve the symptoms of the diseases
1. Non Medication
1.1.  Physical therapy 

Physical therapy with functions of  re mediated impairments and promoted mobility, used conjunction with others including education, medical treatment,and occupational therapy may play an essential role for management of RA(172). In the treatment of patient with RA using the Whole-body cryotherapy (WBC) in supplement to physical therapy, Dr. combination and the research team at the joint study lead by the University School of Physical Education in Poznań said" (The combined therapies showed )improvement in pain, disease activity, fatigue, time of walking, and the number of steps over a distance of 50 m,...... similar significant reduction in IL-6 and TNF-α level (the inflammatory cytokines),...regardless of the kind of the applied physical procedure in patient with RA(173). 

1.2. Relaxation therapy and biofeedback training
Relaxation and temperature biofeedback training as an adjunctive therapy has showed to alleviate both pain and stress-related symptoms as well as improvement of pain, tension, and sleep patterns. In fact, the therapy are found to induced higher physical/functional indices in comparison to physical therapy(174). Dr. Astin JA. and the research team at the University of Maryland School of Medicine suggested that psychological interventions such as relaxation, biofeedback, cognitive-behavioral therapy, may form an important part in may be important adjunctive therapies in the medical management of RA, especially for patients who have had the illness for shorter duration(175).In fact, a systematic review and meta-analysis of randomized controlled trials, also showed that psychological intervention improved both depressive symptoms and anxiety among patients with RA(176).

1.3. Low level laser therapy
Low level laser therapy may be beneficiary in modulated inflammatory response both in early as well as in late progression stages of RA, through its effects in significantly improved mononuclear inflammatory cells(177) as well as modulating inflammatory mediators (IL-1β, IL-6)(178). The study of 132 patients at the age varying from 18 to 85 years presenting with rheumatoid arthritis by Dr.Kulova LA, and Dr. Burduli NM also found thatn the therapy showed an improvement of the endothelial function and the microcirculation indices in patient with rheumatoid arthritis(179). But according to a randomized double-blind controlled trial laser therapy using low-level aluminum gallium arsenide was not effective at the wavelength, dosage, and power studied for the treatment of hands among patients with rheumatoid arthritis(180).

1.4. Occupational therapy
According to the Canadian association of occupation therapy, it is form of treatment  to solve the problems that interfere with your ability to do the things that are important to you. It can also prevent a problem or minimize its effects(181). According to the Netherlands Institute for Health Services Research, in controlled (randomized and non-randomized) and other than controlled studies (OD) addressing OT for RA patients showed that occupation therapy improved outcome on functional ability, social participation and/or health related quality of life(182). Rheumatologically, occupation therapy in many cases has successfully improved and maintained functional capacity, prevented progression of deformities, ......... of that may require for the engagement of the individual in meaningful occupations, favoring autonomy and independence in self-care activities, employment, educational, social and leisure(183)

1.5. Prosorba column apheresis therapy (PCT)
Prosorba column apheresis therapy (PCT), a medical device containnig purified staphylococcal protein A covalently bound to a silica matrix has been used in many medical centers for treatment severerheumatoid arthritis (RA) since its approval in 1999(184) with some promising result(185).
The therapy showed a 52% improvement in joint tenderness, 40% improvement in swelling, 42% improvement in patient's pain, 38% improvement in patient's global response, and 48% improvement in physician's global scores 76% of responders, according to the study by Cypress Bioscience(184).

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
References
(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)

(172) Juvenile rheumatoid arthritis: physical therapy and rehabilitation by Cakmak A1, Bolukbas N.(PubMed)

(173) Effects of Whole-Body Cryotherapy in Comparison with Other Physical Modalities Used with Kinesitherapy inRheumatoid Arthritis by Gizińska M1, Rutkowski R1, Romanowski W2, Lewandowski J3, Straburzyńska-Lupa A4.(PubMed)

(174) Rheumatoid arthritis: a study of relaxation and temperature biofeedback training as an adjunctive therapy by Achterberg J, McGraw P, Lawlis GF.(PubMed)
(175) Psychological interventions for rheumatoid arthritis: a meta-analysis of randomized controlled trials by Astin JA1, Beckner W, Soeken K, Hochberg MC, Berman B.(PubMed)
(176) Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials by Knittle K1, Maes S, de Gucht V.(PubMed)
(177) Low-level laser therapy in different stages of rheumatoid arthritis: a histological study by Alves AC1, de Carvalho PT, Parente M, Xavier M, Frigo L, Aimbire F, Leal Junior EC, Albertini R.(PubMed)
(178) Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation by Alves AC, Vieira R, Leal-Junior E, dos Santos S, Ligeiro AP, Albertini R, Junior J, de Carvalho P.(PubMed)
(179) [The influence of intravenous laser therapy on the endothelial function and the state of microcirculation in the patients presenting with rheumatoid arthritis].[Article in Russian] by Kulova LA, Burduli NM.(PubMed)
(180) Assessment of the effectiveness of low-level laser therapy on the hands of patients with rheumatoid arthritis: a randomized double-blind controlled trial by Meireles SM1, Jones A, Jennings F, Suda AL, Parizotto NA, Natour J.(PubMed)
(181) What is occupation therapy(Canadian association of occupation therapy)
(182) Occupational therapy for rheumatoid arthritis by Steultjens EM1, Dekker J, Bouter LM, van Schaardenburg D, van Kuyk MA, van den Ende CH.(PubMed)
(183) [Occupational therapy in rheumatoid arthritis: what rheumatologists need to know?].[Article in Portuguese] by de Almeida PH1, Pontes TB2, Matheus JP2, Muniz LF3, da Mota LM3.(PubMed)
(184) Effects of Prosorba column apheresis in patients with chronic refractory rheumatoid arthritis by
Roth S1(PubMed)

