Is a positive ANA always significant? What does the titer mean? Is the pattern of the ANA helpful? What patient histories should you not get an ANA for and which aspects of the history would raise suspicion for autoimmunity? How can you use the physical exam to assess likelihood of autoimmune disease? What is the ddx for a positive ANA?Show notes, Transcript and References: https://www.coreimpodcast.com/2022/10/05/ana-antinuclear-…5-pearls-segment/Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imSponsor: Visit www.medmastery.com/coreim for 15% off on all subscriptions. Discount code: “COREIM”Timestamps:01:37 Pearl 103:54 Pearl 213:53 Pearl 318:07 Pearl 429:30 Pearl 5Tags: IM Core, CoreIM, autoimmune, joint disease, titers, Raynaud's, lupus, Rheumatology
Irene Blanco, MD, is a professor of Medicine in the Division of Rheumatology at Northwestern Medicine and co-chair of the Diversity, Equity and Inclusion Sub-Committee of the American College of Rheumatology. In this episode, Dr. Blanco discusses her research on the health disparities in rheumatic diseases and the role of medical education in addressing such disparities and thus improving patient care and outcomes.
In this episode, Leonard Calabrese, DO, reviews the history and controversies of post-infection sequelae, as well as the facts and epidemiology of long COVID. Intro :12 Calabrese introduction :15 COVID-19 and the history of modern medicine :48 In this episode 1:39 The course of COVID-19 2:05 COVID-19 vaccines and immunity 2:50 Controversy, facts, fascination, long COVID 3:16 The history of post-acute sequelae 3:59 Post-infectious sequelae 10:15 What is long COVID and how do we define it? 11:02 How common is long COVID? 13:50 The epidemiology of long COVID 15:32 What are protective factors? 16:53 Preview of Part 2 17:36 Shoutout to rheumatologists 18:46 Conclusion 19:08 Wrap up of Part 2 preview 20:11 Thanks 21:02 Disclosures: Calabrese reports no relevant financial disclosures. We'd love to hear from you! Send your comments/questions to Dr. Brown at email@example.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum
Editor-in-chief of The Lancet Rheumatology Heather Van Epps joins Gavin and Jessamy to discuss the journal's recent work on gender and equity, and their podcast series looking at the realities of clinical care in under-served populations.You can find out about their Lancet summit hereAnd you should definitely listen to their podcast miniseries, Clinical Realities, which you can do by clicking here.You can continue the conversation with Jessamy and Gavin on Twitter by following them at @JessamyBagenal and @GavinCleaver.
Managing chronic pain and fatigue in patients with PsA and spondyloarthritis can be challenging for providers. Hear rheumatologists Dr. Philip Mease (Director, Rheumatology Research Swedish Medical Center/Providence St. Joseph Health) and Dr. Ernest Choy (Cardiff University School of Medicine), and patients Melissa Leeolou and Minionette "Mini" Wilson discuss causes, symptoms, risks and the latest in managing chronic pain and fatigue successfully. This is the second of three CME episodes in CAPES (Clinician and Patient Education Series) presented by NPF, GRAPPA, SPARTAN and SAA. This program is supported by an educational grant from Pfizer Inc.
Join Prof Iain McInnes as he reviews two interesting papers. The first covers the impact of initial therapy with upadacitinib or adalimumab on achievement of 48-week treatment goals in patients with rheumatoid arthritis. The second discusses infections in patients with rheumatoid arthritis receiving tofacitinib versus tumour necrosis factor inhibitors. Keep up to date with the latest in arthritis and cytokine signalling with Prof Iain McInnes. Everything discussed is available in a more detailed slide format in the publications section at cytokinesignalling.com.
Chronic pain and fatigue in PsA and spondyloarthritis can be challenging. Rheumatologists Dr. Philip Mease (Seattle Rheumatology Associates) and Dr. Ernest Choy (Cardiff University School of Medicine), with patients Melissa and Mini discuss causes, symptoms, risks and tips for managing both successfully. This is the second episode in CAPES (Clinician and Patient Education Series) presented by NPF, GRAPPA, SPARTAN and SAA.
Jobs which involve repetitive movements and excessive knee loading, such as farming and mining have been linked to the development of knee osteoarthritis. On this episode of Joint Action, we discuss which jobs put you at risk of osteoarthritis, which ones may have a protective effect and if you are in a physically demanding job, what can you do to minimise your risk.Dr Thomas Perry is a postdoctoral researcher in the Vincent Group at the Kennedy Institute of Rheumatology, Oxford University. His work explores the relationship between molecular-based pain biomarkers and patient-reported outcome measures of pain using data from the STEpUP OA Consortium; a prospective study of knee OA utilizing existing clinical data and knee synovial fluid samples from 17 cohorts (~N = 2000 participants) of both participants with differing severities of knee OA or with a history of recent knee injury.RESOURCESJournal articles- Occupational risk in knee osteoarthritis: a systematic review and meta-analysis of observational studies- Occupation and risk of knee osteoarthritis and knee replacement: A longitudinal, multiple-cohort studyCONNECT WITH USTwitter: @ProfDavidHunter @jointactionorgEmail: firstname.lastname@example.orgWebsite: www.jointaction.info/podcastIf you enjoyed this episode, don't forget to subscribe to learn more about osteoarthritis from the world's leading experts! Hosted on Acast. See acast.com/privacy for more information.
