Saturday 23 January 2016

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

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 Diseases associated to Rheumatoid Arthritis(Comorbidities)

The simultaneous presence of chronic Rheumatoid Arthritis with other diseases or conditions, include cardiovascular diseases (CVD), cancer, osteoporosis, and depression  with often underrecognized in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), or psoriasis (PsO)(94).according to the joint study lead by Notre-Dame Hospital.

1. Cardiovascular disease (CVD)
 Cardiovascular disease (CVD), one the most leading cause of death in US, in particular Coronary artery disease, is found to associate to patient with RA(95). Dr.Goodson N said" Cardiovascular death is........ responsible for approximately half the deaths observed in RA(95).  The study of 54 patients with RA :87% were women, with a mean age of 51 and 92% with rheumatoid factor positive showed that high homocysteine concentration is correlate to highest risk of CVD in RA patient(96).
Recent study by Dr. Kumar N and Armstrong DJ. insisted that traditional risk factors such as homocysteine, oxidised low-density lipoprotein, high-sensitivity C-reactive protein and leptin may contribute to the growing rates CVD death in RA patient(97).

2. Infections
The chronic, debilitating, autoimmune nature of RA affected directly or indirectly in almost all organ systems of RA patient, have shown to induced risk of infection(98) which is found to be responsible for death of 25% of RA patients(99). According to the joint study lead by Tampere University, in total of 10,994 patient-years, 341 serious infections were found in patient with RA(100).
3. Mental health issues
According to the study by National Institute for Science and Technology high prevalence of anxiety and depression and even suicide ideation has been found to associated to patient with RA(101) probably due to inflict of medicine(101). Dr. Rouse PC and the research team at the joint study lead by the University of Birmingham, Birmingham, suggested that depression is one most concern and positive psychological well-being in RA patients(102).
Dr. Ryan and Dr. McGuire B insisted that chronic pain associated to PA may constitute to psychological symptoms of depression and anxiety in patients with RA(103).

4. Cancers
Use of TNF-alpha antagonists for treatment of inflammatory diseases may associate to risk of cancer, particular lung cancer(104). According Dr. Buchbinder R and the research team lead by the Monash University, "Malignancy incidence was low in this RA cohort and biologic exposure did not increase the risk of malignancy. Melanoma risk was increased in both TNFi-treated and biologic-naïve RA patients compared with the general population suggesting that RA status, and possibly methotrexate exposure, may be responsible"(105).

5. Gastrointestinal ulcer
Use of Non-steroidal anti-inflammatory drugs (NSAIDs) for treatment of RA is frequently associated to gastrointestinal (GI) ulcers and complications of ulcers(106). The Tokyo Women's Medical University study suggests the prevalence of upper gastrointestinal (UGI) ulcer in patient with RA is also related to Helicobacter pylori and the association of H. pylori infectionas well as the intake of nonsteroidal anti-inflammatory drug (NSAID), according to a cohort of Japanese patients with rheumatoid arthritis (RA)(107).

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)
(95) Coronary artery disease and rheumatoid arthritis by Goodson N1.(PubMed)
(96) Cardiovascular risk factors in Chilean patients with rheumatoid arthritis by Cisternas M1, Gutiérrez MA, Klaassen J, Acosta AM, Jacobelli S.(PubMed)
(97) Cardiovascular disease--the silent killer in rheumatoid arthritis by Kumar N1, Armstrong DJ.(PubMed)
(98) Comorbidities in rheumatoid arthritis by Michaud K1, Wolfe F.(PubMed)
(99) Rheumatoid Arthritis (RA)(CDC)
(100) Rates of serious infections and malignancies among patients with rheumatoid arthritis receiving either tumor necrosis factor inhibitor or rituximab therapy by Aaltonen KJ1, Joensuu JT2, Virkki L2, Sokka T2, Aronen P2, Relas H2, Valleala H2, Rantalaiho V2, Pirilä L2, Puolakka K2, Uusitalo T2, Blom M2, Konttinen YT2,Nordström D2(PubMed)
(101) Anxiety, depression and suicidal ideation in patients with rheumatoid arthritis in use of methotrexate, hydroxychloroquine, leflunomide and biological drugs by Pinho de Oliveira Ribeiro N1, Rafael de Mello Schier A, Ornelas AC, Pinho de Oliveira CM, Nardi AE, Silva AC.(PubMed)
(102) Measuring the positive psychological well-being of people with rheumatoid arthritis: a cross-sectional validation of the subjective vitality scale by Rouse PC1, Veldhuijzen Van Zanten JJ2,3, Ntoumanis N4, Metsios GS5,6, Yu CA7, Kitas GD8,9, Duda JL10.(PubMed)
(103) Psychological predictors of pain severity, pain interference, depression, and anxiety in rheumatoid arthritispatients with chronic pain by Ryan S1, McGuire B2.(PubMed)
(104) Risk of solid cancer in patients exposed to anti-tumour necrosis factor therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis by Mercer LK1, Lunt M1, Low AL1, Dixon WG1, Watson KD1, Symmons DP1, Hyrich KL1; BSRBR Control Centre Consortium(PubMed)
(105) Malignancy risk in Australian rheumatoid arthritis patients treated with anti-tumour necrosis factor therapy: analysis of the Australian Rheumatology Association Database (ARAD) prospective cohort study by Buchbinder R1,2, Van Doornum S3, Staples M4,5, Lassere M6, March L7.(PubMed)
(106) Decreasing incidence of symptomatic gastrointestinal ulcers and ulcer complications in patients with rheumatoid arthritis by Steen KS1, Nurmohamed MT, Visman I, Heijerman M, Boers M, Dijkmans BA, Lems WF.(PubMed)
(107) Prevalence of Helicobacter pylori infection and risk of upper gastrointestinal ulcer in patients with rheumatoid arthritis in Japan by Tanaka E1, Singh G, Saito A, Syouji A, Yamada T, Urano W, Nakajima A, Taniguchi A, Tomatsu T, Hara M, Saito T, Kamatani N, Yamanaka H.(PubMed)

Friday 22 January 2016

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

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 Complications 

The progression of RA as of other chronic diseases in most cases induced complications constitute the expressions of other diseases, especially of the adverse effects of certain medication use.