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: The Antioxidant

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

                             The Antioxidant

Antioxidants found abundantly in fruits and vegetables can enhance the immune system fighting against forming of free radicals causes of irregular cell growth and foreign invasion of inflammation and infection.
1. Vitamin C
Vitamin C, one of most powerful free radical scavengers, played an important role in prevention of domino effects of imbalance of estrogen may be a potent antioxidant effectively in normalization of the impaired oxidant/antioxidant system and delayed complication of RA(161). Dr, Al-Okbi SY in the study of elevated oxidative stress and inflammatory biomarkers suggested that vitamin C can be used as as complementary medicine to manage rheumatoid arthritis due to its anti-inflammatory and antioxidant activities(162).
But Dr. Rosenbaum CC and the research team at the the Bethesda North Hospital Pharmacy iunsisted that more high quality research are necessary before supplements including vitamin C can be effectively and safely recommended to reduce nonsteroidal antiinflammatory drug or steroid usage"(163)

2. Vitamin E 
Low intake of vitamin E and selenium have been found to the RA elder patient(166).Vitamin E, another free radical scavenger may also be  effective for patient with RA due to its positive effect on autoimmune disease by decreasing proinflammatory cytokines and lipid mediator(164). Dr. Aryaeian N. in the investigation of the effectiveness of supplements in RA, showed that the procession of property in promoted immunity and involvement of inflammatory parameters may put vitamin E in front of other rheumatoid arthritis (RA)management supplements(165).

3. Glucosamine
Glucosamine, a compound of the simple sugar glucose and the amino acid glutamine, is a precursor for glycosaminoglycans may be another antioxidant used for management of symptoms of patient with RA, according to the study of 25 patients in the glucosamine group and 26 patients in the placebo group(167). Dr. Matsuno H. and the research team at the Matsuno Clinic for Rheumatic Diseases, said" (oral administration of) glucosamine-chondroitin-quercetin glucoside (GCQG) for 3 months showed a significant improvement in pain symptoms, daily activities (walking and climbing up and down stairs), and visual analogue scale, and changes in the synovial fluid properties"(168) in patient of OA and RA. Further more, the supplement also found to consist the therapeutic potential for arthritis by exerting antioxidative and immunomodulatory effects(169).

4. Methylsulfonylmethane
Methylsulfonylmethane (MSM), an antioxidant with organosulfur compound has shown to involve in reduced the progression of inflammatory processes in RA patient(170). The Jazan University study in the comparison of the effectiveness of Echinacea extract and composite glucosamine, chondroitin and methyl sulfonyl methane supplements, showed that both ingredient exhibit anti inflammation, oedema and mild proliferation of synovial cells activities, through reduced cartilage damage and bone density of that may be a promising light on arthritis treatment(171)

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
References
(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)
(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)

(161) Effect of green tea extract and vitamin C on oxidant or antioxidant status of rheumatoid arthritis rat model by Meki AR1, Hamed EA, Ezam KA(PubMed)
(162) Nutraceuticals of anti-inflammatory activity as complementary therapy for rheumatoid arthritis.
Al-Okbi SY1(PubMed)

(163) Antioxidants and antiinflammatory dietary supplements for osteoarthritis and rheumatoid arthritis by Rosenbaum CC1, O'Mathúna DP, Chavez M, Shields K.(PubMed)

(164) Effects of diets containing fish oil and vitamin E on rheumatoid arthritis. by Tidow-Kebritchi S1, Mobarhan S.(PubMed)

(165) Effect of conjugated linoleic Acid, vitamin e, alone or combined on immunity and inflammatory parameters in adults with active rheumatoid arthritis: a randomized controlled trial. by Aryaeian N1, Djalali M2, Shahram F3, Djazayery A4, Eshragian MR5(PubMed)

(166)Intake of antioxidants in patients with rheumatoid arthritis by Silva BN1, Araújo ÍL1, Queiroz PM2, Duarte AL3, Burgos MG4.(PubMed)

(167) Effects of glucosamine administration on patients with rheumatoid arthritis by Nakamura H1, Masuko K, Yudoh K, Kato T, Kamada T, Kawahara T.(PubMed)

(168) Effects of an oral administration of glucosamine-chondroitin-quercetin glucoside on the synovial fluid properties in patients with osteoarthritis and rheumatoid arthritis by Matsuno H1, Nakamura H, Katayama K, Hayashi S, Kano S, Yudoh K, Kiso Y.(PubMed)

(169) The anti-arthritic and immune-modulatory effects of NHAG: a novel glucosamine analogue in adjuvant-induced arthritis by Shah SU1, Jawed H, Awan SI, Anjum S, Simjee SU.(PubMed)

(170) The "MESACA" study: methylsulfonylmethane and boswellic acids in the treatment of gonarthrosis by Notarnicola A1, Tafuri S, Fusaro L, Moretti L, Pesce V, Moretti B.(PubMed)

(171) The effectiveness of Echinacea extract or composite glucosamine, chondroitin and methyl sulfonyl methane supplements on acute and chronic rheumatoid arthritis rat model by Arafa NM1, Hamuda HM, Melek ST, Darwish SK.(PubMed)

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Rheumatoid Arthritis: The Phytochemicals

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

                             The Phytochemicals

1. Curcumin
Curcumin is a phytochemical found abundantly in Turmeric, principal curcuminoid of the popular Indian spice
1.1. Anti-inflammatory agent

Curcumin (diferuloyl methane) may be used as nonsteroidal anti-inflammatory drugs (NSAIDs for treatment of rheumatoid arthritis(143). Dr. Sarker MR and the research team at the University of North Texas Health Science Center in the study of animal model, suggested that dietary curcumin amy have a positive effects on improved anti-inflammatory or antioxidant actions(144).

