StemCell Therapy

"Motion is medicine" is a saying to live by, and it may be more important than ever during the COVID-19 crisis.

Michael Mason, DO, is an orthopedic surgeon with Newport Orthopedics, a Lifespan Physician Group practice. We asked him to explain why its so vital to stay active.

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Exercise is valuable self-care practice at all times, but especially now, during the era of COVID-19.

Regular exercise provides enormous orthopedic and general health benefits, including protection against diabetes, obesity, high blood pressure, osteoporosis and fractures, heart disease, and more. Some of these conditions put people at higher risk of serious COVID-19 illness.

The pandemic certainly has heightened our stress levels. Exercise helps by causing our body to release endorphins, which lift our mood. Getting outdoors in the sun spurs our skin cells production of vitamin D, which is good for bones, muscles, and teeth.

Besides maintaining your bodys strength and endurance, exercise helps your joints function better. Cartilage, which cushions the ends of the bones in our joints, relies on synovial fluid, not blood, for its nutrients. Exercise compresses the joints, forcing more of this nutrient-rich fluid into the cartilage, helping it stay lubricated and healthy.

Some kinds of exercise lend themselves to social distancing, such as tennis, golfing, bicycling, swimming, and walking or hiking.

A combination of exercises flexibility, aerobic and strengthening is great for everyone, but especially for people with arthritis. Swimming is particularly beneficial, and according to the Centers for Disease Control, theres no evidence that SARS-CoV-2, the virus that causes COVID-19, can spread to people through water. The CDC advises that you not wear a mask while in the water, because its harder to breathe if it gets wet. Be sure to stay at least 6 feet away from others, unless they are from the same household.

In summer, I like to sail, but I also enjoy taking walks and playing outdoors with my dog. Aquidneck Island has plenty of options for walkers who want to enjoy nature and beautiful scenery, which uplifting for your spirits.

If youre still not comfortable being near others, or have concerns because youre in a high-risk group, you can exercise at home with online fitness classes. There are many options to choose from.

Without exercise, arthritic joints become more stiff and painful, and bones become brittle and susceptible to fractures. Studies have shown that exercising may help patients with mild to moderate arthritis delay hip replacement surgery.

When joint replacement cant be put off any longer, todays patients benefit from major advances such as reduced surgery time, shorter hospital stays, and quicker recovery time. Patients regain a greater range of motion than in years past, and the joint implants last much longer.

Newport Hospital is unique in Rhode Island in using Radlink GPS imaging technology during joint replacement procedures. This technology allows the surgeon to analyze the size, position and orientation of hip replacement implants and place them precisely where they need to be for the best results.

Remember, motion is medicine, so be sure to stay active despite COVID concerns.

You can find lots more information about COVID-19 best practices on the Rhode Island Department of Health website.

Michael Mason, DO, is a board-certified orthopedic surgeon. He sees patients at Newport Orthopedics, a Lifespan Physician Group practice. Newport Hospital provides this monthly column for The Daily News.

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HEALTH MATTERS: Exercise benefits in the time of COVID-19 - newportri.com

During my first month with fibromyalgia, I lived in a daze. Bizarre new sensations were plaguing my body that I had never felt before. What, for example, were my fluttering heart and inexplicable new intolerance to the heat trying to tell me? Or the seismic waves of pain racking my body, my sudden apathy to sex and my new inability to digest previously loved foods? I initially attributed it all to the heat in New Delhi and carried on, hoping for the best.

But the rapid worsening of symptoms made it hard to ignore them. In the absence of an answer, I turned to the web, where WebMD suggested lung cancer and allergies with cheerful alacrity. I cheated on one doctor with the next, experimenting with ones test and then anothers treatment, like physicians roulette, but nothing worked. And then, one day, a wizened rheumatologist squeezed mounds of my flesh between the tips of his fingers and hmmed and ahhed before ruling me a survivor of the chronic pain syndrome, fibromyalgia.

As it turns out, Im one in a vast pool of fibromyalgia syndrome (FMS) sufferers. The condition affects 10 million people just in the U.S., and an estimated 80 to 90 percent of all diagnosed patients in the world are women. But the jurys been out for decades on what causes it. Conjectures vary from family history of rheumatoid illnesses to childhood trauma and severe physical or emotional stress. To make matters more difficult, a general practitioner can't confirm or rule the condition out through bloodwork or an X-ray. Widespread pain for over three months the key criteria for a fibromyalgia diagnosis could also point to other conditions, all of which need to be laboriously ruled out before a patient receives the diagnosis.

Severity of symptoms vary, ranging from a tolerable, dull pain to discomfort so severe that its nearly impossible to get out of bed. Lady Gaga, for example, tells in the Netflix documentary Five Foot Two, how she powers through on bad pain days with a bevy of physicians at her side, pumping her body with corticosteroids before performances. But it can take years to get where she is. Labyrinthine corridors of pain management clinics, at any given time, teem with FMS sufferers who hunt for solidarity amongst strangers as they ask one another, Do you also? and what do you do for the? and Im tired of being disbelieved.

Yet, even as FMS continues to be a mystery to medical practitioners around the world, recent research has slowly started to shed light on some of its major symptoms offering new hope to the millions who suffer from it.

Amir Minerbi, a specialized pain physician at the Alan Edwards Pain Management Unit at McGill University, says he treats many individuals affected by fibromyalgia. And his patients are frustrated.

They share how long it takes to get diagnosed, how ineffective many of our treatment modalities are, how difficult it is for others to understand what they are going through friends, family and even medical personnel, Minerbi says.

In a June 2019 study in the journal Pain, Minerbi and colleagues found that compared to healthy individuals, patients with fibromyalgia had a different composition of gut microbes. We used this correlation to teach a computer to classify patients from controls, and reached reasonably good accuracy, says Minerbi.

While the demonstration so far doesnt confirm that the absence or presence of certain bacteria causes fibromyalgia, the team is keen to build on the study to search for a causal relationship. Minerbi says that the hope is to be able not only to make faster, more accurate diagnoses of fibromyalgia, but also to treat it by manipulating the microbiome.

This improved understanding could one day lead to the creation of new diagnostic tools, the researchers concluded in their study.

Gut disturbances arent the only symptoms that have received recent attention in relation to FMS. This year, researchers also studied the chronic conditions overlap with mental health.

In June 2020, a study in the journal Arthritis Care & Research examined the connection between self-harm and severe rheumatological conditions. The group of scientists, led by epidemiologist James Prior at Keele University in the UK found that, of all the conditions studied, self-harm was most prevalent among patients with fibromyalgia even more than conditions like rheumatoid arthritis or osteoarthritis.

Fibromyalgia sufferers were also found to have greater incidence of depression and mental health issues than patients with the other arthritic conditions studied. Prior says the link between fibromyalgia and depression was unearthed out of medical records of patients, who have their conditions listed on the UKs primary care database as soon as they visit a primary care provider. This makes sense, given that anti-depressants are a recommended treatment for fibromyalgia symptoms.

We were certainly pleased that our work has highlighted that healthcare professionals need to be aware of the impact that this invisible condition has on the mental health of patients with rheumatological conditions, especially fibromyalgia, says Prior.

Mental health is indeed an important factor to look out for in FMS, since it can both cause and be the cause of other symptoms. Sexual dysfunction, for instance, is an FMS symptom that rarely gets attention even though it, too, can lead to mental health issues. Fortunately, recent research has been shedding light on fibromyalgia's effects on the reproductive system, as well.

Several studies over the years have recorded the loss of libido and sexual dysfunction among patients with fibromyalgia. What should comfort both FMS patientsand their partners, though, is the understanding developing in this arena. Research is examining how women on anti-depressants can face loss of arousal, vaginal lubrication and apathy to sex and how their long-term sexual partners are working with them to find a solution.