1. Osteoporosis
The condition of gradually loss of bone mineral density due to aging has found to be associate to the complication of rheumatoid arthritis. It mat be result of bone weakening induced by the progression of the disease.
 Dr Lee SG, and the research team at the Pusan National University School of Medicine, suggest, the prevalence of osteoporosis in the RA patients was 1.9 times higher than in healthy subjects. Glucocorticoid use for treatment of osteoporosis was a risk factor for generalized bone loss in female RA patients(80). In the study of  Italian Study Group on Bone Mass in patient with Rheumatoid Arthritis, Dr. Insignia L and his team concluded "... osteoporosis and its dramatic complications in RA the therapeutic challenge is to preserve functional capacity using the lowest possible dosage of corticosteroids"(81).

2.  Lymphoproliferative diseases
The use of Methotrexate (MTX) as a first choice of medicine for treatment of RA has been found to induced complication of MTX-related lymphoproliferative diseases (MTX-LPDs). The joint study by the Niigata Rheumatic Center suggests the cytological examinations of the synovial fluid followed by knee operation are important and effective for early diagnosis of MTX-LPD(82). The study 589 RA outpatients examined at the National Center for Global Health and Medicine in the period from January 1990 to October 2010 conducted by the Osaka University Graduate School of Medicine also supported of the above claim and expressed the concern of the therapeutic challenge is to preserve functional capacity using the lowest possible dosage of corticosteroids.(83).

3. Neurologic complications
According to Dr. Bhattacharyya S and Dr. Helfgott SM, insisted that patient with RA in many cases have found to associate to neurologic complications because of its inflammatory origins and affect on nervous system (84). Recent study of 2624 patients treated with rituximab for rheumatoid arthritis RA and other autoimmune diseases, the late-onset neutropenia was observed in 40 patients with 25 of RA  of which contributed to risk of 1.3% of patients(85). Other support of above includes the study by the
The Ipswich Hospital NHS Trust, of which insisted that Late-onset neutropenia (LON) occurs infrequently after treatment with RTX, but can present with infection(86).

4. Carpal tunnel syndrome
Carpal tunnel syndrome is defined as a condition of pressure on the nerve in the wrist that supplies Carpal tunnel syndrome caused by volar dislocation of the lunate, associated with median nerve neuropathy has found in a patient with rheumatoid arthritis(87).

5. Scabies
Scabies is highly contagious skin disease caused by an infestation by the itch mite Sarcoptes is found to be another complication of medication use cause of disease(89).

6. Dry eye syndrome and Sjogren’s syndrome
According to 61 patients with rheumatoid arthritis recruited at Siriraj Hospital during March 2009-September 2010. the prevalence of secondary Sjogren's syndrome and dry eye were found with astonished rate of 28%(90). The awareness and detection of dry eye syndrome and secondary Sjogren’s syndrome in rheumatoid arthritis may has constituted the importantevaluation of their severity and proper management(91), the Mahidol University suggested.

7. Cerebral vasculitis
Cerebral vasculitis is a condition of inflammation of blood vessel wall involving the nervous system.
The diseases also share some characteristics with RA such as elevated levels of white blood cells, erythrocyte sedimentation rate, C-reactive protein, IgG-rheumatoid factor and immune complex(92). Dr. Ohno T and the reaserch team at the Ohtsu Red Cross Hospital reported that methotrexate is found effectively in treatment of long lasting rheumatoid cerebral vasculitis(93).

8. Other complications
According to 10 relevant studies out of 2326 bibliographic citations found by the University of Palermo, complication associate to RA, include ericardial effusion (OR 10.7; 95% CI 5.0-23.0), valvular nodules (OR 12.5; 95% CI 2.8-55.4), tricuspidal valve insufficiency (OR 5.3; 95% CI 2.4-11.6), aortic valve stenosis (OR 5.2; 95% CI 1.1-24.1), mitral valve insufficiency (OR 3.4; 95% CI 1.7-6.7), aortic valve insufficiency (OR 1.7; 95% CI 1.0-2.7), combined valvular alterations (OR 4.3; 95% CI 2.3-8.0), mitral valve thickening and/or calcification (OR 5.0; 95% CI 2.0-12.7), aortic valve thickening and/or calcification (OR 4.4; 95% CI 1.1-17.4), valvular thickening and/or calcification (OR 4.8; 95% CI 2.2-10.5), and mitral valve prolapse (OR 2.2; 95% CI 1.2-4.0)(88).

