PSORIATIC ARTHRITIS NEWS AND VIEWS
VOLUME- 5 ISSUE- 01
January 15, 2005
PSORIATIC ARTHRITIS MEDICAL NEWS
TOP TEN NEWS STORIES OF 2004
FDA Orders Review of Celebrex, Bextra & Aleve
Drugs For US By Way Of Canada?
Loosening the Belt on Flu Vaccine
FDA Knew Antidepressant Danger to Kids
Experts: PSA Test Still Valuable for Prostate Cancer Screening
Breast Cancer, Now Which Drug?
Christopher Reeve & Spinal Cord Injury
The "Skinny" On Weight Loss Plans
Update on Cholesterol Guidelines
Latest Rabies Death From Transplant
Vioxx, Celebrex Furor Tops Health News for '04
Imported drugs, flu vaccine shortage were other big issues this year
Dec. 30 By E.J. Mundell HealthDay Reporter (HealthDayNews)
For years, Americans turned to the blockbuster drugs Vioxx and Celebrex for
relief from chronic pain. But as 2004 ends, Vioxx is no longer on the market
and the future of Celebrex remains unclear.
The tattered reputation of the cox-2 inhibitor class of analgesics not only
left millions without their preferred method of pain relief, it also prompted
criticism of the role -- even the integrity -- of the U.S. Food and Drug
Administration, making the drug debacle the year's top health news story.
Other stories vied for that top spot, however -- this fall's flu vaccine
shortage, an impassioned election-year debate over stem cell research, and new
warnings from the FDA on heightened suicide risks in children taking
antidepressants.
Here are the Top 10 health stories for 2004, as determined by HealthDay
editors:
Vioxx, Celebrex Lose Their Luster. The billion-dollar blockbuster drug Vioxx
fell first, with maker Merck & Co. withdrawing it from the market in
September after data linked long-term use of the medication with increased
cardiovascular risk. Earlier this month, similar findings surfaced regarding
Pfizer's
Celebrex, although that drug remains on pharmacy shelves. Cardiovascular
concerns have also put the spotlight on a popular over-the-counter cox-1
inhibitor, Aleve. The FDA ordered a review of trial data on Celebrex and a
third
cox-2, Bextra, while battling its critics. Those include agency "whistleblower"
Dr. David Graham, who claimed the FDA pressured him to downplay results of a
study reviewing the safety of Vioxx.
More Americans "Import" Drugs From Canada. The Bush administration this week
said the importation of cheaper prescription drugs from Canada would offer
U.S. consumers little, if any, cost savings. Consumers may not be listening,
however -- experts estimate that Americans this year spent more than $1.4
billion on drugs from foreign pharmacies. And in August, Illinois Governor Rod
Blagojevich led what amounted to a states-rights rebellion, announcing plans to
grant citizens online access to pharmacies in the United Kingdom and Canada,
even as President Bush expressed doubts about the safety of foreign drugs.
U.S. Flu Vaccine Supply Falls Short. In early October, federal health
officials announced that the nation's supply of flu vaccine had been slashed by
nearly half after a key manufacturer detected bacterial contamination in this
year's batch. State and federal officials scrambled to make up the difference,
securing additional -- but not nearly enough -- vaccines from other sources.
In the meantime, distribution of available vaccine remains restricted to
those aged 50 and older, small children, pregnant women, and those with chronic
health conditions.
Antidepressants' Link to Child Suicide Prompts Warning. After a series of
emotional public hearings in Washington, D.C., the FDA in October followed the
advice of two advisory committees and slapped a tough "black box" warning on
antidepressants such as Prozac and Zoloft, warning doctors to watch for signs
of suicidal behavior in pediatric patients. FDA commissioner Dr. Lester
Crawford stressed, however, that the drugs also provide "significant benefit"
to
many depressed children.
