Arthritis Cost Double

The amount Americans spent on arthritis medications more than doubled between 1998 and 2003, due to the fast-rising number of people with the disease, increases in the number of medications they take each month and the inflation-adjusted cost per prescription, according to a new study led by a UCSF researcher. 

The study was performed in response to a growing concern about the escalating costs of arthritis care as the
U.S. population ages, according to Ed Yelin, PhD, a professor of rheumatology in the UCSF School of Medicine and lead author of the study. 

“Arthritis can be a highly debilitating disease that, as this study shows, presents a substantial cost to our society,” Yelin said. “We are also seeing a shift in the burden of that cost onto patients, who rely on Medicare to cover a large fraction of their inpatient care, but pay for a relatively larger share of their drug treatments from their own pockets.”From 1997 to 2003, the number of Americans with arthritis or other rheumatic conditions rose 25 percent, due to the aging
U.S. population, Yelin said, from 36.8 million adults to 46.1 million. Those numbers correspond to 18.7 percent and 21.5 percent of the population, respectively. 

During the same period, the cost of prescription drugs to treat the condition nearly doubled, from $897.60 per patient per year to $1,638, Yelin said. The change was due to both an increase in the mean number of prescriptions each patient received (from 18.7 per year to 25.2) and a rise in the cost of each prescription from $48 to $65, after adjusting for inflation. 

In 2003, employed adults with arthritis earned an average of $3,613 less than healthy working adults between the ages of 18 and 64. Nationwide, raw earnings losses due to arthritis totalled $108 billion, up from $99 billion in 1997. 

Exercise May Lower Risk For Parkinson’s Disease

The risk of developing Parkinson’s disease may be reduced with moderate to vigorous exercise or other recreational activities, according to recent research presented at the American Academy of Neurology’s 59th Annual Meeting in
Boston, April 28 — May 5, 2007.  The study followed more than 143,000 people with an average age of 63 over 10 years. In that time, 413 people developed Parkinson’s disease. Researchers found that those with moderate to vigorous activity levels were 40 percent less likely to develop Parkinson’s disease than those with no or light activity levels. Those with moderate to vigorous activity were exercising an average of a half hour per day or more.  “This study does not prove that exercise caused the lowered risk of Parkinson’s disease — it’s possible that something else lowers the risk,” said the study’s lead author Evan L. Thacker, SM, from the Harvard School of Public Health in
Boston, MA. “But considering all of the other benefits of exercise, it certainly doesn’t hurt to make sure you get some moderate or vigorous exercise several times a week.”

American Heart Association Recommends Doctors Change Approach

Many doctors should change the way they prescribe pain relievers for chronic pain in patients with or at risk for heart disease based on accumulated evidence that nonsteroidal anti-inflammatory drugs (NSAIDs), with the exception of aspirin, increase risk for heart attack and stroke, according to an American Heart Association statement published in Circulation: Journal of the American Heart Association.

“We believe that some physicians have been prescribing the new COX-2 inhibitors as the first line of treatment. We are turning that around and saying that, for chronic pain in patients with known heart disease or who are at risk for heart disease, these drugs should be the last line of treatment,” said Elliott M. Antman, M.D., FAHA, lead author of the American Heart Association scientific statement and Professor of Medicine at Harvard Medical School and Brigham and Women’s Hospital.

“We advise physicians to start with non-pharmacologic treatments such as physical therapy and exercise, weight loss to reduce stress on joints, and heat or cold therapy. If the non-pharmacologic approach does not provide enough pain relief or control of symptoms, we recommend a stepped-care approach when it comes to prescribing drugs,” he added.

Drugs in the NSAIDs class work by inhibiting cyclooxygenase (COX), an enzyme system that comes in two major forms: COX-1, which the body produces constantly in most tissues, and COX-2, produced during the body’s inflammatory response. Because COX-1 is also protective of the gastrointestinal (GI) tract, long-term use of drugs that suppress COX-1, such as aspirin, have been associated with gastrointestinal complications, including ulcers. “Selective” COX-2 inhibitors were developed to avoid the GI complications of traditional NSAIDs, not because they had advantages in terms of pain relief,

Antman explained. However, multiple studies have indicated an increased risk of cardiovascular disease (CVD) complications from COX-2 selective NSAIDS, particularly in patients with prior CVD or risk factors for CVD.

The scientific statement comes two years after the association released the last one on the issue. It was prompted, in part, by new analyses indicating that the increased cardiovascular risk associated with COX-2 selective NSAIDs may also extend to less selective traditional NSAIDs.

