StemCell Therapy

Over the past 15 years, Californias stem cell program has funded over 1,000 research, training and community engagement projects focused on stem cell technology in the state.

But in October of last year, the agency in charge of administering the states stem cell program awarded its last round of new funds, allocating the last of a total of $3 billion in funding approved by California voters. Now, the author of Proposition 71, which established the program in 2004, is seeking another round of $5.5 billion in funding for stem cell research in a measure vying for a spot on the Nov. 5 ballot.

The scientists and patient advocates in California have proven through the California stem cell initiative funding that they can change the future of medicine and human suffering, the measures author, Robert Bob Klein II told the Business Journal. California funding has filled the gap of the federal governments failure to fund this revolution in medicine.

Kleins interest in stem cell research and regenerative medicine arose from his youngest sons ultimately fatal battle with diabetes. Diagnosed with Type I Diabetes at age 11, Kleins son Jordan required human insulin-producing beta cells, the artificial production of which to the best knowledge of the scientific community at this point requires stem cells.

In 2016, 26-year-old Jordan Klein died of complications related to the disease, two years after scientists first made significant progress on finding a treatment developed with the help of human embryonic stem cells.

Klein blames the federal governments resistance to embracing stem cell research for the lack of adequate treatment options that lead to his sons death. My youngest son died. If they hadnt held it up in D.C., he would be alive, he said. How many children, how many adults are going to die before they create enough stability to advance therapies that mitigate or cure these chronic diseases?

For years, Klein a wealthy real estate developer had tried to affect change on the federal level, before shifting his attention to his home state. I became focused on what California could do, because the federal government was encumbered by religious issues, he explained.

Despite having no experience in the field of scientific research, Klein was able to mount a successful campaign, with 59.1% of California voters approving the creation of a state-funded stem cell program and an agency to govern it. The California Institute of Regenerative Medicine held its first meeting in December 2004 and issued its first round of funding in 2006, after battling several challenges to the proposition in state and federal court.

Since then, CIRMs funding has enabled conferences, translational research projects and clinical trials exploring cures for various types of cancers, diabetes and neurological disorders. While a majority of funding went to the University of Californias main campuses as well as regenerative medicine companies and institutes in major hubs like San Diego and the Bay Area, California State University, Long Beach and Torrance-based Pathways to Stem Cell Science have also received funds from CIRM.

CIRM has created a new industry in California that has been tremendously beneficial for the California economy, Dr. Victoria Fox, president of Pathways, told the Business Journal. Her company, which offers stem cell extraction and education services, has received both direct and indirect funding from CIRM.

Last year, Pathways hosted the SPARK Annual Meeting, an event that highlights the scientific accomplishments of students in the SPARK high school summer training program funded through a CIRM grant. Foxs company also provides educational services through CIRMs Bridges program at CSULB, in which students from state and junior colleges compete for six-month lab positions at UC research labs.

[These programs] are important to us, not only because they generate income to operate, but because they generate a workforce, Fox explained.

She said other companies often approach her in search of stem cell scientists. If voters decided not to extend funding for CIRM and its program in November, Fox said shed be hard-pressed to find an equivalent network for talent acquisition. I dont know where Im going to refer companies to find talent. I really dont know.

Dr. Aaron Levine, an associate professor at the School of Public Policy at Georgia Tech, has focused primarily on the intersection between public policy and bioethics. In this context, Levine has followed and reviewed Californias stem cell program for years, and he agreed that its impact has been transformative.

CIRM stepped in to fill a gap when the National Institutes of Health was restricting its funding in this space, Levine said. The research that CIRM has supported, as well as the training programs, has had quite a big impact on the field.

But Levine also pointed to what he described as missed opportunities, as the program enters its bid for renewal. One example is the new proposals requirement to commit a certain percentage of funds to finding cures for specific diseases, such as Alzheimers and other neurological disorders.

From a science policy perspective, I dont really like that. I would like the funding agency to have the flexibility to fund the best science they see submitted, the most promising science, Levine said. Klein argued that setting aside a certain percentage of funds for research on neurological diseases will ensure that they wont be left behind in favor of less costly research projects.

Levine also noted that the program has yet to resolve one crucial question: Who will pay for patients treatment with costly stem cell therapies once theyre ready to hit the market? Per-patient costs for stem cell therapies can easily reach several hundred thousand dollars and as research advances, more patients are expected to qualify.

Suddenly, thats just such a substantial sum of money that it becomes a fundamental challenge to how we pay for healthcare, how we pay for medicine in the United States, Levine said. Subsidies for California residents, whose taxes helped pay for the research necessary to bring these cures and therapies to market, would be one option, Levine noted.

Despite these concerns, Levine said he supports the measure to extend the program. Even though this is not the perfect measure, I think theres a lot of value in CIRM and it makes sense to continue it, he said. In the end, it will be up to California voters to decide.

It largely will rise and fall on whether theres a motivated campaign for and against it and what people whove never really thought about stem cell research as a state ballot issue are going to think about this particular initiative when it comes in the fall, Levine said.

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Should California invest another $5.5 Billion into stem cell research? - Long Beach Business Journal - Long Beach News

NEW YORK, Feb. 14, 2020 /PRNewswire/ -- JDRF, the leading global organization funding type 1 diabetes (T1D) research, funded $121.5 million directly and helped generate more than $400 million in total T1D research funds from nonprofits, government, and industry to propel a year of remarkable breakthroughs in 2019, JDRF announced today. JDRF research funding increased by 10 percent over the previous year.

"I am more excited about our progress than ever before, given the tremendous breakthroughs made in 2019," said Aaron J. Kowalski, Ph.D., president and CEO of JDRF. "We could not be driving this work forward without the support of so many dedicated individuals, partners and organizations all helping us deliver on our mission to cure T1D and improve lives."

JDRF funding supported more than 180 active T1D research grants and is funding about 70 clinical trials for drugs, biologic and devices to prevent or cure T1D. The organization also supported new investment through the JDRF T1D Fund in 15 T1D companies, including 11 focused on cures.

"We are focused on beta cell therapies and immune therapies to deliver cures for T1D," Kowalski said. "At the same time, we continue accelerating work in glucose control and complication therapies to improve the lives of those living with type 1 diabetes today."

Highlights of breakthroughs outlined in the 2019 Annual Report are:

Progress Toward Cures:

Improving Lives:

Reducing Complications:

JDRF's Annual Report also cites progress in advocacy and community engagement, two areas aimed at both supporting research and the T1D community. "The combined strengths of research, advocacy and community engagement are helping us support more members of the T1D community and enabling more people to support our mission," Dr. Kowalski said. "JDRF works to build partnerships that advance research and build and sustain critical support for type 1 diabetes (T1D) research funded by the Federal Government."

Expanding Access to Coverage:

Learn more about JDRF's research and advocacy priorities at jdrf.org and read the health insurance guide JDRF has complied to help the T1D community navigate their healthcare and health insurance here.

About JDRF

JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat T1D and its complications. To accomplish this, JDRF has invested more than $2.2 billion in research funding since our inception. We are an organization built on a grassroots model of people connecting in their local communities, collaborating regionally for efficiency and broader fundraising impact and uniting on a national stage to pool resources, passion and energy. We collaborate with academic institutions, policymakers and corporate and industry partners to develop and deliver a pipeline of innovative therapies to people living with T1D. Our staff and volunteers throughout the United States and our five international affiliates are dedicated to advocacy, community engagement and our vision of a world without T1D. For more information, please visit jdrf.org or follow us on Twitter: @JDRF.

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The Australian Rheumatology Association this week warned people not to take the supplement glucosamine for their osteoarthritis due to possible allergic side-effects.

Whats the evidence behind this latest advice? And do you really need to stop taking it?

For years, glucosamine has been marketed as a treatment for osteoarthritis, which can occur when the protective cartilage in the joints wears down over time.

This is despite conflicting evidence on whether the supplement works. Yet many patients may buy glucosamine, presuming that even if it doesnt help, at least its natural and so wont do any harm.

Read more: Arthritis isn't just a condition affecting older people, it likely starts much earlier

But an Australian study, which has been online since last year and was cited in one of this weeks media reports, has given us more information about glucosamines safety.

The study found hundreds of allergic reactions to glucosamine have been reported to Australias medicines watchdog, the Therapeutic Goods Administration (TGA).

So is it safe for you to take glucosamine? In short, if it works for you and you havent had any side-effects, and your doctor and pharmacist know you are taking it, it is likely to be safe based on the multiple trials conducted to date.

Glucosamine is a naturally occurring substance the body uses to help build joint tissue, such as cartilage and tendons. In a supplement, the glucosamine can be made from the shells of prawns and other crustaceans, or it can be made synthetically in a factory.

Whether it works to manage osteoarthritis seems open to debate. The most recent evidence suggests little to no clinical benefit.

Read more: Science or Snake Oil: is glucosamine good for joints?