Pioneer Researcher Casts Doubt on PSA Test. It's been a health-care staple
for older men for years -- the annual PSA blood test, used to detect prostate
cancer. But in May, Dr. Thomas Stamey, the researcher who first identified
the screen, said 20 years of data suggest the test "is no longer finding
significant cancers." Other experts believe the test is still useful in
detecting
early malignancies, and the American Cancer Society continues to recommend PSA
screening for men over 50.
Good News, Bad News For Breast Cancer. Women battling breast cancer had some
reason to cheer in '04: Researchers found the drug Arimidex (anastrazole) to
be significantly more effective than the "gold standard" medication,
tamoxifen, at keeping breast cancer survivors cancer-free over the long term.
On the
down side, new research found that hormone replacement therapy -- already
blamed for raising risks for breast cancer -- might also make tumors harder to
detect on mammogram.
Reagans, Reeve Re-Energize Stem Cell Debate. Microscopic embryonic stem
cells became powerful players in the 2004 election cycle, with Nancy Reagan and
Ron Reagan Jr. breaking ranks with the Republican Party to issue impassioned
pleas for their use in research into Alzheimer's and other illnesses. Weeks
before his death in October, actor Christopher Reeve appeared alongside
Democratic presidential nominee John Kerry, asking for similar action. In
California, at least, Reeve and the Reagans got their wish: Voters there said
"yes" to
a ballot earmarking $3 billion in state funds for embryonic stem cell
research.
Low-Carb Craze Crumbles. It has been a long, pasta-free run, but America's
fixation with low-carbohydrate regimens may finally be past its peak. In
February, nearly one in 10 (9.1 percent) of all Americans said they shunned
carbs
on a regular basis. But in a poll taken just before Christmas, that
percentage had dropped by nearly half, to just 4.9 percent. And a study
released this
month found that of the nation's 10 most popular diet regimens, only Weight
Watchers keeps the pounds off over the long term.
Cholesterol Busters Get A Boost. In July, the nation's leading consortium of
experts on cholesterol control issued new guidelines recommending that
patients use even higher doses of statin medications such as Lipitor or
Pravachol,
to help lower levels of vessel-clogging fats. The recommendations also
encourage healthy diet and exercise -- especially timely, with U.S. health
officials this year labeling obesity as one of the country's major killers.
Tougher Transplant Rules After Rabies Deaths. This summer, doctors at Baylor
University Medical, Dallas, announced that four transplant patients had died
from rabies after receiving organs and tissues from a donor infected with
the disease. The Texas deaths prompted officials at the FDA to tighten rules
governing "good tissue practice." The new guidelines should help reduce
contamination and improve the labeling and distribution of transplant
materials.
© 1996-2004 MedicineNet, Inc. All rights reserved. Copyright and Legal
Disclaimer.
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ARTHRITIS OVERVIEW - HOW THE JOINT WORKS - HOW ARTHRITIS AFFECTS THE JOINTS
- Reviewed by Harvard Medical School
We all have mornings when we wake up a bit stiff. We all know the achy
feeling that comes from working too hard in the garden, sitting too long at the
computer or sleeping in an awkward position. And, from time to time, we have all
suffered pain because we've lifted a heavy object in a slightly wrong way.
Even a particularly ferocious sneeze can cause a twinge of discomfort. But
arthritis goes far beyond these occasional aches and pains.
The condition that we commonly refer to as arthritis includes a number of
diseases that result in inflammation, pain and stiffness, primarily in the
joints and connective tissues. Connective tissues are the supporting structures
for joints, such as muscles, cartilage, ligaments and tendons. In many cases,
these diseases affect other parts of the body as well. Arthritic disorders may
be are chronic, but some, such as gout, are intermittent. The conditions
that are truly inflammatory (that is, with actual joint inflammation present)
cause warmth and swelling, whereas others are degenerative, in which cartilage
lining the joint wears out and the amount of inflammation is minor.
