Viagra Linked to Hearing Loss

Business Week

 

The erectile dysfunction drug Viagra, and possibly other similar medications, may prompt long-term hearing loss among users, a new study suggests.

In the May 18 issue of the Archives of Otolaryngology -- Head and Neck Surgery, researchers from the University of Alabama at Birmingham discuss evidence supporting an association between the onset of hearing problems and Viagra. The medication is one of the so-called class of phosphodiesterase type 5 inhibitors (PDE-5i), which also includes Cialis and Levitra.

The finding follows the 2007 decision by the U.S. Food and Drug Administration to adjust labeling for such medications to more prominently display warnings about hearing loss risks. The move stemmed from reports that year regarding sudden hearing loss among users of these drugs.

"It appears from these findings that the current government warning regarding hearing loss and the use of PDE-5i medications is warranted," study author Gerald McGwin, a professor of epidemiology in the University of Alabama at Birmingham School of Public Health, said in a news release. "Though there are limitations to this study, it is prudent that patients using these medications be warned about the signs and symptoms of hearing impairment and be encouraged to seek immediate medical attention to potentially forestall permanent damage."

The finding stems from an analysis of survey data concerning more than 11,500 men over the age of 40 that had been collected by the federal Agency for Healthcare Research and Quality between 2003 and 2006.

McGwin and his team found that men who said they used PDE-5i drugs had twice the risk for developing hearing loss as those who did not.

The authors stressed that more research is needed, while suggesting that one possible explanation could lie in the original purpose of these medications. They note that although now used mainly for erectile dysfunction, this class of drugs was initially prescribed for the treatment of pulmonary high blood pressure.

"PDE-5i medications work in erectile dysfunction patients by their ability to increase blood flow to certain tissues in the body," said McGwin. "It has been hypothesized that they may have a similar effect on similar tissues in the ear, where an increase of blood flow could potentially cause damage leading to hearing loss."

UnitedHealth, Humana Seek Medicare’s 5-Star Bonus Pay

Bloomberg

 

Insurers led by UnitedHealth Group Inc. and Humana Inc. may share in an estimated $2.5 billion in yearly bonuses if their U.S-backed Medicare plans rate four or five stars under a system created to improve quality of care.

The U.S. has ranked Medicare Advantage insurance plans that serve the elderly on a one- to five-star basis since 2007, weighing clinical outcomes, access to tests, preventive care and consumer satisfaction, among 33 criteria. Under the health law signed in March, those scores will be used to award bonuses that can boost U.S. subsidies for the plans by five percent.

The money may help offset an estimated $136 billion, 10- year scheduled cut in U.S. payments for the plans. UnitedHealth has begun an improvement push because most of their customers are in plans now ranked from three to three-and-a-half stars, said spokesman Matthew Burns. At the same time, America’s Health Insurance Plans, the industry’s lobbyist, is urging changes in the system that may allow more plans to get higher ratings.

It’s “health-care Darwinism,” said Nathan Goldstein, senior vice president of strategic development with Gorman Health Group, a Washington consulting firm that works with Medicare Advantage plans, in an interview.

The program begins with a 1.5 percent bonus in 2012, then 3 percent in 2013 and 5 percent in 2014.

Payments will be worth at least $700 million a year by 2014, said Brian Biles, a professor at George Washington University’s Department of Health Policy who wrote a study on the program. If all the three-star plans improved to four, the total bonus payments would be worth about $2.5 billion, according to a separate analysis by Biles.

‘Taking the Edge Off’

The bonuses “could be significant in taking the edge off cuts to Medicare Advantage,” said Ana Gupte, a Sanford C. Bernstein & Co. analyst in New York, in an e-mail.

UnitedHealth, based in Minnetonka, Minnesota, lost 26 cents to $30.18 at 4 p.m. in New York Stock Exchange trading. Humana, of Louisville, Kentucky, increased 31 cents to $46.20. The Standard & Poor’s 500 Managed-Care Index has fallen 12 percent since President Barack Obama signed the health-care law on March 30, compared with a 4.5 percent decline in the S&P 500.

Advantage plans compete with traditional Medicare plans by offering expanded benefits and different premiums. About 10.2 million of the 45 million Medicare recipients were Advantage members in 2009, according to the Kaiser Family Foundation, a Menlo Park, California, health-care research group.