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Host: Anisha Dua, MD, MPH Guest: Michael Putman, MD, MSci What does the therapeutic landscape look like for patients with giant cell arthritis (GCA)? Joining Dr. Anisha Dua to highlight the need for more targeted therapies is Dr. Mike Putman from the Medical College of Wisconsin. Dr. Dua and Dr. Putman are Novartis consultants. 199849 6/22
Jack March is the founder of Rheumatology.Physio and the Director of the Physio Matters ecosystem. Jack graduated in 2008 from Plymouth University before settling into a specialty in Rheumatology. Jack is a teacher at heart offering full day courses on rheumatology, alongside his clinical work and his extensive work with Physio Matters podcast and ecosystem. In this episode Jack outlines what rheumatology is, the incidence and prevalence of Rheumatology amongst athletes and the greater population, key rheumatological conditions that athletes may hear about or come across or perhaps even be experiencing themselves including gout, rheumatoid arthritis, ankylosing spondylitis and much more. Show Sponsor: For over 40 years, Polar has been a global leader in fitness and GPS sports watches, and heart rate monitors. Their heart rate tracking technology is world-famous for being the most reliable and accurate in the industry. Over decades, they've spent every day in search of undeniable truths about the human body; obsessed by what it is trying to tell us, poring over the data, sweating over the science. They believe the most important thing you can do … is listen to your heart. What Polar does helps to improve the health, fitness and quality of millions of lives around the world – and that is what drives them. But what is driving you? If you are interested in the next step for your fitness and health tracking do take a moment to check out our friends at Polar.com. If you are looking for the latest in running watches they have the all new Pacer range, for multisport it's the Vantage V2 or if you are getting off the beaten track and need a premium outdoor GPS watch look no further than the stunning and tough Grit X Pro watches. If you need to get the most out of your training and racing, take a beat to grab the gold standard in heart rate monitors - the Polar H10, or for an even more flexible heart rate monitor the Verity Sense which also tracks your heart rate for swimming. Their range starts at $129, but what's most important is that whatever you are doing, do it with heart. to Shop at POLAR Livestream Event "ON DEMAND" The recent Livestream was a great success and we are excited to now offer those that missed the Livestream event access to the sessions via a post event purchasable recording. Click HERE>> to purchase the post event recording. Join the The Physical Performance Show LEARNINGS membership through weekly podcasts | Patreon If you enjoyed this episode of The Physical Performance Show please hit SUBSCRIBE for to ensure you are one of the first to future episodes. Jump over to The Physical Performance Show - https://physicalperformanceshow.com/ for more details. Follow @Brad_Beer Instagram & Twitter The Physical Performance Show: Facebook, Instagram, & Twitter (@tppshow1) Please direct any questions, comments, and feedback to the above social media handles.
In this episode, Kate shares her journey getting diagnosed with psoriatic arthritis while working as a chef in London. She opens up about her post-diagnosis emotional roller coaster and shares how joining Cheryl's Rheum to THRIVE online support and education program helped her feel more confident, empowered and supported. She also details other programs that helped her including a mindfulness course and CBT therapy. The episode ends with Kate sharing what it means to her to live a “good life” with rheumatic disease.Medical disclaimer:All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, a community support & education program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. Join the next group today! Rheumatoid Arthritis Roadmap, a self-paced online course Cheryl created that teaches you how to confidently manage your physical, social and emotional life with rheumatoid arthritis.Full episode details and transcriptPlease go to the show page on www.MyArthritisLife.Net for full episode details including a transcript.
Host: Ethan Craig, MD, MHS Guest: Alexis Ogdie-Beatty, MD, MSCE How does preclinical psoriatic arthritis (PsA) progress into chronic PsA? To dive into this path of progression, Dr. Ethan Craig is joined by Dr. Alexis Ogdie-Beatty from the Perelman School of Medicine at the University of Pennsylvania. Dr. Craig and Dr. Ogdie-Beatty are Novartis consultants. 221663 7/22
Recruitment season is coming our way. If you are planning to apply for residency or want to learn tips on recruitment processes, join your host Andrew Tisser with his guest, Dr. Alysia Kwiatkowski, as they talk about screening and choosing the ideal resident. “Dr. K” is the program director for the internal medicine residency program at the State University of New York, Buffalo. She views the ideal resident as someone to whom she could entrust her loved ones. She shares the things she looks for in the application, describes 360 degree reviews, and others tips for the candidate!In this episode you will learn: On her journey to the field of Education Filters and other approaches regarding recruitmentThe ideal residentThe couple's matchOne factor that would kill an application About Dr. Alysia Kwiatkowski:Alysia Kwiatkowski DO, MS is the Program Director for the Internal Medicine Training Program at the State University of New York SUNY at Buffalo (UB). In her work with the training program, Dr. Kwiatkowski has redesigned and transitioned the curriculum to interactive, multifaceted, near-peer