How The Joint Works
The ends of bones meet at the joint, where they are cushioned by cartilage,
a layer of smooth pliable tissue. Around many of the larger joints, such as
the knee, hip and shoulder, there is a pad-like sac or cavity called the
bursa, which is lined with cells similar to those lining the joint. In addition
to
acting as a buffer to reduce friction between the muscle, tendon tissue and
bone, this inner lining produces a fluid, synovial fluid, that keeps the
joints lubricated and provides nutrients. Ligaments connect and support bones
to
keep them in proper alignment, whereas tendons connect muscles to bones.
Joints move when a muscle on one side of a joint contracts and pulls on the
tendons that attach to a bone on the other side of the joint.
How Arthritis Affects The Joints
The word arthritis means joint inflammation. Inflammation, a natural part of
the body's response to injury and infection, is a complex process that
produces swelling, pain, warmth and redness. But inflammation is not only a
response to injury, it may perpetuate injury as well. Significant problems
arise
when inflammation is persistent, intense or recurrent or spreads to other areas
of the body.
Joints and the surrounding areas become inflamed for a number of reasons,
including trauma, disease, infection or merely wear and tear, which naturally
occurs over time. Many forms of arthritis are thought to result from the
uncontrolled inflammation of an autoimmune disease, in which the body's defense
mechanism malfunctions and attacks its own tissues. At other times, the joint
area becomes inflamed and tender for no apparent reason.
When joints become arthritic, swelling causes stiffness, rigidity and tissue
damage. Pain, which is the body's signal that something is wrong, occurs as
the joint is moved to the brink of its own limits. As mobility decreases, the
muscles surrounding the joint also weaken, allowing for further injury to the
joint. Over time, the cartilage breaks down, the bone erodes and the joints
become misshapen. It is this process, regardless of the source, that may
develop in the worst forms of arthritis.
There are more than 100 different types of arthritis, and each has its own
characteristic symptoms and its own course. In addition, the way in which the
disease progresses varies from individual to individual. If you suffer from an
arthritic condition, you will most likely experience pain and limited
movement at the involved sites. In chronic forms of arthritis, there may be
times
when the disease is active (flares) and times when it is inactive (remission).
Depending on the specific condition and how severe it is, arthritis can
interfere with even the most ordinary activities, such as walking, dressing or
bathing. In the most inflammatory types of arthritis, such as rheumatoid
arthritis, pain and stiffness are more severe in the morning or on certain days.
Sometimes symptoms disappear completely for considerable stretches of time,
only to flare up again later.
Reviewed by Harvard Medical School
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NSAID PAIN DRUGS INJURE SMALL INTESTINE
Among Daily Users of Aspirin-Like Drugs, 71% Have Small Intestine Injury
Jan. 5, 2005 -- More than 70% of people who take daily doses of aspirin and
similar drugs, sustain small bowel injuries, a new study shows.
But don't throw your pain pills or baby aspirin out the window. Most of
these injuries are small -- and it's not at all clear whether they mean trouble.
On the other hand, some of these injuries may be serious.
The drugs are called "traditional" NSAIDs to distinguish them from the newer
NSAIDs known as Cox-2 inhibitors. There are around 20 traditional NSAIDs,
including aspirin, ibuprofen (Advil and Motrin), naproxen (Aleve), indomethacin
(Indocin), and piroxicam (Feldene).
The findings come from a study led by David Y. Graham, MD, head of
gastroenterology at Michael DeBakey Medical Center, and professor of medicine at
Baylor College of Medicine in Houston. Graham and colleagues used a tiny new
"pill
camera" to look inside the small intestines of 21 men and women who used
NSAIDs every day and 20 people who did not use the drugs. None of the people in
the study had any symptoms of small intestine problems.
They found that 71% of the traditional NSAID users had some damage to their
small intestines, compared with 10% of the nonusers. Five of the traditional
NSAID users had large erosions or ulcers -- a problem not seen in any of the
nonusers. The findings appear in the January 2005 issue of Clinical
Gastroenterology and Hepatology.