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)
(81) A multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis by Sinigaglia L1, Nervetti A, Mela Q, Bianchi G, Del Puente A, Di Munno O, Frediani B, Cantatore F, Pellerito R, Bartolone S, La Montagna G, Adami S.(PubMed)
(82) A case of rheumatoid arthritis with methotrexate related lymphoproliferative diseases of the knee by Abe A1, Wakaki K2, Ishikawa H1, Ito S1, Murasawa A1.(PubMed)
(83) Clinical characteristics and incidence of methotrexate-related lymphoproliferative disorders of patients withrheumatoid arthritis by Yoshida Y1, Takahashi Y, Yamashita H, Kano T, Kaneko H, Mimori A(PubMed)
(84) Neurologic complications of systemic lupus erythematosus, sjögren syndrome, and rheumatoid arthritis by Bhattacharyya S1, Helfgott SM2.(PubMed)
(85) Late-onset neutropenia after treatment with rituximab for rheumatoid arthritis and other autoimmune diseases: data from the AutoImmunity and Rituximab registry by Salmon JH1, Cacoub P2, Combe B3, Sibilia J4, Pallot-Prades B5, Fain O6, Cantagrel A7, Dougados M8, Andres E9, Meyer O10, Carli P11, Pertuiset E12, Pane I13, Maurier F14, Ravaud P13, Mariette X15, Gottenberg JE16.(PubMed)
(86) Late-onset neutropenia in patients with rheumatoid arthritis after treatment with rituximab by Abdulkader R1, Dharmapalaiah C, Rose G, Shand LM, Clunie GP, Watts RA.(PubMed)
(87) Carpal tunnel syndrome caused by volar dislocation of the lunate in a patient with rheumatoid arthritis by Oka Y1, Tokunaga D, Fujiwara H, Hojo T, Takatori R, Kubo T.(PubMed)
(88) Heart involvement in rheumatoid arthritis: systematic review and meta-analysis by Corrao S1, Messina S, Pistone G, Calvo L, Scaglione R, Licata G.(PubMed)
(89) Scabies in a Patient with Rheumatoid Arthritis Treated with Adalimumab - A Case Report by Marković I, Pukšić S, Gudelj Gračanin A, Čulo MI, Mitrović J, Morović-Vergles J1.(PubMed)
(90) Prevalence of dry eye syndrome and Sjogren's syndrome in patients with rheumatoid arthritis by Kosrirukvongs P1, Ngowyutagon P, Pusuwan P, Koolvisoot A, Nilganuwong S.(PubMed)
(91) A study of the prevalence of sicca symptoms and secondary Sjögren's syndrome in patients with rheumatoid arthritis, and its association to disease activity and treatment profile by Haga HJ1, Naderi Y, Moreno AM, Peen E.(PubMed)
(92) [Multiple cerebral infarction associated with cerebral vasculitis in rheumatoid arthritis].[Article in Japanese]by Ohta K1, Tanaka M, Funaki M, Sakauchi M, Suzuki N.(PubMed)
(93) Recovery from rheumatoid cerebral vasculitis by low-dose methotrexate by Ohno T1, Matsuda I, Furukawa H, Kanoh T.(PubMed)
(94) Evidence-based Recommendations for the Management of Comorbidities in Rheumatoid Arthritis, Psoriasis, and Psoriatic Arthritis: Expert Opinion of the Canadian Dermatology-Rheumatology Comorbidity Initiative by Roubille C1, Richer V1, Starnino T1, McCourt C1, McFarlane A1, Fleming P1, Siu S1, Kraft J1, Lynde C1, Pope J1, Gulliver W1, Keeling S1, Dutz J1, Bessette L1,Bissonnette R1, Haraoui B1.(PubMed)

Thursday 21 January 2016

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

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).

 Misdiagnosis and Delay diagnosis

1. Polyarticular gout
 Polyarticular gout, a inflammatory condition with painful crystals forming in the joints has been found to be misdiagnosed as Rheumatoid Arthritis in elderly of that can constitute to poor treatment as well as failure to recognize underlying renal insufficiency, and increased cardiac risks(75), according to the Albert Einstein College of Medicine.

2. Hypercalcemia and Lytic Bone Lesions Masquerading Inflammatory Arthritis 
According to the Mashhad University of Medical Sciences,  a 50-year-old woman with hypercalcemia, lytic bone lesions and inflammatory arthritis of both hands was misdiagnosed as rheumatoid arthritis due to the presence of perparathyroidism in rheumatologic manifestations(76).

3. Systemic sclerosis
Systemic sclerosis (SSc) is an autoimmune disease of the connective tissue may be misdiagnosed as rheumatoid arthritis. According to the Dr. Horimoto AM and Dr. Costa IP, arthritis, clinically observed, may be a feature often found in patient with Systemic sclerosis, often leading to early misdiagnosis with rheumatoid arthritis (RA)(77).

4. Jaccoud's arthropathy (JA)
Jaccoud's arthropathy (JA), a clinical situation foundt mostly in patient withsystemic lupus erythematosus (SLE) is found to be misdiagnosed as RA, due to swan neck," ulnar deviation and "Z-thumb which overlap with symptoms of patient with RA, according to the joint study lead by the Universidade Federal da Bahia, Salvador(78).

In fact, according to the joint study by the University of Texas Southwestern Medical Center and Victoria Hospital, the misdiagnosis of the atypical Infections versus Inflammatory Conditions of the Hand due to some similarity to inflammatory conditions regarding their clinical and imaging finding is rare but delay diagnosis can increase risk of severe bone and joint destruction, and higher morbidity(79).


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)
(75) Misdiagnosis of rheumatoid arthritis in an elderly woman with gout by Sewell KL1, Petrucci R, Keiser HD(PubMed)
(76) Hypercalcemia and Lytic Bone Lesions Masquerading Inflammatory Arthritis Treated as Rheumatoid Arthritis by Salari M1, Aboutorabi RB2, Rezaieyazdi Z1(PubMed)
(77) [Overlap between systemic sclerosis and rheumatoid arthritis: a distinct clinical entity?][Article in Portuguese] by Horimoto AM1, Costa IP2.(PubMed)
(78) Severe Jaccoud's arthropathy in systemic lupus erythematosus by Santiago MB1,2, Galvão V3, Ribeiro DS3, Santos WD3, da Hora PR3, Mota AP3, Pimenta E3, Oliveira I4, Atta AM4, Reis MG5, Reis EA5, Lins C3(PubMed)
(79) Atypical Infections versus Inflammatory Conditions of the Hand: The Role of Imaging in Diagnosis by Soldatos T1, Omar H, Sammer D, Chhabra A.(PubMed)

Wednesday 20 January 2016

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

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 Diagnosis


If you are experience certain subtle symptoms, such as achy joints or a morning stiffness, etc,....you may be at the early stage onset of rheumatoid arthritis. If your doctor suspect that have develop RA because of some RA symptoms such as such as warmth, swelling and pain in the joints, after physical exam, certain blood tests may be necessary, including
1. Erythrocyte sedimentation rate
ESR is a a common hematology test to calculate the rate of red blood cells sediment in a period of one hour. According to Dr. Wolfe F said " ESR is sensitive to immunoglobulins and rheumatoid factor (RF),... but a a poorer measure of inflammation"(64a) and may be effected by other factors. Other clinical findings, the individual's health history, and results from laboratory tests are necessary, such as C-reactive protein(64a) to rule out a suspected diagnosis for the confirmation of the result. Dr Sokka T and Dr. Pincus T. normal ESR and CRPC-reactive protein, are seen in a substantial proportion of patients with RA.(65a)


2.  C-reactive protein
A group of "acute phase reactants" protein produced by liver and found in patient with rheumatoid arthritis.,tends to elevate in case of inflammation. According to the Copenhagen University Hospital, oral nonsteroidal antiinflammatory drugs (NSAIDs) does not effects the levels of protein but may be constituted to the influence of NSAIDs on cardiovascular complications in patient with RA(66).