1.1. Antioxidants

Curcumin, one of most powerful antioxidant found in foods was found epidemiologically as a proven antioxidant for its anti-inflammatory, anti-amyloidogenic, neuroprotective, and cognition-enhancing effects(145).  The antioxidant is also considered as a novel promising therapeutics against chronic neuroinflammation and neurodegeneration in Alzheimer's disease by the Western Sydney University(146).
In rheumatoid arthritis patients, oral administration of curcumin sginificantly improved the American College of Rheumatology (ACR) DAS scores in reduction in tenderness and swelling of joint and and other arthritic conditions(147) such as dramatic amelioration of arthritis symptoms(148).

2. Gingerol
Gingerole, is also known as gingerol, a phytochemical of Flavonoids (polyphenols) found in fresh ginger.
2.1. Antioxidants and Anti-inflammatory effects

Crude ginger and rosemary extracts showed to inhibit the production of pro-inflammatory cytokines due ot its function as an inflammatory mediators with high antioxidant activity(149). The comparison of different ginger constituents, such as [6]-gingerol, [8]-gingerol, [10]-gingerol and [6]-shogaol, 6-Shogaol has found to be most potent antioxidant and anti-inflammatory phytochemical due the presence of alpha,beta-unsaturated ketone moiety(150).

Dr. Masuda Y. and the research team at the Osaka City University said" antioxidants isolated from the rhizomes of ginger,....the antioxidant activity might be due to not only radical scavenging activity of antioxidants but also their affinity of the antioxidants to the substrates"(151).

2.2. Rheumatoid arthritis

In rheumatoid arthritis, ginger-turmeric rhizomes mixture on animal model, may be effective against rheumatoid arthritis (RA) severity and complications, through the mediation of decreasing the systemic inflammation that occur at the appearance of polyarthritis, oxidative stress and dyslipidemia(152). According to DR. Ramadan G1 and the research team at the King Faisal University, the anti-inflammatory/anti-oxidant activity of ginger is less potent than turmeric but constitute to some beneficial effects against rheumatoid arthritis onset/progression(153).

3. Quercetin
Quercetin is a member of flavonoids, found in fruits, vegetables, leaves and grains with anti inflammatory and antioxidant property(154)(155). which have been found effectively in reduce the early onset and stop the progression of rheumatoid arthritis.

In rat adjuvant arthritis, an oral daily dose of 150 mg/kg b.w. of quercetin for 28 days,quercetin lowered levels of pro inflammatory cytokines, interleukin-1β, C-reactive protein, and monocyte chemotactic protein-1 and restored plasma antioxidant capacity(156), . Dr.Ji JJ and the research team at the Dalian Medical University, suggested that quecetin may be a potent agent for treatment of symptoms of RA such as disabling joint disease involved hands, wrists, feet and other small joints, through its anti inflammatory and antioxidant effects(157).

  

4. Epigallocatechin-3-gallate (EGCG) 

Epigallocatechin-3-gallate (EGCG) found in green tea has been found to process antitumor,anti-Alzheimer, and anti-aging properties throguh epidemiological studies(158). According to the joint study lead by the Zhejiang University, Epigallocatechin-3-gallate (EGCG) improved anti-oxidant defense enzyme, reduced mitochondrial oxidative stress, through its antioxidants and inflammatory effects which may contribute to the treatment of rheumatoid arthritis(159).
In rheumatoid arthritis, Epigallocatechin-3-gallate (EGCG) may have a beneficiary effects for treatment of RA due to its suppressed autoimmune arthritis activity(160), also through vary antioxidant and anti inflammatory pathways.

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
References

(143) Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation by Satoskar RR, Shah SJ, Shenoy SG.(PubMed)

(144) Curcumin Mimics the Neurocognitive and Anti-Inflammatory Effects of Caloric Restriction in a Mouse Model of Midlife Obesity by Sarker MR1, Franks S2, Sumien N1, Thangthaeng N1, Filipetto F2, Forster M1.(PubMed)

(145) Curcumin and Apigenin - novel and promising therapeutics against chronic neuroinflammation in Alzheimer's disease by Venigalla M1, Gyengesi E2, Münch G3(PubMed)

(146) Novel promising therapeutics against chronic neuroinflammation and neurodegeneration in Alzheimer's disease by Venigalla M1, Gyengesi E2, Sharman MJ3, Münch G4(PubMed)

(147) A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis by Chandran B1, Goel A.(PubMed)

(148) Oral curcumin has anti-arthritic efficacy through somatostatin generation via cAMP/PKA and Ca(2+)/CaMKII signaling pathways in the small intestine by Yang Y1, Wu X2, Wei Z2, Dou Y2, Zhao D3, Wang T2, Bian D2, Tong B2, Xia Y2, Xia Y4, Dai Y5(PubMed)

(149) Evaluation of in vitro anti-inflammatory effects of crude ginger and rosemary extracts obtained through supercritical CO2 extraction on macrophage and tumor cell line: the influence of vehicle type by Justo OR1, Simioni PU2, Gabriel DL2, Tamashiro WM2, Rosa Pde T3, Moraes ÂM4.(PubMed)