A study published in November 2019 in PLOS ONE, led by Patricia Romero-Alcal at the University of Almeria in Spain, investigated the changing realities of couples living with fibromyalgia. Although limited in that it looked only at heterosexual relationships, the study is promising in its recognition of sexuality as an important aspect of FMS.

Other studies have found a definite association between female sexual dysfunction and fibromyalgia as well as a possible relationship between depression and sexual dysfunction in premenopausal women with the condition. The one thing common among them is all, is the evidence for patients need for sexological support.

While research is ongoing, a medical breakthrough to treat FMS is still some distance away. Science is still no closer to explaining is what actually causes fibromyalgia and how one can map its probable development in the next generation.

Besides concrete data, what FMS sufferers need in general is empathy. Millions of FMSsufferers around the world currently struggle with validation, considering their condition is still widely considered an invisible illness. Coupled with the disquieting feeling of never knowing which symptom will hit next, fibromyalgia can be a hard burden to bear. Perhaps now, as we inch closer and closer to effectively diagnosing and treating fibromyalgia, those in-between years of waiting will be cut significantly shorter.

Heres hoping.

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What Science Knows About Fibromyalgia, a Painful Illness That is Often Invisible - Discover Magazine

Damaged cartilage can be treated through a technique called microfracture, in which tiny holes are drilled in the surface of a joint. The microfracture technique prompts the body to create new tissue in the joint, but the new tissue is not much like cartilage.

Microfracture results in what is called fibrocartilage, which is really more like scar tissue than natural cartilage, said Chan. It covers the bone and is better than nothing, but it doesnt have the bounce and elasticity of natural cartilage, and it tends to degrade relatively quickly.

The most recent research arose, in part, through the work of surgeon Matthew Murphy, PhD, a visiting researcher at Stanford who is now at the University of Manchester. I never felt anyone really understood how microfracture really worked, Murphy said. I realized the only way to understand the process was to look at what stem cells are doing after microfracture. Murphy is the lead author on the paper. Chan and Longaker are co-senior authors.

For a long time, Chan said, people assumed that adult cartilage did not regenerate after injury because the tissue did not have many skeletal stem cells that could be activated. Working in a mouse model, the team documented that microfracture did activate skeletal stem cells. Left to their own devices, however, those activated skeletal stem cells regenerated fibrocartilage in the joint.

But what if the healing process after microfracture could be steered toward development of cartilage and away from fibrocartilage? The researchers knew that as bone develops, cells must first go through a cartilage stage before turning into bone. They had the idea that they might encourage the skeletal stem cells in the joint to start along a path toward becoming bone, but stop the process at the cartilage stage.

The researchers used a powerful molecule called bone morphogenetic protein 2 (BMP2) to initiate bone formation after microfracture, but then stopped the process midway with a molecule that blocked another signaling molecule important in bone formation, called vascular endothelial growth factor (VEGF).

What we ended up with was cartilage that is made of the same sort of cells as natural cartilage with comparable mechanical properties, unlike the fibrocartilage that we usually get, Chan said. It also restored mobility to osteoarthritic mice and significantly reduced their pain.

As a proof of principle that this might also work in humans, the researchers transferred human tissue into mice that were bred to not reject the tissue, and were able to show that human skeletal stem cells could be steered toward bone development but stopped at the cartilage stage.

The next stage of research is to conduct similar experiments in larger animals before starting human clinical trials. Murphy points out that because of the difficulty in working with very small mouse joints, there might be some improvements to the system they could make as they move into relatively larger joints.

The first human clinical trials might be for people who have arthritis in their fingers and toes. We might start with small joints, and if that works we would move up to larger joints like knees, Murphy says. Right now, one of the most common surgeries for arthritis in the fingers is to have the bone at the base of the thumb taken out. In such cases we might try this to save the joint, and if it doesnt work we just take out the bone as we would have anyway. Theres a big potential for improvement, and the downside is that we would be back to where we were before.

Longaker points out that one advantage of their discovery is that the main components of a potential therapy are approved as safe and effective by the FDA. BMP2 has already been approved for helping bone heal, and VEGF inhibitors are already used as anti-cancer therapies, Longaker said. This would help speed the approval of any therapy we develop.

Joint replacement surgery has revolutionized how doctors treat arthritis and is very common: By age 80, 1 in 10 people will have a hip replacement and 1 in 20 will have a knee replaced. But such joint replacement is extremely invasive, has a limited lifespan and is performed only after arthritis hits and patients endure lasting pain. The researchers say they can envision a time when people are able to avoid getting arthritis in the first place by rejuvenating their cartilage in their joints before it is badly degraded.

One idea is to follow a Jiffy Lube model of cartilage replenishment, Longaker said. You dont wait for damage to accumulate you go in periodically and use this technique to boost your articular cartilage before you have a problem.

Longaker is the Deane P. and Louise Mitchell Professor in the School of Medicine and co-director of the Institute for Stem Cell Biology and Regenerative Medicine. Chan is a member of the Institute for Stem Cell Biology and Regenerative Medicine and Stanford Immunology.

Other Stanford scientist taking part in the research were professor of pathology Irving Weissman, MD, the Virginia and D. K. Ludwig Professor in Clinical Investigation in Cancer Research; professor of surgery Stuart B. Goodman, MD, the Robert L. and Mary Ellenburg Professor in Surgery; associate professor of orthopaedic surgery Fan Yang, PhD; professor of surgery Derrick C. Wan, MD; instructor in orthopaedic surgery Xinming Tong, PhD; postdoctoral research fellow Thomas H. Ambrosi, PhD; visiting postdoctoral scholar Liming Zhao, MD; life science research professionals Lauren S. Koepke and Holly Steininger; MD/PhD student Gunsagar S. Gulati, PhD; graduate student Malachia Y. Hoover; former student Owen Marecic; former medical student Yuting Wang, MD; and scanning probe microscopy laboratory manager Marcin P. Walkiewicz, PhD.

The research was supported by the National Institutes of Health (grants R00AG049958, R01 DE027323, R56 DE025597, R01 DE026730, R01 DE021683, R21 DE024230, U01HL099776, U24DE026914, R21 DE019274, NIGMS K08GM109105, NIH R01GM123069 and NIH1R01AR071379), the California Institute for Regenerative Medicine, the Oak Foundation, the Pitch Johnson Fund, the Gunn/Olivier Research Fund, the Stinehart/Reed Foundation, The Siebel Foundation, the Howard Hughes Medical Institute, the German Research Foundation, the PSRF National Endowment, National Center for Research Resources, the Prostate Cancer Research Foundation, the American Federation of Aging Research and the Arthritis National Research Foundation.

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Researchers find method to regrow cartilage in the joints - Stanford Medical Center Report

So with the help of Clapham, weve rounded up the five best Pilates moves to help relieve joint pain. She recommends incorporating these moves into your daily routine at least three times a week, however, Clapham cautions that you should speak with your doctor before starting a new exercise program.

Clapham says the cat-cow pose is a stretch and release exercise thats wonderful for the lower back and thoracic spine. This move is performed on your hands and knees. To get started, round your spine up towards the ceiling, and keep your gaze between your legs. This is your cat-like shape. Then, arch your back, let your belly relax and lift your head up. This is your cow-like shape.

Clapham says the pike is an effective exercise that can help loosen stiff joints in the neck, shoulders, back, hips, knees and ankles. To get started, Clapham says to start on your hands and knees. Lift your knees off the floor and place your head between your arms with your gaze between your legs. Using your upper body, push the tops of your thighs back and stretch your heels down, creating an inverted V shape with your body. Try to straighten your legs as much as possible without locking your knees.

For those less flexible you can bend your legs on the inhale and straighten them on the exhale and repeat, Clapham advises.

This is a weight-bearing strength exercise that targets your core, glutes and hamstrings, Clapham says, adding: The quadricep is beneficial for those with back pain as it improves your core muscles and [helps] stabilise your spine.

