Archive for the ‘Healthy bones Osteoporosis Rheumatic’ Category

CHONDROITIN FOR OSTEOARTHRITIS: WHAT IS THE SCIENTIFIC EVIDENCE FOR CHONDROITIN?

Sunday, May 8th, 2011

Until recently, the evidence for oral chondroitin sulfate was very weak. However, in 1998, the journal Osteoarthritis and Cartilage published a supplement devoted to updating the science on this supplement. Three double-blind placebo-controlled studies were reported that provide evidence that chondroitin sulfate is an effective treatment for arthritis.One of these was a 6-month double-blind placebo-controlled study that followed 85 participants with osteoarthritis of the knee. In this study, participants received 400 mg of chondroitin sulfate twice a day or an identical-appearing placebo. Researchers evaluated improvement in arthritis symptoms by recording the level of pain as judged subjectively by the patient, the time it took to walk about 22 yards on flat ground, and the overall effectiveness of the treatment as rated by physicians and participants.The results showed that after 1 month of treatment, there was a 23% decrease in joint pain in the chondroitin sulfate group versus only a 12% decrease in the placebo group. By 6 months there was a 43% improvement in the chondroitin sulfate group versus only a 3% improvement in the placebo group (the placebo effect sometimes wears off after a while). Walking speed did not improve over the 6 months with chondroitin sulfate (it stayed the same), while in the placebo group walking speed gradually and steadily declined. Finally, physicians rated the improvement as “good” or “very good” in 69% of those taking chondroitin sulfate but in only 32% of those taking placebo.This was a reasonably long-term study that involved enough participants to be meaningful. However, another study lasted even longer, a full year, but it enrolled only 42 participants. Again, the results showed that chondroitin sulfate produced tangible benefits as compared to placebo, with the differences generally increasing steadily over the entire year.Another study was larger than either of these two, enrolling 127 participants, but it lasted for only 3 months. Again, the results were positive.Finally, an earlier study found that the benefits of chondroitin sulfate, like glucosamine sulfate, persist for months after treatment is stopped. This study compared chondroitin sulfate to the drug diclofenac sodium (Voltaren). Two previous controlled studies also compared chondroitin sulfate to NSAIDs. All together, six controlled trials have been performed in humans, involving a total of over 450 participants.*41/306/5*

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DESCRIBING RHEUMATOID ARTHRITIS

Wednesday, February 9th, 2011
Rheumatoid arthritis is described in medical textbooks as a chronic systemic disease of unknown cause for which there is no cure. It is characterized by inflammation of the joints, which is very often combined with other manifestations not directly associated with the joints. This disease occurs at all ages, including in young children, and is most often seen in young and middle-aged females. It is three times as common in females as in males and most often starts between the ages of forty and sixty.
Information from North America and Europe shows that rheumatoid arthritis affects at least 1 to 3 percent of the population. In the United States it is estimated that there are six million cases, one third of them people under fifty-five years of age. Among the young and middle-aged, it is the leading cause of occupational disability due to the high rate of serious interference with joint function.
The course of the disease varies greatly from patient to patient and is characterized by a striking tendency toward “spontaneous” remissions (temporary recovery) and exacerbations (flare-ups). 10 to 20 percent of arthritics will recover completely after their first attack. Between 30 and 50 percent of cases may be controlled with aspirin. Approximately 15 percent will be bed or wheelchair cases. The average patient will gradually become disabled and have increasing deformity.
In the majority of cases the onset is insidious, with general weakness, aching, and stiffness. This is gradually followed by joint inflammation with pain, swelling, redness, and tenderness. It usually starts in the small joints of the hands and feet and in most cases spreads to other areas, especially the wrists, elbows, hips, knees, and ankles. In severe cases almost all the joints may be affected, including the jaw, those between the spinal vertebrae, and even the joints in the larynx.
Many symptoms are not associated with the joints. There may be blood-vessel inflammation, chronic leg ulcers, anemia, enlarged lymph glands, and inflammation of the nerves (called neuritis), pericardium (area around the heart), sclerae (eyes), and lungs (inflammation and formation of nodules in the lung and pleura). In one out of twenty patients there is enlargement of the spleen.
The condition begins in the synovial membranes that line the joints. Inflammation of the synovial tissue leads to thickening of the joint lining and increase in the amount of fluid (rheum) in the joints. As inflammation of the synovia continues, the underlying cartilage at the ends of the bones is involved, and damage leads to erosion and destruction of the cartilage.
The amount of disability, to a great extent, depends on the amount of damage done to the cartilage.
In severe cases large areas of bone may lose their cartilage, producing “raw spots” that may grow together with the formation of connective tissue (adhesions) between the denuded areas at the bone ends. The connective tissue matures and becomes stronger with calcium deposits and even the formation of new bone within the joint, leading to ankylosis (firm union between the bony surfaces) and interfering to different degrees with the motion of the joint, which may become fixed – totally immobile.
In other instances the loss of cartilage and bone within a joint and the weakening of supporting structures of the joint lead to the development of an unstable structure that involves some degree of dislocation of the bones from their normal positions. The skin, bones, and muscles adjacent to the joints may atrophy from disuse. Destruction can be rapid and severe in a small number of cases.
*4/295/5*