3. Test for Anemia
According to statistic, the prevalence of mild anemia characterized by low serum iron concentration ranged between 33% and 60% are found in patient with rheumatoid arthritis(67), such as aplastic anemia and iron deficiency anemia. In fact, patient with combination of RA and amenia are mostly experience severe forms of joint disease and improvement of anemia is found to contribute to over all quality of life (QOL) and response to RA therapy(67).

4. Anti-cyclic citrullinate d peptide (anti-CCP antibodies)
Cyclic citrullinated peptides (CCP) in most cases is ordered in conjunction with the test of rheumatoid factor in patient with RA. The positive find of anti-citrullinated peptide/protein antibodies may contribute to the presence of the early event in the disease(68). Dr van Venrooij WJ and the research team at the Radboud University said"...., the presence of these antibodies was highly predictive of and specific for RA, and illustrating the importance of ACPA"(69).

5. Rheumatoid factor
Rheumatoid factor test is a blood test to measure the antibody in patient with rheumatoid arthritis.
The study of 71 patients with rheumatoid arthritis and 25 control subjects. AIF-1 is found to associated with the pathogenesis of RA involved in the immunological process underlying RA(70).
Others such as elevation of interleukin-7 receptor (IL-7Ralpha)(71), interleukin-18(72),.... also involve in the presence of RA.
6. X ray
X ray may be important to determine the changes of bone mineral density. Patient with RA are found to have an lower BMD of that can lead to increased risk of major fracture and hip fracture(73). The family notebook suggested the relative change of  Rheumatoid Arthritis found in X ray according to Dr. Kirwan J and Dr. Byron M, Watt I. include soft tissue swelling, joint space narrowing and erosive damage(74).

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)
(64) Risk of rheumatoid arthritis following vaccination with tetanus, influenza and hepatitis B vaccines among persons 15-59 years of age by Ray P1, Black S, Shinefield H, Dillon A, Carpenter D, Lewis E, Ross P, Chen RT, Klein NP, Baxter R; Vaccine Safety Datalink Team.(PubMed)
(65) Can immunisation trigger rheumatoid arthritis? by D P Symmons and K Chakravarty(PubMed)
(64a) Comparative usefulness of C-reactive protein and erythrocyte sedimentation rate in patients with rheumatoid arthritis by Wolfe F1.(PubMed)
(65a) Erythrocyte sedimentation rate, C-reactive protein, or rheumatoid factor are normal at presentation in 35%-45% of patients with rheumatoid arthritis seen between 1980 and 2004: analyses from Finland and the United States by Sokka T1, Pincus T.(PubMed)
(66) Effect of nonsteroidal antiinflammatory drugs on the C-reactive protein level in rheumatoid arthritis: a meta-analysis of randomized controlled trials by Tarp S1, Bartels EM, Bliddal H, Furst DE, Boers M, Danneskiold-Samsøe B, Rasmussen M, Christensen R.(PubMed)
(67) Prevalence and outcomes of anemia in rheumatoid arthritis: a systematic review of the literature by Wilson A1, Yu HT, Goodnough LT, Nissenson AR.(PubMed)
(68) Anti-CCP antibodies: the past, the present and the future by van Venrooij WJ1, van Beers JJ, Pruijn GJ.(PubMed)
(69) Anti-citrullinated protein antibodies (ACPA) in early rheumatoid arthritis by Suwannalai P1, Trouw LA, Toes RE, Huizinga TW(PubMed)
(70) Expression of allograft inflammatory factor-1 in peripheral blood monocytes and synovial membranes in patients with rheumatoid arthritis by Pawlik A1, Kotrych D2, Paczkowska E3, Roginska D3, Dziedziejko V4, Safranow K4, Machalinski B5.(PubMed)
(71) Elevated expression of interleukin-7 receptor in inflamed joints mediates interleukin-7-induced immune activation in rheumatoid arthritis by Hartgring SA1, van Roon JA, Wenting-van Wijk M, Jacobs KM, Jahangier ZN, Willis CR, Bijlsma JW, Lafeber FP.(PubMed)
(72) Interferon-gamma-inducing activity of interleukin-18 in the joint with rheumatoid arthritis by Yamamura M1, Kawashima M, Taniai M, Yamauchi H, Tanimoto T, Kurimoto M, Morita Y, Ohmoto Y, Makino H.(PubMed)
(73) [Risk factors for bone mineral density changes in patients with rheumatoid arthritis and fracture risk assessment].[Article in Chinese] by Wang Y1, Hao YJ1, Deng XR1, Li GT1, Geng Y1, Zhao J1, Zhou W1, Zhang ZL1.(PubMed)
(74) The relationship between soft tissue swelling, joint space narrowing and erosive damage in hand X-rays of patients with rheumatoid arthritis by Kirwan J1, Byron M, Watt I.(PubMed)


Tuesday 19 January 2016

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

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 Risk factors 


1. Age
The prevalence of Rheumatoid arthritis is proportional with the progression of age. The University of Twente study suggests age is independently associated with the levels of both acute phase reactants in early RA.(48).
In a study of 950 RA patients, the median age at the time of onset of RA according to age of the young-onset RA (YORA) and late-onset RA (LORA) is 58(49).
According to the joint study lead by the Leiden University Medical Center, Zone, expression of gene IL7R gene expression associates with longevity and healthy ageing are also found to involved risk of immune-related disease, such as RA and reduced health(50).

2. Gender and body mass index
If you are women and overweight, you are at increased risk to develop Rheumatoid Arthritis(51)(52)(54), probably due to  the association between body composition BMI and inflammatory activity of in rheumatoid arthritis(55). The Korea study suggests, Middle- and old-aged women accounted for the majority of the Korean RA population, of which interfere with daily activity and employment rate(53).