UnitedHealth Coverage

UnitedHealth covered 2 million people in Advantage plans as of March 31 and Humana had 1.74 million, according to statements released last month. The Advantage program accounted for one- fifth of UnitedHealth’s $3.82 billion in earnings last year, said Matthew Borsch, a Goldman Sachs Group Inc. analyst in New York, in a May 3 note.

In 2009, he U.S. paid insurers an estimated $110 billion to run the plans, according to Kaiser. The payments were about 14 percent higher per-patient than the cost of traditional Medicare, the U.S. government’s basic health program for those 65 and older, the Medicare Payment Advisory Commission said.

In an effort to raise its ratings by 2014, UnitedHealth will encourage patients to use chronic and preventive care services more often, and the company plans to put resources into added call centers and customer support, said Rhonda Medows, the insurer’s chief medical officer for public and senior markets.

“We believe we’ll achieve four or better in time,” Medows said in a telephone interview.

Industry Lobbying

The insurance industry has been lobbying to influence many parts of the health-care overhaul that will affect how companies do business, including rules about the proportion of premium dollars to be used for administrative costs and profits. The rating system is also at issue, said Robert Zirkelbach, the group’s spokesman.

The star system grades insurers against one another on some of the 33 measures. America’s Health Insurance Plans is challenging the objectivity of having the criteria rated on a curve, Zirkelbach said in a telephone interview.

“We have raised concerns that some of the measures in the current star systems are not based on objective criteria, which could prevent some plans from moving up,” he said.

That means companies will find it harder to improve their ratings unless the metrics grading them against one another are changed to allow measurements against universal standards, said Biles, who wrote the study about the bonus program.

“For somebody as big as UnitedHealth, that all their plans could be four stars under the current system is impossible,” Biles said in a phone interview.

No Decision on Changes

Medicare hasn’t decided whether to change the criteria, said Peter Ashkenaz, a spokesman for the Centers for Medicare and Medicaid Services, in an e-mail.

Biles said ending the grading curve might make the star rating system less meaningful.

“They’ll set absolute values, but they’ll set them so low that everybody lives in the world of Lake Wobegon, where all the children and all the plans are above average,” he said, referring to radio show host Garrison Keillor’s fictional town in Minnesota.

Nonprofit Medicare Advantage plans tend to have higher ratings than for-profit companies. The average nonprofit plan has 3.87 stars, compared with 3.02 stars for the for-profit insurers, according to the Kaiser foundation.

Martin’s Point Health Care in Portland, Maine, a nonprofit insurer, is one of four plans in the U.S. with a five-star rating. The insurer had 2,652 Advantage patients that brought in $16.4 million in 2009. Martin’s Point competes locally against Humana among about 10 rivals, Chief Executive Officer David Howes said in a phone interview.

9 Percent Cut

All the local Maine plans are facing about a 9 percent cut to their government payment rates next year. “But they’re not all going to be getting the quality bonuses. I think the quality bonuses may be critical for success going forward,” Howes said.

Howes said Martin’s Point expects to double the number of Advantage customers in the next year. The plan relies on its existing relationships with doctors and hospitals to make sure they’re providing preventive care, one of Medicare’s metrics.

“We’ve spent a lot of time thinking about, ‘Who do we want to have in that network?’” Howes said. “Who gives nice access? Who gives us the ability to touch our members and patients in a way that is positive?”

Martin’s Point’s five-star ratings will help it win more customers from its competitors and perhaps eventually drive them from the market, said Goldstein, of Gorman Health Group, who has consulted with the Maine nonprofit.

“To the victor goes the members,” Goldstein said. “Mr. CEO, what I’m here to tell you is that your payment rate is getting cut down, and you have two levers you can pull to increase it -- your risk adjustment, and your star system.”

$35M for Dartmouth Health Care Delivery Center

Associated Press

 

 

Dartmouth College is getting $35 million to open a center it hopes will help the nation take the next big steps in health care reform: improving quality while lowering costs.

The historic health care overhaul legislation President Barack Obama signed in March will give millions of Americans access to health care, but "the real rocket science in health care right now is in the delivery," said Dartmouth President Jim Yong Kim, who has been promoting the idea of a national institute on health care delivery since arriving at Dartmouth last July.