But advice to GPs about how to treat osteoarthritis says the issue isnt just confined to glucosamine.

When the Royal Australian College of General Practitioners looked at about 62 other medicines and possible treatments for osteoarthritis of the knee and hip (which include registered drugs and complementary medicines), none were backed by high-quality evidence to say they worked. Most of the evidence was based on low- or very low-quality studies.

The Australia study found 336 cases of side-effects to glucosamine (and to another supplement used for osteoarthritis called chondroitin) were reported to the TGA over 11 years. Of these, 263 cases were allergies, which ranged from mild to severe.

We dont know if these reactions included those from people with a known allergy to seafood or sulfur, as these would increase their risk of a reaction to glucosamine (glucosamine can come in different formulations, including glucosamine sulfate).

But a large percentage of people take glucosamine daily in Australia, with no ill effects. The cases reported to the TGA amount to just 30 people a year, with 16% of allergic reactions considered severe.

Beyond allergic reactions, there are other safety concerns about glucosamine.

For instance, if you are taking glucosamine and a medicine that thins your blood (such as warfarin after a stroke), this can increase your risk of bleeding.

Read more: Weekly Dose: Warfarin, the blood-thinner that's still used as a rat killer

Glucosamine supplements have also been implicated in chronic liver disease and in worsening underlying asthma. Some patients may also experience digestive symptoms such as heartburn.

The risks of other side-effects seem unclear, including whether it raises blood glucose levels in people with or without diabetes.

While the Australian Rheumatology Association has warned people to stop taking glucosamine, other advice is not so clear-cut.

Arthritis Australia reports glucosamine is a relatively safe treatment option for people with osteoarthritis and has relatively few side-effects compared with traditional medicines.

And the guidelines for GPs on how to manage osteoarthritis of the knee and hip makes a conditional recommendation not to use it, based on uncertainty over the balance of harms with potential benefit.

What should you do if youre taking glucosamine? If it works for you and you want to keep using it, then do so only on the advice of your doctor. Thats especially the case if you have any underlying medical conditions including diabetes, allergies or asthma.

Next, let your pharmacist know so they can check for any possible interactions with your other medicines, which can increase your risk of side-effects. You are most at risk if you are also taking warfarin, or any other type of blood thinning medicine.

Finally, if you do have unwanted side-effects from glucosamine, stop using it immediately and report it to your doctor.

Read more: The best foods for arthritis symptoms new research

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I'm taking glucosamine for my arthritis. So what's behind the new advice to stop? - The Conversation AU

Studies reveal that people with rheumatoid arthritis are at a greater risk of developing bipolar disorder than the general population.

Specifics vary across studies, as does conjecture about the cause, but an analysis of several research filings state that people with RA are nearly 3 times more likely to have bipolar disorder.

Many researchers surmise that inflammation is the cause. RA is an autoimmune disorder, and neurologists are beginning to believe that even BP may be an autoimmune disease.

At 56 Im at an age where everything suddenly hurts, especially my joints. As this pain has spread to my hands and my knuckles have disfigured its time to get checked out for arthritis. I mean, I already have osteoporosis, which may be a result of my bipolar disorder or long-term use of anticonvulsants. Why not RA, too (then theres always hypochondria, which I wrote about here)?

Some of the data is contradictory. One study states that the average person with BP and RA is a 41-year old woman. Another only finds a relationship between the diseases in people under 19 and over 75. But a meta-analysis of a number of studies implies that the co-morbidity holds across populations, and the most common clinical features that co-occur with RA are psychiatric.

Its easy to point to stress as the common factor between the conditions, or even an inflammatory diet. But there may be a smoking gun lurking behind the data and the results.

That smoking gun is smoking.

Its well established that smoking is a contributing factor to RA. And any trip to a psych ward or the patio around the entrance of a building where a support group is meeting will quickly show that many people with bipolar disorder smoke. 68.8% of people with bipolar disorder currently smoke, and 82.5% of people with BP have smoked at some point during their lives. Of those who currently smoke, the average number of cigarettes smoked per day is 30.

So when it comes to the co-morbidity between BP and RA, maybe its not the BP at all. Maybe the true culprit is heavy smoking.

Medical research is hard, and drawing distinctions between correlation and causation is even harder. Just because diseases seem to occur together in lots of people doesnt mean that one causes the other.

The best way we can mitigate co-morbidity is to live as healthy a life as we can.

If you want to prevent or manage RA, you cant decide to not have BP. But you can manage stress, eat an anti-inflammatory diet and, above all else, stop smoking.

BP is difficult enough. We dont have to make it more difficult to live with by making choices, like smoking, that invite other health problems into our lives.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167853/

https://www.sciencedirect.com/science/article/abs/pii/S0165032715303864

https://mdquit.org/special-populations/bipolar-disorder

Photo by handarmdoc

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Arthritis and Bipolar Disorder - PsychCentral.com

Based on emerging new evidence and expert consensus, an international task force put together by the European League Against Rheumatism (EULAR) released updated recommendations for the management of rheumatoid arthritis (RA) with synthetic and biologic disease-modifying antirheumatic drugs (DMARDs). This report was published in Annals of the Rheumatic Diseases.

Investigators performed a systematic review of studies focused on the efficacy and safety of DMARDs as monotherapy or combination therapy, including conventional synthetic, targeted synthetic, and biologic DMARDs. The task force agreed on 5 overarching principles and 12 recommendations by devising related questions, eliciting expert opinions, and reaching consensus by vote.

Overarching Principles for Managing RA

1. According to the researchers, treatment of patients with RA should be based on shared decision-making between the patient and the treating rheumatologist. In addition, patient and provider education should be included in best care practices, which may increase adherence to medications and appropriate assessment strategies, respectively.

2. Researchers indicated that decisions regarding the treatment of patients with RA particularly when considering biologic and targeted synthetic DMARDs should be based on disease activity, safety issues, and other patient factors, including comorbidities and progression of structural damage.

3. Recommendations included that primary care for patients with RA should be provided by rheumatologists; it is especially important for patients with RA to receive specialty care when initiating any type of DMARD therapy.

4. The newest principle in managing patients with RA recognizes the heterogeneity of RA, in which the increasing number of drugs with different modes of action should be made accessible to patients as they may require multiple successive drug options throughout life to reach their therapeutic goal.

5. According to the researchers, RA is associated with a high economic burden to both patients and society; the treating rheumatologist should recommend drugs that are less costly compared with drugs that are more costly if efficacy and safety profiles are therapeutically similar.

Recommendations for Goals of Therapy

Therapy with DMARDs should be immediately initiated upon RA diagnosis as the disease will not remit spontaneously.

Sustained remission or low disease activity should be the primary goal in treating patients with RA, and both the American College of Rheumatology and EULAR agreed on the Boolean- and index-based definitions of remission.

Recommendations included the rapid attainment of the treatment target. It was agreed by the task force that disease activity should be assessed every 1 to 3 months; if no improvement is observed after 3 months or the target has not been achieved after 6 months, the treatment strategy should be adjusted.

Recommendations for First-Line Treatment Strategies

In treating patients with RA, methotrexate was recommended as first-line treatment. Investigators indicated that methotrexate is an efficacious conventional synthetic DMARD used as monotherapy but is also the basis for combination therapies with other DMARDs or glucocorticoids; dose escalation should occur within 4 to 6 weeks to reach a weekly dose of about 0.3 mg per kg.

If patients experience early intolerance or have a contraindication to methotrexate, the task force recommended that leflunomide or sulfasalazine be considered as part of first-line treatment strategy.

The EULAR recommended a short-term course of glucocorticoids as a bridging therapy when initiating or changing conventional synthetic DMARD therapies; once the treatment exhibits efficacy, rapidly tapering glucocorticoid use (within 3 months) is important.

Recommendations for Secondary Treatment Strategies

If the treatment target is not achieved after the first-line conventional synthetic DMARD strategy, other conventional synthetic DMARDs should be considered in the absence of poor prognostic factors. These factors include high disease activity and the presence of clinical features, as well as failure to achieve low disease activity after at least 2 conventional synthetic DMARDs.

If poor prognostic factors are present, and the treatment target is not achieved with the first conventional synthetic DMARD strategy, then the task force recommended adding a biologic DMARD or a targeted synthetic DMARD. Patient contraindications, preferences, and cost of care should be considered in deciding on combination therapy.

Recommendations for Combination Therapies

All biologic and targeted synthetic DMARDs are more efficacious in combination therapy compared with monotherapy; EULAR recommends that biologic DMARDs and targeted synthetic DMARDs be combined with a conventional synthetic DMARD. Among patients with contraindications to conventional synthetic DMARDs, interleukin-6 pathway inhibitors and targeted synthetic DMARDs may be used as comedication.

Researchers indicated that if a biologic DMARD or targeted synthetic DMARD therapy fails, treatment with another biologic DMARD or targeted synthetic DMARD should be considered. Similarly, if treatment with tumor necrosis factor inhibitor (TNFi) fails, patients may be effectively treated with a different mode of action or a second TNFi therapy.