3. Race
Genome-wide association studies and meta-analysis indicate that several genes/loci are consistently associated with rheumatoid arthritis (RA) in European and Asian populations(40). In treatment of RA, Dr. Constantinescu F and the research team at the Virginia Commonwealth University said " (there is) racial disparities in treatment preferences for rheumatoid arthritis(56). The University of Nebraska, Omaha suggests 52 percent of African American subjects were found to be risk averse compared with 12% of the white subjects. Race remained strongly associated with risk aversion in RA(57).

4. Smoking
Smoking is considered as one of the environment risk factor in involvement of Rheumatoid arthritis (RA) development and severity(58). The Danish study insisted that smoking exhibits other risk factors including IgM-rheumatoid factor, anti-CCP and shared epitopes in contribution to the early onset of rheumatoid arthritis(59). In fact, the medical literature was reviewed from 1985 to 2001 with the assistance of a MEDLINE showed that cigarette smoking has been increasingly shown in epidemiologic and case-control studies to be an important risk factor for both the incidence and severity of RA, especially in seropositive men. The poor habit also induce mutations or alterations in p53, a suppressor gene found in patients with RA(60).

5. Family history
 Rheumatoid arthritis (RA) is associated to greater risk in the first degree relatives in familial clustering, mothers confer susceptibility to RA on their offspring more often than fathers(61). According to the data on patients with RA were ascertained through the nationwide Swedish Patient Register of 88,639, the clinical Swedish Rheumatology Quality Register of 11,519, risk of RA are same in both sex but Familial factors is found to be overlap between seropositive RA and seronegative RA(62).

6. Vaccines
Certain vaccines may cause Rheumatoid Arthritis(65). But there is no statistically significant association between exposure to vaccine and onset of RA, according to the Kaiser Permanente Vaccine Study Center(64).

7. Other risk factors
Dr. Oliver JE and Dr. Silman AJ. in the study risk factors are that lead to the development of rheumatoid arthritis (RA). suggest diets high in caffeine, low in antioxidants, high in red meat, changes in the female hormonal environment such as in pregnancy, breastfeeding and the use of the oral contraceptive (OC) pill, cigarette smoking and passive inhalation of smoke may also contribute to an increased risk of RA(63). 

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)
(48) How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis by Siemons L1, Ten Klooster PM, Vonkeman HE, van Riel PL, Glas CA, van de Laar MA.(PubMed)
(49) Age at onset determines severity and choice of treatment in early rheumatoid arthritis: a prospective study by Innala L, Berglin E, Möller B, Ljung L, Smedby T, Södergren A, Magnusson S, Rantapää-Dahlqvist S, Wållberg-Jonsson S.(PubMed)
(50) IL7R gene expression network associates with human healthy ageing by Passtoors WM1, van den Akker EB2, Deelen J3, Maier AB4, van der Breggen R1, Jansen R5, Trompet S6, van Heemst D7, Derhovanessian E8, Pawelec G8, van Ommen GJ9, Slagboom PE3, Beekman M3.(PubMed)
(51) Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study by Jawaheer D, Olsen J, Lahiff M, Forsberg S, Lähteenmäki J, da Silveira IG, Rocha FA, Magalhães Laurindo IM, Henrique da Mota LM, Drosos AA, Murphy E,Sheehy C, Quirke E, Cutolo M, Rexhepi S, Dadoniene J, Verstappen SM, Sokka T; QUEST-RA.(PubMed)
(52) Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study by Sokka T, Toloza S, Cutolo M, Kautiainen H, Makinen H, Gogus F, Skakic V, Badsha H, Peets T, Baranauskaite A, Géher P, Ujfalussy I, Skopouli FN, Mavrommati M, Alten R, Pohl C, Sibilia J, Stancati A, Salaffi F, Romanowski W, Zarowny-Wierzbinska D, Henrohn D, Bresnihan B, Minnock P, Knudsen LS, Jacobs JW,Calvo-Alen J, Lazovskis J, Pinheiro Gda R, Karateev D, Andersone D, Rexhepi S, Yazici Y, Pincus T; QUEST-RA Group.(PubMed)
(53) Socioeconomic and employment status of patients with rheumatoid arthritis in Korea by Kwon JM1, Rhee J, Ku H, Lee EK.(PubMed)
(54) Body mass index and the risk of rheumatoid arthritis: a systematic review and dose-response meta-analysis by Qin B1, Yang M2,3, Fu H4, Ma N5, Wei T6, Tang Q7, Hu Z8, Liang Y9, Yang Z10, Zhong R11.(PubMed)
(55) Association between body composition and inflammatory activity in rheumatoid arthritis. A systematic review.[Article in English, Spanish]by Alvarez-Nemegyei J1, Buenfil-Relloy FA2, Pacheco-Pantoja EL3.(PubMed)
(56) Racial disparities in treatment preferences for rheumatoid arthritis by Constantinescu F1, Goucher S, Weinstein A, Fraenkel L.(PubMed)
(57) The association of race and ethnicity with disease expression in male US veterans with rheumatoid arthritis by Mikuls TR1, Kazi S, Cipher D, Hooker R, Kerr GS, Richards JS, Cannon GW.(PubMed)
(58) Smoking and rheumatoid arthritis by Chang K1, Yang SM2, Kim SH3, Han KH4, Park SJ5, Shin JI2.(PubMed)
(59) [Smoking--a risk factor for rheumatoid arthritis development].[Article in Danish] by Christensen AF1, Lindegaard HM, Junker P.(PubMed)
(60) Cigarette smoking and rheumatoid arthritis by Albano SA1, Santana-Sahagun E, Weisman MH.(PubMed)
(61) Family history as a risk factor for rheumatoid arthritis: a case-control study by Koumantaki Y1, Giziaki E, Linos A, Kontomerkos A, Kaklamanis P, Vaiopoulos G, Mandas J, Kaklamani E.(PubMed)
(62) Familial risks and heritability of rheumatoid arthritis: role of rheumatoid factor/anti-citrullinated protein antibody status, number and type of affected relatives, sex, and age by Frisell T1, Holmqvist M, Källberg H, Klareskog L, Alfredsson L, Askling J.(PubMed)
(63) Risk factors for the development of rheumatoid arthritis by Oliver JE1, Silman AJ.(PubMed)

Monday 18 January 2016

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

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 Causes

Rheumatoid arthritis is caused by immune dysfunction in attacking its own tissues, causing severe damage and inflammation of the joints, especially in the progresses to destruction of cartilage and bone. The causes of auto immune disorder is unknown, but some researchers expected the following.