Now, he has a $35 million commitment from an anonymous donor to establish the Dartmouth Center for Health Care Delivery Science, which will bring together experts in everything from medicine and management to sociology and systems engineering to figure out what is working in successful health care systems such as Minnesota's Mayo Clinic. They'll then teach practitioners, who can return home and make changes immediately, Kim said.

"We're not just doing the research and presenting it for people to either accept or not accept," he said.

The center also will be home to a new master's degree in health care delivery science, which will begin enrolling students in July 2011.

"The science of health care delivery is being practiced by many wonderful scholars throughout the country, but most colleges and universities have not made it a major focus," Kim said. "A lot of medical schools teach health policy, but they don't really teach the complexities of what it takes to actually build effective, functioning, health care systems, clinics or hospitals."

Kim, the first Asian-American to lead an Ivy League school, is a former director of the World Health Organization's HIV/AIDS department. He helped found Partners in Health to support health programs in poor communities worldwide. Kim came to Dartmouth from Harvard Medical School, where he was chairman of the Department of Global Health and Social Medicine.

He said he hopes Dartmouth's new center will be a clarion call to other colleges and universities.

"We're talking about an industry that's growing so quickly, and we're really worried that without improving quality, we're just going to have increased costs," he said. "So I think there's a tremendous urgency to tackling health care delivery, and I firmly believe that American institutions of higher education have a central role in tackling that problem."

Kim described the anonymous donor as a consumer who recognizes the health care system is in trouble. He expects the initial seed money will be enough to set the center up to attract government and private funding. And though he agrees with goals of Obama's health care legislation, Kim emphasized that the new center "is not about cheerleading" for the administration.

He pointed out that Sen. Judd Gregg, R-N.H., has long supported the research done by Dartmouth's Institute for Health Policy and has been involved in the planning for the new center, along with Sen. Jeanne Shaheen and Gov. John Lynch, both Democrats.

One idea they've discussed is using the center to make New Hampshire a model for innovative health care delivery.

"There's a lot of talk in Washington right now about setting up pilot programs," Kim said. "I think a really, really exciting possibility though would be to set up a pilot state to take on an entire state with multiple health care systems in it."

While a single health care system, such as a hospital, can perform well because of centralized control, "the challenge of performing well across an entire state is a different kind of challenge, and one we'd love to take on," he said.

American Heart Association Teaming up with Nintendo Wii

Joystiq

 

Nintendo of America announced a strategic partnership with the American Heart Association this morning, effectively adding the AHA stamp of approval to all retail boxes of Wii Fit Plus, Wii Sports Resort, and the Nintendo Wii itself. "The brand serves as a chance to remind people about the benefits of a healthy approach to living and how active-play video games can be an integral part of a healthy lifestyle," the partnership's official website explains.

In addition to the marketing partnership, the AHA and Nintendo will host a "multidisciplinary summit of representatives from a variety of fields ... to take a closer look at the synergies and benefits of active-play video games," entitled the "Innovation Summit." No details have been provided on when and where said summit will occur. Finally, various "active-play Nintendo video games" will be available to play at select "Start! Heart Walk" events this fall.

Also, no, Nintendo hasn't explained the Vitality Sensor yet.

Health Reform's Next Test

The Washington Post

Jim Yong Kim

 

Health insurance reform is now law, giving millions of Americans access to the full resources of our health-care system for the first time. The question becomes: How can we ensure that they -- and all of us -- receive value-based and high-quality care?

It is well known that U.S. health-care costs, as a share of our economy, are the highest in the world but that compared to other industrialized countries, our results are the worst. The Dartmouth Atlas has documented the enormous waste in our system and shown that spending more money and performing more medical procedures do not equal better outcomes for patients.

Americans deserve health care that is coordinated across physicians and health systems, and that is effective, appropriate and safe. As a nation, we have a moral and a fiscal responsibility to ensure that all patients receive value for health services. While the achievement of health insurance reform was historic, it is time to focus on the next step: improving quality while bending the unsustainable cost curve significantly.

We are physicians and researchers; one of us is now a college president, and the other head of a leading academic medical center. We share a history of work in medicine, science, policy reform and education. We also share the view that throughout history, our most difficult problems have found scientific solutions.

We propose the rapid expansion of a new field to tackle the twin problems of how to provide high-quality health care while lowering costs: health-care delivery science.