Recommendations for Persistent Remission

If persistent remission is achieved after tapering any glucocorticoid bridging therapies, EULAR suggests that clinicians consider tapering biologic DMARDS or targeted synthetic DMARDs, especially when these therapies are combined with a conventional synthetic DMARD. Discontinuation of biologic DMARDs is often associated with flares, and tapering of biologic DMARDs may be preferred just as a dose reduction or interval increase.

Investigators indicated that if persistent remission is achieved with conventional synthetic DMARD monotherapy or if remission can be sustained after cessation of any added therapies from a combination therapy regimen, tapering the conventional synthetic DMARD may be considered.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please refer to the original reference for a full list of authors disclosures.

Reference

Smolen JS, Landew RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update [published online January 22, 2020]. Ann Rheum Dis. doi:10.1136/annrhumdis-2019-216655

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Updated EULAR Recommendations for Rheumatoid Arthritis Management With DMARDs - Rheumatology Advisor

Rheumatoid Arthritis (RA) is the most common autoimmune arthritis caused by the improper functioning of the bodys defense system. Research has shown that depression is among the most common mental health disorders associated with RA. However, the prevalence of concurrence ranges between 14% to 48% due to different factors including measurement methods, frequency of depressive symptoms and diagnosis threshold. Recent advances in clinical rheumatology have developed our understanding of RA and depression at a molecular level. However, several other studies need to be conducted to find the proportion and strong association between RA and depression among the population and find therapeutic treatments.

A recent study, published in the British Medical Journal showed that women suffering from RA exhibited depressive symptoms, which was linked to disease activity and dysfunction. A cross-sectional study comprising 319 female RA patients along with 306 healthy controls was conducted in Austria, based on Becks depression Inventory-Fast Screen (BDI-FS) a self-report to evaluate depression rate in patients suffering from medical disease. Factors including medication, alcohol intake, disease activity, smoking, and occupation were also evaluated in the study.

The results showed that depression was significantly higher in female patients (one-third of patients) suffering from RA as compared to the healthy controls. Furthermore, depressive symptoms were strongly linked with the disease disability and activity despite alcohol intake, age, occupation, and smoking status.

The study provided strong support for the rate of depressive symptoms among RA female patients. It should be noted, however, that pain assessment was not included in the study, and the study group consisted of only females. Further research will be necessary to confirm the findings and extend them further to enable potential treatment strategies.

Written by Sakina Bano Mendha

References:

April Chang-Miller, M. D. (2019, October 18). Is depression a factor in rheumatoid arthritis? Retrieved from https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/expert-answers/rheumatoid-arthritis-depression/faq-20119780

Sautner, J., Puchner, R., Alkin, A., & Pieringer, H. (2020). Depression: a common comorbidity in women with rheumatoid arthritisresults from an Austrian cross-sectional study. BMJ Open, 10(1). doi: 10.1136/bmjopen-2019-033958

Image byMabel Amber fromPixabay

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Possible link between rheumatoid arthritis and depression - Medical News Bulletin

Young adults who have had knee injuries are much more likely than uninjured peers to develop arthritis in the knee by middle age, especially if they have broken bones or torn connective tissue, a study suggests.

Researchers followed almost 150,000 adults from ages 25 to 34, including about 5,200 with a history of knee injuries, for almost two decades.

Compared to people who never had knee injuries, those who did were nearly six times as likely to develop knee osteoarthritis during the first 11 years of follow-up, with more than triple the risk over the next eight years.

"Injuries that occur inside the knee joint, for example in the meniscus or cruciate ligament, may alter the biomechanical loading patterns in the knee," said study leader Barbara Snoeker, of Sweden's Lund University.

"Such injuries may lead to an imbalance in force transmissions inside the knee joint, consequently overloading the joint cartilage and leading to increased risk of developing osteoarthritis, compared to injuries that mainly affect the outside of the knee joint, such as contusions."

Osteoarthritis often affects the large weight-bearing joints and can eventually lead to the need for total joint replacement, the researchers noted in the British Journal of Sports Medicine.

Known risk factors include being overweight, older, female or having a job that puts a lot of stress on the joints, the study team note.

While a history of knee injuries is also a known risk factor, research to date has not offered a clear picture of whether certain types of injuries might be more likely to lead to osteoarthritis.

Two-thirds of the people in the study with knee injuries were male. After 19 years of follow-up, 422 people with knee injuries, or 11.3 per cent, developed knee osteoarthritis. So did 2,854, or 4 per cent, of people without knee injuries.

Most often, injuries involved multiple structures of the knee; this accounted for 21 per cent of participant knee injuries.

The second most common type of injury was cuts and contusions, at 18 per cent, followed by cartilage or other tissue tears at 17 per cent.

CRUCIATE LIGAMENT INJURIES

Damage to the tissue connecting the thighbone to the shinbone.

MENISCAL TEARS

Damage to cartilage connecting the same two bones.

FRACTURES OF THE SHINBONE

Where it meets the knee, or of the kneecap.

Cruciate-ligament injuries, or damage to the tissue connecting the thighbone to the shinbone, were associated with a 19.6 per cent greater risk of knee osteoarthritis, the study also found.

Meniscal tears, or damage to cartilage connecting the same two bones, were associated with a 10.5 per cent greater risk of osteoarthritis.

Fractures of the shinbone where it meets the knee, or of the kneecap, were associated with a 6.6 per cent greater risk.

Injuries involving multiple structures in the knee may have been under-reported, leading researchers to underestimate the risk associated with these types of injuries, said Jonas Bloch Thorlund, a professor of musculoskeletal health at the University of Southern Denmark, who was not involved in the study.

Another limitation is that researchers did not look at patient's body mass index (BMI), so they could not tell whether differences in weight might explain patients' risk of osteoarthritis, said Dr Kyle Hammond of the Emory Sports Medicine Centre in Atlanta.

What happens after knee injuries can also influence the risk of osteoarthritis down the line, said Hammond, who also was not involved in the study.

"Counselling a patient on how to safely and consistently return to a positive fitness programme ensures that they will maintain flexibility and strength, as well as keeping their weight at their ideal body weight," he said.

Rehabilitation matters, regardless of what other treatments patients receive, said Adam Culvenor, a sports and exercise medicine researcher at La Trobe University in Bundoora, Australia.

"Once these injuries occur, optimally managing them with an intense and progressive period of rehabilitation under the guidance of a physical therapist (irrespective of the decision to have surgery or not) to strengthen the muscles around the knee to facilitate a return to function and physical activity is likely to reduce the risk of osteoarthritis and persistent symptoms longer-term," Culvenor said by e-mail.

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Knee injuries in adults can lead to arthritis - The Straits Times

Karin Luttropp,1 Johan Daln,1 Axel Svedbom,1 Mary Dozier,2 Christopher M Black,3 Amy Puenpatom3

1ICON Clinical Research, Plc., Stockholm, Sweden; 2ICON Clinical Research, Plc., Boston, MA, USA; 3Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA

Correspondence: Amy PuenpatomCenter of Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ Tel +1 267 305 0620Fax +1 215 850 4549Email puenpatom.amy@merck.com

Purpose: To obtain an up-to-date overview of the measurement of patient experience of switching biologic treatment in patients with inflammatory arthritis (IA) or ulcerative colitis (UC). Secondary objectives included summarizing the types of patient-reported outcomes (PROs) used (if any), and related findings; and summarizing medical and non-medical reasons for treatment switch and/or discontinuation.Methods: A systematic literature review (SLR) was performed, searching Medline and Embase for relevant publications.Results: In total, 70 relevant publications were identified. While the majority of these reported reasons for switching and/or discontinuing treatment, only four provided information explicitly regarding patient-reported experience of switching biologic treatment. All four utilized ranking tools to assess patient experience of switching biologic treatment. The most common reason for switching and/or discontinuing treatment was loss of efficacy, while the least common reason was patient preference.Conclusion: Although the number of available treatments in IA and UC have increased, there is a sparsity of information regarding patient-reported experience of switching biologic treatment. Further research regarding patient preference and/or experience would benefit this therapeutic area and help guide treatment choices.

Keywords: arthritis, colitis, ulcerative, biological products, patient reported outcome measures, treatment switch

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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Real-World Patient Experience of Switching Biologic Treatment in Infla | PPA - Dove Medical Press

Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis.

Osteoarthritis is the most common type of arthritis in the UK, affecting nearly nine million people.

It most often develops in adults who are in their mid-40s or older. It's also more common in women and people with a family history of the condition.

But it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis. Osteoarthritis initially affects the smooth cartilage lining of the joint.

This makes movement more difficult than usual, leading to pain and stiffness. Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder.

This can cause swelling and the formation of bony spurs called osteophytes.

Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.