and learner centered models. She also focuses on empowering her learners to be integral parts of their educational experiences. Dr. Kwiatkowski works in the Medical Education and Educational Research Institute (MEERI) on faculty development, interactive learning models and medical education research. She completed the Jacobs Excellence Educator Program, a faculty development program to enhance teaching and evaluation skills, the SUNY SAIL Leadership Academy, is a member of the Gold Humanism Honor Society and has received multiple teaching awards. Dr. Kwiatkowski earned her doctorate from the New York Institute of Technology, College of Osteopathic Medicine. She completed her residency and chief residency at Albany Medical Center, the major academic center associated with Albany Medical College, Dr. Kwiatkowski completed her fellowship in Rheumatology at Rush University Medical Center where she received a certification in Teaching Excellence. She earned her Masters of Science in the Natural Sciences from the University at Buffalo/Roswell Park Cancer Institute.Connect with Dr. Alysia Kwiatkowski:Website : https://medicine.buffalo.edu/faculty/profile.html?ubit=avk6LinkedIn: https://www.linkedin.com/in/alysia-kwiatkowski-do-ms-403834a0/ Connect with Talk2Medoc on:Website: https://www.andrewtisserdo.com/LinkedIn: https://www.linkedin.com/in/andrewtisserdo/Facebook: https://www.facebook.com/andrew.tisserInstagram: https://www.instagram.com/talk2medoc_llc/Twitter: https://twitter.com/Talk2MeDocYouTube: https://www.youtube.com/channel/UC0O_Sf3aYLavYaJ_hg7bM8g
Interview with Dr. Nisha Manek Nisha Manek, MD, is a physician, author, educator, and integrative health specialist. Formerly an esteemed member of the Mayo Clinic's Division of Rheumatology in Rochester, Minnesota, Nisha is an internationally recognized leader in the field of integrative medicine. Nisha is also a protégé of Professor William A. Tiller and is a student of the theoretical and practical applications of Tiller's physics in medicine. This conversation is about the incredible science of intention, how we can condition our space to support us in our wellbeing and how to navigate these hard times. It's a MUST conversation!!!♥️ we also talk about her incredible book “Bridging Science and Spirit”. Learn more about Dr. Nisha Manek at https://nishamanekmd.com/ My name is Jasna Burza & I am a Life and Business Strategist and Motivational Speaker based in Minneapolis. Having lived through war in native Bosnia, I teach and inspire others to learn resilience, create purpose and connect to deeper meaning of life, aligning their skills and passions with their work. I run multiple businesses & talk about many different topics around starting and growing a business, life & business mindset, purpose and spirituality. I hope my positivity and passion for dreams is not only infectious, but is guaranteed to energize and empower those around.
The "Patients and Communities Driving Research" topic was originally presented during National Minority Quality Forum's weekly webinar series. Listen now for a closer look at addressing existing disparities. Panelists: Lina Victoria Mata McMurry, MD, Vice President, Clinical & Social Research and Development, National Minority Quality Forum Megan Lockwood, MD, Assistant Professor of Medicine Division of Rheumatology, Department of Medicine, MedStar Georgetown University Hospital Ana Vasquez, Patient and DC resident Bishop J. L. Carter Pastor, ARK Church Baltimore, MD Mary Stober Murray, MS PopH Vice President, Collaborative Action Networks National Minority Quality Forum (Moderator)
Host: Anisha Dua, MD, MPH Guest: Michael Putman, MD, MSci What are some imaging factors we should consider when monitoring giant cell arthritis (GCA) and the medication prescribed for it? Dr. Anisha Dua is joined by Dr. Mike Putman to explore these factors. Dr. Dua and Dr. Putman are Novartis consultants. 199849 6/22
Fibromyalgia is a challenging condition for both the patient and the physician. There is no quick fix and no magic medication that will fix fibromyalgia pain. With an integrative, multidimensional approach, however, people with fibromyalgia can absolutely feel better! Dr. Ziegenbein is a rheumatologist and expert in fibromyalgia. She shares her approach for helping patients with fibromyalgia reduce their pain and regain the joy in their life. You will love this episode! Dr. Ziegenbein has a podcast called Winning at Fibromyalgia and a Facebook group of the same name. She has a private fibromyalgia coaching practice in addition to her standard rheumatology practice. She can be reached at www.winningatfibromyalgia.comThanks for listening!Delia Chiaramonte, MDThe Institute for Integrative Palliative Medicinewww.integrativepalliative.comCome learn with me! I am offering an exciting program: Integrative Symptom Management that starts in October. Check it out at: https://trainings.integrativepalliative.com/symptom-management-trainingWhen your patient is crying do you know just what to do? Can you confidently help patients manage anxiety or pain without controlled medications? Come learn with Dr. Chiaramonte and improve your integrative symptom management skills!- evidence supported patient care skills- self care for you- patient resources for your office- group case-based discussionswww.integrativepalliative.com/training
Some mission experts estimate that up to 90% of young people who consider missions cease to pursue it because of various fears and obstacles, including the fear of fundraising. Some workers view fundraising as a rite of passage or as an obstacle to overcome. Others understand God’s purposes to include each follower of Jesus in His worldwide kingdom work through going, serving, sending, praying, encouraging, and giving.