She says to start on your hands and knees, keeping your knees hip-width apart. Then lift one arm in front of you and the opposite leg behind you. Hold this for a few seconds and then repeat on the alternate arm and leg.

Clapham says horse kicks are great for those with hip pain as it loosens the hip joint and strengthens the muscles surrounding the hip. To get started, start on your hands and knees, keeping your knees hip-width apart. Using a kicking motion, lift one leg off the ground, keeping the knee bent at a 90-degree angle and the foot flexed. Lower the leg and then switch legs.

Double leg lifts are a fantastic way to improve your posture, create a stronger core and alleviate back pain, Clapham explains.

Begin by lying on your side with your legs slightly bent, then use your arms to support yourself up. Slowly lift both legs up off the floor before lowering them back down again without touching the floor.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesnt take into account your personal health requirements or existing medical conditions. That means its not personalised health advice and shouldnt be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.

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Living with arthritis? 5 easy Pilates moves that can help relieve joint pain - Starts at 60

Nobody enjoys needless pain it's not like you're getting any benefit from aching joints. Put a stop to it today by popping a simple pill.

Arthritis is a common condition, attests the National Health Service (NHS), that causes pain and inflammation in a joint.

Apparently, the disease affects "more than 10 million people" in the UK.

The consumption of a natural remedy - only 28p could help to reduce symptoms of arthritis.

These are said to block the production of inflammatory chemicals, such as "TNF-alpha", making them useful to ease joint pain.

The Cellular and Molecular Biology Division, in India, conducted a placebo- controlled study into the effects of Boswellia on joint pain.

The study enrolled 75 volunteers who had been diagnosed with osteoarthritis - a type of arthritis.

Each participant was given either 100mg or 250mg of Boswellia extract, or a daily placebo.

The trail went on for three months, and the participants were evaluated for pain and physical functions at different intervals.

On day 0, day seven, day 30, day 60, and day 90, the participants' levels of pain were documented.

In addition to this, the cartilage degrading enzyme, matrix metalloproteinase-3, was evaluated in patients' synovial fluids.

At the end of the study, the researchers noted that both doses of Boswellia extract (100mg or 250mg) showed "clinically and statistically significant improvements in pain scores and physical function scores".

The higher dosage of Boswellia extract saw a "significant improvement in pain score and functional ability" in seven days after starting treatment.

In line with these findings, the 250mg of Boswellia extract also showed a reduction in synovial fluid matrix metalloproteinase-3 in seven days.

Natures Way Boswellia Extract provides 307mg in each supplement pill, which suggests it would be an effective pain reliever.

The active ingredient is Boswellia serrata Tree Resin, which is native to India, North Africa and the Middle East.

The resin is obtained by peeling away strips of bark and then harvesting the gum that oozes out to harden over the wound.

This isn't a new development, in fact it's been used in Chinese medicine for years.

Mr Wakeman added: "[Boswellia] has the added benefit of low side effects.

"For those patients seeking an alternative to paracetamol and ibuprofen for relief of joint pain especially, it is worth considering Boswellia.

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Best supplement for arthritis: The 28p natural remedy that could ease your joint pain - Express

Tumor necrosis factor inhibitors (TNFis) have comparable effectiveness to non-TNFis in the treatment of rheumatoid arthritis (RA), according to study data published in Annals of the Rheumatic Diseases.

Investigators extracted data from the Consortium of Rheumatology Researchers of North America RA Registry, a large healthcare database of patients with RA in the United States. Adult patients with clinician-diagnosed RA and a Clinical Disease Activity Index (CDAI) >2.8 were eligible for inclusion in the study. Patients who were initiated with a first-line TNFi or non-TNFi between 2001 and 2018 were enrolled. Patients with prior exposure to a biologic or targeted synthetic DMARD were excluded from the study. Baseline clinical and demographic characteristics were collected before treatment initiation. The primary outcome was change in CDAI at 1 year after initiation of TNFi or non-TNFi. Low disease activity was defined as CDAI 10; remission was defined as CDAI 2.8. Secondary end points included various patient-reported outcomes, such as quality of life, quality of sleep, fatigue, and morning stiffness. Groups were propensity score-matched at baseline. Random effect regression models were used to compare outcome measures between the TNFi and non-TNFi treatment groups.

The study cohort included 4816 individuals, among whom 4186 were with initiated a TNFi and 630 with a non-TNFi. The mean age of patients in the TNFi and non-TNFi groups were 56.912.7 years and 62.713.0 years, respectively. A majority of the TNFi and non-TNFi groups were women (76.5% and 79.8%, respectively).

Overall, both groups had significant improvements in RA symptoms and patient-reported quality of life. At 1 year, similar proportions of the TNFi and non-TNFi groups achieved low disease activity (39.9% and 41.6%, respectively; P =.87) and remission (17.6% vs 16.3%; P =.26). Both groups also had comparable improvements in mean changes in CDAI (P =.16), Health Assessment Questionnaire scores (P =.07), and patient-reported morning stiffness (P =.29) and fatigue (P =.42). After propensity matching, the TNFi vs non-TNFi groups had lower incidence of anemia (19.04 vs 24.01 cases per 100 person-years, respectively; P =.03). However, the 2 groups did not significantly differ on other outcomes.

Results indicated that both TNFi and non-TNFi treatment may be appropriate after the failure to respond to csDMARDs.

The findings of no significant differences in outcomes between first-line TNF and first-line non-TNF groups support RA guidelines which recommend [individualized] care based on clinical judgement and consideration of patient preferences, the investigators concluded.

Disclosures: This study was supported by Corrona, LLC, and the analysis was supported by Regeneron Pharmaceuticals, Inc, and Sanofi.

Pappas DA, St John G, Etzel CJ, et al. Comparative effectiveness of first-line tumour necrosis factor inhibitor versus non-tumour necrosis factor inhibitor biologics and targeted synthetic agents in patients with rheumatoid arthritis: results from a large US registry study. Ann Rheum Dis. Published online July 21, 2020. doi:10.1136/annrheumdis-2020-217209

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TNF and Non-TNF Inhibitors Display Comparable Effectiveness for Rheumatoid Arthritis Treatment - Rheumatology Advisor

Arthritis and joint pain become very common as one age. From feeling the pain while sitting or standing to swellings in the joint, people are increasingly suffering from joint pain. Neck, back, knee, wrists pain have become overtly common during the lockdown because of long working hours. Sitting in one position for work for long hours is also a reason for people suffering from arthritis.

Arthritis isof two types. One is osteoarthritis that results from the breakdown of the cartilage and the other is rheumatoid arthritis which is caused by weak immunity. The reason behind all this is the lack of exercise and a bad lifestyle. Swami Ramdev, in a special show on India TV, shares effective yoga asanas and pranayamas that are effective in treating Arthritis and joint pain.

Swami Ramdev claims that sukshma vyayamas are very effective in keeping the joints flexible and protects the body from arthritis. He suggests doing yoga asanas like tadasanas, chakki asana, sthit konasana, makrasana, bhujangasana, markatasana, setubandh asana and uttanpadasana to treat neck, back and knee pain.

Swami Ramdev says that pranayamas maintain proper blood circulation in the body which helps keep our organs healthy. He suggests starting the day with surya namaskar and then perform pranayamas like kapalbhati, anulom vilom, and bhastrika for effective results. He says that one can do kapalbhati for half an hour to one hour. He also suggests increasing the number of pranayamas every week as your body gets used to it.

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Treat Arthritis and Joint Pain with Swami Ramdev's effective yoga asanas - India TV News

It adds: "Controlling the rash or ulcers requires controlling the underlying inflammation."

According to the NHS, treatments can help reduce inflammation in the joints, relieve pain, prevent or slow down joint damage, reduce disability and enable you to be as active as possible.

"If you've been diagnosed with rheumatoid arthritis, you'll usually be offered a combination of DMARD tablets as part of your initial treatment," explains the health body.