"Our study looked only at asymptomatic people, so we couldn't say anything
about the meaning of the damage," Graham tells WebMD. "The fact is, there is
damage that does extend down into the bowel. Mostly these are little erosions
that will heal without any problem. But some patients had big lesions. One
would expect that the size and number of lesions would be important, but we
have
not yet shown this. The number of ulcers was small."
Meaning of Small Intestine Injuries Not Clear
Graham notes that his study was too small to show whether the traditional
NSAID injuries would ever cause problems. However, the findings do indicate
many cases of unexplained blood loss and other symptoms may be due to long-term
use of traditional NSAIDs.
"What does this mean? It can't mean nothing," Graham says. "But we may find
out these [unexplained symptoms] are not due to the kinds of injuries we see
here."
Graham's study doesn't prove that the small intestine injuries linked to
traditional NSAIDs cause clinical problems, says James M. Scheiman, MD,
professor of gastroenterology at the University of Michigan.
"Traditional NSAIDs do damage the small intestine," Scheiman tells WebMD.
"We have known that taking these drugs injures the gut. The question is, what
does it mean? It is likely that those with the most damage as seen by this pill
camera will get symptoms. It is possible; it is fairly likely, but we
actually don't know that yet."
Scheiman notes that small intestine injury linked to traditional NSAIDs
isn't as dramatic as the stomach bleeding seen in a small proportion of those
who
take the drugs. Indeed, Graham notes that traditional NSAIDs cause problems
in a small but significant percentage of people. However, that has to be
balanced against the great good that they do.
"People take these drugs because they get such benefits," Graham says.
"Before we had them, if you had pain, you had pain. Now people with chronic
arthritis pain can walk and go back to work."
Graham argues that some traditional NSAIDs are much safer than others.
"Feldene is always leading the list of NSAIDs linked to problems," he says.
"The less-dangerous ones are ibuprofen or naproxen. But NSAIDs are remarkable
for their ability to cause damage. Some shouldn't even be on the market. Now
we can do studies to find which ones we should eliminate."
Scheiman echoes Graham's warning. "People shouldn't use NSAIDs willy nilly,"
Scheiman says. "One of my areas of concern is the widespread use of aspirin.
A lot of the patients in the Graham study were just on low-dose aspirin."
SOURCES: Graham, D.Y. Clinical Gastroenterology and Hepatology, January
2005; vol 3. David Y. Graham, MD, head, gastroenterology, Michael DeBakey
Medical
Center and professor of medicine, Baylor College of Medicine, Houston. James
M. Scheiman, MD, professor of gastroenterology, University of Michigan, Ann
Arbor. WebMD- All Rights Reserved
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EXPENSIVE MEDS BEST FOR RHEUMATOID ARTHRITIS?
High-Priced Remicade Shows Promise in Newly Diagnosed Patients, Study Shows
By Miranda Hitti WebMD Medical News Reviewed By Brunilda Nazario, MD
Jan. 10, 2005 -- Newly diagnosed rheumatoid arthritis (RA) patients may get
the most benefit from effective but high-priced medications, a British study
shows.
An autoimmune disease, RA is a leading cause of disability. It involves
inflammation of joints and surrounding tissues. Over time, rheumatoid arthritis
can destroy joints' cartilage, ligaments, tendons, and bone. In some cases, it
can also damage the body's organs.
Drugs are available to treat rheumatoid arthritis. But some of the newest,
most effective medications are costly. In fact, they're so expensive that it's
not practical for most patients to take them for a lifetime. Remicade's
annual tab is $12,000 for an average of eight treatments, according to the
National Psoriasis Foundation.
That weighed on the mind of British researcher Mark Quinn, MBChB, MRCP. He
worked with colleagues from England's Leeds General Infirmary to look for ways
to reap the drugs' benefits without going broke. Their study appears in the
January issue of Arthritis & Rheumatism.