*This information in this podcast is intended for Healthcare Practitioners. Professor Paul Peter Tak, a pioneering researcher and transformational innovator, joins the podcast to describe the power and potential of a little-known homeostatic pathway, known as the cholinergeric anti-inflammatory pathway (CAP). Prof Tak was a key researcher in the identification of the CAP, which is an innate and reflexive anti-inflammatory response mediated by the vagus nerve. Learn the origins of the discovery of the CAP and Tak's groundbreaking work that showed a loss of vagal tone precedes the development of rheumatoid arthritis (RA). Moreover, Prof Tak's team went on to show that electrical stimulation of the vagus nerve had a profound effect on disease activity in RA. The conversation moves to exploring how the gut, nutrition and lifestyle factors can potentially activate the CAP and help prevent or manage autoimmune and inflammatory disorders. Learn how the CAP can be an important target for combating chronic disease. Paul Peter Tak is a business leader, academic, entrepreneur and clinician who has over 30 years' experience in medicine as a prominent expert in Immunology, Internal Medicine, and Rheumatology. Alongside his industry career, Prof Tak has dedicated much of his life to academia and advancing our understanding in medicine. He has served as Professor of Medicine at the University of Amsterdam and holds numerous honours for his service to medicine, with a special focus on Immunology and Rheumatology. Useful Links Prof Paul Peter Tak's website: https://paulpetertak.com/ First description of the hypothesis that stimulation of the cholinergic anti-inflammatory pathway may be used to reduce chronic inflammation: van Maanen MA, Vervoordeldonk MJ, Tak PP. The cholinergic anti-inflammatory pathway: towards innovative treatment of rheumatoid arthritis. Nat Rev Rheumatol. 2009 Apr;5(4):229-32. doi: 10.1038/nrrheum.2009.31. PMID: 19337288. https://pubmed.ncbi.nlm.nih.gov/19337288/ Pioneering study that found low vagal tone precedes rheumatoid arthritis. Koopman FA, Tang MW, Vermeij J, de Hair MJ, Choi IY, Vervoordeldonk MJ, Gerlag DM, Karemaker JM, Tak PP. Autonomic Dysfunction Precedes Development of Rheumatoid Arthritis: A Prospective Cohort Study. EBioMedicine. 2016 Apr;6:231-237. doi: 10.1016/j.ebiom.2016.02.029. Epub 2016 Feb 19. PMID: 27211565; PMCID: PMC4856742. https://pubmed.ncbi.nlm.nih.gov/27211565/ First clinical trial in patients showing the effects of stimulation of the chronic immune-mediated inflammatory disease: Koopman FA, Chavan SS, Miljko S, Grazio S, Sokolovic S, Schuurman PR, Mehta AD, Levine YA, Faltys M, Zitnik R, Tracey KJ, Tak PP. Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proc Natl Acad Sci U S A. 2016 Jul 19;113(29):8284-9. doi: 10.1073/pnas.1605635113. Epub 2016 Jul 5. PMID: 27382171; PMCID: PMC4961187. https://pubmed.ncbi.nlm.nih.gov/27382171/ Interview summarising the discovery of vagal involvement in chronic inflammation Tak PP. Interview with Paul-Peter Tak: stimulating the vagus nerve to treat rheumatoid arthritis. Bioelectronics in Medicine. 2018 Jan;1(1):17-20. https://www.futuremedicine.com/doi/10.2217/bem-2017-0012
Vax Whistleblower – Mary Hollen Anna Maria Mihalcea – D-Dimer elevation in the Unvaccinated. A Marker of Shedding? Why You Should Have Faith Plandemic – Indoctrination Green tea compound shows promise for treating rheumatoid arthritis Washington State University August 25, 2022 A compound found in green tea could be an effective treatment for rheumatoid arthritis, according to the results of a new study. Green tea being poured into a cup] EGCG – a compound found in green tea – could help treat rheumatoid arthritis, new research suggests. In the journal Arthritis and Rheumatology, researchers from Washington State University (WSU) in Spokane reveal how the compound – called epigallocatechin-3-gallate (EGCG) – reduced ankle swelling in a mouse model of the disease. Rheumatoid arthritis (RA) is a disease that affects the joints of the body, most commonly the joints of the hands, feet, wrists, elbows knees and ankles. In RA, the immune system mistakingly attacks the synovial tissues surrounding the joints, causing inflammation, swelling and pain. This can cause damage to the cartilage and bone. Current treatments for RA include non-steroidal anti-inflammatory drugs (NSAIDS), corticosteroids and JAK inhibitors. But study leader Salah-uddin Ahmed, of the WSU College of Pharmacy, notes that some of these treatments are expensive, reduce immune system activity and can be unsuitable for long-term use. In their study, Ahmed and colleagues suggest that the compound EGCG may be a promising alternative to current treatments for RA. EGCG targets key signaling protein to reduce RA inflammation EGCG is a chemical compound that belongs to a class of flavanols known as catechins. After giving EGCG to mouse models of RA for 10 days, the team noticed that treatment with the compound led to a significant reduction in ankle swelling. The researchers found that EGCG reduces the activity of TAK1 – a key signaling protein through which pro-inflammatory cytokines transmit their signals to trigger the inflammation and tissue damage found in RA. What is more, the team says that EGCG reduced inflammation in RA without interfering with other cellular functions – unlike some current medications for the disease. According to Ahmed, their study suggests the green tea compound may be highly effective against RA. Antioxidant-rich pomegranate juice may aid blood sugar management for diabetics: Human data Jordan University of Science and Technology, August 20, 2022 Daily consumption of pomegranate juice may help control blood sugar levels in type-2 diabetics, as well as improving the function of beta cells in the pancreas, say data from a human trial. Scientists from the Jordan University of Science and Technology report that pomegranate juice at a dose of 1.5 mL per kg of body weight (or 105 mL for a 70 kg human) was associated with reductions in fasting glucose levels in type-2 diabetics. “Studying the effects of pomegranate consumption (in a juice form) on the reduction of blood glucose levels in type-2 diabetes patients could lead to a dietary approach to control this disease,” they added. “Since there are many herbs and fruits that are easily available and of value in controlling this disease, this study may contribute to a better understanding and improved management of type 2 diabetes by the individual.” To investigate this, they recruited 85 people with type-2 diabetes and assigned them to receive 1.5 mL of the juice per kg of body weight. Blood sugar and insulin levels, and beta cell function were assessed three hours after ingestion. (Beta-cells are found in the pancreas and their primary function is to store and release insulin.) Results showed that pomegranate juice was associated with significantly lower fasting glucose levels (8.5 mmol/L) compared with the control participants (9.44 mmol/L). However, this result was an average for the whole cohort and about 20% of the participants did not experience this benefit. Going with the flow: Study shows canals and rivers help boost your mood King's College London, August 31, 2022 Researchers report that the combination of blue and green space with wildlife, has a greater impact on well-being than spending time in an environment that is characterized by only green space. The researchers used Urban