This new field will work with the recognition that truly reforming health care requires more than the efforts of one entity. We cannot blame government or insurers or physicians for the complex and multilayered problem. No single group or entity created the puzzle that is our health-care system; it is not reasonable to expect one group to solve it.

What will lead to improvements is a multidisciplinary approach that brings the best minds to focus on the problem. Experts in management, systems thinking and engineering, sociology, anthropology, environmental science, economics, medicine, health policy and other fields must join together to apply a laser focus to fixing the delivery system.

Why? Consider the moving pieces of a patient-health system encounter. A patient comes into the emergency room. Immediately, judgments are made about how sick she is and what treatments she needs. There is no universal medical record for that patient, so the provider has no idea about her medical history, medication use or preexisting conditions. Incomplete information is relayed through layers of nurses, physicians, specialists and the shifts of personnel who replace them. In the absence of real-time information, tests are ordered and treatment decisions made. Perhaps after an overnight stay, barring complications from drug interactions or perhaps an unrecognized underlying condition, she is discharged, with no further transfer of information to a provider and, more important, no follow-up to see whether the treatment was effective. The symptoms were treated; the patient was not.

The best insurance in the world will not fix this problem. We need a whole new cadre of people committed to applying their expertise to the challenge of health-care delivery.

We have begun building that cadre at Dartmouth with the establishment of a Center for Health Care Delivery Science. But it is our hope that many more institutions will work together to generate the needed evidence on health-care delivery solutions, to disseminate that knowledge and to train the current and future professionals who will put solutions into practice. We envision a network of centers across the country that will marry research and implementation from the start -- finding and testing delivery solutions with practitioners and patients on the front lines.

The recent health legislation establishes an implicit covenant with the American people. The spirit of this covenant goes far beyond insurance. In exchange for new public and private investment in the health system, Americans expect access to effective, high-quality care within a financially sustainable system. With a robust science of health-care delivery, this goal can be achieved.

Jim Yong Kim is president of Dartmouth College. James N. Weinstein is president of the Dartmouth-Hitchcock Clinic.

Cancer Treatment Uses Body's Immune System

BND

A first-of-its kind prostate cancer treatment that uses the body's own immune system has received federal approval, offering a gentler alternative to chemotherapy and radiation.

Studies by the Dendreon Corp., of Seattle, found that its Provenge vaccine added four months to the lives of men with advanced prostate treatment. That's a month longer than the chemo drug Taxotere, and doctors hope it will provide even more benefit if given earlier in the course of the disease.

It works like this: From each patient, doctors collect special blood cells that allow the immune system to recognize cancer as a threat. The cells then are mixed with a protein found on most prostate cancer cells and another substance to rev up the immune system. The resulting "vaccine" is then given to the patient through three infusions over a two-week period.

"The big news here is that this is the first immunotherapy to win approval, and I suspect within five to ten years immunotherapies will be a big part of cancer therapy in general," said Dr. Phil Kantoff, an oncologist at the Dana-Farber Cancer Institute who helped run the Provenge research.

Side effects are relatively mild, including chills, fatigue, fever and headache. The one limiting factor will be the cost: nearly $100,000 per patient.

"There are going to be a lot of patients that want it and there will be limited resources as they are getting this up and running," said Dr. Deborah Bradle of Duke University.

Don't eat raw crawfish

Don't try to show friends what a cast-iron stomach you have by eating raw crawfish. You could wind up with a potentially fatal illness.

That's what at least six people recently discovered when they came down with lung-fluke infections after ingesting raw crawfish from Missouri rivers, according to the state's Department of Health and Human Services.

Usually seen in Asia, the lung fluke (paragonimiasis) is a food-borne infection caused by eating raw or undercooked freshwater crabs or crayfish. The parasitic trematode eventually breaks through the digestive tract to infest the rest of the body, including lungs, brain and nervous system. Symptoms can mimic tuberculosis -- fever, cough and spitting up blood.

People who develop such symptoms after eating raw crabs or crayfish are urged to seek immediate medical care. All six Missouri patients improved after they were hospitalized and give medicine to treat parasitic infections.

New cancer treatment study

A new study of women diagnosed with ductal carcinoma in situ may have uncovered important clues that will lead to personalized treatment.

DCIS is a common form of cancer in which malignant cells develop within the milk ducts of the breast. Currently, a woman who is diagnosed chooses either a lumpectomy with radiation treatment or has a mastectomy.