Quinn focused on two drugs: methotrexate and Remicade. Since there is no
cure for rheumatoid arthritis the goal is to treat the disease early to prevent
disabling pain and permanent damage to joints.
Methotrexate is the mainstay of rheumatoid arthritis treatment. Originally
prescribed as a cancer chemotherapy drug, methotrexate is used in lower doses
to attack the overactive immune system cells that damage joints in RA.
Remicade is a newer drug and tames the inflammation associated with RA by
targeting a protein called tumor necrosis factor. Remicade is usually taken with
methotrexate. Both methotrexate and Remicade can slow progression of RA.
Remicade and the similar drug Enbrel have also had success against other
inflammatory conditions including Crohn's disease, ankylosing spondylitis,
psoriasis, and psoriatic arthritis, say the researchers.
The study was small, with 20 newly diagnosed rheumatoid arthritis patients.
They were about 52 years old, with symptoms present for less than a year
before the study began.
All participants received methotrexate. In addition, half took Remicade
along with methotrexate. The remaining participants received a placebo instead
of
Remicade. They were not aware if they were receiving Remicade or a placebo.
Participants took their drugs for a year.
After a year, everyone had improved to some degree. MRI scans showed a
significant reduction in joint problems.
But relief came faster, lasted longer, and improved life more for the
Remicade group. Their MRI scans showed no new signs of joint erosion after a
year.
They also had greater gains in function and quality of life, starting at 14
weeks and lasting throughout the study.
Treatment with Remicade resulted in a rapid decrease of the blood
inflammatory marker C-reactive protein (CRP), which indicates decreased
inflammation
and less potential for joint damage.
Those improvements didn't vanish overnight. Function and quality-of-life
improvements lasted a year after the patients had stopped taking the drugs.
That surprised the researchers. Previous studies showed that rheumatoid
arthritis quickly reared back up when patients stopped taking drugs like
Remicade, they say.
Larger studies are already underway to double-check the results. While the
findings need confirming, they indicate that early treatment with Remicade and
other similar drugs may be the best option.
SOURCES: Quinn, M. Arthritis & Rheumatism, January 2005; vol 52: pp 27-35.
National Psoriasis Foundation, "Remicade." WebMD Medical Reference from
Healthwise: "Rheumatoid Arthritis." WebMD Medical Reference from Healthwise:
"Rheumatoid Arthritis -- Medications." News release, John Wiley & Sons, Inc.
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NEW REMICADE WARNING
Arthritis, Crohn's Disease Drug Linked to Rare but Deadly Liver Failure
By Daniel DeNoon WebMD Medical News Reviewed By Michael Smith, MD
Dec. 23, 2004 -- Remicade is linked to rare but sometimes deadly liver
reactions, drug maker Centocor and the FDA announced Wednesday.
Remicade is approved to treat rheumatoid arthritis and Crohn's disease.
In a "Dear Healthcare Professional" letter, Centocor is warning doctors that
patients treated with Remicade have developed acute liver failure and other
liver problems, including jaundice.
Some patients died or required liver transplants to save their lives. The
liver reactions occurred two weeks to more than a year after Remicade treatment.
Lab tests for abnormal liver enzymes -- a standard test for liver trouble --
did not always predict these liver reactions.
These events appear to be quite rare. They've been reported in 3 patients
before Remicade approval, and in 35 patients worldwide since the drug has been
approved. In that time, some 576,000 patients have been treated with Remicade.
Remicade works by suppressing the immune system. That's helpful to patients
whose overactive immune reactions underlie their rheumatoid arthritis, Crohn's
disease, or ankylosing spondylitis. But it can also be a problem. Remicade
treatment has been previously linked to serious infections including
tuberculosis. Some of these infections have been fatal.
