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By: Lifestyle Desk | New Delhi | Updated: August 22, 2020 2:26:34 pmPeople who suffer from long standing arthritis of the joints find it difficult to move andwalk around because of pain. (Photo: Getty Images/Thinkstock)

Covid-19 pandemic has taught us the importance of being fit. It is a well-known fact that a healthy mind lives in a healthy body. Certain medical conditions like diabetes, obesity and hypertension need to be well controlled to have better immunity against infections.

People who are suffering from long-standing arthritis of the joints are not able to move and walk around because of pain and disability in their joints. This can lead to uncontrolled diabetes, hypertension, and weight gain because of less calorie expenditure. This can, in turn, weaken the bones and muscles of the limbs, causing a disease called osteoporosis. This complicates the whole situation because now these people are not only just suffering from arthritis but also osteoporosis and weak muscles. This leads to increased fragility of the bone and also instability while walking. These patients have an increased tendency to fall and we are witnessing many such patients with fractures around the hip and leg bones, Dr Subhash Jangid, director and unit head, Fortis bone and joint institute, Fortis Memorial Research Institute, Gurugram told indianexpress.com.

If someone is not able to move because of weak bones and arthritis, they should get themselves treated by medication or by surgery. That is because, if they get COVID-19 infection in such a situation, they may face a tough time recovering because of weak muscles (including chest muscles) and poor immunity. Taking multivitamins and other healthy foods are not just enough to boost immunity. Health experts have repeatedly emphasised on exercising every day, maybe just a brisk walk for 30 min every day.

So, if you are suffering from hip and knee arthritis, dont delay the surgery and prolong the suffering as it is a vicious cycle that will further cause deterioration in your health. We have to take precautions and stop fearing the pandemic. Precautions are the most important thing which can save us from this illness, Dr Jangid added.

Read| Have arthritis? Some of these exercises can help

Delaying your health needs will take a toll on the recovery as well and the results may be compromised. We are seeing a lot of patients with advanced diseases owing to the delay in surgery now that they are scared to step out. Your health and immunity are the only saviour against COVID-19 and we need to focus on the same, the doctor further said.

The biggest myth is that the hospitals are COVID-19 hot spots. If hospitals would have been hot spots, almost all medical staff would have been infected by now. But that is not what we are seeing all over the world. Actually, coronavirus is everywhere and the hospitals are one of the safest places because the guards against the virus are always on. People are getting the infection from the grocery stores and markets rather than from the hospitals. Everyone remains safe if they take precautions. And in hospitals, people take maximum precautions, Dr Jangid remarked.

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Covid-19 and arthritis: Why people with joint pain should not delay treatment - The Indian Express

The use of disease-modifying antirheumatic drugs (DMARDs) and the adoption of an early and aggressive treatment strategy have transformed the outcomes of patients with rheumatoid arthritis (RA). These immunosuppressive and immunomodulatory agents are essential to the comprehensive RA treatment strategy, with an objective of achieving disease remission or sustained minimal disease activity, to prevent radiographic progression.1

The DMARDs currently available are broadly categorized as conventional synthetic DMARDs (csDMARDs) and biologic DMARDs (bDMARDs). Conventional synthetic DMARDs typically include methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and are generally used in the first-line setting.2 Several bDMARDs are approved for RA in 6 therapeutic classes, including tumor necrosis factor inhibitors (etanercept, adalimumab, infliximab, certolizumab pegol, and golimumab); T-cell costimulatory blocking agent (abatacept); B-cell depleting agents (rituximab); interleukin-1 receptor antagonists (anakinra); interleukin(IL)-6 inhibitors (tocilizumab and sarilumab); and Janus kinase inhibitors (JAK; tofacitinib, baricitinib, and upadacitinib).3 Biosimilars, a highly similar copy of the original approved biologic agent, with no clinically meaningful differences in safety, purity, and potency, has expanded the options of bDMARDs.4 In general, bDMARDs are prescribed after the failure of first-line csDMARD therapy.