But a study of nearly 1,200 women at 63 San Francisco area hospitals uncovered three "biomarkers" that may help doctors determine how aggressively they should treat each patient. Of women with all three markers, 20 percent developed an invasive cancer within eight years. Of those with none of the markers, only 4 percent developed invasive cancer.

If the findings are confirmed, such differences may help women choose a more appropriate treatment, experts said.

"At this point in time we're probably overtreating people and undertreating people," said Dr. Karla Kerlikowske, a professor of medicine, epidemiology and biostatistics at the University of California San Francisco. "If we can define a woman's risk a little better, then we can personalize what they want to do."

Sun protection in vehicles

If you're in a car or truck for extended periods, you might want to add skin cancer to the list of traffic hazards you face.

A new study finds that skin cancer is found predominantly on the left side of the face -- and especially in men.

"Drivers need to be aware of the amount of sun exposure they receive behind the wheel," said Dr. Scott Fosko, the chair of dermatology at St. Louis University and co-author of the study, which appears in the Journal of the American Academy of Dermatology. "The cumulative effect of being exposed to the sun builds up over many years."

And, he says, professional drivers aren't the only ones that need to monitor exposure to the sun. Carpooling moms and daily commuters should be concerned as well.

His recommendations: Regularly apply sunscreen that blocks both UVA and UVB rays. Tinting glass and using UV filters on windows also can help. Wear protective clothing whenever possible.

The American Cancer Society estimates that most of the more than 1 million cases of non-melanoma skin cancer diagnosed annually in the United States are sun-related. Melanoma caused most of the 12,000 skin cancer deaths last year.

Noninvasive depression treatment

Psychiatrists at the Southern Illinois University School of Medicine in Springfield have become the first in downstate Illinois to use a new noninvasive treatment for depression.

Approved by the Food and Drug Administration in 2008, transcranial magnetic stimulation -- or TMS -- may help adults who have not had successful treatment results from anti-depressant medications.

TMS therapy uses magnetic pulses to stimulate targeted regions in the brain during the 45-minute outpatient procedure. The pulses induce a painless electric current, which, in turn, causes neurons to release mood-boosting natural substances such as serotonin and dopamine.

Patients are awake and alert during the treatment, which is usually administered daily for four to six weeks. National studies found it produced statistically significant improvement in such symptoms as sadness, loss of interest, insomnia, fatigue and low self-worth.

Kareem Abdul-Jabbar in area

Helping make cancer cures a slam-dunk will be Kareem Abdul-Jabbar's goal when he hosts "illumination10," the annual gala benefiting The Siteman Cancer Center in St. Louis.

This year's program on May 15 at the Chase Park Plaza will support the Barnes-Jewish Hospital's Foundation's Cancer Frontier Fund, a 10-year, $50-million initiative to boost research at Siteman.

Abdul-Jabbar, the National Basketball Association's all-time scoring leader and six-time MVP, has had a stake in the work long before he was diagnosed with chronic myeloid leukemia last year.

"My grandfather died from colorectal cancer, my uncle died from colorectal cancer and my father almost died from colorectal cancer," he told CNN last November. "I think it's possible for someone in my position to help save lives."

Hip Joint Replacement Can Help Severe Arthritis Pain

SC Now

After years of work and play, and sometimes injuries or illnesses, some joints just wear out.  The years of wear and tear on joints can lead to arthritis and the pain and disability that go along with it.

The joints that bear the most weight are usually the ones to wear out first. The hips have a very great pressure across the joint because of the leverage action of the thigh muscles.

When a person’s doctor has determined that the joint damage is great enough and the symptoms severe enough, he may suggest a hip joint replacement in Dearborn. Usually, a person must have significant disability or uncontrollable pain before the operation is considered.

Hip joint surgery involves replacing the surfaces of the joint. A polyethylene socket is placed into the hip socket and the ball of the hip is replaced with a metal ball that is stabilized by a spike extending several inches down the thigh bone.

After surgery the person must be careful how he sits. He should not cross his legs for six weeks or there is a possibility of dislocating the joint.

Although the period of recovery and rehabilitation will take several months, the arthritis pain relief improves quickly with the surgery.

After Detroit hip replacement surgery a person can do almost anything he wishes, but in moderation because the prosthesis has the risk of loosening over 10 to 15 years if a person puts excessive stresses on the prosthesis.