The Centocor letter also notes that a warning about risk of pneumonia has
been added to the Remicade label.
Liver Failure Symptoms
Patients taking Remicade should be aware of symptoms of liver damage or
failure, which include:
Nausea
Loss of appetite
Fatigue
Diarrhea
Jaundice
SOURCES: FDA. WebMD Medical Reference in collaboration with The Cleveland
Clinic: Liver Failure.
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ANTIBIOTIC RESISTANT SUPERBUG ON THE RISE
More super bug infections seen in ER patients NEW YORK (Reuters Health)
Among patients treated at urban public hospital emergency rooms for skin and
soft-tissue infections, more and more often the cause appears to be the
antibiotic-resistant 'super bug' known as MRSA, new research shows.
MRSA -- methicillin resistant Staphylococcus aureus -- is not killed by
penicillin-type drugs, so these kinds of antibiotics can no longer be considered
standard treatment for wounds and abscesses, Dr. Bradley W. Frazee and
colleagues suggest in the Annals of Emergency Medicine.
Frazee's team at Alameda County Medical Center in Oakland, California,
obtained cultures from 137 patients who came to their emergency department with
such infections.
Staph aureus was identified in 119 infection sites, and the bacterium was
the methicillin-resistant type in 75 percent of cases, the authors report.
Overall, MRSA was present in 51 percent of infection site cultures.
However, the bug could be knocked out by other types of antibiotics -- for
example, 100 percent of the specimens were susceptible to vancomycin and 94
percent were susceptible to clindamycin.
So, these antibiotics may be a more appropriate first choice for treating
skin and soft tissue infections, if MRSA is common in the region, Frazee and his
colleagues advise. SOURCE: Annals of Emergency Medicine
Copyright © 2004 Reuters Limited. All rights reserved. © 1996-2004
MedicineNet, Inc. All rights reserved.
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FDA APPROVES NEW DRUG FOR SEVERE PAIN - WASHINGTON (AP)
The government approved a drug Tuesday that offers a new way of fighting
severe pain -- an option for patients who no longer benefit from morphine and
other traditional pain medications.
It's the first in a new class of drugs that selectively blocks the nerve
channels responsible for transmitting pain signals. It will be marketed as
Prialt and should be available by the end of January.
"When you've taken all the kinds of pain medication that there is and you
still have pain, that is a very frightening situation," said Dr. Lars Ekman,
president of research and development for the drug's Ireland-based manufacturer,
Elan. "When you have that kind of pain, there is nowhere to go."
The drug is part of a new class known as N-type calcium channel blockers. It
is known chemically as ziconotide.
Morphine is the standard treatment for severe pain from cancer, AIDS,
amputations and other significant illnesses, but its effects eventually wear off
and the dosage must be increased. At some point, many patients switch from
taking medication by mouth or by injection to a microinfusion pump implanted
under the skin that delivers drugs directly into the fluid surrounding the
spinal
cord.
Ekman said about 35,000 to 50,000 Americans have these pumps now. The Food
and Drug Administration approved Prialt for patients who are already using
these pumps but not getting effective relief from them or who cannot tolerate
the
available treatments.
This is the first new drug in 20 years to treat pain using such a pump.
Prialt has been studied in patients with cancer, AIDS and other chronic
pain, such as back pain. More than 1,200 patients took part in three clinical
trials.
There are side effects, and the FDA was including a "black box" warning --
the government's strongest warning short of a ban. Side effects may include
dizziness, drowsiness and altered mental status, with patients confused at
times.
Despite the side effects, the drug was approved because there are no other
options for these patients and the benefits outweighed the risks, said Dr.
Robert Meyer, director of the FDA's Office of Drug Evaluation II.
"Because this is such an important patient population where they have such
pain and they have so few options we felt this drug does offer some real
gains," he said.
Patients with a history of psychoses should not receive it, and all others
should be monitored for signs of cognitive impairment, he said.