(150) Comparative antioxidant and anti-inflammatory effects of [6]-gingerol, [8]-gingerol, [10]-gingerol and [6]-shogaol by Dugasani S1, Pichika MR, Nadarajah VD, Balijepalli MK, Tandra S, Korlakunta JN.(PubMed)

(151) Antioxidant properties of gingerol related compounds from ginger by Masuda Y1, Kikuzaki H, Hisamoto M, Nakatani N.(PubMed)

(152) Protective effects of ginger-turmeric rhizomes mixture on joint inflammation, atherogenesis, kidney dysfunction and other complications in a rat model of human rheumatoid arthritis by Ramadan G1, El-Menshawy O.(PubMed)

(153) Anti-inflammatory and anti-oxidant properties of Curcuma longa (turmeric) versus Zingiber officinale (ginger) rhizomes in rat adjuvant-induced arthritis by Ramadan G1, Al-Kahtani MA, El-Sayed WM.(PubMed)

(154) Antioxidant and Anti-Inflammatory Activity Determination of One Hundred Kinds of Pure Chemical Compounds Using Offline and Online Screening HPLC Assay by Lee KJ1, Oh YC1, Cho WK1, Ma JY1.(PubMed)

(155) Radical-scavenging and Anti-inflammatory Activity of Quercetin and Related Compounds and Their Combinations Against RAW264.7 Cells Stimulated with Porphyromonas gingivalis Fimbriae. Relationships between Anti-inflammatory Activity and Quantum Chemical Parameters by Murakami Y1, Kawata A2, Ito S3, Katayama T2, Fujisawa S2(PubMed)

(156) Quercetin reduced inflammation and increased antioxidant defense in rat adjuvant arthritis by Gardi C1, Bauerova K2, Stringa B3, Kuncirova V4, Slovak L4, Ponist S4, Drafi F4, Bezakova L5, Tedesco I6, Acquaviva A3, Bilotto S6, Russo GL7.(PubMed)

(157) Quercetin: a potential natural drug for adjuvant treatment of rheumatoid arthritis by Ji JJ1, Lin Y, Huang SS, Zhang HL, Diao YP, Li K.(PubMed)

(158) Green tea polyphenols and their potential role in health and disease by Afzal M1, Safer AM, Menon M.(PubMed)

(159) Mitochondrial modulation by Epigallocatechin 3-Gallate ameliorates cisplatin induced renal injury through decreasing oxidative/nitrative stress, inflammation and NF-kB in micebyPan H1, Chen J2, Shen K3, Wang X1, Wang P1, Fu G1, Meng H1, Wang Y1, Jin B1.(PubMed)

(160) Green Tea Epigallocatechin-3-Gallate Suppresses Autoimmune Arthritis Through Indoleamine-2,3-Dioxygenase Expressing Dendritic Cells and the Nuclear Factor, Erythroid 2-Like 2 Antioxidant Pathway by Min SY1, Yan M1, Kim SB2, Ravikumar S3, Kwon SR4, Vanarsa K3, Kim HY5, Davis LS1, Mohan C3.(PubMed)

(161) Effect of green tea extract and vitamin C on oxidant or antioxidant status of rheumatoid arthritis rat model by Meki AR1, Hamed EA, Ezam KA(PubMed)

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

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

                          Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

                                   The Diet


The Diet reduced risk of over expression of pro inflammatory cytokine is always important to prevent the early onset and patient with progression of the rheumatoid arthritis.
1. Organic Soy
Intake of soy protein can enhance the protective effect against Rheumatoid Arthritis(129). Genistein, an isoflavone derivative found in soy suppressed the proinflammatory cytokine production, through inhibiting the expression of accumulation of reactive oxygen species (ROS)(130).

In animal model with with collagen-induced arthritis (CIA),, genistein, daidzein, and soy protein found in organic soy, restore the paraoxonase and arylesterase activity as well as malondialdehyde (MDA) level fo that have a related improvement of patient with Rheumatoid Arthritis(131).

2. Green tea

Green tea uss as a precious drink in social activities in many culture has been found to prevent the onset of rheumatoid arthritis and protect against the progression of the diseases due tom aging, via its antioxidant property(132). In animal models, green tea aqueous extract improve over function of rat with rheumatoid arthritis through significantly decreasing and down-regulating the systemic production of pro-inflammatory cytokines and the expression of chemokine receptor-5 in synovial tissues(133). Dr. Ahmed S. said "Green tea's active ingredient, epigallocatechin 3-gallate (EGCG), ....one of the leading plant-derived molecules studied for its potential health benefits,........I summarize the findings from some of the most significant preclinical studies with EGCG in arthritic diseases(134).

3. Olive oil
Olive oil when used conjunction with fish oil is found to prevent the early development and protect against progression the diseases in patient with RA, in our earlier research(135). In other study of a total 145 RA patients and 188 control subjects, regular intake of of both cooked vegetables and olive oil was inversely and independently associated with risk of RA, probably through the consumption of n-3 fatty acids and nutrients effects(136). Dr. Rosillo MÁ and the research team lead by the University of Seville showed that phenolic compounds found in the extra virgin olive oil (EVOO) inhibited the levels of proinflammatory cytokines and prostaglandin E2 in the joint as well as down-regulation of the arthritic process(137).