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Paddy McGuinness health: Top Gear presenters shock diagnosis at the age of 44 - Express

Millions of residents in the tristate area recognize Dr. Jay B. Adlersberg from his longtime position as the medical correspondent for WABC-TVs Eyewitness News. For 30 years, hes reported nightly on advances in the art and science of medicine. As an award-winning journalist and renowned rheumatologist and internist, Adlersberg provided his audience with well-explained insight on how scientific research relates to patients.

Now, Adlersberg is bringing that same commitment to patient care to New York Health.NY Health is a new, but rapidly growing network of independent board certified physicians with facilities in Manhattan, Queens, the Bronx, Nassau County and Suffolk County. Its specialties range from nephrology to urology, complemented with physical therapy. Through its parent company, New York Cancer Blood, NY Health has robust infusion centers that not only allow for advanced cancer treatments, but also allow Adlersberg to treat rheumatology patients in one place in less time.

Adlersberg, who has 45 years of experience treating the most severe forms of arthritis and joint disease, often employs intravenously-administered biologic medications like Humira to help patients achieve remission for debilitating conditions like rheumatoid arthritis. These drugs cannot be taken orally, and require patients to go to infusion centers for treatment. Prior to joining NY Health, Adlersberg would have to send patients to facilities outside his office to receive these life-changing infusions.

Joining NY Health was a no-brainer for me, Adlersberg said. Previously, I was sending patients to a different place for these infusions and if someone had a reaction to the drug, I couldnt see it. I would have to depend on nurses to describe it to me because I couldnt get to the place of infusion. Now, I have an office that is 40 feet away from the infusion center. If someone does have a reaction, I can walk right over and look and talk to the patient. That is the way I want to practice medicine, now I have a hand in everything that happens.

Dr. Jay Adlersberg

Adlersbergs new position at NY Health allows for a better, more personalized patient experience. Patients can now receive their infusions in one place in less than 90 minutes.

Previously, it would take three hours, Adlerberg said. They would have to sign in, and sign in a second time. It was a lot more paperwork and a lot more time consuming. Now, they can do it on a lunch hour if they wanted to. They will save so much time.

Adlersberg, brings a robust resume to NY Health. Aside from his award-winning reporting for WABC-TVs Eyewitness News, Adlersberg serves on the board of the New York chapter of the Arthritis Foundation. Educated at the University of Pittsburgh, where he graduated junior year Phi Beta Kappa and magna cum laude, he went on to graduate from the University of Pennsylvania School of Medicine, the nations oldest medical school and one of its most prestigious.

He completed a coveted residency at the countrys most respected city hospital and training ground for clinical medicine, the Bellevue Hospital Center of NYU Langone Medical Center. Adlersberg did his fellowship in rheumatology and immunology as an NIH-Postdoctoral Fellow at the Irvington House Institute of NYU Medical Center under the guidance of the late Dr. Edward C. Franklin, a world-renowned immunologist and member of the National Academy of Sciences.

Adlersberg, whose main interests are rheumatoid arthritis, the arthritis of psoriasis, back pain and autoimmune disorders, has been a forefront of intravenously administering biologic medications to treat his patient for two decades.

These drugs dont just treat the disease, Adlersberg said. They can essentially make it go away. I have been using them to treat patients for 20 years. One woman went from gaining 30 pounds because she couldnt go to the gym since her knees and ankles were so swollen and painful to going back to wearing high heels after four months of treatment.

Dr. Rohit Reejsinghani, executive director of NY Health, said the addition of Adlersberg is part of NY Healths commitment to creating a patient-centric model of care, through better connecting patients with their doctors for more personalized attention.

Dr. Adlersberg is one of the most respected rheumatologists in the country, Reejsinghani said. He invented the infusion game and because of that I said we need to have him on board. Our infusions centers are built within our cancer offices so having Dr. Adlersberg allows us to treat a different patient population within these state-of-the-art infusion centers. Bringing him on board will bring NY Health to the next frontier.

The rest is here:
Former WABC-TV Eyewitness News Medical Reporter Joins New York Health - Long Island Weekly News

Global Rheumatoid Arthritis Therapeutics Market research report gives a comprehensive outlook of the markets 2019-2025 and offers an in-depth summary of the current market status, historic, and expected way forward for the Rheumatoid Arthritis Therapeutics Market. Additionally, to this, the report provides data on the restraints negatively impacting the markets growth. The report includes valuable information to assist new entrants, as well as established players, to understand the prevailing trends in the Market.

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Key Objectives of Rheumatoid Arthritis Therapeutics Market Report: Study of the annual revenues and market developments of the major players that supply Rheumatoid Arthritis Therapeutics Analysis of the demand for Rheumatoid Arthritis Therapeutics by component Assessment of future trends and growth of architecture in the Rheumatoid Arthritis Therapeutics Market Assessment of the Rheumatoid Arthritis Therapeutics Market with respect to the type of application Study of the market trends in various regions and countries, by component, of the Rheumatoid Arthritis Therapeutics Market Study of contracts and developments related to the Rheumatoid Arthritis Therapeutics Market by key players across different regions Finalization of overall market sizes by triangulating the supply-side data, which includes product developments, supply chain, and annual revenues of companies supplying Rheumatoid Arthritis Therapeutics across the globe

Major Players included in this report are as follows AbbVieBoehringer IngelheimNovartisRegeneron PharmaceuticalsPfizerBristol-Myers SquibbF. Hoffmann-La RocheUCB S.A.Johnson & Johnson ServicesAmgen

Rheumatoid Arthritis Therapeutics Market can be segmented into Product Types as PharmaceuticalsBiopharmaceuticals

Rheumatoid Arthritis Therapeutics Market can be segmented into Applications as PrescriptionOver-the-Counter (OTC)

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Rheumatoid Arthritis Therapeutics Market: Regional analysis includes: Asia-Pacific (Vietnam, China, Malaysia, Japan, Philippines, Korea, Thailand, India, Indonesia, and Australia) Europe (Turkey, Germany, Russia UK, Italy, France, etc.) North America (United States, Mexico, and Canada.) South America (Brazil etc.) The Middle East and Africa (GCC Countries and Egypt.)

Target Audience: Rheumatoid Arthritis Therapeutics Equipment Manufacturers Traders, Importers, and Exporters Raw Material Suppliers and Distributors Research and Consulting Firms Government and Research Organizations Associations and Industry Bodies

Stakeholders, marketing executives and business owners planning to refer a market research report can use this study to design their offerings and understand how competitors attract their potential customers and manage their supply and distribution channels. When tracking the trends researchers have made a conscious effort to analyse and interpret the consumer behaviour. Besides, the research helps product owners to understand the changes in culture, target market as well as brands so they can draw the attention of the potential customers more effectively.

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These market dynamics have the potential to impact the global Rheumatoid Arthritis Therapeutics Market. This report has provided the detailed information to the audience about the way Rheumatoid Arthritis Therapeutics industry has been heading since past few months and how it is going to take a shape in the years to come.

DataIntelo has offered a comprehensive analysis of the Rheumatoid Arthritis Therapeutics industry. The report has provided crucial information about the elements that are impacting and driving the sales of the Rheumatoid Arthritis Therapeutics Market. The section of competitive landscape keeps utmost importance in the reports published by DataIntelo. Competitive landscape section consists of key market players functioning in the worldwide industry of Rheumatoid Arthritis Therapeutics.

The report has also analysed the changing trends in the industry. Several macroeconomic factors such as Gross domestic product (GDP) and the increasing inflation rate is expected to affect directly or indirectly in the development of the Rheumatoid Arthritis Therapeutics Market.

Table of Contents 1 Industry Overview of Rheumatoid Arthritis Therapeutics 2 Manufacturing Cost Structure Analysis 3 Development and Manufacturing Plants Analysis of Rheumatoid Arthritis Therapeutics 4 Key Figures of Major Manufacturers 5 Rheumatoid Arthritis Therapeutics Regional Market Analysis 6 Rheumatoid Arthritis Therapeutics Segment Market Analysis (by Type) 7 Rheumatoid Arthritis Therapeutics Segment Market Analysis (by Application) 8 Rheumatoid Arthritis Therapeutics Major Manufacturers Analysis 9 Development Trend of Analysis of Rheumatoid Arthritis Therapeutics Market 10 Marketing Channel 11 Market Dynamics 12 Conclusion 13 Appendix

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Rheumatoid Arthritis Therapeutics Market Worldwide Industry Share, Size, Gross Margin, Trend, Future Demand and Forecast till 2025 - Nyse Nasdaq Live

Last week I talked about babysitting with the 3-year-old triplets Isla, Luke and Quinn. This week I want to talk about my challenge and eventual triumph over the child-proof locks in their home. It was not without drama.

There were six different types of locks in the house, none of which are suited for a 66-year-old woman who has flunked every kind of spatial test she has ever taken. I havent had to take many, but I have not scored nearly as well as I do on any given vocabulary test.

Here is a picture of a perfectly square box. Is it right-side up or upside-down? Mensa asks.

Box, I can offer. You spell it box.