The most commonly used csDMARD in the first-line setting is methotrexate. When RA progresses despite treatment with csDMARDs, a bDMARD may be introduced as monotherapy, typically in combination with a csDMARD, such as methotrexate. In cases of disease progression, despite treatment with methotrexate and bDMARDs, clinicians are faced with an increasingly challenging choice of treatment selection to achieve optimal disease management. Over time, 2 key questions have emerged: the comparative effectiveness of bDMARD monotherapy vs the combination of a bDMARD with methotrexate, and the comparative effectiveness of the available bDMARD either as monotherapy or in combination with methotrexate. The importance of these questions may be related to treatment efficacy and safety, given the diverse RA patient population among whom approximately one-third are treated with bDMARD monotherapy, primarily because of intolerance or noncompliance with methotrexate.5

The comparative effectiveness of bDMARD vs methotrexate monotherapy has been addressed in several studies. Overall, the superiority of bDMARD vs methotrexate monotherapy has been established for all 6 classes of bDMARDs, particularly in the setting of disease progression with methotrexate.6-9

With respect to the comparative effectiveness of bDMARD monotherapy vs combination with methotrexate, available studies have shown that some bDMARDs were more efficacious in combination with methotrexate, others as efficacious as either monotherapy or in combination, and the evidence for other DMARDs were less clear.

Specifically, the superiority of the efficacy of bDMARDs in combination with methotrexate compared to bDMARD monotherapy has been evident for tumor necrosis factor inhibitors (TNFis), but not non-TNFis.5,8 Both abatacept and tocilizumab have showed effectiveness whether combined with methotrexate or used as monotherapy.5,8,10 The effectiveness of rituximab as monotherapy compared to combination with methotrexate has been less clear, with some studies reporting superior efficacy as a combination,11-13 although the effectiveness either as monotherapy or in combination with methotrexate has also been reported.14 The use of tofacitinib in RA has been inconclusive because of lack of available data.5,15 Taken together, the evidence suggests that the currently available bDMARDs vs methotrexate monotherapy achieve greater control of disease activity. However, the combination of a bDMARD with methotrexate may be more efficacious than bDMARD monotherapy for anti-TNF agents, comparable for tocilizumab and abatacept, and inconclusive for rituximab, tofacitinib, and anakinra because of paucity of studies and data.

While it has been established that bDMARDs vs methotrexate may be more efficacious in disease control, the choice of available bDMARDs can be challenging because of the lack of head-to-head comparative studies and the limited data for use of these agents. The majority of the studies that have evaluated the comparative effectiveness of bDMARDs have concluded that anakinra may be the least efficacious.16 Furthermore, the American College of Rheumatology (ACR) response was found to be higher with tocilizumab compared to a TNFi or the JAK inhibitor tofacitinib.5 Among the TNFi agents, etanercept has been reported to be the most efficacious and infliximab the least.16,17 In combination with methotrexate, excluding anakinra, available data suggest comparable efficacy across the bDMARDs evaluated.10,18

A meaningful comparative effectiveness analysis of bDMARDs has been challenged by several limitations that question the accuracy of the comparisons.3 In many cases, there are variations in study design and clinical end points. Furthermore, available data may not be comparable for all agents; for example, there is fewer data for the newer approved agents such as the JAK inhibitors. Data has typically included heterogeneous, selected patient populations, with outdated definitions of clinical end points of clinical remission and low disease activity. Furthermore, in the absence of head-to-head studies, an indirect comparison of trial findings has often resulted in inconclusive analyses challenging clinical decision-making.

A recent systematic review and network meta-analysis by Janke et al provides a more rigorous comparative effectiveness analysis of the approved bDMARDs, using a method that included data from clinical study reports and reanalyses from individual patient data on key outcomes for RA, adopting the current definitions of clinical end points.3 This approach enabled a more homogeneous patient population for comparative analysis. The 34 studies that met the criteria for comparative effectiveness analyses included 10,869 patients and investigated 8 different biologic agents in combination with methotrexate (etanercept, adalimumab, infliximab, certolizumab pegol, golimumab, anakinra, abatacept, and tocilizumab). However, the analysis did not include rituximab, or the more recently approved agents such as sarilumab, tofacitinib, baricitinib, and upadacitinib. Overall, as reported in previous studies, there were few statistically significant differences between the bDMARDs in combination with methotrexate in terms of benefits and harms.