4. Salmon
Salmon containing high amount Omega 3 fatty acid which is found to decrease the risk of RA(138).
Salmon cartilage proteoglycan (PG), in animal model is found effective in suppressed excess inflammation in different mouse inflammatory diseases, including rheumatoid arthritis, through attenuated collagen-induced arthritis (CIA) pathogenesis by modulating immune response and local production inflammatory cytokines and chemokines in the joints(139).Salmon calcitonin, a hormone found in salmon and used as spray for treatment of osteoporosis exhibited anti inappropriate inflammatory responses contribute to the pathogenesis of rheumatoid arthritis (RA), according to the School of Food Science and Environmental Health(140).

5. Ginger
Ginger (Zingiber officinale), one of traditional herbal medicine and spicy used in many Asian culture today, is being used as an anti-inflammatory in Chinese and Ayurvedic medicine. Crude dichloromethane extract from ginger, contained essential oils and more polar compounds, was found more efficacious in preventing both joint inflammation and destruction, according to Dr. Funk JL and scientists at the University of Arizona(141)).
Dr. Al-Nahain A and the research team at the University of Development Alternative said"..., phytochemicals( found in ginger) can form the basis of discovery of new drugs, which not only can provide symptomatic relief but also may provide total relief from RA by stopping RA-induced bone destruction"(142).

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.caReferences

(127) Yoga as a method of symptom management in multiple sclerosis by Frank R1, Larimore J1.(PubMed)

(128) The effects of mind-body therapies on the immune system: meta-analysis by Morgan N1, Irwin MR2, Chung M3, Wang C1.(PubMed)

(129) Protective effect of soy protein on collagen-induced arthritis in rat by Mohammad Shahi M1, Rashidi MR, Mahboob S, Haidari F, Rashidi B, Hanaee J.(PubMed)

(130) Genistein suppresses tumor necrosis factor α-induced inflammation via modulating reactive oxygen species/Akt/nuclear factor κB and adenosine monophosphate-activated protein kinase signal pathways in human synoviocyte MH7A cells by Li J1, Li J2, Yue Y1, Hu Y1, Cheng W1, Liu R3, Pan X4, Zhang P1.(PubMed)

(131) Soy protein, genistein, and daidzein improve serum paraoxonase activity and lipid profiles in rheumatoid arthritisin rats by Mohammadshahi M1, Haidari F, Saei AA, Rashidi B, Mahboob S, Rashidi MR.(PubMed)

(132) Green Tea Epigallocatechin-3-Gallate Suppresses Autoimmune Arthritis Through Indoleamine-2,3-Dioxygenase Expressing Dendritic Cells and the Nuclear Factor, Erythroid 2-Like 2 Antioxidant Pathway by Min SY1, Yan M1, Kim SB2, Ravikumar S3, Kwon SR4, Vanarsa K3, Kim HY5, Davis LS1, Mohan C3.(PubMed)

(133) Anti-inflammatory activity of green versus black tea aqueous extract in a rat model of human rheumatoid arthritis by Ramadan G1, El-Beih NM1, Talaat RM2, Abd El-Ghffar EA1.(PubMed)

(134) Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and promise by Ahmed S1.(PubMed)

(135) The effect of olive oil and fish consumption on rheumatoid arthritis--a case control study by Linos A1, Kaklamanis E, Kontomerkos A, Koumantaki Y, Gazi S, Vaiopoulos G, Tsokos GC, Kaklamanis P.(PubMed)

(136) Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables? by Linos A1, Kaklamani VG, Kaklamani E, Koumantaki Y, Giziaki E, Papazoglou S, Mantzoros CS.(PubMed)

(137) 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,(PubMed)

(138) Lower omega-3 fatty acids are associated with the presence of anti-cyclic citrullinated peptide autoantibodies in a population at risk for future rheumatoid arthritis: a nested case-control study. by Gan RW1, Young KA1, Zerbe GO2, Demoruelle MK3, Weisman MH4, Buckner JH5, Gregersen PK6, Mikuls TR7, O'Dell JR7, Keating RM8, Clare-Salzler MJ9,Deane KD3, Holers VM3, Norris JM10. Alarcón-de-la-Lastra C1, Ferrándiz ML4.(PubMed)

(139) Attenuation of collagen-induced arthritis in mice by salmon proteoglycan by Yoshimura S1, Asano K1, Nakane A1.(PubMed)

(140) An intra-articular salmon calcitonin-based nanocomplex reduces experimental inflammatory arthritis by Ryan SM1, McMorrow J, Umerska A, Patel HB, Kornerup KN, Tajber L, Murphy EP, Perretti M, Corrigan OI, Brayden DJ.(PubMed)

(141) Comparative effects of two gingerol-containing Zingiber officinale extracts on experimental rheumatoid arthritis by Funk JL1, Frye JB, Oyarzo JN, Timmermann BN.(PubMed)

(142) Zingiber officinale: A Potential Plant against Rheumatoid Arthritis by Al-Nahain A1, Jahan R2, Rahmatullah M1.(PubMed)

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

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

 The Prevention and Management

The do’s and do not’s list

The aim of the do and do not list is to find the common strategy with the use of natural remedies to prevent the early onset of RA and protect against the progression and pregressive symptoms of rheumatoid arthritis. Dr. Combe B said in the study of early rheumatoid arthritis: strategies for prevention and management"... A very early use of effective disease-modifying anti-rheumatic drugs (DMARDs) is a key point in patients at risk of developing persistent and erosive arthritis" and " Information and education for patients, as well as some non-pharmacological interventions, can be proposed as treatment adjuncts. Finally, the reduction or stopping of smoking, which could prevent the development and progression of early RA, is the only prevention tool currently available"

In herbal medicine, disease-modifying anti-rheumatic drugs (DMARDs) may be replaced with the intake of anti inflammatory foods.