The idea for the drug came from a snail called the Conus magus that lives in
the South Pacific, which paralyzes its victims with venom after capturing
them, the company said. Researchers set out learning how to develop a drug based
on this venom and eventually copied the amino acid sequence. Elan would not
say how much it plans to charge for the drug. Copyright 2004 The Associated
Press. All rights reserved.
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50 & OLDER, GET MOVING - EXERCISE CUTS HEART, DIABETES RISK FACTORS
Program reduces incidence of metabolic syndrome By Ed Edelson - Healthday
News
Regular exercise can reduce the incidence of a deadly combination of risk
factors for heart disease and diabetes in middle-aged and older people.
A six-month program of aerobic exercise and weightlifting lowered the rate
of this combination, called metabolic syndrome, by 41 percent in 104 people
aged 55 to 75, according to a report in the January issue of the American
Journal of Preventive Medicine.
Metabolic syndrome is defined as having three or more of six major risk
factors for cardiovascular disease: obesity, high blood cholesterol levels, high
blood pressure, high blood sugar readings, a tendency to form blood clots, and
high blood levels of C-reactive protein, a marker of inflammation.
When the study began, 43 percent of participants had metabolic syndrome,
although none had cardiovascular disease. Half were simply given a booklet that
encouraged increased activity such as walking, while the others were assigned
to a program of supervised exercises, three 60-minute sessions each week.
"We followed the guidelines of the American College of Sports Medicine,"
said study leader Kerry Stewart, a professor of medicine at Johns Hopkins
University School of Medicine. "It was a combination of aerobic exercises such
as
walking, swimming and jogging, as well as weightlifting."
After six months, there were no new cases of metabolic syndrome in the
exercise group, and nine of them no longer had the syndrome. While the syndrome
was no longer present in eight of the people in the sedentary group who had it
at the start, four new cases were diagnosed in that group.
While tests showed substantial improvement in fitness, such as peak oxygen
uptake, "the changes in disease risk factors with exercise training were more
closely related to reductions in body fat, particularly in abdominal fat, and
increases in muscle tissue," Stewart said.
The kind of exercise program in the study can easily be done by anyone
without supervision, he said. "You can do brisk walking or bicycling on your
own,"
he said. "You can also work with things like hand-held weights at home."
The weightlifting part of the program had participants in a 20-minute
session in which they did two sets of 12 to 15 lifts each, with weights tailored
to
individual ability.
"They did resistance exercises, which we now recommend for everyone," said
Dr. Gerald Fletcher, a cardiologist at the Mayo Clinic in Jacksonville, Fla.,
and a spokesman for the American Heart Association. "Weightlifting, carefully
done, is something we recommend more and more along with aerobic exercises."
But "carefully" is the keynote, especially for older and sedentary people,
Fletcher said, because of the possibility of injury to unused muscles. Exercise
programs are best when tailored to an individual's abilities, he said.
"Initially, it might be better to have someone teach you how to exercise,"
Fletcher said. "Getting a trainer might be worth it, or getting someone to give
you a personalized exercise program."
SOURCES: Kerry Stewart, Ed.D., professor, medicine, Johns Hopkins University
School of Medicine, Baltimore; Gerald Fletcher, M.D., cardiologist, Mayo
Clinic, Jacksonville, Fla.; January 2005 American Journal of Preventive
Medicine
© 1996-2004 MedicineNet, Inc. All rights reserved
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44% OF AMERICANS TAKE PRESCRIPTION DRUGS
CDC report says rates have increased over the past 16 years
WASHINGTON - More than four in 10 Americans take at least one prescription
drug and one-in-six takes at least three, the government reported Thursday.
âAmericans are taking medicines that lower cholesterol and reduce the threat
of heart disease, that help lift people out of debilitating depressions, and
that keep diabetes in check,â Health and Human Services Secretary Tommy G.
Thompson said in a statement.