These medicines ease the symptoms of the condition and slow down its progression.

It's also important to ensure your overall diet is still healthy and balanced.

"A Mediterranean-style diet, which is based on vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats such as olive oil, is recommended," says the NHS.

There's also some evidence to suggest that taking fish oil supplements may help reduce joint pain and stiffness caused by rheumatoid arthritis.

It is worth noting that some people with rheumatoid arthritis feel their symptoms get worse after they have eaten certain foods.

"If you think this may be the case for you, it may be useful to try avoiding problematic foods for a few weeks to see if your symptoms improve," advises the NHS.

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Rheumatoid arthritis symptoms: The warning sign on your skin to watch out for - Express

Photo credit: NBC - Getty Images

From Woman's Day

On Tuesday, Todays Al Roker announced he would be undergoing total shoulder replacement surgery. The NBC weatherman said hes been living with intense pain in his right shoulder due to arthritis, a general term for a range of conditions that cause swelling, pain, and stiffness in or around a joint.

According to the Centers for Disease Control and Prevention, 1 in 4 Americans have arthritis, and its typically treated with medication or surgery to repair the joint or manage symptoms.

The arthritis in Al's right shoulder has caused pain and affected his range of motion, particularly his ability to move his shoulder up and down. Its not bad during the day, but at night its an intense pain that literally wakes me up. For the last month, Ive only been sleeping about two or three hours a night, which even for me is a little bit less, Al said on the 3rd hour of Today. Its gotten to the point where I cant even sleep at night.

Al, who said his moms side of the family suffers from really intense arthritis, has osteoarthritis, the most common form of the condition. Osteoarthritis occurs when the protective cartilage that cushions the bones begins to wear down over time, causing pain and joint damage.

The surgery will be Al's second shoulder surgery in six years, after he had his rotator cuff repaired in his left shoulder in 2014. The procedure also marks Rokers second procedure in less than a year, as the Today host had hip replacement surgery in September 2019. The deal is that Im going to have replaced everything by 2027, Al joked.

Al's doctor, Riley Williams III, M.D., an orthopedic surgeon at the Hospital for Special Surgery, told Today that the surgery is designed to restore the normal joint services so that arthritic, achy pain that hes been having and waking him up at night can go away, and we can kind of get him back on a road to recovery.

Story continues

What you can expect after having a shoulder replacement is 25-plus years of really good function, provided you do all the requisite things after surgery [like] getting good healing, good nutrition and physical therapy to re-strengthen the muscles around the shoulder, Williams added. It really, really is life-changing and can bring you back to a point where you dont even realize that you had the shoulder operated on in the first place.

Al will not host Today this week as he recovers, and he will likely be in a sling for the next three weeks. He will also undergo physical therapy in the days after his procedure.

Want more entertainment news? You're in luck! Sign up for our FREE newsletter for even more of the Woman's Day content you want.

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Al Roker Will Have Total Shoulder Replacement Surgery Due to Intense Arthritis Pain - Yahoo Lifestyle

Emphasising the point, a study published in the Oxford Journal of Rheumatology stated that 41 percent of those suffering from rheumatoid arthritis improved on a gluten-free diet conducted over a one year period.

According to Peyton, you should go easy on steak if you are looking to avoid a flare up.

She explained: "Whilst there are fats that send out anti-inflammatory messages, there are also fats that can create pro-inflammatory messages in the body. These typically come from animal fats."

"We all require the ability to create some inflammation when there is a need to heal (after an injury for example)."

However, as Peyton pointed out, the ratio of inflammatory fats is too high in the typical Western diet.

"Therefore take a look at your diet and assess whether you are consuming sufficient anti-inflammatory fats and not too many pro-inflammatory fats. It is all about the balance," she said.

According to the NHS, if you feel your arthritis is aggravated by eating certain foods, it may be useful to try avoiding problematic foods for a few weeks to see if your symptoms improve.

"But it's important to ensure your overall diet is still healthy and balanced," the healthy body says.

A Mediterranean-style diet, which is based on vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats such as olive oil, is recommended.

According to the NHS, there's some evidence to suggest that taking fish oil supplements may help reduce joint pain and stiffness caused by rheumatoid arthritis.

Eating a healthy diet can also help to maintain a healthy weight.

According to the National Rheumatoid Arthritis Society (NRAS), excess weight is bad for joints and overall health.

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Rheumatoid arthritis: The healthy bread alternative that could be making symptoms worse - Express

Here are the top stories recently covered by DocWire News in the rheumatology section. In this edition, read about the effect of rheumatic diseases on COVID-19 severity, virtual computer-assisted preoperative planning in hip fracture, racial disparities in psoriatic arthritis, and fatigue in rheumatic diseases.

Hospitalized COVID-19 patients with connective tissue diseases may be at risk for increased illness severity, according to a recent study, but inflammatory arthritis (IA) may not have the same effect. Final analysis included 456 patients each in rheumatic and non-rheumatic groups. In the rheumatic disease cohort, 60% of patients had IA, and 40% had connective tissue disease. About three-quarters of patients (74%) were hospitalized. The risk of severe COVID-19 was 31.6% in the rheumatic cohort and 28.1% in the non-rheumatic cohort. In bivariate analysis, factors associated with increased COVID-19 severity risk in the rheumatic group were aging; male sex; and previous comorbidity including obesity, diabetes, hypertension, or cardiovascular or lung disease. Upon logistic regression analysis, the factors independently associated with severe COVID-19 disease were increased age, male sex, and connective tissue disease.

An estimated 300,000 hip fractures occur in the U.S. each yeara number that is expected to double with the aging population. About half of hip fractures are intertrochanteric fractures, but postoperative outcomes tend to be poor, including a high risk of mortality as well as poorer functional and quality of life outcomes. Certain risk factors for such poor outcomes are age and sexwhich cannot be modified. One thing that can be modified, though, is preoperative planning. And according to a study, computer-assisted virtual planning in cases of intertrochanteric hip fracture may improve postoperative complications, including mortality risk.

A study observed how ethnicity may affect disease expression of psoriatic arthritis (PsA), observing differences between patients of South Asian (SA) versus North European (NE) descent. They concluded that SA patients may have poorer clinical outcomes and be more adversely affected by PsA disease than NE patients.

IA patients often experience fatigue; 41% to 51% of rheumatoid arthritis, PsA, and spondyloarthritis patients suffer from severe fatigue. Patients with these rheumatic diseases who are plagued by fatigue may suffer in several domains, including quality of life, work impairment, depression, and more, according to a new study.

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Rheum Round-up: Rheumatic Disease and COVID-19 Severity, Improving Hip Fracture Outcomes, and more - DocWire News

Hospitalized COVID-19 patients with connective tissue diseases may be at risk for increased illness severity, according to a recent study, but inflammatory arthritis may not have the same effect.

Since severe COVID-19 is associated with a hyperinflammatory process, it is of particular interest to investigate how pre-existing inflammatory diseases or the previous use of immunosuppressive agents influence COVID-19 expression, the study authors explained.

The researchers identified PCR+COVID-19 rheumatic patients with chronic inflammatory arthritis (including rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis) or connective tissue diseases (including systemic lupus erythematosus, Sjgrens syndrome, systemic sclerosis, polymyalgia rheumatica, and vasculitides) and compared them 1:1 to non-rheumatic controls matched based on age, sex, and PCR date. The primary outcome was severe COVID-19 (death, invasive ventilation, intensive care unit admission, or serious complications). The correlation between severe COVID-19 and potential prognostic variables was evaluated, adjusting for COVID-19 treatment.

