Rheumatoid Arthritis and Osteoporosis Study

Abstract—Osteoporosis is more common in India. It
predominantly affects postmenopausal women, and
elderly of both sexes. The mal-nutrition, and smoking,
consumption of liquor and tobacco may have an effect on
bone mineral density (BMD). The aim of this study was
to screen the rural as well as urban population for osteoporosis
using a portable ultrasound heel bone densitometer; A total
number of 497 Indian people were screened for osteoporosis
using portable heel ultrasound bone densitometer. It includes
342 urban populations, and 155 rural populations. In all the
participants, the heel bone mineral density (BMD) was
measured. The peak value of estimated heel BMD (g cm-2)
measured in the rural young females was 0.515, whereas, in
urban females, it was 0.462, It was higher in rural young
females than in urban females, and was significant; The peak
value of estimated heel bone mineral density, BMD (g cm-2)
measured in the rural young males was 0.522, whereas, in
urban males, it was 0.528, and there was no significant
difference between the two types male population; In rural
females, the calculated percentage loss in estimated heel BMD
(g cm-2) between young adult age and moderate age was found
to be 17.1%, whereas in urban females, it was 8.4%; The
percentage loss in estimated heel BMD between young adult
age and old age were found to be 33.6% and 21.6% in rural
females and urban females respectively; In rural females, the
calculated percentage loss in estimated heel BMD value was
greater than in urban females; In rural males, the calculated
percentage loss in estimated heel BMD (g cm-2) between young
adult age and moderate age was found to be 8.6%, whereas, in
rural males, it was 1.5%; The percentage loss in estimated heel
BMD between young adult age and old age was found to be
12.1% in rural males; When using QUS device specific
threshold (-1.9 T-score), it was found that 10.3% and 14.3% of
the rural Indian women and men respectively, aged above 50
years had osteoporosis, whereas in urban women and men, the
percentage of osteoporotic were found to be 0% and 10.5%
respectively; The prevalence for the disease was greater in
rural population and it was more prominent in men.

Objective:The aim of this study was to evaluate the progression of arthritis in a complete Freund’s adjuvant (CFA)-induced Wistar rat model and to monitor inflammatory arthritis activity using thermal imaging compared with histopathology.Methodology: Fifteen adult male Wistar rats were studied in an adjuvant induced arthritis model by the injection of complete Freund’s adjuvant in the right hind limb and right forelimb, respectively, with the left limbs used as controls. Thermal image analysis based on skin temperature measurement, radiographic analysis based on erosion, limb circumference measurement, and histopathological evaluation were performed.Results. The average skin temperature difference on the arthritis-induced side and control for both the forelimb and hind limb were found to be 1.09 °C and 0.98 °C, respectively. Pearson correlation analysis revealed that skin surface temperature was positively correlated with the arthritis severity score (forelimb: r=0.64, hind limb: r=0.66, p<0.05).A significant correlation also existed between thermal imaging temperature and visual scoring of X-ray (forelimb: r=0.56, hind limb: r=0.67, p<0.05). Conclusion:Thermal imaging measurements correlated with arthritis severity score,radiological score, and ankle diameters. Hence, thermography could be used to diagnose and analyze inflammatory activity of arthritis at the preclinical stage.

TNF alpha is an inflammatory mediator that is relevant to several autoimmune diseases. Macromolecular inhibitors of TNF alpha have proven therapeutically useful in some preliminary studies. We have developed small molecule TNF alpha antagonist based on the crystal structure of TNF receptor complex. The TNF alpha inhibitor is specific and mediates biological function similar to the inhibitory soluble TNF receptor. This review focuses on development of small molecule anti-TNF alpha mimetics by us and current status of other agents.

Background and Purpose
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of the
joints and other body organs, which 1 % of the human population is affected. RA
induced  in  the  fourth  and  fifth  decades  of  life  and  in  women  is  more  common.
Kelussiao doratissima contains compounds such as flavonoids, mainly aggregated
in the inflorescence and stems of Kelussia, has anti-inflammatory effects. Present
study aimed to investigate the anti-inflammatory effect of Kelussia odoratissima
on rheumatoid arthritis induced in Wistar rats.
Materials and Methods
A  total  of  30  female  Wistar  rats  using  subcutaneous  injection  of  complete
Freund's adjuvant has been induced and were randomly divided into five groups
containing  negative  control  (no  treatment),  positive  control  (receiving
indomethacin  (3mg/  Kg)  and  three  rheumatoid  arthritis  group  receiving  three
different doses (100,200and 300mg/kg) of hydroalcoholic Kelussia odoratissima
extract. material injection were tested in the animals for 10 days.
The symptomsof Rheumatoid arthritis were evaluated according to standardized
scoring method at paw  and double-blind for the different categories daily. CRP
levels were measured and Data were analyzed using the SPSS statistical program
(version 17 for Windows). In all the cases for comparison between different
groups, Mann-Whitney U-test was used.
Results
The  symptoms  indicating  disease  severity  was  observed  in  the  treated  group
compared to the negative control so that decreasing trend in disease severity in the
group  receiving300  mg  /  kg  of Kelussia extract  was  significant  However  these
verity of the disease was increasingly in the negative control. Serum CRP levels
in groups () were significantly decreased.
Conclusions
Kelussia  odortissima  has  a  anti-inflammatory  effects  and  can  reduce  the
inflammation and morbidity in rheumatoid arthritis. Thusit can be used as a drug
for reducing and controlling inflammation in Rheumatoid arthritis.