And I have arthritis in my hands and have pretty much lost the ability to squeeze.

Thank goodness there was an 8-year-old and a 10-year-old sister in the house to help me during my lock-out. During the school day, however, I was on my own.

It was a school day when I first encountered the locked silverware drawer. There wasnt even anything on the outside that I could see. I pulled it out as far as I could, which wasnt far, and tried to push what looked like a lock down on the inside, but it didnt budge.

Isla didnt see me for some reason, or she would have looked at me through narrowed eyes like she does when she thinks Im pretty clueless. I had to wait until 8-year-old Faith got home and said, Oh, those are magnetic. There are magnets on the refrigerator and microwave to use.

So you rub those along the outside until you hear a click and the drawer magically opens. Or in my case, I hear a click and it doesnt open, and I call for an older child. I found out where the plastic ware was so I could live without silverware during the day.

Then there are some long lock things that fit into a thing with teeth. I figured that out but then put it back backward and Faith had to give me a lesson on that.

Moving on. The lock on the sink totally flummoxed me. (See. I spelled that hard word correctly, even if I wondered if you can be partially flummoxed or if flummoxation is always total. And I know its written right-side up.)

I sent a picture to my daughter with five kids in hopes she could help, even though she gave up on child-proof locks with child No. 2, I believe.

Just squeeze the little square things together to open it and then click it shut, she said. See above note about not having much finger squeezability anymore.

I finally got it and reopened it and just put what I needed from there on the counter so I didnt have to repeat that until Faith got home.

Now, the lock on the trash is broken. That is the lock I kept forgetting to close on my last visit and Luke fussed with me and Isla locked it for me. I dont think she realized I was not the one needing to stay out of the trash.

Luke also fusses if the lock on the water and ice dispenser on the refrigerator isnt locked. Wherever they are in the house, they can hear I have not silently held the spot down for three seconds and locked it. I either get reminded by a 3-year-old, or a 3-year-old pushes it and dispenses water on the floor.

Those locks are all in the kitchen. There are also locks on all the doors I have trouble with. I also have forgotten a couple of times to close the bathroom door when coming out, and that has been disastrous. A while back they unrolled toilet paper into the toilet and then Luke got upset because wet toilet paper was sticking to his hands. Isla didnt care.

I left it open again this trip after their parents got home and basically the same thing happened. My son helped me clean it up.

Is there anything I need to know about? the mother called from the next room.

Nope, I said, sopping up the floor.

My son whispered, You might want to wash their hands. They have been playing in the toilet, you know.

I dont remember if when my children were growing up, it was a jungle with a bunch of out-of-control monkeys, but maybe it was.

Or maybe Im just old(er), slow(er) and arthritic.

Brady seems to have idyllic memories of his childhood with every child behaving, so Ill just go with that.

As long as the triplets dont lock me out of their hearts, Ill be just fine.

Elzey is a freelance writer for the Register & Bee. She can be reached at susanelzey@yahoo.com or (434) 791-7991.

See original here:
Capable of handling triplets, but not the locks - GoDanRiver.com

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Psoriatic Arthritis (PsA) Treatment Market to Perceive Incremental Opportunity by 2018-2028 - Redhill Local Councillors

Harvard epidemiologistMarcLipsitchtold The Wall Street Journalthat "it's likely we'll see a global pandemic" of coronavirus, with 40 to 70 percent of the world's population likely to be infected this year.

"What proportion of those will be symptomatic, I can't give a good number," addedLipsitch, who is theDirector of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health.

Two other experts have recently given similar estimates.

Ira Longini, a biostatistician and adviser to the World Health Organization, has predicted that two-thirds of the global populationmay eventually contract COVID-19.

Prof Gabriel Leung, the chair of public health medicine at Hong Kong University, says if the transmission estimate of 2.5 additional people for each infected rate is accurate, that would result inan "attack rate" that wouldaffect 60 to 80 percent of the world's population.

The Centers for Disease Control and Prevention (CDC) has already saidthat it is preparing for the coronavirus to have a greater impact in the U.S. than the 15 confirmed cases currently.

In an interview withCNNon Feb. 13,Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), said,Right now we're in an aggressive containment mode. He addedthat this virus is probably with us beyond this season, beyond this year, and I think eventually the virus will find a foothold and we will get community-based transmission."

Dr. Nancy Messonnier, the director of the CDCs National Center for Immunization and Respiratory Diseases, recentlyconfirmedthat the CDC is taking steps to prepare for the coronavirus to take a foothold in the U.S.

Along with communicating with health care facilities and resources, Messonnier says that the CDC is in constant talks with the medical supplies manufacturers, distributors and other health care partners to ensure there are plenty of preventative devices like masks and gloves available in the U.S. in the event of a larger outbreak.

Some of these partners have reported higher demand for N95 face masks and respirators.

She also took the time to explain the CDCs recommended use of any preventative supplies, especially face masks. Because the virus isnt spreading through the communityin the U.S., Messonnier only advises using face masks if you are sick or under investigation and not hospitalized, before one enters a health care providers office, or when caring for a potential infected patient.

When alone and at home, however, Messonnier says that people do not need to wear a mask.

She also confirmed that 195 people from Wuhan have completed the 14 day quarantine and left the March Air Reserve Base to be self-monitored with the help of state and local health authorities.

Additionally, amid reports of poor treatment of quarantined individuals and the military staff tending to them, Messonnier stated that the individuals discharged pose no health threat to their surrounding communities or the community they will return to.

After the CDC confirmed that a lab error led to the accidental discharge of an infected patient from a San Diego hospital, Messionnier told reporters that the CDC and other health officials are adding additional quality controls to keep patients organized.

See the original post here:
Harvard professor says global coronavirus pandemic 'likely,' infecting 40-70% of world this year - The Hill

CORBIN Baptist Health Corbin in collaboration with the Corbin Public Library held its monthly Noontime Knowledge at the library on Thursday.

In honor of American Heart Month, this months Noontime Knowledge focused on heart health and heart attacks. More specifically, heart attack signs, symptoms and how to react if you or somebody you know is having a heart attack.

Heart attacks are the number one killer of adults here in the United States, said cardiovascular educator at Baptist Health Corbin Tracy Bruck. Over 735,000 Americans have heart attacks every single year. 525,000 people have their first heart attack every year, a lot of people have more than one.

Heart attacks kill 116,000 Americans each year.

Heart attacks are a community problem with a community solution. That community solution is education because if a community knows early symptoms of a heart attack, then you can seek medical treatment early, explained Bruck.

When it comes to symptoms, Bruck said the most common are chest pain and discomfort. Other symptoms include pain in your back, shoulders, arms, neck, throat or jaw; abdominal discomfort; shortness of breath; weakness and fatigue; nausea; and sweating.

According to Bruck, early signs of a heart attack are present in about half of all patients that have suffered one.

Symptoms can suddenly accelerate just before somebody has a heart attack. Most early symptoms happen around 24 hours before someone suffers one. However, some symptoms can occur two to three weeks before someone suffers a heart attack.

Bruck says that men are more likely to suffer heart attacks on their first symptom than women are. Men normally feel pain and numbness on their left arm or side of their chest, while women will typically feel it on their right side.

A womans risk of suffering a heart attack increases four times after going through menopause. Women are also more likely to have what are known as silent heart attacks, which can result in a person having a heart attack and not even realizing it. Women are also more likely to suffer a fatal heart attack.

According to the CDC, heart attacks are more common in men, smokers, people who are obese or overweight, those with family histories of cardiac issues, and people aged 55 or older.

Bruck says knowing your family's personal history with heart disease can help in preventing a heart attack. She also recommends knowing and modifying those things in ones control that can attribute to a higher chance of heart attack.

Those factors one can modify to lower the chance of suffering a heart attack include keeping your blood pressure under control, maintaining an active lifestyle (getting at least 20-30 minutes of physical activity three times a week), stopping the use of tobacco, and keeping an eye on metabolic diseases like diabetes.

If you or someone you know is showing signs of a heart attack, Bruck says its important to seek medical attention right away.

We have a tendency as human beings to delay recognizing and responding to these early symptoms. Were our own worst enemy.

Some of the most common excuses people make are that theyre too busy or that theyre too healthy to be suffering a heart attack. Bruck says some try to pass it off as something else or ignore it all together. This could be dangerous because although the symptoms may subside, theyll come back and thats when it may be too late.

Along with medicine, modifications to lifestyle and preventative measures, the medical community has also created the Life Vest to help those who suffer with a heart related medical condition.

Kim Deering with Zoll Life Vest explained that the vest is a wearable cardioverter defibrillator that can be used to detect sudden cardiac arrest and defibrillate its wearer.

Available to the public since 2003, the vest was designed for those with a compromised heart function, a heart functioning at less than 35% of full capacity.

The Life Vest can be worn under clothing and can be hidden from public view. The vest monitors its wearer the entire time it is worn through the use of four dry electrodes that are placed around ones chest.