The annual report on Americansâ health found that just over 44 percent of
all Americans take at least one prescription drug, and 16.5 percent take at
least three.
Those rates were up from 39 percent and 12 percent between 1988 and 1994,
the Centers for Disease Control and Prevention reported.
The report, âHealth, United States 2004,â presents the latest data
collected by the CDC, the National Center for Health Statistics and dozens of
other
Federal health agencies, academic and professional health associations, and
international health organizations.
Americansâ life expectancy increased to 77.3 years in 2002, a record. And
deaths from heart disease, cancer and stroke â the nationâs three leading
killers â are all down 1 percent to 3 percent, the analysis said.
Health spending up 9 percent
The study also found that spending on health climbed 9.3 percent in 2002 to
$1.6 trillion.
Prescription drugs, which make up about one-tenth of the total medical bill,
were the fastest growing expenditure. The price of drugs rose 5 percent, but
wider use of medicines pushed total expenditures up 15.3 percent in 2002.
Drug expenditures have risen at least 15 percent every year since 1998.
The report said prescription drug use was increasing among people of all
ages, and use increases with age.
Nearly half of all women were taking prescription drugs â 49 percent â
compared to 39 percent of men.
Usage peaked at 84 percent for people aged 65 and over, with the top rate at
89 percent for black women over 65.
Even for people under age 18, however, nearly one-fourth â 24.1 percent â
were taking at least one prescription medication. The rate rose to 34.7 percent
between age 18 and 44; for those ages 45 to 64, it was 62.1 percent. © 2004
The Associated Press. All rights reserved.
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POSSIBLE MARKER FOR OSTEOARTHRITIS FOUND
High levels of hyaluronic acid pointed to joint trouble
Jan. 11 (HealthDayNews) -- Scientists have identified a possible biomarker
to predict osteoarthritis (OA), says a study in the January issue of Arthritis
& Rheumatism.
The study of blood samples from 753 white and black American men and women
found a strong association between high levels of hyaluronic acid and severe
knee and hip arthritis. Hyaluronic acid is a component of connective tissue
that's widely distributed throughout the body and plays an important role in
joint function.
Researchers from the University of North Carolina at Chapel Hill and Duke
University Medical Center found that hyaluronic acid levels were higher in
people with more severe OA and with OA in more than one joint.
The study found no independent links between high hyaluronic acid levels and
other health problems seen in the OA patients, such as high blood pressure,
diabetes, cancer, chronic pulmonary disease, or persistent liver, kidney,
prostate or bladder conditions.
Gout was the only condition that showed a sustained independent association
with elevated hyaluronic acid (HA) levels. Like osteoarthritis, gout causes
joint inflammation and damage.
"The results of this study suggest that serum HA measurements are useful for
assessing overall OA load. The lack of independent associations of serum HA
levels with several comorbid conditions commonly associated with OA further
supports its promise in the study of OA," study co-author Dr. Alan L. Elliott,
of the Thurston Arthritis Research Center at the University of North Carolina
at Chapel Hill, said in a prepared statement.
It's hoped that early identification and intervention can improve outcomes
for people with OA, a common cause of pain and disability among older
Americans. Knee OA affects up to 6 percent of older Americans and hip OA
affects about
another 3 percent.
Robert Preidt - SOURCE: John Wiley & Sons Inc., news release, Jan. 7, 2004
Copyright © 2005 ScoutNews LLC.
**********************************************
Welcome to 2005 and the 5th year of our newsletter. This year has started
with a great deal of confusion and uncertainty about many of the drugs we take.
As new developments become known, I will publish any and all findings in the
newsletter. The FDA and its Arthritis Advisory Committee is scheduled to
meet February 16-17 to review all NSAIDS, Cox-2âs, etc.
Good Health to All,
Jack Nicholas
Newsletter Editor
_Cornishpro@..._ (mailto:Cornishpro@...)
Issue 2005-01 01/15/05