The statement includes details from a meta-analysis indicating that, compared with placebo, COX-2 selective drugs seem to increase the risk of a heart attack by about 86 percent. The statement also points out that two common NSAIDs traditionally thought of an non-selective – diclofenac and ibuprofen – appear to increase the relative risk of cardiovascular disease. In the last two years, the U.S. Food and Drug Administration (FDA) added warning statements to NSAIDs,

Cold Workouts

Research from the University of South Carolina suggests that regular exercise helps prevent the common cold. More than 500 volunteers averaging about 48 years of age reported to researchers their exercise habits and frequency of upper respiratory infections during this 12-month study. Those participants who did enough to meet the U.S.surgeon general’s minimum recommendations reported up to 32 percent fewer colds than the more sedentary subjects. Other studies suggest that the duration of the infection is somewhat shorter in regular exercisers, although suddenly changing your exercise habits when you contract a cold appears to have no effect.Diet, Exercise, Vitamins, Sleep, Water and a positive mental attitude are all important for HEALTH,

Thanks for reading, Dr Daniel Jacobsen.

Slipped Disc? (Herniated Disc)

The vertebrae (bones of the spine) protect the spinal cord.  Between each vertebrae (except C1-2) there are intervertebral discs, (shock absorber, cushions) discs between the vertebrae.  The bones above the and below the disc and the disc make up a hole (foramen) that a nerve from the spine, to the body, travels through. 

There are 31 pairs of spinal nerves.  The shock absorber discs allow the body to bend and twist freely, without injuring the delicate nerve tissue.The discs are made up of a thick Jell-O like substance known as the nucleus.  The nucleus is surrounded by a tough outer layer known as the annular ligament.

When discs are healthy, they act as shock absorbers for the spine, keeping the spine flexible. When discs are damaged by injury, disease or abnormal wear and tear, they may bulge or rupture, becoming a herniated disc (sometimes called a slipped or ruptured disc).

When a disc herniations it can cause inflammation, nerve irritation or direct nerve pressure.  Symptoms are usually back pain and/or nerve pain.  If the disc herniated in the lower back the pain may radiate into the groin, hip, leg or foot.  If the disc herniated in the neck it will usually radiate to the upper back, between the shoulder blades, chest, shoulder, arm and/or hand.As the condition progresses/worsens the spine pain may ease and the extremity, radiating pain may increase or change to numbness, tingling or a feeling of pins and needles.  This is a sign that the problem is getting worse not better.

A herniated disk is not visible on an x-ray.  A herniated disk is best diagnosed on an MRI.  The disc is measured in millimeters and direction.  The most important information gained from an MRI is the amount if any of direct nerve or spine compression and the degree of herniation or fragmentation of the disc.

The majority of small disc herniations (80-90%) are successfully resolved with conservative care.  7-10% require a more aggressive intervention.  Of the 7- 10% that undergo surgery almost 50% of those do not fare any better than the ones that do not have surgery.

My personal experience of the small disc herniations that are not successfully resolves with conservative care are a result of multiple or repetitive injuries, lack of patient compliance with their home therapy or other complications such as diabetes, osteoarthritis and obesity. 

Fish Oil Alzheimer’s and Dementia

The compound found in fish, docosahexaenoic acid (DHA) seems to help the central nervous system function properly, allowing the body to stave off dementia. It is produced when the liver processes alpha-linolenic acid, a type of omega-3 fatty acid found primarily in fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna and salmon. “In our study, the correlation between blood DHA content and fish intake was significant,” write the study authors from the Human Nutrition Research Center on Aging at Tufts University in Boston in the Archives of Neurology,. “indicating that fish intake is an important source of dietary DHA.” For the study, researchers looked at the blood levels of DHA and dementia rates for almost 900 men and women who were involved in the Framingham Heart Study.

The participants had an average age of 76 at the beginning of the study were followed for nine years. While none of the participants had dementia at the beginning of the study, 99 ultimately developed some form of it, with 71 being diagnosed with Alzheimer’s disease. Alzheimer’s disease is known to cause about 70 percent of dementia cases in the elderly. However, those men and women who had the highest blood levels of DHA throughout the study, had a 47 percent lower risk of developing dementia and a 39 percent lower risk of developing Alzheimer’s disease than those who had lower DHA levels. Moreover, those with the lowest risk of dementia reported eating an average of three servings of fish a week. The researchers suggest, therefore, that increased fish intake can help to prevent age-related dementia. 

You can buy pharmaceutical grade, ultra refined Omega Fish oil from My web site or if you’re in
Beverly Hills stop by the office.  Thank you for reading my blog.