Mind, a smartphone-based app, to collect thousands of real time audits about participants' location and mental well-being. Results from this first of its kind study showed positive associations between visits to canals and rivers and mental well-being, as well as a positive experience for feelings of safety and social inclusion relative to all other types of environments (such as indoors, or outside in an urban environment, or near green spaces). Andrea Mechelli, Professor of Early Intervention in Mental Health, King's College London, said, “Canals and rivers contain not only water but also an abundance of trees and plants, which means their capacity to improve mental well-being is likely to be due to the multiple benefits associated with both green and blue spaces. Canals and rivers also provide homes to a range of wildlife, and we know from other research that there is a positive association between encountering wildlife and mental well-being. Taken collectively, these findings provide an evidence base for what we thought about water and well-being and support the proposal that visits to canals and rivers could become part of social prescribing schemes, playing a role in supporting mental health.” The study found that visiting canals and rivers was associated with a greater improvement in mental well-being, and this relationship was still present when accounting for individual variation due to age, gender, education, ethnicity, and a diagnosis of a mental health condition. People also reported continued improvements in their mental well-being for up to 24 hours after the visit had taken place.”The powerful mix of blue, green and wildlife-rich space shows that although built for industry, repurposed canals are actually amongst our most important places of health and well-being in our towns and cities. Men, people over 65 sleep better when they have access to nature University of Illinois College of Agricultural, August 24, 2022 Men and persons age 65 and older who have access to natural surroundings, whether it's the green space of a nearby park or a sandy beach and an ocean view, report sleeping better, according to a new University of Illinois study published in Preventive Medicine. In the study, Grigsby-Toussaint worked with both U of I researchers and scientists from the New York University School of Medicine. The team used data from the CDC's Behavioral Risk Factor Surveillance System, which surveyed 255,171 representative U.S. adults, to learn whether there was an association between self-reported days of insufficient sleep and access to green space. The team also used a USDA index that scores the country's geographical areas for their natural amenities, using hours of sunlight, which is important in regulating a person's circadian rhythm, and temperature. In response to the survey question about sleep quality in the last month, the researchers found that the most common answer was that respondents had slept poorly for less than one week. “Interestingly, though, across the entire sample, individuals reporting 21 to 29 days of insufficient sleep consistently had lower odds of access to green space and natural amenities compared to those reporting less than one week,” she said. For men, the relationship between sleep and exposure to green space was much stronger than for women. And males and females 65 and over found nature to be a potent sleep aid, she added. Grigsby-Toussaint noted that living near green landscapes is associated with higher levels of physical activity and that exercise in turn predicts beneficial sleep patterns. But men appeared to benefit much more from their natural surroundings. The researcher speculated that women may take less advantage of nearby natural settings out of concern for their safety, but she added that more research is needed. New study links ultra-processed foods and colorectal cancer in men Tufts University and Harvard University, August 31 ,2022 For many Americans, the convenience of pre-cooked and instant meals may make it easy to overlook the less-than-ideal nutritional information, but a team led by researchers at Tufts University and Harvard University hope that will change after recently discovering a link between the high consumption of ultra-processed foods and an increased risk of colorectal cancer. In a study published in the BMJ, researchers found that men who consumed high rates of ultra-processed foods were at 29% higher risk for developing colorectal cancer—the third most diagnosed cancer in the United States—than men who consumed much smaller amounts. They did not find the same association in women. “We started out thinking that colorectal cancer could be the cancer most impacted by diet compared to other cancer types,” said Lu Wang, the study's lead author and a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts. “Processed meats, most of which fall into the category of ultra-processed foods, are a strong risk factor for colorectal cancer. Ultra-processed foods are also high in added sugars and low in fiber, which contribute to weight gain and obesity, and obesity is an established risk factor for colorectal cancer.” The study analyzed responses from over 200,000 participants—159,907 women and 46,341 men—across three large prospective studies which assessed dietary intakeand were conducted over more than 25 years. The analyses revealed differences in the ways that men and women consume ultra-processed foods and the prospective associated cancer risk. Out of the 206,000 participants followed for more than 25 years, the research team documented 1,294 cases of colorectal cancer among men, and 1,922 cases among women. The team found the strongest association between colorectal cancer and ultra-processed foods among men come from the meat, poultry, or fish-based, ready-to-eat products. “These products include some processed meats like sausages, bacon, ham, and fish cakes. This is consistent with our hypothesis,” Wang said. The team also found higher consumption of sugar-sweetened beverages, like soda, fruit-based beverages, and sugary milk-based beverages, is associated with an increased risk of colorectal cancer in men. However, not all ultra-processed foods are equally harmful with regard to colorectal cancer risk. “We found an inverse association between ultra-processed dairy foods like yogurt and colorectal cancer risk among women,” said co-senior author Fang Fang Zhang, a cancer epidemiologist and interim chair of the Division of Nutrition Epidemiology and Data Science at the Friedman School. Overall, there was not a link between ultra-processed food consumption and colorectal cancer risk among women. It's possible that the composition of the ultra-processed foods consumed by women could be different than that from men. “Foods like yogurt can potentially counteract the harmful impacts of other types of ultra-processed foods in women,” Zhang said. 8 Benefits of Pine Bark Extract for Your Brain GreenMedInfo, August 31, 2022 Our brains can be harmed by many factors such as disease, stress from the environment, physical injuries or natural aging but pine bark extract may be one key to a healthier brain Pine bark extract (PE), trade name Pycnogenol (pronounced “pig-nah-gen-all”), has many beneficial properties such as being anti-inflammatory, antioxidant and neuroprotective. It can help with memory, cognition, inattention, hyperactivity, mood, thinking and various symptoms of brain injuries, aging and neurological diseases. Fights Inflammation and Protects the Brain In a systematic review and meta-analysis of Pycnogenol supplementation on C-reactive protein (CRP) — a marker of oxidative stress — researchers examined five trials including 324 participants. Pycnogenol supplementation had a significant effect in reducing CRP and demonstrated a strong anti-inflammatory effect.