Final analysis included 456 patients each in the rheumatic and non-rheumatic groups. Both cohorts had a mean ae of 63 years and were 41% male. In the rheumatic disease cohort, 60% of patients had inflammatory arthritis, and 40% had connective tissue disease. About three-quarters of patients (74%) were hospitalized. The risk of severe COVID-19 was 31.6% in the rheumatic cohort and 28.1% in the non-rheumatic cohort. In bivariate analysis, factors associated with increased COVID-19 severity risk in the rheumatic group were aging; male sex; and previous comorbidity including obesity, diabetes, hypertension, or cardiovascular or lung disease. Upon logistic regression analysis, the factors independently associated with severe COVID-19 disease were increased age (odds ratio [OR]=4.83; 95% confidence interval [CI], 2.78 to 8.36), male sex (OR=1.93; 95% CI, 1.21 to 3.07), and connective tissue disease (OR=1.82; 95% CI, 1.00 to 3.30).

The researchers stated in their conclusion that among hospitalised patients with inflammatory rheumatic diseases, having a [connective tissue disease] pose[s] a significantly greater risk for poor outcomes, whereas immunosuppressive therapies do not. Previously known risk factors as ageing and male sex also apply to patients with rheumatic diseases. This observation should help to tailor recommendations to specific diagnostic and therapeutic groups of patients with rheumatic diseases during this or future coronavirus pandemics.

The study was published in Annals of the Rheumatic Diseases.

Read more here:
Do Inflammatory and Autoimmune Rheumatic Diseases Affect COVID-19 Illness Severity? - DocWire News

A model incorporating gene expression and clinical factors predicts response to anti-tumor necrosis factor (TNF) therapy in patients with rheumatoid arthritis (RA), according to study results published in Network and Systems Medicine.

Rheumatoid arthritis is a complex disease and the molecular factors that predict response to treatment are poorly understood. Using gene expression data from patients receiving anti-TNF therapy, investigators aimed to build a biomarker panel, which predicts response to anti-TNF therapies in patients with RA.

Using publicly available data, a comprehensive map of the human protein-protein interactome was generated and used to identify an RA disease module, which contained approximately 200 proteins. Within this module, 66% of the proteins had been previously linked to RA in genome-wide association studies, and the remaining were significantly enriched in similar Gene Ontology biological processes.

Microarray data were obtained from the Gene Expression Omnibus database for 58 women receiving anti-TNF therapy. Using a random forest machine-learning algorithm, the data were used to identify genes for which expression was predictive of response and nonresponse to therapy. Based on the microarray profile and the RA disease module, 37 genes were identified as discriminatory biomarkers for anti-TNF response.

In addition, RNA sequencing (RNAseq) data were obtained for 143 patients with RA from the Comparative Effectiveness Registry to Study Therapies for Arthritis and Inflammatory Conditions (CERTAIN) study. In addition to gene expression, RNAseq data enabled the identification of single-nucleotide variations (SNVs; formerly single-nucleotide polymorphisms) that were associated with treatment response. An additional 22 SNVs, which were associated with the RA disease model, were identified that were linked to response to anti-TNF therapy.

With the inclusion of clinical factors, a total of 70 biomarkers were identified and used to train a machine-learning algorithm to predict response to anti-TNF therapy. The final model generated, which predicted nonresponse to anti-TNF therapy, consisted of 10 SNPs, 8 gene transcripts, 2 laboratory tests, and 3 clinical measures.

To confirm that the model was broadly generalizable, data from an independent group of 175 patients from the CERTAIN study were used for a validation trial. Patients who were identified by the model as being nonresponders to anti-TNF therapy were 6.57-times more likely to be a true nonresponder than a responder (95% CI, 2.75-15.70). The model predicted nonresponse to therapy with a positive predictive value of 89.7% (95% CI, 79.0-95.7%), a specificity of 86.8% (95% CI, 72.4-94.1%), and a sensitivity of 50.0% (95% CI, 40.8-58.7%). There was no significant difference observed in the predictive power of the model based on ethnicity.

When the relevant gene transcripts and SNVs were mapped to the human interactome, they were all within close proximity to the RA disease module as well as established RA drug targets, including Janus kinase and TNF-. Pathway enrichment identified genes involved in T-cell signaling as the most enriched pathway in the biomarkers associated with a therapeutic response.

Customization of treatment regimens to match the individualized disease biology of each patient is a goal of modern medicine, the researchers concluded. Development and validation of a drug response algorithm that predicts nonresponse to a targeted therapy using this machine-learning and network medicine approach show great promise for advancing precision medicine in the treatment of RA and other complex autoimmune diseases where costly therapeutic interventions are met with inadequate patient response.

Disclosure: This study was supported by Scipher Medicine Corporation. Please see the original reference for a full list of authors disclosures.

Mellors T, Withers JB, Ameli A, et al. Clinical validation of a blood-based predictive test for stratification of response to tumor necrosis factor inhibitor therapies in rheumatoid arthritis patients. Network and Systems Medicine. 2020;3(1):91-104.

Continue reading here:
Clinically Validated Blood-Based Test Predicts Response to Anti-TNF Therapies in RA - Rheumatology Advisor

Tulsi or holy basil is loaded with several health benefits. You can prepare tulsi tea to fight various ailments. Read here to know some notable health benefits of drinking tulsi tea.

Drinking tulsi tea can help you boost immunity

Holy basil or tulsi is a part of almost every Indian household. This auspicious plant is loaded with several amazing health benefits too. Holy basil has a strong taste and aroma and can be added to your diet in several ways. One of the healthiest ways to add holy basil to your diet is by preparing tulsi tea. If you are a tea lover, you should definitely try tulsi tea to reap the health benefits these leaves can offer. If you are curious to know the benefits of tulsi tea, keep reading to know these.

Tulsi tea has a positive effect on your mental health. Drinking this tea leaves a soothing effect that can help you relieve stress. Studies also suggest that it can help you control symptoms of anxiety.

Drinking tulsi tea can help you beat stress effectivelyPhoto Credit: iStock

Holy basil helps in controlling inflammation and joint pain. These are the two common symptoms of arthritis. Therefore, drinking tulsi tea can help in controlling arthritis symptoms.

Also read:Arthritis Diet: Foods You Should Avoid To Control Inflammation

Tulsi leaves are loaded with anti-microbial properties which can help you promote overall oral health. This tea can help control harmful bacteria and germs in the mouth.

Studies suggest that tulsi is beneficial in controlling blood sugar levels and other symptoms of type-2 diabetes.

Also read:Diabetes Diet: Know How Many Almonds You Should Eat To Lower Blood Sugar Levels

Bad cholesterol levels are linked with a higher risk of heart disease. Adding tulsi to your diet can help in controlling bad cholesterol levels.

Tulsi tes is beneficial for your heart health as it helps control cholesterol levelsPhoto Credit: iStock

Tulsi is one of the herbs which can help you boost immunity. Aa sting immunity system will help you fight against illness effectively.

Preparing tulsi tea is quite simple. You can boil some tulsi leaves in one to two cups of water. Add ginger to enhance the taste of the tea. Boil the mixture properly. After some time, strain the tea and add lemon and honey to enhance the taste.

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Also read:How Many Cups Of Green Tea Should You Drink Per Day? Know The Side Effects Of Drinking Too Much Green Tea

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

DoctorNDTV is the one stop site for all your health needs providing the most credible health information, health news and tips with expert advice on healthy living, diet plans, informative videos etc. You can get the most relevant and accurate info you need about health problems like diabetes, cancer, pregnancy, HIV and AIDS, weight loss and many other lifestyle diseases. We have a panel of over 350 experts who help us develop content by giving their valuable inputs and bringing to us the latest in the world of healthcare.

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Holy Basil: Know The Many Health Benefits Of Drinking Tulsi Tea - Doctor NDTV

The Rheumatoid Arthritis Diagnosis Tests market report provides a detailed analysis of global market size, regional and country-level market size, segmentation market growth, market share, competitive Landscape, sales analysis, impact of domestic and global market players, value chain optimization, trade regulations, recent developments, opportunities analysis, strategic market growth analysis, product launches, area marketplace expanding, and technological innovations.