An 18-year-old man suffered from acute Sydenham chorea appearing coincidently with β-haemolytic streptococcal throat infection. Imaging techniques documented lesions of basal ganglia and substantia nigra. In the early course of the disease vascular lesions may be important pathogenetic mechanisms of this acquired movement disorder.

Objectives: The aim of the present study was to compare and correlate body composition measurements and bone mineral density in patients with rheumatoid arthritis (RA) and age-matched controls to identify the possible prediction factors for low bone mass, fractures, and body composition changes.
Methods: Ninety-two RA patients and 92 age- and sex-matched healthy controls were included for the study. A health assessment questionnaire (HAQ) score, disease activity score - (DAS 28), forearm bone mineral density (BMD) determined by dual energy x-ray absorptiometry (DXA), estimated heel BMD based on quantitative ultrasound and  body composition parameters were analyzed in  both RA patients and controls.
Results: Body fat mass (BFM) differed significantly between RA patient group (26.37±10.05 (kg)) and controls (30.11±8.64 kg, p<0.05). The Fat free mass (FFM) was also significantly different between RA patients (37.63±9.82 kg) and controls (42.97±6.68 kg, p<0.01). Forearm BMD and estimated heel BMD was significantly higher in controls (0.377±0.04 g/cm2, 0.493±0.08 g/cm2), than in RA patients (0.320±0.13 g/cm2 , 0.452±0.10 g/cm2;  p<0.01 and  p<0.05, respectively). The Fat free mass (FFM), muscle mass (MM), segmental muscle mass (SMM) was significantly correlated with the estimated  heel BMD and forearm BMD.
Conclusions: These findings indicated that the body composition measurements might be useful for predicting bone mineral density (BMD) in RA patients. High RA activity was found to be  associated with reduced function, and altered body composition and BMD.

Background: Interaction between patients and clinicians is a key part of building a therapeutic relationship. Whilst it is anticipated there are similarities and differences between patient interaction with clinical nurse specialists (CNS) and consultant rheumatologists (CR) there is a paucity of research in this area.

Objectives: To compare communication with patients in CNS and CR rheumatology clinics.

Methods: Direct observation of CNS and CR clinics at 9 rheumatology outpatients departments in the UK was undertaken by a non-participant observer (KV). Field notes and audio recordings were made of the consultations. Roter’s Interaction
Analysis Scale (RIAS) was used to code the communication into categories (table1). Kruskal-Wallis test was used to assess the difference between CR and CNS according to speaker (significance ≤p=0.025 Bonferonni adjusted).

Results: CR saw 63 patients (43 female), mean age 60 (SD16), median disease duration 10.5 yrs (IQR 2.8-25). 40% had RA, 44% other rheumatic diseases and 16% undiagnosed.CNS saw 44 patients (24 female), mean age 58 (SD15), median disease duration 5 yrs (IQR 2-14.5). 71% had RA, 11% PsA, 18% other diagnoses. Rapport building positive and social differed significantly across groups (table 1). Both the CNS and their patients engaged in more social rapport building (non-medical conversation) implying a relaxed/established relationship which is less medically driven. The CR consultations demonstrate rapport-building positive, encompassing a lot of social niceties which is more indicative of new/building relationships. CRs engaged in more patient education and instructions about disease and its progression than CNS. However, there is more patient activation and engagement with CNS;requests for services; seeking reassurance/understanding. Coupled with the higher incidence of social rapport building this may indicate a less formal environment in which the patient is more likely to engage in shared clinical decision making, express uncertainty and seek reassurance.

Conclusions: Consultations with CNS contained more social interaction, and were more relaxed with a less medically driven agenda which allowed more patient activation & engagement. Surprisingly the CR provided more biomedical information than the CNS, even though the CNS consultation times were longer.

Osteoporosis and osteoarthritis are two different medical conditions, which beside the first part of their name „osteo“, have very little in common. Osteoporosis is a disorder which influences bones in terms of reduction of quality and quantity, which can easily result in bone fracture. Clinical signs of osteoporosis show no pain or other symptoms which could point to changes in bone structure, unless a bone fracture is diagnosed. Osteoarthritis is a disease which influences joints and its surrounding tissues. Seeing through clinical signs, changes could be verifi ed in terms of pain and limitations of movement and the cause of pain and way of its treatment are numerous. A person can suffer from osteoporosis and osteoarthritis at the same time. Although these medical conditions are more frequent in female than in male population, mechanisms which lead to them may interfere. Osteoporosis and osteoarthritis are muscular-bone disorders with signifi cant morbidity and mortality, but cli...

Consumption of Joint Pain Supplements in US Compared to Rest of the World
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