[i] In a study of gerbils, pine bark extract was administered at 100 milligrams (mg) per kilogram (kg) once a day for seven days before the brain was submitted to a brain ischemic injury. The PE treatment markedly inhibited the death of neurons in the brain, significantly decreased the pro-inflammatory cytokines — interleukin 1β and tumor necrosis factor α — and showed a strong activation effect on anti-inflammatory cytokines of interleukin 4 (IL-4) and interleukin 13 (IL-13). Pine bark protected the brain and decreased inflammation.[ii] Improves Attention, Memory, Executive Functions and Mood in Healthy People In a study over eight weeks, Pycnogenol supplementation improved sustained attention, memory, executive functions and mood ratings in 53 healthy students compared to an equivalent control group.[iii] In a trial of 60 healthy professionals from 35 to 55 years old, half of the participants supplemented with Pycnogenol of 50 mg three times a day for 12 weeks in combination with a controlled health plan — regular sleep, balanced meals and daily exercise — and the other half followed only the health plan as the control group. PE significantly improved mood by 16%, mental performance by 9%, attention by 13% and memory by 4%, and reduced oxidative stress by 30%, outperforming all results of the control group.[iv] Prevents Brain Aging and Cognitive Decline Brain aging is a complex process involving changes in the brain's structure, neuron activity and biochemical profile that has been linked to age-associated variations in cognitive function. Increased oxidative stress may also be an important factor related to reduced cognition in older people. In a systematic review of over 100 research trials and animal studies, the antioxidant Pycnogenol significantly improved cognitive function after chronic administration.[v] Improves Cognition and Stress in the Mildly Impaired or Highly Oxidative Stressed Eighty-seven healthy subjects with mild cognitive impairment scores were included in a trial with one group given standard management (SM) and the other half given Pycnogenol supplements for two months. The median increase in mild impairment scores was 18% with Pycnogenol compared to 2.48% in the SM group, largely due to its effects on oxidative stress levels.[vi] In a study of 88 healthy patients ages 55 to 70 who had high oxidative stress, half were supplemented with 100 mg per day of Pycnogenol for 12 months and the other half were the control group followed as a reference point for a year. Those in the pine bark group had significantly improved cognitive function scores, attention and mental performance and lowered oxidative stress levels compared to those in the reference group.[vii] Increases Cognitive Function and Helps Symptoms in Parkinson's Disease Researchers studied 43 Parkinson's disease (PD) patients who had been diagnosed at least one year before the trial. The condition was considered “mild,” with minimal progression. The standard management (SM) for PD — carbidopa/levodopa — was used in a similar-sized reference group of PD subjects for comparison purposes. The trial subjects were supplemented with Pycnogenol of 150 mg per day along with SM for a period of four weeks. Cognitive function was significantly higher with the Pycnogenol group. Target symptoms including tremors, rigidity, bradykinesia — slow or impaired movements in limbs — and speech were improved in the PE group compared to the control group. Oxidative stress was also significantly lower in the pine bark group at four weeks.[viii] Enhances Memory and Prevents Harmful Plaque and Tau Buildup in Alzheimer's Disease In Alzheimer's disease (AD), the release of amyloid-beta (Aβ) is a marker. Aβ aggregates into oligomers, then plaques, which induce inflammatory responses, synapse loss and misfolding of tau, a second hallmark of AD. Accumulation of tau misfolding leads to tangles in the brain and neuron cell death impacting brain synapses in a pattern of progression closely related to cognitive decline, which can happen years before memory loss symptoms even appear.[ix] Pycnogenol significantly decreased the number of plaques in both pre-onset and post-onset treatment paradigms and improved spatial memory in the pre-onset treatment only in an AD-induced mouse model.[x] In an in vitro study of AD-induced animals, pine bark — Oligopin — prevented and halted the progression of AD preclinically by inhibiting oligomer formation of not only Aβ1-40 and Aβ1-42, but also tau in vitro.[xi] Reduces Inflammation and Improves Outcomes for Traumatic Brain Injuries In a scientific trial of 67 traumatic brain injury (TBI) patients admitted to an intensive care unit (ICU), the intervention group received 150 mg of the PE supplement Oligopin with enteral nutrition — tube feeding through stomach or intestine — for 10 days while the control group received a placebo.[xii] Pine bark supplementation significantly decreased inflammatory biomarkers of IL-6, IL-1β and CRP compared to the control group after 10 days. In addition, pine bark reduced clinical scores for acute physiology and chronic health evaluation as well as sequential organ failure. The Nutric score — a way to measure if a patient is under-nourished and at critical risk of dying[xiii] — was reduced compared to the control group as well. Overall, the survival rate was 15% higher in the pine bark group compared to the placebo group. PE supplementation for TBI patients in ICUs reduced inflammation, improved their clinical status and malnutrition score and, thereby, reduced their mortality rate. Improves Attention, Focus, Thinking, Behavior and Antioxidant Levels in ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by impulsivity, distractibility and hyperactivity. One of the factors associated with ADHD is oxidative stress. Pycnogenol consists of bioflavonoids, catechins, procyanidins and phenolic acids.[xiv] Pycnogenol acts as a powerful antioxidant stimulating certain enzymes, like superoxide dismutase (SOD) and endothelial nitric oxide synthase (eNOS), which can defend against oxidative stress. In the pathophysiology of ADHD, damage to adrenaline, noradrenaline and dopamine metabolism occurs in the brain. These changes can modify attention, thinking and acting.[xv] In a trial of 43 children ages 6 to 14 with ADHD, patients were administered Pycnogenol — 1 mg per kg of body weight every day — or a placebo of look-alike pills daily for a month. The PE group had a significant decrease in GSSG and a highly significant increase in GSH levels as well as improvement of GSH/GSSG ratio in comparison to the placebo group. The total antioxidant status (TAS) decreased in children with ADHD who took pine bark, showing a normalization of TAS in ADHD children.[xvii] In a crossover study of 20 children with ADHD, participants experienced two experimental units — four weeks of pine bark supplementation with 25 or 50 mg PE and four weeks with placebo supplementation — separated by two weeks of a washout period. PE supplementation caused a significant reduction in inattention and hyperactivity-impulsivity measures.
