Category Archives: increased risk

Are you at risk for the complications due to ankylosing spondylitis? Discover what they are…

Ankylosing spondylitis (AS) is an inflammatory form of arthritis that preferentially attacks the spine.  Many people are under the impression it’s one of the less serious forms of arthritis. Uh-uh.  Unfortunately, it has a number of potential complications associated with it.  These include:

  1. Acute eye inflammation, termed “uveitis”, in one-third of patients.  Symptoms include pain, redness, blurred vision, light sensitivity, and if left untreated, blindness.
  2. Osteoporosis occurring in a significant number of patients.  This is a condition where the bones become brittle and more likely to fracture.
  3. Approximately 10-15% of patients have inflammatory bowel disease such as Crohn’s or ulcerative colitis.
  4. Skin involvement occurs in as many as a quarter of patients.  The most common skin condition is psoriasis.
  5. AS can lead to conduction abnormalities in the heart as well as inflammation of the aorta.
  6. Fibrosis of the lungs can cause restrictive lung disease.
  7. Neurologic complications are due to compression of the spinal cord and can be life-threatening.
  8. Long term ankylosing spondylitis can cause a condition called amyloidosis of the kidneys leading to kidney failure.

Comment: Not such a benign condition is it?

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More deaths from painkillers

Scott Glover and Lisa Girion writing in the Los Angeles Times reported that despite efforts “by law enforcement and public health officials to curb prescription drug abuse, drug-related deaths in the United States have continued oxycontinto rise, the latest data show.”

CDC data “reveal that drug fatalities increased 3% in 2010, the most recent year for which complete data are available. Preliminary data for 2011 indicate the trend has continued. The figures reflect all drug deaths, but the increase was propelled largely by prescription painkillers such as OxyContin and Vicodin, according to just-released analyses by CDC researchers.”

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Fish oil builds strength

A study published in the American Journal of Clinical Nutrition looked at 45 women (average age 64) who completed a 90 day strength training program.

fish-oil-capsules One group was randomized to strength training only;  one group  had strength training plus 2 grams of fish oil daily during training; and one group had strength training plus 2 grams of fish oil daily during and for 60 days before training. All three groups had improved strength but the two fish oil groups had significantly more gains in strength than the strength training group only.

So fish oil is not just good for arthritis and the heart; it’ll make you strong too!

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Epidural steroid injections for arthritis… another risk

One of the most common problems seen in clinical rheumatology practice is low back pain related to osteoarthritis.  Many of us rheumatologists do epidural injections for patients with spinal arthritis, particularly when patients have spinal stenosis.

As you can imagine there has been a furor over recent reported of fungal, meningitis related to tainted steroid preparations.  The New York Times reported “that more people may be at risk from contaminated drugs” produced by the “company linked to a growing meningitis outbreak.” The FDA also said that products from the New England Compounding Center in Framingham, Massachusetts, “may have also caused other types of infections in patients who have had eye operations or open-heart surgery.”

Fortunately, our practice does not use a compounding pharmacy as a source for injectable steroids.

This is a terrible occurrence, and is one that should remind us all about the risks of medical therapies.

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RA patients shouldn’t stop statins

A study published in the journal Arthritis Care & Research found that RA patients who stopped their statins had a  60% increased risk of dying from heart disease and a 79% risk of dying from all causes compared with RA patients who continued statins.

According to the study authors, even quitting for a short period of time- a few months- increased risk of death.

I’ve had so many patients who have had side effects with these drugs and they ask about stopping them.  This certainly gives pause to that notion.

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Joint replacement surgery associated with heart attack risk

Jim Morelli writing in Arthritis Today commented on a new study published in the Archives of Internal Medicine.

joint-replacement-surgery“We found that total hip and knee replacements substantially increase the risk of heart attack during the first two weeks, in particular in patients older than 60,” says lead study author Arief Lalmohamed, a researcher in the department of pharmaceutical sciences at Utrecht University in the Netherlands. “We learned from this study that we need to focus more on preventing cardiac outcomes following this major surgery.”

The study relied on national registry data on about 95,000 Danish patients who underwent total hip replacement or total knee replacement surgeries between 1998 and 2007. The average age of the hip patients was 72, while the average age of the knee patients was 67. The researchers found that during the two weeks immediately following each surgery, heart attack risk rose sharply – 25-fold for heart-attack-in-hospitalhip patients and 31-fold for knee patients, compared with similar people in the Danish registries who did not have these surgeries.

After two weeks, heart attack risk dropped dramatically – although the overall risk of heart attack after hip replacement surgery remained elevated for six weeks. Researchers also found that the association between hip and knee replacement surgeries and heart attack was strongest in those 80 years or older. They found no significantly increased risk in patients younger than 60.

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