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

Omega-3 FAs imay protect against the development of RA-related autoimmunity in pre-clinical RA, according to a nested case-control study (109). But according to Dr. Devaraj S. and the research team at the UC Davis Medical Center, oonly limit study showed the effects of dietary fatty acids (ie, oleic acid and alpha-linolenic acid) reduce biomarkers of inflammation, null effects in fish oil(110).

According to  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.

Intake of high amount of saturated fat and trans fay can increase the production of inflammatory cytokines(111).

 
2. Increase intake of fruit and vegetable 

Vegetables and fruit formed a important part of human nutrition with good sources of nutrients, dietary fibre, and phytochemicals have been found to reduce risk of chronic diseases, including rheimatoid arthritis RA(112)

In a cross-sectional study of  1200 Puerto Rican adults aged 45-75 y, intake variety of fruits and vegetable but not quantity appears to be important in reducing inflammation(113). The healthy  Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats showed to contribute to over all health including complications of RA and RA itself(114).

3. Avoid high glycemic index diets
High glycemic index diets, which have low fiber content and are rich in trans fat cause the activation of the immune system, leading to excessive production of pro-inflammatory mediators(116). Dr. Kremer JM and Dr. Bigaouette J. of American diet in patients with RA said" Patients with RA ingest too much total fat and too little PUFA and fiber. Their diets are deficient in pyridoxine, zinc and magnesium vs the RDA and copper and folate vs the TAD"(115). Increase intake of  fruits, vegetables, and whole grain consumption seem to be associated with the improvement in subclinical inflammatory condition(116).

4. Maintaining body weight
According to the joint study lead by the Philadelphia VA Medical Center and University of Pennsylvania, a low body mass index (BMI) has been associated with accelerated mortality in patients with rheumatoid arthritis (RA) and obesity showed no support a biologically protective role in RA patients(117). Patients with high BMI have lower mortality than thinner patients(118).

5. Reduced intake of pro inflammatory foods
Foods sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc. induced the production of pro inflammatory cytokine is associated to the expression and progression of  Rheumatoid Arthritis(120) as Dr. Seaman DR. said" Nearly all degenerative diseases have the same underlying biochemical etiology, that is, a diet-induced proinflammatory state" and "treatment program must also include nutritional protocols to reduce the proinflammatory state"(119).

6. Increase in take of anti inflammatory foods
such as fresh vegetables and fruits, seeds and sprouts whole grain, fish, turkey, chicken, legumes, etc.
A high vegetable diet and fish oil are found to associate to reduce inflammation and progression of RA. Dr. Adam O and the research team at the Medizinische Klinik Innenstadt der LMU suggested that auch diet improved tender and swollen joints decreased caused by expression of pro inflammatory cytokines(121). Others in the study of 49 patients with active rheumatoid arthritis completed a 24-week, showed the intake of fish oil with olive oil is also associated with certain changes in immune function, probably through the health benefits from the presence of omega-3 fatty acids in olive(122).

7. Stop smoking
Smoking are associated with increased of Rheumatoid Arthritis as it is considered as the most important extrinsic risk factors for the development and severity of Rheumatoid Arthritis, causing over expression of oxidative stress, inflammation, autoantibody formation and epigenetic changes(124).
According to the data of 2,800 adult patients included in the BARFOT early RA between 1992 and 2005study in Sweden. stop smoking after onset of RA did not change the poor prognosis of smokers with RA but reduced risk cardiovascular mortality and morbidity and the association of smoking with vasculitis and noduli in RA(123).

8. Occupations
 If you are in occupation of increased risk of Rheumatoid Arthritis(RA), such as farmers, upholsterers, lacquerers, concrete workers, and hair-dressers, you should take all precaution if necessary(124).
According to the Department of Occupational Health, Karolinska Hospital, in a register based cohort study of a total of 375,035 men and 140,139 women concluded "there were rather small differences in the relative risk of RA in different exposure groups and different occupations"(125).

9. Moderate exercise
Moderate exercise such as yoga(127)(128), taichi(128), qi kong(128),.....enhances immune function in fighting against inflammatory and infectious disease outcomes(128).
In the study of habitual physical activity levels of 29 female patients with RA, researchers at the joint study lead by University of the Witwatersrand showed that the exercise improved bone density and induced protective effects on bone health(126).
In animal model,

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

References

(109) Lower omega-3 fatty acids are associated with the presence of anti-cyclic citrullinated peptide autoantibodies in a population at risk for future rheumatoid arthritis: a nested case-control study by Gan RW1, Young KA1, Zerbe GO2, Demoruelle MK3, Weisman MH4, Buckner JH5, Gregersen PK6, Mikuls TR7, O'Dell JR7, Keating RM8, Clare-Salzler MJ9,Deane KD3, Holers VM3, Norris JM10.(PubMed)