https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.122.059410?af=RThe Biomarkers say REDUCE-IT was a scamhttps://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2791663NO! Just NO-- stick with the calculator for nowhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059038start the SLGT-2 inhibitors early! maybe an early dischargehttps://pubmed.ncbi.nlm.nih.gov/35849407/If we could get the EMR to do it automatically else you cant expect providers tohttps://pubmed.ncbi.nlm.nih.gov/35727595/the head CT for psych stuff can probably be put on holdhttps://eprints.whiterose.ac.uk/180135/continue the disease modifying agents
Host: Anisha Dua, MD, MPH Guest: Elaine Husni, MD, MPH The risk of developing cancer may be higher in patients with spondyloarthritis, or SpA for short.1-6 What do we need to know about the risk of cancer, as well as other malignancies in these patients? Dr. Anisha Dua joins Dr. Elaine Husni from the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University to explore malignancies in SpA. Dr. Dua and Dr. Husni are Novartis consultants. Deng C, Li W, Fei Y, Li Y, Zhang F. Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis. Sci Rep. 2016;6:1-6. Gross R, Schwartzman-Morris J, Krathen M, et al. A comparison of malignancy incidence among psoriatic and rheumatoid arthritis patients in a large US cohort. Arthritis Rheumatol. 2014;66(6):1472-1481. Chiesa Fuxench ZC, Shin DB, Ogdie Beatty A, Gelfand JM. The risk of cancer in patients with psoriasis: a population-based cohort study in the health improvement network. JAMA Dermatology. 2016;152(3):282-290. Moon H-I, Chang H-J, Kim J-E, Ko H-Y, Ann S-H, Min C-K. The association between multiple myeloma and ankylosing spondylitis: a report of two cases. Korean J Hematol. 2009;44(3):182-187. Chang CC, Chang CW, Nguyen PAA, et al. Ankylosing spondylitis and the risk of cancer. Oncol Lett. 2017;14(2):1315-1322. Karmacharya P, Shahukhal …
Earlier this month actor, Ashton Kutcher revealed that he has vasculitis, a disease that left the actor unable to see, hear or walk for a period of time. Rheumatology specialist, Anna Broder, M.D., sat down and talked us through this very complex autoimmune disease.
This week's episode is another installment of our popular “Hot Topics” series, where we discuss “must read” studies recently published in one of ACR's three peer-reviewed journals. Joining us is Dr. Vicki Shanmugam. Not just our guest today, but also the host of a new ACR podcast series, “ACR Journals on Air” scheduled to launch later this summer. Today, we'll hear what we can expect from her new podcast, and we'll talk about some of her favorite studies in the ACR's journals right now. Enjoy!