Walgreens to Begin Selling Genetic Testing Kits

The Chicago Tribune

Scientists, bio-ethicists and genetic counselors worry consumers will misuse or misunderstand test results

 

 

Coming soon to a drugstore near you, alongside the aspirin and greeting cards, will be the promise of answers to some of life's most personal mysteries: Am I at risk for Alzheimer's disease? Or breast cancer? Or obesity?

Starting Friday, Walgreens will begin selling Insight personal genetic testing kits, becoming the first major retail chain in the U.S. to offer home tests that say they assess the risk of developing one of dozens of different health conditions. CVS plans to have it in stores by August.

The product's introduction raises immediate concerns among scientists, bio-ethicists and genetic counselors. They worry that consumers will misuse or misunderstand the results of a test so open to interpretation it is potentially meaningless, or frightening, especially without a full medical assessment.

On Tuesday, the Food and Drug Administration told the Tribune it is investigating the medical claims the product's manufacturer, California-based Pathway Genomics, is making in marketing its genetic test, which hasn't been approved by U.S. regulators.

Pathway officials say the company's home genetic test meets federal regulations and doesn't require FDA approval.

"The tests conducted are not an in-vitro medical device and are not intended for use in diagnosis, treatment, mitigation or cure of disease. It does provide information that allows a person to learn about their health to make healthier lifestyle choices," said Ed MacBean, Pathway's vice president of product management. "If the FDA contacts us, we will discuss it and address any concerns they might have."

Drugstores already carry DNA paternity and gender prediction tests that can be done at home, and genetic test kits are sold online by several firms. But genetic testing typically requires a visit to the doctor's office, allowing for consultation with a health care professional.

Marketers think such kits could become as common as early pregnancy tests, helping consumers get initial information before going to the doctor.

"We recognize that for some people, genetic responses are becoming a more important component of managing their health care," said Jim Cohn, a spokesman for Deerfield-based Walgreens. "There are people who want to know more about their genetic makeup, and we pride ourselves on being convenient and accessible."

The Insight genetic test kit, priced at $20 to $30, comes with a vial and a shipping envelope. Buyers send a sample of their saliva to a Pathway Genomics laboratory and receive their results online. The report costs $79 to $179, depending on the type of test requested.

The kits will be appear on the shelves at about 6,000 of Walgreens' 7,500 stores nationwide.

Pathway Genomics Chief Executive Jim Plante said in a statement that his company is "revolutionizing" the way people access information about their genetics. "The value of knowing how genes play a role in our personal lives, and potentially the lives of our children, is critical for making well-informed health and wellness decisions," he said.

Pathway screens for genetic markers of more than 70 diseases, including diabetes, prostate cancer and cystic fibrosis. The company notes that "some markers have been researched more thoroughly than others, but scientific knowledge advances rapidly."

It recommends buyers discuss results with a doctor or one of Pathway's genetic counselors, particularly for complex health issues such as heart disease and cancer that have multiple causes, including lifestyle and environmental factors, MacBean said.

Scientists question the value of home genetic testing. For most diseases, no one knows exactly why one person gets it and another does not, said Peter Kraft, deputy director of the Program in Molecular and Genetic Epidemiology at Harvard School of Public Health.

"The company states, everyone has the right to know the secrets hidden within their DNA," he said. "Fair enough, but that is a lot of work. I don't think this is the way to go."

According to a paper published in The Lancet in May, a team of more than 30 researchers took a year to analyze the results from full-genome testing of a 40-year-old man with a family history of coronary artery disease who died suddenly. Although the amount of data they analyzed was far greater than that of Pathway's kit, the researchers used much of the same data on genetic health risks, disease risk and drug information.

Even then, the researchers acknowledged that the genetic information was incomplete, said Dr. Nilesh Samani, a professor of cardiology at the University of Leicester in England who wrote a commentary on the study.

Many of the risks have been calculated for the entire population, Samani said, but that doesn't mean it applies neatly to any one individual because of family history, lifestyle habits or, importantly, genetic variations.

Samani likened it to a card game in which you can only see a few cards. At first blush, you may be holding a bad hand, but what if the cards you can't see are all aces?

"You need to know the rest to know whether it is worthwhile," Samani said. "That is a limitation. It is a big limitation. [The companies] don't present it like this."