1. Abnormal autoimmune response
 Scientists in the study of Abnormal networks of immune response-related molecules in bone marrow cells from patients with rheumatoid arthritis suggested that  patients with abnormal gene expressions of interleukin (IL) -37,(32a), miR-573 on IL-6 production(33) and microRNA-203(34),... are associated to increased risk of rheumatoid arthritis.
Dr. Lee HM and the research team at the Osaka University said" Abnormal regulatory networks in the immune response and one marrow (BM) cells from RA patients, indicating that the BM is pathologically involved in RA"(35).

2. Abnormal lipid profile
Abnormal lipid profile in many cases is associated to the metabolic syndrome risk, especially in patient with type II diabetes(36). The University of California suggested that patient with rheumatoid arthritis are found to have a high expression of low-density lipoprotein (LDL) cholesterol driven by increases in cholesterol ester catabolism(37). Dr. Xue C and the research team at the People's Hospital of Peking University showed that the association of rheumatoid arthritis and an abnormal lipid profile may be contributed as a result of increased inflammation markers and autoimmune antibodies(38) or inflammatory changes in HDL-C and Lp(a) metabolisms(39).

3. Genetic susceptibility
Certain genetic variations inherited from a parent, may be involved in the expression of RA patient, some research insisted. The Immunochip custom SNP array of 11,475 individuals with rheumatoid arthritis (cases) of European ancestry and 15,870 controls for 129,464 markers found that people with certain gene of loci are found to have an increased risk of rheumatoid arthritis(40).
Genetic association of CCR5 promoter polymorphism also seems to play an important role in determining different forms of rheumatoid arthritis(41), according to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. In fact, over expression of Aiolos polymorphisms(42), LRP3 rs35829419 polymorphism(43), Interleukin-6 promoter haplotypes(44),... are all found to induced certain human diseases, including rheumatoid arthritis.


4. Inflammatory and infectious connections
Chronic inflammation of the joint can result of thickens the synovium, of that affect the cartilage and bone within the joint. Dr. Liao F. and the the research team at the Wuhan University said" Rheumatoid arthritis (RA) is a common, systemic autoimmune disease which leads to destruction of the joint architecture and consequent disability"(46). According to Epidemiological studies, the prevalence of RA affects about 5% of the population are aged 50 years or older, involved the connection of infectious etiology with a complex inflammatory response(45).
T helper 17 cells (Th17), a major effector cells in several chronic inflammatory states, correlated with local and systemic parameters of inflammation may also be a causative link to the expression of patient with RA(47).


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)
(32a) Insights into IL-37, the role in autoimmune diseases by Xu WD1, Zhao Y1, Liu Y2.(PubMed)
(33) miR-573 is a negative regulator in the pathogenesis of rheumatoid arthritis by Wang L1, Song G2, Zheng Y3, Wang D4, Dong H4, Pan J1, Chang X3.(PubMed)
(34) Altered expression of microRNA-203 in rheumatoid arthritis synovial fibroblasts and its role in fibroblast activation by Stanczyk J1, Ospelt C, Karouzakis E, Filer A, Raza K, Kolling C, Gay R, Buckley CD, Tak PP, Gay S, Kyburz D.(PubMed)
(35) Abnormal networks of immune response-related molecules in bone marrow cells from patients with rheumatoid arthritis as revealed by DNA microarray analysis by Lee HM1, Sugino H, Aoki C, Shimaoka Y, Suzuki R, Ochi K, Ochi T, Nishimoto N.(PubMed)
(36) What is the consequence of an abnormal lipid profile in patients with type 2 diabetes or the metabolic syndrome? by Windler E1(PubMed)
(37) Potential mechanisms leading to the abnormal lipid profile in patients with rheumatoid arthritis versus healthy volunteers and reversal by tofacitinib by Charles-Schoeman C1, Fleischmann R, Davignon J, Schwartz H, Turner SM, Beysen C, Milad M, Hellerstein MK, Luo Z, Kaplan IV, Riese R, Zuckerman A,McInnes IB.(PubMed)
(38) [Association between systemic inflammation and autoimmunity parameters and plasma lipid in patients withrheumatoid arthritis].[Article in Chinese]by Xue C1, Liu WL, Sun YH, Ding RJ, Hu DY.(PubMed)
(39) Lp(a) lipoprotein and lipids in patients with rheumatoid arthritis: serum levels and relationship to inflammation by Dursunoğlu D1, Evrengül H, Polat B, Tanriverdi H, Cobankara V, Kaftan A, Kiliç M.(PubMed)
(40) High-density genetic mapping identifies new susceptibility loci for rheumatoid arthritis by
Eyre S, Bowes J, Diogo D, Lee A, Barton A, Martin P, Zhernakova A, Stahl E, Viatte S, McAllister K, Amos CI, Padyukov L, Toes RE, Huizinga TW, Wijmenga C,Trynka G, Franke L, Westra HJ, Alfredsson L, Hu X, Sandor C, de Bakker PI, Davila S, Khor CC, Heng KK, Andrews R, Edkins S, Hunt SE, Langford C, Symmons D; Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate; Wellcome Trust Case Control Consortium, Concannon P, Onengut-Gumuscu S,Rich SS, Deloukas P, Gonzalez-Gay MA, Rodriguez-Rodriguez L, Ärlsetig L, Martin J, Rantapää-Dahlqvist S, Plenge RM, Raychaudhuri S, Klareskog L,Gregersen PK, Worthington J.(PubMed)
(41) Genetic association of CCR5 promoter single nucleotide polymorphism in seronegative and seropositiverheumatoid arthritis by Lima G1, Furuzawa-Carballeda J, Ramos-Bello D, Jakez-Ocampo J, Pascual-Ramos V, Núñez-Alvarez CA, Granados J, Llorente L.(PubMed)
(42) Overexpression of Aiolos in Peripheral Blood Mononuclear Cell Subsets from Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis by Cai X1, Liu X1, Du S1, Xu X1, Liu A1, Ge X1, Qiao Y1, Jiang Y2,3.(PubMed)
(43) NLRP3 rs35829419 polymorphism is associated with increased susceptibility to multiple diseases in humans by Zhang Q1, Fan HW1, Zhang JZ1, Wang YM1, Xing HJ1.(PubMed)
(44) Interleukin-6 promoter haplotypes are associated with etanercept response in patients with rheumatoid arthritis by Schotte H1, Schmidt H2, Gaubitz M3, Drynda S4, Kekow J4, Willeke P5, Schlüter B2.(PubMed)
(45) Rheumatoid arthritis and periodontitis - inflammatory and infectious connections. Review of the literature by Rutger Persson G1(PubMed)
(46) Porphyromonas gingivalis may play an important role in the pathogenesis of periodontitis-associatedrheumatoid arthritis by Liao F1, Li Z, Wang Y, Shi B, Gong Z, Cheng X.(PubMed)
(47) The potential role of Th17 in mediating the transition from acute to chronic autoimmune inflammation:rheumatoid arthritis as a model by Ferraccioli G1, Zizzo G.(PubMed)