Rainbow Rheumatology (8.26.2022) Dr. Jack Cush delivers this weeks rheumatology "weather report" with the best and least of news and journal articles from the past week on RheumNow.com “Climate is what we expect, weather is what we get.” – Mark Twain
Host: Anisha Dua, MD, MPH Guest: Michael Putman, MD, MSci With several guidelines available—what imaging considerations should we keep in mind when it comes to diagnosing giant cell arthritis (GCA)? Joining Dr. Anisha Dua to walk us through the guidelines and make recommendations is Dr. Mike Putman. Dr. Dua and Dr. Putman are Novartis consultants. 199849 6/22
Is it possible to heal autoimmune conditions using nontraditional approaches? That's where we're going on this week's episode! Dr. Micah Yu, a Rheumatologist AND Integrative/Functional Medicine physician is our guest. He has a fresh approach to tackling autoimmune diseases and knows personally how important diet, lifestyle and hidden stressors can impact the immune system. By changing his diet, he was able to reverse his own autoimmune condition. If you are battling autoimmune problems, don't settle for just the prescription approach. Listen up and learn how to advocate for your health, find the root cause and make long lasting changes instead of patching a problem with a pill. PS: He has some super fun social media posts you need to follow too! More about Dr. Yu; Dr. Yu is an integrative rheumatologist who incorporates complementary medicine with traditional rheumatology. He is triple board-certified in Rheumatology, Internal Medicine and Lifestyle Medicine. He obtained his MD from Chicago Medical School and holds a Masters in Healthcare Administration and Biomedical sciences. He completed his internal medicine residency and rheumatology fellowship at Loma Linda University in Southern California. He has been accepted with a full scholarship to the Andrew Weil Integrative Medicine Fellowship at the University of Arizona. In addition, he has also taken courses in functional medicine through the Institute of Functional Medicine. Dr. Yu has a very unique perspective on autoimmune disease and arthritis as he is both a patient with arthritis and physician. Dr. Yu was diagnosed with gout at the age of 17 and later diagnosed with spondyloarthritis as well. He is able to understand his patient's medical problems from a patient perspective. The foundation of his practice is to combine allopathic medicine with complementary medicine. He works with his patients to come up with a treatment plan that not only fights the disease but also is aligned with his patient's goals. Find Dr. Yu here: https://myautoimmunemd.com/ Autoimmune MD And also on TikTok, IG, FB and LI as myautoimmunemd Instagram: myautoimmunemd Facebook:https://www.facebook.com/MYAutoimmuneMD Linked IN:https://www.linkedin.com/in/micah-yu/ Our Advice! Everything in this podcast is for educational purposes only. It does not constitute the practice of medicine and we are not providing medical advice. No Physician-patient relationship is formed and anything discussed in this podcast does not represent the views of our employers. The Fine Print! All opinions expressed by the hosts or guests in this episode are solely their opinion and are not to be used as specific medical advice. The hosts, May and Tim Hindmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Thanks for joining us! You are the reason we are here. If you have questions, reach out to us at firstname.lastname@example.org or find Tim and I on Facebook and IG. Please check out our every growing website as well at bsfreemd.com (no www) GET SOCIAL WITH US! Instagram:: https://www.instagram.com/bsfreemd/ Facebook: https://www.facebook.com/bsfree
Dr Thoraiya Kanafani from the Human Relations Institute and Clinics clarifies the differences.Dr Salman Hameed from Zia Medical Center in Jumeirah joins us for a Knee Clinic- from anatomy to injuries to treatments, and two patients share their experiences too.And do you suffer from sudden and severe attacks of pain on the joints? Dr Beena Hameed, Consultant Rheumatologist at King's College Hospital Dubai explains what really is gout.See omnystudio.com/listener for privacy information.
In this week's episode, we discuss the "ACR's 2022 Guideline Summary for Vaccinations in Patients with Rheumatic and Musculoskeletal Diseases" with lead author Dr. Anne Bass, Attending Physician in the Division of Rheumatology at Hospital for Special Surgery and a Professor of Clinical Medicine at Weill Cornell Medicine. During our conversation we consider the importance of guidelines for vaccines, the impact certain drugs like rituximab and methotrexate have on vaccinations, cover some vaccine highlights within the guidelines, how these guidelines can aid in navigation with insurance companies and much, much more.
Happy Friyay! Ashton Kutcher almost died from vasculitis recently, but what actually happened to him? An expert explains this rare disease. Also, we are pump because actor André Ward joins us to discuss his role as Toulouse-Lautrec in Moulin Rouge and we are obsess! Pus, so much more. Special guests: Dr. Peter A. Merkel, Chief, Division of Rheumatology, Professor of Medicine and Epidemiology at University of Pennsylvania. André Ward - Actor/ Broadway star.
Dr Kim Lauper, from the Division of Rheumatology, Department of Internal Medicine and Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Geneve, Switzerland. Join Professor Peter Nash as he interviews authors of recent notable papers in rheumatology. In this addition Dr Lauper discusses her latest paper; Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31 846 patients with rheumatoid arthritis in 19 registers from the ‘JAK-pot' collaboration.
Cheryl reflects on a blog post she wrote at age thirty called: “Ten Years with Rheumatoid Arthritis: What's the Impact?” This includes a deep dive into the physical effects of rheumatoid arthritis, effects on my daily routines, as well as finances, social and emotional life, school, career, hobbies, travel and overall life philosophy. Cheryl shares how pregnancy and parenting changed her disease progression, and details how she coped with additional health issues and injuries in her thirties along with adjusting to her new role as a mother. For full show notes plus a transcript, go to the episode page on the Arthritis Life Website. Medical disclaimer:All content found on Arthritis Life public channels was created for generalized informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.Episode SponsorsRheum to THRIVE, a community support & education program Cheryl created to help people with rheumatic disease go from overwhelmed, confused and alone to confident, supported and connected. Join the waitlist for the next group! Rheumatoid Arthritis Roadmap, a self-paced online course Cheryl created that teaches you how to confidently manage your physical, social and emotional life with rheumatoid arthritis. Full Show Notes, Links & TranscriptFor full show notes plus a transcript, go to the episode page on the Arthritis Life Website.
Today we're talking about implicit bias with Dr Arin Reeves. What bias is, how it permeates our lives, how it can negatively impact our workforce, and its impact on clinical research and patient care. Most importantly, we discuss what we can do about our implicit biases to prevent them from causing damage.
As we see an increasing number of culturally diverse patients in our practices, there is no doubt of the importance of cultural competency in medicine. Specific circumstances and miscommunications have been well documented. But how can we develop an eye to see where a patient’s values and worldview may differ from our own? We will review an approach to cultural competency highlighted by medical missions case studies.