Our analysts monitoring the situation around the Globe explain that after COVID-19 crisis the market will generate remunerative prospects for producers. The goal of the report is to provide a further illustration of the current scenario, economic slowdown and effect of COVID-19 on the industry as a whole.

Global Rheumatoid Arthritis Diagnosis Tests Market is valued at USD 529.4 Million in 2018 and expected to reach USD 822.7 Million by 2025 with a CAGR of 6.5% over the forecast period. Increasing geriatric population globally is anticipated to drive growth of Global Rheumatoid Arthritis Diagnosis Tests Market.

Rheumatoid arthritis is a long-term, progressive and disabling autoimmune disease (as in this condition a persons immune system mistakes the bodys healthy tissues for foreign invaders). It is also a systemic disease, which means it affects the whole body. It causes inflammation, swelling, and pain in and around the joints and other body organs. It most commonly affects the hands and feet first, but it can occur in any joint. Its major symptoms includes; pain, swelling, and stiffness in more than one joint, symmetrical joint involvement, joint deformity, unsteadiness when walking, a general feeling of being unwell, fever, loss of function and mobility, weight loss, weakness and others. There are several different types of rheumatoid arthritis, some of them are seropositive RA, seronegative RA and JIA (juvenile idiopathic arthritis). It affects adults of any age, although most people are diagnosed between the ages of 40 and 60 and it is two to three times more common among women than men. A diagnosis of rheumatoid arthritis is based on the patients symptoms, a physical examination and the results of x-rays, scans and blood tests.

Global rheumatoid arthritis diagnosis tests market report is segmented on the basis of type, end-user and region & country level. Based upon type, global rheumatoid arthritis diagnosis tests market is classified into serology tests and monitoring rheumatoid arthritis treatment efficiency tests. The serology tests segment is further categorized into erythrocyte sedimentation rate, anti-cyclic citrullinated peptide, rheumatoid factor, antinuclear antibody, uric acid and others. The monitoring rheumatoid arthritis treatment efficiency tests segment is further categorized into muscle enzyme tests, salicylate level count and creatinine test. Based upon end-user, global rheumatoid arthritis diagnosis tests market is divided into hospitals, diagnostics laboratories and ambulatory surgical centers.

The regions covered in this Rheumatoid Arthritis Diagnosis Tests Market report are North America, Europe, Asia-Pacific and Rest of the World. On the basis of country level, the market of rheumatoid arthritis diagnosis tests is sub divided into U.S., Mexico, Canada, U.K., France, Germany, Italy, China, Japan, India, South East Asia, Middle East Asia (UAE, Saudi Arabia, Egypt) GCC, Africa, etc.

Scope Of The Report:Report evaluates the growth rate and the Market value based on Market dynamics, growth inducing factors. The complete knowledge is based on latest industry news, opportunities and trends. The report contains a comprehensive Market analysis and vendor landscape in addition to a SWOT analysis of the key vendors.Geographically, this report split global into several key Regions, revenue (Million USD) The geography (North America, Europe, Asia-Pacific, Latin America and Middle East & Africa) focusing on key countries in each region. It also covers market drivers, restraints, opportunities, challenges, and key issues in Global Rheumatoid Arthritis Diagnosis Tests Market.

Key Benefits for Rheumatoid Arthritis Diagnosis Tests Market Reports Global market report covers in-depth historical and forecast analysis. Global market research report provides detail information about Market Introduction, Market Summary, Global market Revenue (Revenue USD), Market Drivers, Market Restraints, Market Opportunities, Competitive Analysis, Regional and Country Level. Global market report helps to identify opportunities in market place. Global market report covers extensive analysis of emerging trends and competitive landscape.

Rheumatoid Arthritis Diagnosis Tests Market Segmentation:By Type: Serology Tests o Erythrocyte Sedimentation rate o Anti-Cyclic Citrullinated Peptide o Rheumatoid Factor o Antinuclear Antibodyo Uric Acido Others Monitoring Rheumatoid Arthritis Treatment Efficiency Tests o Muscle Enzyme Tests o Salicylate Level Counto Creatinine TestBy End-User: Hospitals Diagnostics Laboratories Ambulatory Surgical Centers By Region North Americao U.S.o Canadao Mexico Europeo UKo Franceo Germanyo Russiao Rest of Europe Asia-Pacifico Chinao South Koreao Indiao Japano Rest of Asia-Pacific LAMEAo Latin Americao Middle Easto Africa

Rheumatoid Arthritis Diagnosis Tests Market Key Players:Antibodies Inc.Euro Diagnostica ABQiagen NVSiemens Healthcare GmbHBio Rad Laboratories Inc.Genway Biotech, Inc.Abbott DiagnosticsBeckman Coulter, Inc.F. Hoffmann-La Roche Ltd.Thermo Fisher Scientific Incothers.

This comprehensive report will provide: Enhance your strategic decision making Assist with your research, presentations and business plans Show which emerging market opportunities to focus on Increase your industry knowledge Keep you up-to-date with crucial market developments Allow you to develop informed growth strategies Build your technical insight Illustrate trends to exploit Strengthen your analysis of competitors Provide risk analysis, helping you avoid the pitfalls other companies could make Ultimately, help you to maximize profitability for your company.Our Market Research Solution Provides You Answer to Below Mentioned Question: Which are the driving factors responsible for the growth of market? Which are the roadblock factors of this market? What are the new opportunities, by which market will grow in coming years? What are the trends of this market? Which are main factors responsible for new product launch? How big is the global & regional market in terms of revenue, sales and production? How far will the market grow in forecast period in terms of revenue, sales and production? Which region is dominating the global market and what are the market shares of each region in the overall market in 2017? How will each segment grow over the forecast period and how much revenue will these segment account for in 2025? Which region has more opportunities?

Table of Content1 Study Coverage1.1 Rheumatoid Arthritis Diagnosis Tests Product1.2 Key Market Segments in This Study1.3 Key Manufacturers Covered1.4 Market by Type1.5 Market by Application1.6 Study Objectives1.7 Years Considered

2 Executive Summary2.1 Global Rheumatoid Arthritis Diagnosis Tests Market Size2.1.1 Global Rheumatoid Arthritis Diagnosis Tests Revenue 2014-20252.1.2 Global Rheumatoid Arthritis Diagnosis Tests Production 2014-20252.2 Rheumatoid Arthritis Diagnosis Tests Growth Rate (CAGR) 2020-20252.3 Analysis of Competitive Landscape2.3.1 Manufacturers Market Concentration Ratio2.3.2 Key Rheumatoid Arthritis Diagnosis Tests Manufacturers2.3.2.1 Rheumatoid Arthritis Diagnosis Tests Manufacturing Base Distribution, Headquarters2.3.2.2 Manufacturers Rheumatoid Arthritis Diagnosis Tests Product Offered2.3.2.3 Date of Manufacturers Enter into Rheumatoid Arthritis Diagnosis Tests Market2.4 Key Trends for Rheumatoid Arthritis Diagnosis Tests Markets & Products

3 Market Size by Manufacturers3.1 Rheumatoid Arthritis Diagnosis Tests Production by Manufacturers3.1.1 Rheumatoid Arthritis Diagnosis Tests Production by Manufacturers3.1.2 Rheumatoid Arthritis Diagnosis Tests Production Market Share by Manufacturers3.2 Rheumatoid Arthritis Diagnosis Tests Revenue by Manufacturers3.2.1 Rheumatoid Arthritis Diagnosis Tests Revenue by Manufacturers (2014-2020)3.2.2 Rheumatoid Arthritis Diagnosis Tests Revenue Share by Manufacturers (2014-2020)3.3 Rheumatoid Arthritis Diagnosis Tests Price by Manufacturers3.4 Mergers & Acquisitions, Expansion Plans