Saturday 16 January 2016

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

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).

                            Signs and Symptoms


1. The feet and joints
Patient with rheumatoid arthritis (RA) often associate to valgus deformities of the feet and deformities of gait due to body function in effort to support the collapsing longitudinal arch of the foot(3). According to Dr. Brooks F and Dr. Hariharan K., feet demortities, effecting over 90% of the patient, behind only the hand, leading to painful callosities and dislocation of the metatarsophalangeal joints(5). Because of its severity, regardless to "....pharmacological management of rheumatoid arthritis and its impact upon disease progression, forefoot deformity and pain remain common manifestations requiring reconstruction from orthopadic surgeons" Dr. Amin A. and the reaserch team at the Royal National Orthopaedic Hospital, said(6).
In fact, the prevalence of deformations of hands, feet and gait can be seen among patient with rheumatoid arthritis among aging population may be depending to the severity and time factors which can lead to enormous pain and swelling of the ankle of which correlated weakly but statistically significantly with limitation and disability(7). The Jyväskylä Central Hospital, suggested that radiographic damage of hand and foot joints, and the number of tender and swollen joints are frequent found in patient with Rheumatoid Arthritis(8)(9).

2. The gait
Dr. Weiss RJ. and the research team at the Karolinska Institutet, showed that the kinematic and kinetic gait changes in rheumatoid arthritis (RA) patients are the result of a significant reduction in joint motions, joint moments, such as decreased hip flexion-extension range, hip abduction, knee flexion-extension range,...(9). The valgus deformities of the feet in patient withRA may be the main contribution to deformities of gait, including revealed decreases in velocity, stride length, and single-limb-support time(10). Used as characterise dysfunction of the lower limb and foot in people, gait also expressed its effects mainly in RA's patient with conditions of of a slower walk, longer double support time, and avoidance of extreme positions(11).

3. The hands
The affects of deformation of RA's hands can be described through the defects of bone ankylosis as a result of bone damage of the prolonged onset of the disease(12). These deformities of hand and wrist and small peripheral joints (such as fingers and wrist) due to chronic inflammation can be treated by transelectrical nerve stimulation, the University of Ottawa suggested(14).
According to the joint study lead by the University of Warwick, strengthening and stretching have been found effectively in reduced pain and dysfunction of the hands and/or wrists in RA patient with stable medication for at least 3 months(13)

4. The Muscle strength
The effects of muscle strength in patient with RA may contribute to the prevalence of functional limitations physically of that cdan effects daily living and quality of lifeDr. Häkkinen A and the research team at Jyväskylä Central Hospital, suggested that 2-year program of strength training showed a statistically significant improvement in clinical disease activity parameters, walking speed and physical function(15). Some researchers suggested that muscle strength was found inversely and independently associated with all-cause mortality, including the levels of physical activity or even cardiorespiratory fitness(16).
Dr. Brodin N and Dr. Swärdh said"... short-term land-based aerobic and strengthening exercise on moderate to high intensity results in positive effects on oxygen uptake and muscular strength, but not pain,..." (17).of that may be necessary for patient with RA.

5. Rheumatoid nodules
Rheumatoid nodules, lump on the skin, closed to the joint have been found to affect the joints of patients with rheumatoid nodules(18). Treatment of rheumatoid nodules are necessary in odd cases if the patient are experiencing pain or interference of mechanical function, according to Dr. Tilstra JS and Dr.Lienesch DW.(19). Use of methotrexate (MTX) in patient with RA may accelerate the occurance of nodulosis in the fingers. but nodules will be resolved after methotrexate was discontinued and recurred after methotrexate was reintroduced(20).
5. Conjunctival nodule
Although is rare in patients with rheumatoid arthritis, the appreance of the nodules may exhibit the
severity of the underlying disease, according to the Tehran University of Medical Sciences(21), including Pityriasis Lichenoides et Varioliformis Acuta(22), Epstein-Barr virus(23)

6. Morning stiffness
Morning stiffness, as a marker of inflammatory activity in reflecting functional disability and pain is a very common symptoms of patients in early rheumatoid arthritis(24). Use of glucocorticoid is found effectively in pain relief over 70 percent of patient with RA(25).
According to the Charité University Medicine, in a 12-week, multicentre, randomised, double-blind trial, 288 patients with active rheumatoid arthritis, treatment of modified-release prednisone exhibited a clinically relevant reduction of morningstiffness of the joint in comparison of immediate-release prednisone(26).