DESCRIBING RHEUMATOID ARTHRITISRheumatoid arthritis is described in medical textbooks as a chronic systemic disease of unknown cause for which there is no cure. It is characterized by inflammation of the joints, which is very often combined with other manifestations not directly associated with the joints. This disease occurs at all ages, including in young children, and is most often seen in young and middle-aged females. It is three times as common in females as in males and most often starts between the ages of forty and sixty.Information from North America and Europe shows that rheumatoid arthritis affects at least 1 to 3 percent of the population. In the United States it is estimated that there are six million cases, one third of them people under fifty-five years of age. Among the young and middle-aged, it is the leading cause of occupational disability due to the high rate of serious interference with joint function.The course of the disease varies greatly from patient to patient and is characterized by a striking tendency toward “spontaneous” remissions (temporary recovery) and exacerbations (flare-ups). 10 to 20 percent of arthritics will recover completely after their first attack. Between 30 and 50 percent of cases may be controlled with aspirin. Approximately 15 percent will be bed or wheelchair cases. The average patient will gradually become disabled and have increasing deformity.In the majority of cases the onset is insidious, with general weakness, aching, and stiffness. This is gradually followed by joint inflammation with pain, swelling, redness, and tenderness. It usually starts in the small joints of the hands and feet and in most cases spreads to other areas, especially the wrists, elbows, hips, knees, and ankles. In severe cases almost all the joints may be affected, including the jaw, those between the spinal vertebrae, and even the joints in the larynx.Many symptoms are not associated with the joints. There may be blood-vessel inflammation, chronic leg ulcers, anemia, enlarged lymph glands, and inflammation of the nerves (called neuritis), pericardium (area around the heart), sclerae (eyes), and lungs (inflammation and formation of nodules in the lung and pleura). In one out of twenty patients there is enlargement of the spleen.The condition begins in the synovial membranes that line the joints. Inflammation of the synovial tissue leads to thickening of the joint lining and increase in the amount of fluid (rheum) in the joints. As inflammation of the synovia continues, the underlying cartilage at the ends of the bones is involved, and damage leads to erosion and destruction of the cartilage.The amount of disability, to a great extent, depends on the amount of damage done to the cartilage.In severe cases large areas of bone may lose their cartilage, producing “raw spots” that may grow together with the formation of connective tissue (adhesions) between the denuded areas at the bone ends. The connective tissue matures and becomes stronger with calcium deposits and even the formation of new bone within the joint, leading to ankylosis (firm union between the bony surfaces) and interfering to different degrees with the motion of the joint, which may become fixed – totally immobile.In other instances the loss of cartilage and bone within a joint and the weakening of supporting structures of the joint lead to the development of an unstable structure that involves some degree of dislocation of the bones from their normal positions. The skin, bones, and muscles adjacent to the joints may atrophy from disuse. Destruction can be rapid and severe in a small number of cases.*4/295/5*

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