4 Rheumatoid Arthritis Diagnosis Tests Production by Regions4.1 Global Rheumatoid Arthritis Diagnosis Tests Production by Regions4.1.1 Global Rheumatoid Arthritis Diagnosis Tests Production Market Share by Regions4.1.2 Global Rheumatoid Arthritis Diagnosis Tests Revenue Market Share by Regions4.2 North America4.2.1 North America Rheumatoid Arthritis Diagnosis Tests Production4.2.2 North America Rheumatoid Arthritis Diagnosis Tests Revenue4.2.3 Key Players in North America4.2.4 North America Rheumatoid Arthritis Diagnosis Tests Import & Export4.3 Europe4.3.1 Europe Rheumatoid Arthritis Diagnosis Tests Production4.3.2 Europe Rheumatoid Arthritis Diagnosis Tests Revenue4.3.3 Key Players in Europe4.3.4 Europe Rheumatoid Arthritis Diagnosis Tests Import & Export4.4 China4.4.1 China Rheumatoid Arthritis Diagnosis Tests Production4.4.2 China Rheumatoid Arthritis Diagnosis Tests Revenue4.4.3 Key Players in China4.4.4 China Rheumatoid Arthritis Diagnosis Tests Import & Export4.5 Japan4.5.1 Japan Rheumatoid Arthritis Diagnosis Tests Production4.5.2 Japan Rheumatoid Arthritis Diagnosis Tests Revenue4.5.3 Key Players in Japan4.5.4 Japan Rheumatoid Arthritis Diagnosis Tests Import & Export

5 Rheumatoid Arthritis Diagnosis Tests Consumption by Regions5.1 Global Rheumatoid Arthritis Diagnosis Tests Consumption by Regions5.1.1 Global Rheumatoid Arthritis Diagnosis Tests Consumption by Regions5.1.2 Global Rheumatoid Arthritis Diagnosis Tests Consumption Market Share by Regions5.2 North America5.2.1 North America Rheumatoid Arthritis Diagnosis Tests Consumption by Application5.2.2 North America Rheumatoid Arthritis Diagnosis Tests Consumption by Countries5.2.3 United States5.2.4 Canada5.2.5 Mexico5.3 Europe5.3.1 Europe Rheumatoid Arthritis Diagnosis Tests Consumption by Application5.3.2 Europe Rheumatoid Arthritis Diagnosis Tests Consumption by Countries5.3.3 Germany5.3.4 France5.3.5 UK5.3.6 Italy5.3.7 Russia5.4 Asia Pacific5.4.1 Asia Pacific Rheumatoid Arthritis Diagnosis Tests Consumption by Application5.4.2 Asia Pacific Rheumatoid Arthritis Diagnosis Tests Consumption by Regions5.4.3 China5.4.4 Japan5.4.5 South Korea5.4.6 India5.4.7 Australia5.4.8 Indonesia5.4.9 Thailand5.4.10 Malaysia5.4.11 Philippines

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Rheumatoid Arthritis Diagnosis Tests Business opportunity 2020 Sales Revenue Analysis, Major Manufacturers Performance, Industry Share and Forecast...

Methotrexate (MTX) monotherapy may be insufficient for achieving sustained minimal disease activity in patients with psoriatic arthritis (PsA), according to study data published in RMD Open. In a cohort of patients with PsA who were initiated with MTX, only 18% maintained minimal disease activity over 1 year of treatment. Methotrexate nonresponders vs responders were more likely to have interleukin (IL)-23-driven disease.

Investigators abstracted data from the Dutch Southwest Early Psoriatic Arthritis Cohort (DEPAR) study collected between 2013 and 2018. The DEPAR enrollees with oligoarthritis or polyarthritis who had 1 year of follow-up data were eligible for inclusion in the study. According to the DEPAR protocol, patients provided clinical data and blood samples before treatment initiation and every 3 months thereafter. Minimal disease activity was defined according to the following parameters: swollen and tender joint counts 1; Leeds Enthesitis Index 1; Psoriasis Area Severity Index 1; patients global assessment by visual analog scale (VAS) 20 mm; patients pain assessment by VAS 15 mm; and Health Assessment Questionnaire 0.5. Serum cytokine concentrations were determined at baseline, 3 months, and 6 months using a bead-based immunoassay.

The study cohort included 219 patients (50% men), with mean age at enrollment of 5314 years. Overall, 183 patients (84%) were initiated with MTX monotherapy within 6 months of PsA diagnosis, of whom 49% remained on MTX monotherapy for 1 year. A total of 44 patients (24%) reached minimal disease activity at 6 months. At 1 year, 33 patients (18%) remained in minimal disease activity.

Compared with patients who had minimal disease activity at 1 year, patients who did not respond to treatment with MTX had higher mean baseline concentrations of IL-23 (17.444.78 vs 62.9425.02), tumor necrosis factor (2.630.66 vs 7.832.79), granulocyte-macrophage colony-stimulating factor (2.780.64 vs 6.52.07), interferon gamma (6.671.29 vs 19.746.85), and IL-10 (1.030.13 vs 2.080.6; all P <.05). Concentrations of IL-10 and IL-23 remained significantly higher among nonresponders at 6 months.

In this observational care cohort of patients with PsA, only 18% who were initiated on MTX remained in minimal disease activity at 1 year. Higher baseline and follow-up concentrations of IL-23 and IL-10 were observed in nonresponders. Further study is necessary to confirm the validity of these biomarkers for MTX response.

Study limitations included potential confounding factors and the need to validate the use of serum IL-23 as a therapy-response biomarker. Overall, conclusions about the effect of MTX therapy must be drawn with caution.

This study highlights the potential value of use of new tools, such as measuring cytokine profiles, to stratify patients for underlying driving pathogenic mechanisms of their disease, the investigators concluded.

den Braanker H, Wervers K, Mus AMC, et al. Achieving sustained minimal disease activity with methotrexate in early interleukin 23-driven early psoriatic arthritis. RMD Open. 2020;6(2):e001175.

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Evaluating Methotrexate Monotherapy for Minimal Disease Activity Achievement in Early PsA - Rheumatology Advisor

The deformity can impair hand movement to the extent it limits daily activities severely, including self-care and employment, reducing health-related quality of life.

There are no approved treatments for the early stages of the disease and a high recurrence in late-stage disease when therapies including surgery and injection therapy which work for only a limited length of time.

Across the UK, the prevalence of the disease is approximately 20 per cent.

In Scotland the prevalence is much higher 40 per cent of the population - and in Scandinavian countries, it affects around 30 per cent of men over 60. This is because the disease is genetic; Scots are affected more than other parts of the UK because more people carry Celtic or Irish genes.

The drugs are: Cytokine inhibitors which has been used for treating rheumatoid and other forms of arthritis for around 15 years and JAK inhibitors which became available around five years ago, and is also used for the treatment of inflammatory arthritis.

Mr Millar said: Our work using patient samples from Dupuytrens Disease has discovered a key role for these drugs.

We were able to reverse these fibrotic changes in human cells. Until now, there has been nothing out there for these patients.

The two arthritis drugs are licensed for use in the treatment of that disease but under drug regulations, they must undergo further testing for use in the treatment of a different disease.

Mr Millar and his team have submitted a patent for the discovery of the new use of the drugs. They have also been awarded a grant from the Medical Research Council to conduct experimental therapeutic trials which he anticipates could start in a years time.

Retired teacher Andrew Tod from Edinburgh has lived with Dupuytrens Disease for the past 40 years and has undergone two operations on each hand.

He said: Anything that publicises this condition is going down the right lines.

I developed it without knowing what it was.

I just assumed like a pain in the ankle or something that it would just disappear and then it gradually got a little bit worse and a little bit worse in both hands.

So, that when I was working they would give me the nickname of the claw.

Basically it got worse and I did nothing about it - then I had two operations on one hand and two on the other.