The vest senses an arrhythmic beat in its user's heart and activates a vibrating alert. A siren will then sound from the vest and continue to get louder. If the vest were to malfunction or have a bad reading, the wearer can press two buttons simultaneously to cancel the treatment. If the treatment isnt canceled, the vest will perform a treatment shock and release a blue gel.

The blue gel is released in case the wearer were to wake up alone after suffering cardiac arrest and receiving shock treatment. The blue gel would notify them of what had happened and the person could seek medical treatment.

Its saving about three patients a day all across America, said Deering, who added that the vest has a 98% success rate after the first shock.

According to Deering, the Life Vest is meant to be used as bridging tool. If a patient is able to get their heart working above that 35% threshold, then they are no longer at as great of a risk for sudden cardiac arrest, and the device is no longer needed.

The Life Vest is available all over the world, and is accepted by Medicare and all Kentucky Medicaid, as well as most private medical insurances.

The next Noontime Knowledge will be held March 6 at the Corbin Library from noon-1 p.m.

Read more here:
February's Noontime Knowledge event focuses on heart health - Times Tribune of Corbin

Heart disease is the No. 1 cause of death in the United States, and heart-related issues affect hundreds of millions of people worldwide. There are many factors that contribute to heart disease or put individuals at risk for developing heart disease. These factors include both those that can and cannot be controlled.

Many individuals, both male and female, have a genetic predisposition to heart disease and related health problems, and will need to consult their physician or care provider on treatment and/or preventative options. Preventable factors include changing ones diet to lower sodium and lower fat content, getting plenty of exercise, maintaining good hydration and sleep patterns, avoiding stress and quitting (or not starting) tobacco products.

Lack of knowledge on the subject often contributes to the challenge of maintaining good heart health and avoid different types of vascular diseases. The American Heart Association is a good source of information. There are various links on their website that point out the signs of heart health risk as well as preventative measures that can be taken. But keep in mind that there are times when, even if a few signs are present, heart conditions take one completely by surprise.

Mandy Hime, of Ashland, knew there were health issues in her family, but said she had no reason to believe she was at any immediate risk. But after the birth of her son in 1999, Hime began to develop high blood pressure. At the time, she was told many women develop high blood pressure during pregnancy, but usually the blood pressure in such cases returns to normal levels fairly quickly.

About six months later they checked me out again, and found that my blood pressure was still remaining high, Hime said. I developed gall stones, and needed surgery. But my blood pressure was so high they had to put me on medication to lower it before they could operate.

Hime said since her blood pressure remained so elevated, and considering her family had a predisposition for high blood pressure and heart related issues, her doctor decided medication to regulate it was her best option.

They changed my medicine on a regular basis, Hime said. And I was afraid I was going to run out of medicines that would still work. During this time other changes manifested themselves such as headaches and changes in her vision, but her blood pressure was holding its own at the high end of the acceptable spectrum.

This changed in 2019. After experiencing a headache that spanned eight days, Hime decided to go to the hospital. She was diagnosed with an aneurysm and immediately hospitalized.

The doctor told me he was surprised that I was still alive, Hime said. Id had a brain bleed, and it had been so long that my brain was trying to reabsorb the blood. They wouldnt release me until the headaches were completely gone. And for days, every time I would wake up they would give me medicine to put me to sleep.

Hime survived her ordeal, and came through it with information and insight into her condition. Her heart was able to pump blood to her extremities, but due to small veins it was having trouble cycling the blood back. This led, she was told, to her high blood pressure, hypertension and the aneurysm that nearly killed her. Now she is on different medicines and her blood pressure is somewhat under control, but she has to monitor it regularly.

I didnt even know I was at risk until it was almost too late, Hime said. Now she urges others to pay attention to even the smallest warning signs and to take better care of themselves.

Although Himes condition was a result of a genetic disposition that was complicated by a medical condition, not all heart disease or other heart health issues are the result of genetics. Some, as in the case of Boyd County man Daniel Rice, are either caused or affected by what most would consider an unrelated health issue. Rice was being treated for COPD when he had, and unwisely ignored, his first heart attack.

The family used to say my Dad had a mild heart attack years and years ago, but there werent any actual records of it, Rice said. And I had always been pretty active, so a heart attack was the last thing on my radar. In fact, I had taken a wellness test at the VA Hospital just a few years before, and they said my heart was fine.

Rice admits that he should have paid more attention to the signs, but there was always a ready-made excuse for why the occasional pains werent related to his heart.

Looking back, I would say that I had two mild heart attacks before, he said. I thought one was just like angina, a pressure on the chest. And the other passed pretty quickly, so I just wrote it off.

Later, while on vacation in Gatlinburg, Tennessee, his wife was sick and decided to stay in for the day. Rice said he stayed in with her and he began to have pains in his chest.

The weird thing was, it was my right arm that hurt. And since I had always heard it was your left arm that would hurt or go numb when you were having a heart attack, I thought it was probably something else,he said.

Rice said he made excuses and put the episode out of his mind because the pain went away. A few days later, he experienced more short-lived pains, and ignored those as well.

But just after Labor Day in 2018, I was using the weed eater around the house and the pains came back,Rice said. My chest began to hurt, and I got really lightheaded. And my stomach was really upset. I couldnt ignore it anymore, and I called for help around 11:30 a.m. By 2:30 p.m., I woke up with stents.

Rice was taken to the hospital at KDMC, and when a doctor looked at him, he decided to send him straight to the Cath Lab. The decision saved his life, and this was when Rice found out that the other pains he had ignored had been milder heart attacks, and could have gone much worse. Still, he said he had more to learn.

I am pretty hard-headed, Rice said. After I started feeling better, I got a little lazy about taking my medicine. That was a bad move because I ended up having another mild heart attack. That was a wake-up call, and definitely got my attention. These days Im trying to take a little better care of myself.

Rice said he now makes a conscious decision to eat healthier food. He said he doesnt always eat right, but he makes sure to get in a lot of fresh vegetables and limit his sodium intake as much as possible. And though his COPD prevents him from doing much in the way of exercise, KDMC is starting him on Pulmonary Rehab with high expectations for positive results. His advice to others is simple and straight-forward.

If you are hurting, go see your doctor. Even if the pain goes away, the problem isnt gone,Rice said.

Both Hime and Rice were fortunate in that they survived putting off treatment; many are not so lucky. Heart health is far too important, they both now know, to leave to chance.

(606)326-2655 |

cromans@dailyindependent.com

Here is the original post:
Heart Health Month Lesson learned: Be aware of any signs - The Independent

During a meeting of Trinitys College Historical Society on Wednesday March 1st, 1961, the British peer, Lord Windlesham, admitted that apartheid was immoral and wrong but suggested that it would take time to remove it because of the tremendous task in educating the African masses.

This view was immediately challenged by Oladele Olusiji Kale, a young Nigerian student studying medicine in Trinity, who argued that this evil called apartheid is the greatest evil since Nazism. Kale would go on to become professor of preventative and social medicine at the University of Ibadan and a leading public health expert.

When the motion was put to a vote, the system of apartheid was rejected by 35 votes to eight and the result was widely reported. Apartheid condemned in TCD debate was the headline on page 3 of The Irish Times the next day.

Two years later, Nelson Mandela and other leaders of the ANC were put on trial for sabotage and other crimes, in what became known as the Rivonia Trial, and the South African government pressed for the death sentence. Behind the scenes, another former Trinity debater, the Nigerian foreign minister, Jaja Wachuku, persuaded the British and US governments to intervene.

Wachuku, who wore his Trinity College tie at cabinet meetings, had been a leading member of the College Historical Society in the 1940s, where he won a medal for oratory.

In this instance, he used his powers of persuasion to convince the British and Americans that the execution of the leaders, and Mandela especially, would destabilise African politics. The intervention proved decisive and when Mandela was convicted in 1964 he was sentenced to life imprisonment.

Wachuku was honoured posthumously as a hero of the struggle for Nigerias independence who helped persuade competing factions to press for independence in 1957. The Times of London noted that it was Mr Wachukus oratory which brought a compromise.

This year the College Historical Society celebrates the 250th anniversary of its founding. It is the oldest student debating society on these islands and perhaps the oldest student society in the world. The rival University Philosophical Society in Trinity claims an older lineage, going back to 1683, but it was actually created in 1853 as is well documented in the college records.

Throughout its existence, the College Historical Society has been place where different generations of Trinity students have seen the democratic ideal in action, the belief that ideas should be contested in a public sphere, debated by speakers on different sides, and then put to a public vote.

It has provided a forum for members from different backgrounds and beliefs to come together, test their ideas and develop their oratorical styles. Many of its members have gone on to significant careers in Ireland and around the world, including in politics, literature, law, science, business and intellectual life.

They include: Theobald Wolfe Tone and Robert Emmet in the 18th century; Thomas Davis, Isaac Butt and Edward Carson in the 19th; Jaja Wachuku, Mary Harney and Leo Varadkar in the 20th; and Sally Rooney in the 21st.