(110) The effect of weight loss and dietary fatty acids on inflammation by Devaraj S1, Kasim-Karakas S, Jialal I.(PubMed)
(111) 4 Natural Remedies for Rheumatoid Arthritis(About health)
(112) Critical review: vegetables and fruit in the prevention of chronic diseases by Boeing H1, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B.(PubMed)
(113) Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults by Bhupathiraju SN1, Tucker KL.(PubMed)
(114) A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow by McKellar G1, Morrison E, McEntegart A, Hampson R, Tierney A, Mackle G, Scoular J, Scott JA, Capell HA.(PubMed)
(115) Nutrient intake of patients with rheumatoid arthritis is deficient in pyridoxine, zinc, copper, and magnesium by Kremer JM1, Bigaouette J.(PubMed)
(116) [Role of diet on chronic inflammation prevention and control - current evidences].[Article in Portuguese] by Geraldo JM1, Alfenas Rde C.(PubMed)
(117) Weight Loss, the Obesity Paradox, and the Risk of Death in Rheumatoid Arthritis by Baker JF1, Billig E2, Michaud K3, Ibrahim S1, Caplan L4, Cannon GW5, Stokes A6, Majithia V7, Mikuls TR8.(PubMed)
(118) Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation by Escalante A1, Haas RW, del Rincón I.(PubMed)
(119) The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? by Seaman DR.(PubMed)
(120) Osteoarthritis and rheumatoid arthritis pannus have similar qualitative metabolic characteristics and pro-inflammatory cytokine response by Furuzawa-Carballeda J1, Macip-Rodríguez PM, Cabral AR.(PubMed)
(121) Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis by Adam O1, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R, Forth W.(PubMed)
(122) Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects by Kremer JM1, Lawrence DA, Jubiz W, DiGiacomo R, Rynes R, Bartholomew LE, Sherman M.(PubMed)
(123) The Effect of Stopping Smoking on Disease Activity in Rheumatoid Arthritis (RA). Data from BARFOT, a Multicenter Study of Early RA by Andersson ML1, Bergman S, Söderlin MK.(PubMed)
(124) Rheumatoid arthritis and occupation by SNORRASON E.(PubMed)
(125) Occupation, occupational exposure to chemicals and rheumatological disease. A register based cohort study by Lundberg I1, Alfredsson L, Plato N, Sverdrup B, Klareskog L, Kleinau S.(PubMed)
(126) Habitual Physical Activity, Sedentary Behaviour and Bone Health in Rheumatoid Arthritis by Prioreschi A1, Makda MA2, Tikly M2, McVeigh JA1.(PubMed)

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

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
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. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(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

Rheumatoid Arthritis

Rheumatoid Arthritis is defined a chronic disorder as a result of inflammation, affecting mostly the flexible (synovial) joints and tissues and organs in the body. The disease affects more women than men and generally occurs after the ages of 40, causing diminished quality of life of many elders(1). According to CDC, Musculoskeletal disorders (MSDs)  affects over 52 millions of adults in the US alone, including 294,000 children under age 18 with some form of arthritis or rheumatic conditions(2). Rheumatoid Arthritis can induced bone loss through elevating bone resorption without increasing bone formation(4). A cross-sectional population-based study of 1042 patients with rheumatoid arthritis showed that RA patients had an increased risk of death from various causes(4a).

                              The Prevention and Management

The do’s and do not’s list

The aim of the do and do not list is to find the common strategy with the use of natural remedies to prevent the early onset of RA and protect against the progression and pregressive symptoms of rheumatoid arthritis. Dr. Combe B said in the study of early rheumatoid arthritis: strategies for prevention and management"... A very early use of effective disease-modifying anti-rheumatic drugs (DMARDs) is a key point in patients at risk of developing persistent and erosive arthritis" and " Information and education for patients, as well as some non-pharmacological interventions, can be proposed as treatment adjuncts. Finally, the reduction or stopping of smoking, which could prevent the development and progression of early RA, is the only prevention tool currently available"

In herbal medicine, disease-modifying anti-rheumatic drugs (DMARDs) may be replaced with the intake of anti inflammatory foods.

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

Omega-3 FAs imay protect against the development of RA-related autoimmunity in pre-clinical RA, according to a nested case-control study (109). But according to Dr. Devaraj S. and the research team at the UC Davis Medical Center, oonly limit study showed the effects of dietary fatty acids (ie, oleic acid and alpha-linolenic acid) reduce biomarkers of inflammation, null effects in fish oil(110).

According to  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.

Intake of high amount of saturated fat and trans fay can increase the production of inflammatory cytokines(111).

 
2. Increase intake of fruit and vegetable 

Vegetables and fruit formed a important part of human nutrition with good sources of nutrients, dietary fibre, and phytochemicals have been found to reduce risk of chronic diseases, including rheimatoid arthritis RA(112)

In a cross-sectional study of  1200 Puerto Rican adults aged 45-75 y, intake variety of fruits and vegetable but not quantity appears to be important in reducing inflammation(113). The healthy  Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats showed to contribute to over all health including complications of RA and RA itself(114).

3. Avoid high glycemic index diets
High glycemic index diets, which have low fiber content and are rich in trans fat cause the activation of the immune system, leading to excessive production of pro-inflammatory mediators(116). Dr. Kremer JM and Dr. Bigaouette J. of American diet in patients with RA said" Patients with RA ingest too much total fat and too little PUFA and fiber. Their diets are deficient in pyridoxine, zinc and magnesium vs the RDA and copper and folate vs the TAD"(115). Increase intake of  fruits, vegetables, and whole grain consumption seem to be associated with the improvement in subclinical inflammatory condition(116).

4. Maintaining body weight
According to the joint study lead by the Philadelphia VA Medical Center and University of Pennsylvania, a low body mass index (BMI) has been associated with accelerated mortality in patients with rheumatoid arthritis (RA) and obesity showed no support a biologically protective role in RA patients(117). Patients with high BMI have lower mortality than thinner patients(118).

5. Reduced intake of pro inflammatory foods
Foods sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc. induced the production of pro inflammatory cytokine is associated to the expression and progression of  Rheumatoid Arthritis(120) as Dr. Seaman DR. said" Nearly all degenerative diseases have the same underlying biochemical etiology, that is, a diet-induced proinflammatory state" and "treatment program must also include nutritional protocols to reduce the proinflammatory state"(119).