To be honest it was really too late by that point.

I remember one of the surgeons asking me if Id ever heard of something called the bell curve?

It said my hands were off the radar for this measurement - so in other words I had neglected them all these years.

Theyre no better now but theyre no worse.

Ive got one finger on the left hand that works OK and one thats fine on the right, so typing is not a problem - I only use two fingers anyway. I can type and I can brush my teeth and perform the health measures.

My father had muscular dystrophy and I learnt from him that if you have a disability you have to adapt, it may take longer for you to do things but you just adapt.

Ive had no pain of any kind with it at all - all Ive had is inconvenience.

Im delighted theyve found drugs that could be effective and if someone gets the symptoms in their 30s and that means they can then be prepared for life as a professional pianist then splendid.

The condition is also known as the Curse of the MacCrimmons who were the 16th century pipers for the chieftains of Clan MacLeod on the Isle of Skye.

Folklore has it a curse was put on them for revealing piping secrets and it was foretold they would cease to be the official pipers to the MacLeods and would leave the Isle of Skye forever.

So, it came to pass. The fingers of the MacCrimmon men bent so far into their palms they became unable to play the bagpipes any more. Any piper who suffers from Dupuytrens Contracture as it is also known will tell you he has been affected by the Curse of the MacCrimmons.

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New Jersey, United States,- Latest update on Rheumatoid Arthritis Diagnostic Device Market Analysis report published with extensive market research, Rheumatoid Arthritis Diagnostic Device Market growth analysis, and forecast by 2026. this report is highly predictive as it holds the overall market analysis of topmost companies into the Rheumatoid Arthritis Diagnostic Device industry. With the classified Rheumatoid Arthritis Diagnostic Device market research based on various growing regions, this report provides leading players portfolio along with sales, growth, market share, and so on.

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Rheumatoid Arthritis Diagnostic Device Market Report covers the manufacturers data, including shipment, price, revenue, gross profit, interview record, business distribution etc., these data help the consumer know about the competitors better. This report also covers all the regions and countries of the world, which shows a regional development status, including Rheumatoid Arthritis Diagnostic Device market size, volume and value, as well as price data.

Rheumatoid Arthritis Diagnostic Device Market competition by top Manufacturers:

Rheumatoid Arthritis Diagnostic Device Market Classification by Types:

Rheumatoid Arthritis Diagnostic Device Market Size by End-user Application:

Listing a few pointers from the report:

The objective of the Rheumatoid Arthritis Diagnostic Device Market Report:

Cataloging the competitive terrain of the Rheumatoid Arthritis Diagnostic Device market:

Unveiling the geographical penetration of the Rheumatoid Arthritis Diagnostic Device market:

The report of the Rheumatoid Arthritis Diagnostic Device market is an in-depth analysis of the business vertical projected to record a commendable annual growth rate over the estimated time period. It also comprises of a precise evaluation of the dynamics related to this marketplace. The purpose of the Rheumatoid Arthritis Diagnostic Device Market report is to provide important information related to the industry deliverables such as market size, valuation forecast, sales volume, etc.

Major Highlights from Table of contents are listed below for quick lookup into Rheumatoid Arthritis Diagnostic Device Market report

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Rheumatoid Arthritis Diagnostic Device Market Size By Product Analysis, Application, End-Users, Regional Outlook, Competitive Strategies And Forecast...

New Jersey, United States,- Latest update on Psoriatic Arthritis (PsA) Treatment Market Analysis report published with extensive market research, Psoriatic Arthritis (PsA) Treatment Market growth analysis, and forecast by 2026. this report is highly predictive as it holds the overall market analysis of topmost companies into the Psoriatic Arthritis (PsA) Treatment industry. With the classified Psoriatic Arthritis (PsA) Treatment market research based on various growing regions, this report provides leading players portfolio along with sales, growth, market share, and so on.

The research report of the Psoriatic Arthritis (PsA) Treatment market is predicted to accrue a significant remuneration portfolio by the end of the predicted time period. It includes parameters with respect to the Psoriatic Arthritis (PsA) Treatment market dynamics incorporating varied driving forces affecting the commercialization graph of this business vertical and risks prevailing in the sphere. In addition, it also speaks about the Psoriatic Arthritis (PsA) Treatment Market growth opportunities in the industry.

Psoriatic Arthritis (PsA) Treatment Market Report covers the manufacturers data, including shipment, price, revenue, gross profit, interview record, business distribution etc., these data help the consumer know about the competitors better. This report also covers all the regions and countries of the world, which shows a regional development status, including Psoriatic Arthritis (PsA) Treatment market size, volume and value, as well as price data.

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The report of the Psoriatic Arthritis (PsA) Treatment market is an in-depth analysis of the business vertical projected to record a commendable annual growth rate over the estimated time period. It also comprises of a precise evaluation of the dynamics related to this marketplace. The purpose of the Psoriatic Arthritis (PsA) Treatment Market report is to provide important information related to the industry deliverables such as market size, valuation forecast, sales volume, etc.

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Psoriatic Arthritis (PsA) Treatment Market Size By Product Analysis, Application, End-Users, Regional Outlook, Competitive Strategies And Forecast Up...

Vijay Mohan

Tribune News Service

Chandigarh, July 12

Scientists from the Institute of Nano Science and Technology (INST), Mohali, have formulated nano-particles with a zinc-based compound that will help reduce the severity of rheumatoid arthritis.

The particles contain chitosan and zinc gluconate. Zinc is vital for maintaining normal bone homeostasis and its levels are reported to get reduced in rheumatoid arthritis patients. It is also known that oral supplementation of zinc in the form of zinc gluconate has very low bioavailability in humans.

Chitosan is a biocompatible, biodegradable natural polysaccharide (a carbohydrate whose molecules consist of a number of sugar molecules bonded together). It is one of the most abundant biopolymers obtained from the exoskeleton of crustaceans (crab, lobster, shrimp, etc) have shown absorption promoting characteristics.

The INST team particularly chose chitosan as it is biodegradable, biocompatible, non-toxic, and muco-adhesive in nature. A previously published report in the journal Magnesium Research exhibited that after intraperitoneal administration in rats, zinc oxide in standard form resulted in a slight increase in serum zinc level, whereas that in nano form resulted in significantly high serum zinc levels, thus increasing the zinc bioavailability. This motivated the INST team to develop the nanoformulation of zinc gluconate.

They prepared Zinc gluconate loaded chitosan nanoparticles using chitosan and sodium tripolyphosphate in double-distilled water and zinc gluconate was simultaneously added along with the synthesis of chitosan nanoparticles. These were characterised for various physicochemical properties and then anti-arthritic potential was investigated against collagen-induced arthritis in rats.

They observed that the treatment of rats with both zinc gluconate and zinc gluconate loaded chitosan nanoparticles reduced the severity of arthritis by reducing joint swelling, erythema, and edema.

The team assessed various parameters like biochemical analysis, histological observations, and immunohistochemical expression of inflammatory markers and suggested that zinc gluconate-loaded chitosan nanoparticles exerted superior therapeutic effects compared to the free form of zinc gluconate. This was attributed to the inflammatory potential of zinc gluconate-loaded chitosan nanoparticles.

Nanobiotechnology provides several effective solutions for the problems that traditional pharmaceutical formulations are often not able to address as effectively, such as sustained and targeted release of drugs, bioavailability, and efficacy of drugs and nutraceuticals, etc. The nanoformulation of zinc gluconate-loaded chitosan nanoparticles developed at INST Mohali is a creative example of a superior therapeutics for rheumatoid arthritis, said Prof Ashutosh Sharma, Secretary, Department of Science and Technology.

In the recent past, ionic gelation method has been widely employed for formulating chitosan nanoparticles, which may contain various medicinally active pharmacological agents.

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Mohali institute scientists formulate nanoparticle to reduce severity of rheumatoid arthritis - The Tribune India