Called the Historical Society from 1770 to 1815, it dissolved itself rather than submit to restrictions imposed by the college authorities over what it could and could not discuss. Reforming outside the walls, it continued to provide a forum for new ideas to be presented and challenged, before returning Trinity as the College Historical Society in 1843.

Known popularly as The Hist since the 1920s, it continues to meet on Wednesday nights during term time. Today, its meetings are live streamed online.

Ireland changed significantly over the course of this period, from being a subordinate part of the British empire, to an independent state, self-confident about taking its place among the nations of the Earth.

Trinity also changed significantly in this period, admitting Catholics in 1793, women in 1904 and transforming itself into a national institution with an international reputation.

Despite the many changes throughout this period there has been a remarkable continuity in the story of the society. It has consistently been a sphere of ideas, championing free debate and democratic principles, sometimes attracting controversy.

It has also been an arena of ambition where members have tested themselves against their contemporaries and honed the skills that would serve them later in life, a place where great ideas were contested and opposing viewpoints (for the most part) treated with respect.

Over the 250 years oratorical styles have gone through many fashions, motions for debate have changed considerably and even the format of meetings and events has evolved significantly.

Nonetheless, there is a remarkable continuity. For example, every generation suspects that its successors are not as serious, not as impressive, not as good. This attitude was there from the beginning. At the start of the sixth session, in 1775, the chair criticised the society for already being in decline and regretted that it was no longer producing wits and poets and orators. Similar criticisms have been made in later generations and yet wits, and poets and orators, and more besides, continue to come through its ranks.

Some criticisms are more justified. For far too long, the biggest weakness undermining the society was its exclusion of women. It will surprise many people to learn that women sometimes attended meetings of the society in its early years, although this was a controversial issue.

In 1931 the society voted to admit women but unfortunately the change was never implemented. Every year the issue was debated and The Irish Times in 1964 condemned the refusal to change calling it, this traditionally misogynist society.

The exclusion eventually became untenable and was dropped in 1968. Women played a decisive role in bringing about this change and the controversy stands in contrast to the societys role as a driver for change in so many other areas.

For many, the image of debating societies in general, and perhaps The Hist in particular, is one of elitism and exclusivity. By the nature of their activities they attract only a subset of the wider college community, but it is a self-selecting group who get involved and there are no barriers to who can join.

However it is not easy to stand up to speak in the chamber in the Graduates Memorial Building, especially if one is aware of its history. Many find the prospect intimidating or off-putting, or are just not interested.

The talented novelist Sally Rooney came to prominence with an article she wrote about her competitive debating career. She remarked: College debaters are just students wearing ill-fitting formal clothes, and most of them arent even very good. But, crucially, some of them kind of are.

Rooney herself was one of those debaters who excelled in the society, described as eerily clever and stunningly eloquent in equal measure by one of her debating partners. Her subsequent success as a novelist continued a literary tradition in the society, which included Sheridan le Fanu, Bram Stoker, Oscar Wilde and Oliver St John Gogarty.

There are other literary connections. James Joyce, himself a brilliant student debater in UCDs Literary and Historical Society (or L&H), has a passage in Ulysses where one character discusses the finest display of oratory I ever heard and attributes it to a speech made by John F Taylor at the college historical society.

This bestowed a kind of literary immortality on the society, bringing it to the attention of scholars around the world although, as it turns out, the speech it is based on actually took place somewhere else. WB Yeats often spoke and chaired meetings of the society and his son, Michael, was later was elected auditor, the title given to the societys head. It was The Hist that chose this unusual designation in the 18th century and it would bequeath it to other student societies on the island.

Attracting high-profile guest speakers is a long tradition of the society, which in the past has welcomed figures as diverse as Winston Churchill and Michel Martin, John Hume and Mary McAleese (when president of Ireland), Colin Parry (whose son, Tim, was killed in an IRA bombing in Warrington and who delivered many moving appeals for peace in the 1990s) and Hilary Mantel.

Sometimes the focus is on celebrities and this goes back to the origins of the society, when there was some tension after some members proposed presenting a medal to Sarah Siddons, the most famous tragic actress of the 18th century, who was visiting from London.

Ten years ago I was approached by the society to write an official history for its 250th anniversary. Having never been a student in the university, though I occasionally attended debates with the L&H in UCD and then later as a member of staff in Trinity I approached the records with a critical eye.

Not all meetings were historic, not all speeches were profound and the society had its share of self-indulgent theatrics and tedium. It has also been transformative. By providing a peaceful forum to speakers representing every shade of opinion, it has been a place where great ideas have been contested and where national and international figures have been shaped.

Today, in the 21st century, it still serves the same vital function.

Prof Patrick Geoghegan is an historian at Trinity College Dublin and is a vice-president of the College Historical Society. He is the author of The College Historical Society: Oratory and Debate, 1770-2020, to be published by Lilliput Press and Hinds in March.

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The Hist: 250 years of self-indulgent theatrics and transformative debate - The Irish Times

WEST CHESTER Medical professionals in Chester County are confident that international quarantine procedures are keeping Americans at home safe from coronavirus, and most doctors are taking extra steps to ensure their patients stay safe.

While we are investigating any suspected cases of coronavirus, so far no one in Pennsylvania has tested positive for the virus, said Jeanne Casner, director of the Chester County Health Department. The threat of someone from Chester County being infected with the coronavirus is low, unless you have traveled to China or been in contact with someone from China who has been ill with suspected symptoms of novel coronavirus while symptomatic or confirmed positive.

Around the region and across the nation, the medical community is on high-alert as a precaution to combat the virus from harming the general population of Philadelphia and beyond. Coronavirus is a new ailment which recently sprang from the City of Wuhan, located 500 miles west of Shanghai in China.

Ninety-seven people died from the coronavirus on Sunday, a new daily record since the new coronavirus was first detected in December, as the death toll rose to 908, Chinas National Health Commission said on Monday.

That new total surpasses the toll from the SARS epidemic of 2002-3, according to official data.

Last week, Pennsylvania Secretary of Health Rachel Levine said that the threat from 2019 novel Coronavirus (2019-nCoV) remains low. While there have been 11 confirmed cases in the United States, none were documented within the Commonwealth of Pennsylvania.

In Chicago, a woman in her 60s was diagnosed after she returned from Wuhan on Jan. 13. The CDC said the Chicago woman had transmitted the virus to her husband, who had not traveled to China. But he was in close contact with his wife during a long period of time when she was symptomatic, the Illinois Department of Public Health said.

Other U.S. cases of Wuhan coronavirus include a student at the Boston campus of the University of Massachusetts. In Arizona, officials said, an "adult member" of the Arizona State University community was infected. And in Washington state, a man in his 30s sought treatment after returning from Wuhan.

There is limited direct impact on people in our area other than the possible need to change or cancel travel plans, said Charleen Faucette, director of infection prevention at Chester County Hospital. However, this is an evolving situation and people should stay informed so they will be aware if things change.

Faucette continued, While there have been no confirmed cases in Pennsylvania to date, out of an abundance of caution to protect our patients and staff, we are following Centers for Disease Control and Prevention (CDC) recommendations for evaluation of patients who may be at risk of developing the 2019 novel coronavirus.

She said Penn Medicine is working closely with leaders of the CDC, the Pennsylvania Department of Health, and local health officials to monitor this evolving situation and are prepared to quickly adjust our procedures as more information about the virus becomes available.

This is a fluid and rapidly changing situation with extensive local and national attention we are all learning new things every day, said Shafinaz Akhter, assistant clinical professor of medicine, University of Pennsylvania School of Medicine and director of Antimicrobial Stewardship at Chester County Hospital. The most effective personal interventions are optimizing individual health, including management of chronic diseases and making sure vaccinations are up-to-date.

Regional, national and international organizations are taking containment actions to prevent coronavirus from becoming a global crisis. In fact, the situation is not an epidemic in America, officially.

This situation is currently labeled as a public health emergency, Casner said.

We have been monitoring the coronavirus outbreak in China with information from our federal and state partners and are preparing our response teams in the event of an outbreak here, said Casner per proactive steps the Chester County Health Department is taking. We have communicated with clinicians through our health alerts about the potential for coronavirus cases to spread into the United States, and into Pennsylvania, treatment guidelines and collection of lab specimens of potential coronavirus cases.

Pertinent information is also continuously posted on the Chester County Health website as well as on its social media channels.

Casner added, The (Chester County) Health Department in collaboration with the Department of Emergency Services exercise and prepare frequently for a potential infectious disease outbreak.

There are nationwide efforts to limit travel to and from affected areas, according to Akhter. Locally, prompt recognition, testing, and isolation of patients with concerning clinical presentation and exposure history, Akhter said.

As a large academic health system and a national leader with deep experience preparing for and caring for patients with communicable diseases, Faucette said, Penn Medicine hospitals are always at the ready to respond to global public health issues and collaborate with local, state, and federal health agencies.