6. Increase in take of anti inflammatory foods
such as fresh vegetables and fruits, seeds and sprouts whole grain, fish, turkey, chicken, legumes, etc.
A high vegetable diet and fish oil are found to associate to reduce inflammation and progression of RA. Dr. Adam O and the research team at the Medizinische Klinik Innenstadt der LMU suggested that auch diet improved tender and swollen joints decreased caused by expression of pro inflammatory cytokines(121). Others in the study of 49 patients with active rheumatoid arthritis completed a 24-week, showed the intake of fish oil with olive oil is also associated with certain changes in immune function, probably through the health benefits from the presence of omega-3 fatty acids in olive(122).

7. Stop smoking
Smoking are associated with increased of Rheumatoid Arthritis as it is considered as the most important extrinsic risk factors for the development and severity of Rheumatoid Arthritis, causing over expression of oxidative stress, inflammation, autoantibody formation and epigenetic changes(124).
According to the data of 2,800 adult patients included in the BARFOT early RA between 1992 and 2005study in Sweden. stop smoking after onset of RA did not change the poor prognosis of smokers with RA but reduced risk cardiovascular mortality and morbidity and the association of smoking with vasculitis and noduli in RA(123).

8. Occupations
 If you are in occupation of increased risk of Rheumatoid Arthritis(RA), such as farmers, upholsterers, lacquerers, concrete workers, and hair-dressers, you should take all precaution if necessary(124).
According to the Department of Occupational Health, Karolinska Hospital, in a register based cohort study of a total of 375,035 men and 140,139 women concluded "there were rather small differences in the relative risk of RA in different exposure groups and different occupations"(125).

9. Moderate exercise
Moderate exercise such as yoga(127)(128), taichi(128), qi kong(128),.....enhances immune function in fighting against inflammatory and infectious disease outcomes(128).
In the study of habitual physical activity levels of 29 female patients with RA, researchers at the joint study lead by University of the Witwatersrand showed that the exercise improved bone density and induced protective effects on bone health(126).
In animal model,

Arthritis Is 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 recommended by Kyle J. Norton

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

References

(1) 8 Areas of Age-Related Change(NIH)
(2) Arthritis-Related Statistics(CDC)
(3) Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid arthritis by Keenan MA1, Peabody TD, Gronley JK, Perry J.(PubMed)
(4) Serum Sclerostin Level Among Egyptian Rheumatoid Arthritis Patients: Relation to Disease Activity ,Bone Mineral Density and Radiological Grading by Mehaney DA, Eissa M, Anwar S, El-Din SF(PubMed)

(110) The effect of weight loss and dietary fatty acids on inflammation by Devaraj S1, Kasim-Karakas S, Jialal I.(PubMed)

(111) 4 Natural Remedies for Rheumatoid Arthritis(About health)

(112) Critical review: vegetables and fruit in the prevention of chronic diseases by Boeing H1, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A, Leschik-Bonnet E, Müller MJ, Oberritter H, Schulze M, Stehle P, Watzl B.(PubMed)

(113) Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults by Bhupathiraju SN1, Tucker KL.(PubMed)

(114) A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow by McKellar G1, Morrison E, McEntegart A, Hampson R, Tierney A, Mackle G, Scoular J, Scott JA, Capell HA.(PubMed)

(115) Nutrient intake of patients with rheumatoid arthritis is deficient in pyridoxine, zinc, copper, and magnesium by Kremer JM1, Bigaouette J.(PubMed)

(116) [Role of diet on chronic inflammation prevention and control - current evidences].[Article in Portuguese] by Geraldo JM1, Alfenas Rde C.(PubMed)

(117) Weight Loss, the Obesity Paradox, and the Risk of Death in Rheumatoid Arthritis by Baker JF1, Billig E2, Michaud K3, Ibrahim S1, Caplan L4, Cannon GW5, Stokes A6, Majithia V7, Mikuls TR8.(PubMed)

(118) Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation by Escalante A1, Haas RW, del Rincón I.(PubMed)

(119) The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? by Seaman DR.(PubMed)

(120) Osteoarthritis and rheumatoid arthritis pannus have similar qualitative metabolic characteristics and pro-inflammatory cytokine response by Furuzawa-Carballeda J1, Macip-Rodríguez PM, Cabral AR.(PubMed)

(121) Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis by Adam O1, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R, Forth W.(PubMed)

(122) Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects by Kremer JM1, Lawrence DA, Jubiz W, DiGiacomo R, Rynes R, Bartholomew LE, Sherman M.(PubMed)

(123) The Effect of Stopping Smoking on Disease Activity in Rheumatoid Arthritis (RA). Data from BARFOT, a Multicenter Study of Early RA by Andersson ML1, Bergman S, Söderlin MK.(PubMed)

(124) Rheumatoid arthritis and occupation by SNORRASON E.(PubMed)

(125) Occupation, occupational exposure to chemicals and rheumatological disease. A register based cohort study by Lundberg I1, Alfredsson L, Plato N, Sverdrup B, Klareskog L, Kleinau S.(PubMed)

(126) Habitual Physical Activity, Sedentary Behaviour and Bone Health in Rheumatoid Arthritis by Prioreschi A1, Makda MA2, Tikly M2, McVeigh JA1.(PubMed)

(4a) Death rates and causes of death in patients with rheumatoid arthritis: a population-based study by Sihvonen S1, Korpela M, Laippala P, Mustonen J, Pasternack A(PubMed)