Researchers found that anakinra was the least efficacious in clinical remission or low disease activity3; compared to anakinra, adalimumab, certolizumab pegol, and golimumab had statistically significant advantages for RA remission, and abatacept, adalimumab, infliximab, and tocilizumab were found to have statistically significant advantages for low disease activity.3 Regarding safety, certolizumab pegol had a higher risk for serious adverse events (compared to abatacept, adalimumab, anakinra, etanercept, and infliximab) and infections (compared to abatacept, anakinra, etanercept, golimumab, tocilizumab, and infliximab). The risk for serious infections was higher with infliximab compared to golimumab and tocilizumab. The discontinuation rate due to adverse events was higher for anakinra compared to abatacept, adalimumab, etanercept and infliximab, and higher for abatacept compared to tocilizumab.3 Despite the rigorous methodology of this study, the authors acknowledged the limited data for long-term direct comparisons between the bDMARDs, with a recommendation for routine availability of individual patient data.

Although the expansion of bDMARDs provides improved treatment options, selecting treatment for the optimal disease management has been challenging because of the limited robust comparative effectiveness studies available.

The recent rigorous study by Janke and colleagues suggest a small but statistically significant differences in disease remission, and serious adverse events between the biologic agents. From a clinical decision standpoint, it is important to individualize treatment, taking into consideration disease activity, comorbidities, and patient treatment preferences, while weighing the significance of the differences between the bDMARDs for disease management and outcomes.

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Comparing the Effectiveness of Biologic Agents in the Treatment of Rheumatoid Arthritis - Rheumatology Advisor

ENCINO, Calif., Aug. 24, 2020 /PRNewswire/ -- Mounting evidence is suggesting that the onset of mental illness might be due more to the presence of inflammation of the brain than just being a random or spontaneous condition. Chronic stress, traumatic and non-traumatic brain injuries and auto-immune diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, Grave's and Hashimoto's diseases, and even Crohn's disease are known to precipitate inflammation and be associated with depression.

Common to each of these conditions is the production of a group of inflammatory chemicals produced by our immune system and called Cytokines (IL-1, IL-6, and TNF-alpha). These same chemicals are responsible for the lung and neurological damage associated with coronavirus (COVID-19). Studies have demonstrated in patients with auto-immune Psoriatic arthritis that when they are treated with a medication (etanercept) that blocks the inflammatory cytokine TNF-alpha, aside from improvement in the arthritis, there is a significant reduction in their depression.

This neuroinflammatory hypothesis for depression and other psychiatric illnesses explains substantially more than prior models, including why emergent data shows that when analgesics, anti-inflammatory medication, hormonal replenishment, pro-neurogenic, and pro-neurotrophic treatments are used, there are beneficial effects on depression.

The brain is contained within the skull and is surrounded by cerebrospinal fluid (CSF), whose composition is derived from lifestyle choices. Nutrition, water, drugs, alcohol, medication, and traumas all influence the quality of this CSF.When the CSF is healthy, the brain has more resiliency when challenged, but when unhealthy, the changes in its chemical make-up can precipitate cognitive and emotional illnesses. The Millennium Health Centers has been working since 2004 to correct unhealthy changes to the CSF and to influence how the brain can repair after trauma.

Read some of the science at: https://tbihelpnow.org/the-science

About Dr. Mark L. Gordon

Dr. Mark L. Gordon is the founder and medical director of Millennium Health Centers, Inc. in Encino, California. In 2015, Dr. Gordon released the book, "Traumatic Brain Injury - A Clinical Approach to Diagnosis and Treatment" that presents the science and his experience treating all precipitating causes of traumatic brain injury in both active military, veteran, sports, and civilian populations. Dr. Gordon has also joined with the Warrior Angels Foundation, a 501(c)(3) charitable organization founded by veterans Andrew and Adam Marr to provide medical services to members of the armed forces both active duty and veterans. For more information, visit TBIHelpNow.org.

About Millennium Health Centers, Inc

Since 2004, the Millennium Health Centers, Inc., under the direction of Dr. Mark L. Gordon, has worked to develop a diagnostic bio-marker panel and personalized treatment protocols for both traumatic and non-traumatic brain injuries associated with neuropsychiatric symptoms.

In 2015, the Millennium Health Centers, Inc. developed a neuro-regenerative program that involves the assessment and treatment of both traumatic and non-traumatic brain injury symptoms which may include depression, anxiety, lost libido, insomnia, migraines, obsessive-compulsive disorders, bipolar disorder, cognitive disorders, Parkinson's, and dementia conditions. Many of these can present years after the initial insult(s) which are frequently never considered.