7. Quality of life
7.1. Physical disability
Although psychological distress and physical disability have been decreased with the cautious approach with respect to prescribing medication and physical exercise progressed toward RA patient(27), but tools necessary to measure RA disease activity are often incomplete, imprecise, or rely on a combination of physician and patient subjective evaluations(28)
Dr. Motl RW and Dr. McAuley E.said" The rationale and the associated onset of chronic disease conditions that influence function, disability, and quality of life (QOL) is embedded in the "Graying of America""(29), including patient with RA.

7.2. Concurrent psychiatric disorders
Concurrent psychiatric disorders, such as depression or anxiety in patient with Rheumatoid Arthritis is found to associate to poor quality of life, according to  Dr. Mok C, and the scientists at the Tuen
Mun Hospital(30). Patients with RA is found to associate to Neurologic (N) and psychiatric (P) syndromes including depression and anxiety and symptoms of cognitive dysfunction, etc.,....of that induced poorer quality of life, according to the Lby the SF-36 and fatigue by a 10 point Likert scale(32).
Dr. Arnold LM said" Chronic widespread pain is associated with several medical and psychiatric disorders,....,careful and comprehensive differential diagnosis must be performed to ensure a correct diagnosis before an appropriate treatment can be selected"(31).

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)
(5) The rheumatoid forefoot by Brooks F1, Hariharan K.(PubMed)
(6) Rheumatoid forefoot reconstruction by Amin A1, Cullen N, Singh D.(PubMed)
(7) We should not forget the foot: relations between signs and symptoms, damage, and function in rheumatoid arthritis by Baan H1, Drossaers-Bakker W, Dubbeldam R, van de Laar M.(PubMed)
(8) Pain and joint mobility explain individual subdimensions of the health assessment questionnaire (HAQ) disability index in patients with rheumatoid arthritis by Häkkinen A1, Kautiainen H, Hannonen P, Ylinen J, Arkela-Kautiainen M, Sokka T.(PubMed)
(9) Gait pattern in rheumatoid arthritis by Weiss RJ1, Wretenberg P, Stark A, Palmblad K, Larsson P, Gröndal L, Broström E.(PubMed)
(10) 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)
(11) Gait analysis of the lower limb in patients with rheumatoid arthritis: a systematic review by Baan H1, Dubbeldam R, Nene AV, van de Laar MA.(PubMed)
(12) Ankylosis of the wrist bones in patients with rheumatoid arthritis: a study with extremity-dedicated MRI by Barbieri F1, Zampogna G1, Camellino D1, Paparo F2, Cutolo M1, Garlaschi G3, Cimmino MA4.(PubMed)
(13) Strengthening And stretching for Rheumatoid Arthritis of the Hand (SARAH). A randomised controlled trial and economic evaluation by Williams MA1, Williamson EM1, Heine PJ1, Nichols V1, Glover MJ2, Dritsaki M2, Adams J3, Dosanjh S1, Underwood M1, Rahman A4, McConkey C1, Lord J1,Lamb SE1.(PubMed)
(14) Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand by Brosseau L1, Judd MG, Marchand S, Robinson VA, Tugwell P, Wells G, Yonge K(PubMed)
(15) A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis by Häkkinen A1, Sokka T, Kotaniemi A, Hannonen P.(PubMed)
(16) Muscular strength as a strong predictor of mortality: A narrative review by Volaklis KA1, Halle M2, Meisinger C3.(PubMed)
(17) Personer med reumatoid artrit bör uppmanas till fysisk aktivitet.[Article in Swedish]by Brodin N1, Swärdh E1.(PubMed)
(18) Microchimerism in the rheumatoid nodules of patients with rheumatoid arthritis by Chan WF1, Atkins CJ, Naysmith D, van der Westhuizen N, Woo J, Nelson JL.(PubMed)
(19) Rheumatoid Nodules by Tilstra JS1, Lienesch DW2.(PubMed)
(20)Accelerated cutaneous nodulosis during methotrexate therapy in a patient with rheumatoid arthritis by Williams FM1, Cohen PR, Arnett FC.(PubMed)
(21) Conjunctival nodule in rheumatoid arthritis by Kheirkhah A1, Amoli FA, Azari AA, Molaei S, Roozbahani M.(PubMed)
(22) Conjunctival Inflammatory Nodule in a Patient with Pityriasis Lichenoides et Varioliformis Acuta by Elad Moisseiev* and David Varssano(PMC)
(23) Conjunctival lymphocytic nodule associated with the Epstein-Barr virus by Gardner BP1, Margolis TP, Mondino BJ.(PubMed)
(24) Morning stiffness in patients with early rheumatoid arthritis is associated more strongly with functional disability than with joint swelling and erythrocyte sedimentation rate by Yazici Y1, Pincus T, Kautiainen H, Sokka T.(PubMed)(25) Improvement Thresholds for Morning Stiffness Duration in Patients Receiving Delayed- Versus Immediate-Release Prednisone for Rheumatoid Arthritis by Buttgereit F, Kent JD, Holt RJ, Grahn AY, Rice P, Alten R, Yazici Y.(PubMed)
(26) Efficacy of modified-release versus standard prednisone to reduce duration of morning stiffness of the joints inrheumatoid arthritis (CAPRA-1): a double-blind, randomised controlled trial by Buttgereit F1, Doering G, Schaeffler A, Witte S, Sierakowski S, Gromnica-Ihle E, Jeka S, Krueger K, Szechinski J, Alten R.(PubMed)
(27) Change of psychological distress and physical disability in patients with rheumatoid arthritis over the last two decades by Overman CL1, Jurgens MS, Bossema ER, Jacobs JW, Bijlsma JW, Geenen R.(PubMed)
(28) Optimizing Rheumatoid Arthritis Therapy: Using Objective Measures of Disease Activity to Guide Treatment by Owens GM1(PubMed)
(29) Physical activity, disability, and quality of life in older adults by Motl RW1, McAuley E.(PubMed)
(30) Concurrent psychiatric disorders are associated with significantly poorer quality of life in patients with rheumatoid arthritis by Mok CC1, Lok EY, Cheung EF(PubMed)
(31) Pain and the brain: chronic widespread pain by Arnold LM1(PubMed)