New Mutant Genes Linked to Rheumatoid Arthritis

Reuters

A large study of European populations has uncovered seven new clusters of defective genes which may be responsible for rheumatoid arthritis, a painful and disabling disease that affects mainly the joints.

The paper was published in Nature Genetics on Monday together with findings of a separate study in Japan, which identified one of the seven genetic clusters as possibly causing the chronic inflammatory disease among Japanese.

"The findings leverage us to better understand the basic biology of rheumatoid arthritis (RA), with the goals of developing new targets for therapy and new biomarkers for diagnosis and prognosis," wrote research scientist Eli Ayumi Stahl at the Brigham and Women's Hospital in Boston in the United States, who led the study on European populations.

The study was also intended "to develop better genetic tests for RA risk, especially in people already at risk (such as arthritis patients or relatives of patients with autoimmune disorders)," Stahl told Reuters.

RA affects about 1 percent of the world's population. Apart from the joints, it may affect the skin, heart, lungs, kidneys and blood vessels. Many end up with deformed hands and feet, resulting in loss of functions and movement. There are few alternatives in the way of rheumatoid arthritis relief.

In the European study, Stahl and colleagues repeated six previous studies involving 5,539 patients, analyzing their genes using the latest technology. They shortlisted 34 genetic variants which they considered most suspect in causing RA.

They then checked if those genetic defects were found in another batch of 6,768 RA patients in Canada, North America, the Netherlands and Britain. Ten of the 34 variants figured most prominently in this replication phase.

"Ten of the 34 variants tested were validated in the replication phase of our study. Three were previously implicated in RA, leaving the 7 new ones mentioned above," Stahl wrote.

"This is more RA risk variants discovered in a single study than any other study to date, underscoring the importance of large-scale studies and the collaborations that enable them in order to make progress in unraveling common, complex diseases."

"Our results further suggest that many more RA risk variants remain to be definitively identified," Stahl added.

In the Japanese study, researchers led by Yuta Kochi at the RIKEN Center for Genomic Medicine in Yokohama, Japan, analyzed genes of 7,039 RA patients and identified a common genetic mutant near the CCR6 gene.

The CCR6 gene was also identified in the European study.

What you Should Know about Arthritis

Maitland Observer

 

More than 46 million adults in the U.S. report being diagnosed with some form of arthritis. Although often considered a disease affecting only the older population, close to 300,000 children under the age of 18 have some form of arthritis as well, which represents about one in every 250 kids.

In honor of May being designated as National Arthritis Month, we recently sat down with local fellowship trained joint specialist and orthopaedic surgeon, Dr. Samuel S. Blick, M.D., of the Orlando Orthopaedic Center in Winter Park to answer some of the more common questions he hears regarding the joint disorder.

Q: How do I know if I have arthritis and it's not just something that will go away in a day or two?

A: Arthritis is inflammation of one or more joints, which generally results in pain, swelling, stiff joints and, thus, limited movement. There are more than 100 different types of arthritis, one of the most common being osteoarthritis, or a type of arthritis that is caused by the breakdown and eventual loss of the cartilage joints. Usually, it's diagnosed with X-rays.

Q: Besides being an inflammation, what else should I know about the disease?

A: More than 70 percent of individuals in North America affected by arthritis are over the age of 65, however it can affect people of all ages. Arthritis is more common in women than men at all ages and affects all races, ethnic groups and cultures. Genetics, injury and weight also play a role.

Q: What are some risk factors or behaviors I can avoid to keep it from getting worse?

A: Neither rheumatoid arthritis nor osteoarthritis can be completely prevented; you can reduce the risks by becoming physically active while avoiding impact exercise. Instead, focus on low resistance muscle strengthening. Weight loss and a healthier diet may help as well.

Q: Sometimes my arthritis pain is too much to handle. What are some things I can do relieve pain at home quickly?

A: The best remedy for at home arthritis pain relief should be to ice the joint, take an over-the-counter pain reliever such as Tylenol and get plenty of rest. You may also want to try gently massaging the affected area as well.

Q: If I wanted to get rid of the pain for good, what are my options? Does joint replacement work?

A: There is no complete cure for arthritis other than joint replacement at this time. In fact, all other arthritis treatments are temporary whereas success rate for total knee and hip replacement is about 95 percent.