Media Contact

Mark L. Gordon, M.D., Founder and Medical Director

[emailprotected]

SOURCE Millennium Health Centers, Inc

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Rethinking Mental Illness: A Response to Inflammation - PRNewswire

Compared with male patients, female patients with systemic juvenile idiopathic arthritis (JIA) have higher levels of genes related to circulating immature neutrophils, with these genes being associated with response to treatment, according to study results published in Journal of Leukocyte Biology.

The prevalence of systemic JIA has been estimated to be 3 times higher in female than male patients; female patients were also found to have lower rates of response to treatment.

The aim of the current study was to characterize blood gene signatures of 3 cohorts of male and female patients with JIA and assess the effect of sex on the whole blood transcriptomes of patients.

Researchers included clinical metadata from 451 patients and analyzed whole blood transcriptomic data of those with and without systemic JIA. They performed differential expression analyses for male and female patients, separately.

The number of differentially expressed genes was similar in male and female patients with systemic JIA compared with sex-matched control participants. However, because most differentially expressed genes were not shared between males and female patients, researchers suggested sexual dimorphism of systemic JIA at a molecular level.

There were a total of 44 genes whose fold-change expression was much higher in female vs male patients with systemic JIA compared with control participants. Of these genes, 18 were associated with neutrophil functions (adjusted P <.0001). In comparison, a total of 47 genes were highly induced in male patients with systemic JIA. Several of the genes associated with neutrophil functions were specific for female patients and were not expressed in male patients with systemic JIA.

Among the 44 genes in systemic JIA female-specific signature, 9 were highly expressed in neutrophil progenitor cells, suggesting that circulating immature neutrophils may be more positively activated or in higher numbers in female vs male patients with systemic JIA.

The potential effect of patient sex on levels of immature neutrophils in response to treatment with anti-interleukin-1 (anakinra) was assessed by comparing the expression of band neutrophils signature in female and male patients with systemic JIA after treatment. The data suggest that while in male patients there was no change in band neutrophils signature, in female patients compared with healthy control participants, the expression of band neutrophils was higher; expression of band neutrophils was even higher after the first month of treatment and only went down after 6 months of treatment.

Data also suggest that that this immature neutrophil signature is sexually dimorphic across the human lifespan and in adults with rheumatoid arthritis and asthma.

These results suggest that neutrophil maturation is sexually dimorphic in rheumatic inflammation, and that this may impact disease progression and treatment, the researchers concluded.

Prada-Medina CA, Peron JPS, Nakaya HI. Immature neutrophil signature associated with the sexual dimorphism of systemic juvenile idiopathic arthritis. Published online August 13, 2020. J Leukoc Biol. doi:10.1002/JLB.6MA0720-015RR

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Sexual Dimorphism of Systemic Juvenile Idiopathic Arthritis Linked to Immature Neutrophil Signature - Rheumatology Advisor

Fortune Business Insights Published Psoriatic Arthritis Treatment Market Report. The Psoriatic Arthritis Treatment market report provides a detailed analysis of global market size, regional and country-level market size, segmentation market growth, market share, competitive Landscape, sales analysis, impact of domestic and global market players, value chain optimization, trade regulations, recent developments, opportunities analysis, strategic market growth analysis, product launches, area marketplace expanding, and technological innovations.

An Overview of the Impact of COVID-19 on Psoriatic Arthritis Treatment Market:

The emergence of COVID-19 has brought the world to a standstill. We understand that this health crisis has brought an unprecedented impact on businesses across industries. However, this too shall pass. Rising support from governments and several companies can help in the fight against this highly contagious disease. There are some industries that are struggling and some are thriving. Overall, almost every sector is anticipated to be impacted by the pandemic.

We are taking continuous efforts to help your business sustain and grow during COVID-19 pandemics. Based on our experience and expertise, we will offer you an impact analysis of coronavirus outbreak across industries to help you prepare for the future.

Market Highlights:

The report offers insights into the ongoing Psoriatic Arthritis Treatment market trends. The report provides forecast values for the market for the period of 2019-2026. It highlights leading companies in the market and discusses the strategies that these companies have adopted in recent years. The competitive landscape scenario has been discussed in detail. Factual figures have been evaluated through trusted sources. Other forecast values have been gathered through interviews and opinions of experienced market research professionals.