The impact of coronavirus to the Philadelphia region includes modifications of travel plans to and from areas with wide-spread transmission, Akhter said.

The Centers for Disease Control and Prevention has expanded the number of airports screening travelers to include the Philadelphia International Airport, Casner said. Philadelphia International Airport is a U.S. Quarantine Station that is a part of a comprehensive national quarantine system that serves to limit the introduction of infectious diseases into the United States and to prevent their spread.

The novel coronavirus spread is certainly an outbreak and meets some characteristics of an epidemic, Akhter said. That being said these are words and definitions and say little about the impact of the illness.

Vince Schaller, a doctor at American Family Care in West Chester, said residents should be proactive about healthy lifestyles during the outbreak.

Here we have a global scare, Schaller said, yet hopes this situation becomes an opportunity to educate the public on best health practices. He continued, Educate on what we really need to better on, like the flu, another virus like the coronavirus. To use any situation like this (with historic significance considering the World Health and CDCs involvement) as an opportunity to allay peoples fears, the science, to make them aware, and educate them. This is a wonderful opportunity to educate.

The symptoms of the coronavirus are resolvable by healthy people. The public needs to know that, Schaller said.

Schaller said, We can actually improve peoples health with influenza by paying attention to coronavirus and explaining the difference.

As we continue to contain the coronavirus through quarantine, said Schaller, who advised people to take key steps if feeling unwell. He said, If youre getting suddenly sick, with high fever, body aches, he advised people to seek medical help sooner rather than later. Additionally, he noted that the CDC has made an identification test of coronavirus available to doctors.

Coronavirus can look like the flu, Schaller said. He added that, as such, it is far more deadly to the sick, the elderly or the young.

Because this is a newly identified illness, there is definitely heightened attention and concern related to coronavirus at this time but, there are no confirmed cases in Pennsylvania, Faucette said. We are seeing thousands of cases of influenza in Pennsylvania and across the U.S. with some cases leading to serious illness. People should always be following steps to keep themselves healthy, perform frequent hand hygiene, and get immunized for influenza to help prevent respiratory infections, now and throughout the year.

Coronavirus is similar to the flu, and even the common cold, as respiratory ailments.

Understandably, the media attention to the novel coronavirus may make influenza seem less significant, Akhter said. However, it is important to know that there are currently 19 million cases of influenza reported in the U.S. this season with 10,000 deaths. In Pennsylvania, we have 45,000 diagnosed influenza cases and over 30 deaths so far. Despite this, vaccination coverage is only 62 percent for children younger than 17 years old and 45 percent for adults over 18 years old.

He added that the, influenza vaccination is safe and effective.

Casner said human coronaviruses are spread, just like the flu or a cold, through the air by coughing or sneezing as well as via close personal contact, such as shaking hands or even touching an object or surface that is contaminated.

The flu season is still active and there is a higher risk of getting the flu, Casner said.

Medical professionals recommend for people to cover any coughs or sneezes using their elbows rather than their hands.

It is also recommended that people should stay at home when not feeling well.

Additionally, people are advised to clean surfaces frequently, including countertops, light switches, cellphones, and other frequently touched items.

Akhter stressed the importance of optimizing general health as a key step to combat illness. This includes taking care of chronic medical conditions including diabetes and hypertension which can lead to immunosuppression if left untreated. Part of this is preventative medical care, including routine vaccinations when indicated."

Akhter advised people to take care when ill. This means following your doctors instructions on medications and follow up, he said. This should include avoiding work or crowded settings and excellent hand hygiene.

To stay healthy generally during the winter months, and year-round, doctors recommend drinking plenty of water and maintaining a healthy hygiene, which includes washing ones hands frequently.

Good hygiene practices such as washing hands, proper hydration, covering your coughs or sneezes with your elbow and not your hands, cleaning frequently touched surfaces, good sleep and healthy foods, said Casner.

We deeply appreciate the Department of Healths efforts to educate the commonwealth about the very real public health issue coronavirus presents, as well its commitment to combating misinformation about its origins, said Mohan Seshadri, executive director of the Governors Advisory Commission on Asian Pacific American Affairs on Feb. 3.

Too often, national security and public health crises have led to the demonization of particular groups of people, Seshadri continued, and we are committed to ensuring that that does not happen here. Our thoughts and prayers are with our fellow Americans and those in China fighting the virus, as well as with our Chinese-American community members worried for their families.

While this is a worrisome public health situation, CDC believes that the immediate health risk from 2019-nCoV to the general American public continues to be low at this time, Casner said.

"People should stay informed by monitoring reliable sources like the CDC and other public health websites, Faucette said. They can be assured that local, state, and national public health agencies are monitoring the situation closely and updating guidance as needed. Also, health care facilities across the region are collaborating with these public health partners so we can best inform, protect, and care for members of our communities.

On Feb. 7, the Pennsylvania Medical Society, held a press conference via telephone on novel coronavirus. It confirmed that no one in the commonwealth has been diagnosed with the virus.

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Health officials in Chester County urge caution over coronavirus - Daily Local News

Ageing should be classified as a disease to provide better treatment of the elderly, says an international group of leading medics and academics.

They are urging the World Health Organisation (WHO) to rethink the way it classifies illnesses so ageing is no longer seen as a natural process but a disease in its own right that leads to frailty, disability and ultimately death.

They say the WHOs current bible which defines and lists all diseases focuses doctors on individual critical conditions rather than the wider range of degenerative changes as people age.

The 30 experts - from Harvard, Stanford and MIT to Cambridge, Imperial and UCL - said their inclusion would encourage doctors to diagnose and prescribe treatments including drugs, diet and exercise that could prevent age-related conditions developing into critical illnesses.

The WHOs health bible - known as the International Classification of Disease (ICD) - determines what doctors around the world diagnose, treat and record.

However, Dr Stuart Calimport, one of the lead authors, cited inconsistencies such as sarcopenia, an age-related muscle-wasting, which was included in the ICD while age-related wearing out of other organs was not.

Critical to ageing is a process known as senescence in which cells throughout the body age, releasing inflammatory factors and enzymes that the immune system can no longer destroy

When senescent cells build up in the skin causing wrinkles it is considered a natural change. Yet when senescent cells build up in the heart and blood vessels, causing blood vessels to calcify, we call it cardiovascular disease, said Dr Calimport, of Liverpool University.

This is an error of logic and categorisation and not due to the intrinsic nature or complexity of pathology or disease.

An ageing disease classified and assessed for the level of severity in one organ can be unclassified in another.

With a lack of classifications and staging, pathological ageing changes may not be logged. This means that treatment needs may be overlooked, such as atrophy, calcification and ageing in organs and tissues where these are not classified or assessed for severity.

Dr Calimport did not believe the classification of more diseases would provide a bonanza for drug firms to develop treatments that would push up the NHS bill.

He said there were already cheap drugs such as Metformin, which was used to treat diabetes and had been shown to be effective in countering age-related conditions.

It would allow for preventative medicine such as social prescribing or the prescribing of exercise. It might not totally prevent ageing but at the moment we are not even recognising ageing in a way that it can be properly recorded and tracked said Dr Calimport.

If you cant track it, how can you prevent it, or slow it down?

The WHO is currently considering submissions for changes to the ICD which will be published next year. There are major updates every decade.

The proposals comes as the number of elderly are expected more than double from 900 million worldwide aged over 60 to two billion by 2050.

By 2030, one in five people in the UK (21.8 per cent) will be aged 65 or over, 6.8 per cent will be aged 75-plus and 3.2 per cent will be aged 85-plus.

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Ageing should be classed as a disease in itself, say leading academics - Telegraph.co.uk

Last month Swine Health Professionals officially opened its new Sheridan Room Education and Training Facility, a biosecure space in which the practice can provide swine barn workers hands on training in the husbandry and veterinary skills that will help them in their work.

Dr Blaine Tully, a Veterinarian and partner with SHP, observes the role of veterinarians and their relationships with their farms continue to evolve.

"What we've observed over three decades of swine veterinary practice is a shift from what was termed emergency medicine where veterinarians were busy kind of putting out health fires to more of a preventative role," explains Dr Tully, speaking to Farmscape.

"Certainly we still do those on a daily basis within our practice but the shift has really been to having swine farm workers become more adept at some of the husbandry practices that are a part of them.

"As the world around us changes with some of the antimicrobial regulations and welfare regulations that put more pressure on farms to kind of do the right thing, we find it really helps to have an open discussion in some of our workshops to enable workers to understand some of those principles of husbandry and how they can apply them in a better way on their farms."

Dr Tully says the new education and training facility will accommodate programmes SHP has developed over the years as well as several new programmes including euthanasia training to help swine barn workers be more comfortable with performing that job and programmes to help workers become more familiar with disease pathogens on swine farms and the medication and vaccine protocols in place to address them.

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Swine vets play new role in preparing producers for on-farm procedures - The Pig Site