Global Continuous Renal Replacement market 2020 research provides a basic overview of the industry including definitions, classifications, applications, and industry chain structure. The Global Psoriatic Arthritis Treatment market analysis is provided for the international markets including development trends, competitive landscape analysis, and key regions development status. Development policies and plans are discussed as well as manufacturing processes and cost structures are analyzed. This report also states import/export consumption, supply and demand Figures, cost, price, revenue, and gross margins.

The report also focuses on global major leading industry players of Global Psoriatic Arthritis Treatment market providing information such as company profiles, product picture and specification, capacity, production, price, cost, revenue and contact information. Upstream raw materials and equipment and downstream demand analysis is also carried out. The Global Psoriatic Arthritis Treatment Market Share and marketing channels are analyzed. Finally, the feasibility of new investment projects is assessed and overall research conclusions offered.

Psoriatic Arthritis Treatment Market Forecast (2020-2026):

Psoriatic Arthritis Treatment Market Include the Following Manufacturers Based on Psoriatic Arthritis Treatment Sales, Revenue, Price and Gross Margin. The analysis of the Psoriatic Arthritis Treatment Market is a thorough study that offers a select combination of skillful market realities. The study shows changing trends of the market as well as the size of each separate segment in this market. Various product types and application are shown below.

Competition landscape of the global Psoriatic Arthritis Treatment market is brimming with private, commercial and government organizations, progressing towards introducing innovations in the field of life sciences with research & development activities. Established companies in the Psoriatic Arthritis Treatment market are exploring opportunities in developing nations like India to enhance their revenue gains.

Psoriatic Arthritis Treatment Market 2020 global industry research report is a professional and in-depth study on the Psoriatic Arthritis Treatment market trends, share, size, growth, as well as industry analysis. Furthermore, market size, the revenue shares of each segment and its sub-segments, as well as forecast figures are also covered in this report. Psoriatic Arthritis Treatment Market Forecast 2025 report study provides key statistics on the market status of the Psoriatic Arthritis Treatment manufacturers and is a valuable source of guidance and direction for companies and individuals interested in the industry.

Regions Covered in Psoriatic Arthritis Treatment Market Report:

The report begins from overview of Industry Chain structure, and describes industry environment, then analyses market size and forecast of Psoriatic Arthritis Treatment by product, region and application, in addition, this report introduces market competition situation among the vendors and company profile, besides, market price analysis and value chain features are covered in this report.

Table of Contents:

1 Market Overview

1.1 Psoriatic Arthritis Treatment Introduction

1.2 Market Analysis by Type

2 Manufacturers Profiles

3 Sales, Revenue and Market Share by Manufacturer

3.1 Global Psoriatic Arthritis Treatment Sales and Market Share by Manufacturer (2018-2019)

3.2 Global Psoriatic Arthritis Treatment Revenue and Market Share by Manufacturer (2018-2019)

3.3 Market Concentration Rate

3.4 Market Competition Trend

Continued

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Psoriatic Arthritis Treatment Market 2020 Global Industry Analysis By Size, Trends, Share, With Regional Forecast To 2026 - The Daily Chronicle

Suffering from stiff, sore joints? You just might find relief in the form of plants. Studies have identified a number of spices that have anti-inflammatory benefits, and when eaten every day, can have an even greater impact on improving your overall health.

A 2018 study published in the Journal of Translational Medicine shows spices can help to reduce inflammation, which leads to joint pain and swelling.

They may also help prevent certain cancers and other chronic diseases like arthritis, asthma, and gastrointestinal disorders. Epidemiological studies show the rate of certain cancers in countries like Indiawhere spices are consumed on a daily basisare lower than in Western countries like the U.S., where spices are consumed far less.

Inflammation is the bodys natural response to irritants or things that may harm it. These include pathogens, stimuli, toxins, infections, and injuries.

But Dr. Robert H. Shmerling, the medical editor of Understanding Inflammation from Harvard Health Publishing and an associate professor of medicine at Harvard Medical School, says not all inflammation is bad. People think inflammation needs to be stomped out at all times, but it plays an essential role in healing and injury repair to keep your body safe and healthy, he wrote in Harvard Health Publishing.

Inflammation occurs in two main stages: acute and chronic. Shmerling explained that acute inflammation occurs when the bodys immune system releases white blood cells to protect the body. The body can experience swelling, redness, and painful joints as a result.

Acute inflammation is how your body fights infections and helps speed up the healing process, he said.

On the other hand, chronic inflammation occurs when injuries or infections persist and the body continues to produce white blood cells, which can attack the bodys healthy organs and tissues.

According to the 2018 study, chronic inflammation may lead to chronic diseases, such as cancer, arthritis, and diabetes. But researchers say spices can help to mitigate this. Congregate evidence suggests that a diet rich in plant-based agents including spices has the ability to prevent most of the chronic diseases, the studys authors wrote.

Kim Larson, a registered dietitian nutritionist certified by the National Board for Health and Wellness Coaching, agrees that spices have tremendous anti-inflammatory properties. I think people are often surprised at what a great anti-inflammatory source spices can be, she told Arthritis.org.

She continued: The more anti-inflammatory foods and spices you eat, the more you are tamping down on chronic inflammation.

A fan of yellow curry? You may already be reaping the benefits of turmeric. The spice is common in Indian and other South Asian cuisines. Studies have shown the yellow spices active chemical, called curcumin, has a number of anti-inflammatory benefits.

A 2017 study reviewed curcumins effects on human health. It found that curcumin can help to manage certain inflammatory conditions like arthritis and anxiety. It may also help to manage exercise-induced inflammation, such as sore muscles.

A similar study, released last year and published in Biomed Central, found curcumin was equally effective at relieving the symptoms of osteoarthritis as the anti-inflammatory drug NSAID diclofenac. Of those studied, 94 percent of those taking curcumin and 97 percent of those taking diclofenac reported at least a 50 percent improvement in symptoms.

Another popular spice used in Indian, Mexican, and South American dishescumin seed is a fruit of the flowering plant, which is native to India, China, the Middle East, and the eastern Mediterranean region.

Similar to turmeric, studies show the active ingredients in cumin seeds have antiseptic and anti-inflammatory effects.

If you suffer from painful, sore jointsyou just may want to opt for a little fresh ginger in your afternoon cup of tea.

A 2013 study published in the U.S. National Library of Medicine found ginger to have a number of anti-oxidative and anti-inflammatory effects on human health. The anticancer potential of ginger is well documented and its functional ingredients like gingerols, shogaol, and paradols are the valuable ingredients which can prevent various cancers, the studys authors wrote.

In addition to cancer, researchers also found that ginger has the potential to treat a number of ailments. These include degenerative disorders like arthritis, digestive health issues like indigestion and constipation, and cardiovascular disorders like hypertension.

If you can handle the heat, cayenne peppers are another terrific anti-inflammatory spice to cook with.

Cayenne and other hot chili peppers contain capsaicinoids an active compound called capsaicinoids, which have anti-inflammatory properties. Similar to turmeric, studies show capsaicin produces comparable anti-inflammatory effects as diclofenac.

If youre not already cooking with garlic, you definitely should be. Although the spice has a fairly strong taste and smell, studies have shown it has numerous health benefitsincluding reducing inflammation in the body.

Bad breath aside, garlic contains an anti-inflammatory compound called diallyl disulfide. The compound helps to minimize the effects of inflammation-causing cytokines, which are small proteins responsible for cell signaling.

If cayenne pepper is too spicy, opt for black pepper. The common cooking spice still packs a powerful anti-inflammatory punch and also has antibacterial and antioxidant benefits.

Known as the King of Spices, black pepper contains piperine, which studies show has anti-inflammatory and anti-arthritic properties.

Youll want to sprinkle extra cinnamon atop your toast and morning latte because the popular dessert spice is known to also help alleviate some symptoms caused by inflammation.

The cinnamon contains cinnamaldehydea compound that gives the sweet spice its flavor and smell. The compound has been shown to help prevent blood platelets from sticking together, as well as ease swelling.

When consumed on a regular basis, these seven spices may help to reduce the symptoms associated with inflammation for improved overall health.

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Anti-Inflammatory Spices to Cook With Every Day - LIVEKINDLY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Heres hoping.

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

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

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

***

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Photo credit: NBC - Getty Images

From Woman's Day

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

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

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

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

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

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

Story continues

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The study was published in Annals of the Rheumatic Diseases.

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Do Inflammatory and Autoimmune Rheumatic Diseases Affect COVID-19 Illness Severity? - DocWire News

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

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

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

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

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

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

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

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

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

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

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

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

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

Drinking tulsi tea can help you boost immunity

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

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

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

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

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

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

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

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

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

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

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

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

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

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