- Psychiatric disorders may precede MS diagnosis
- Non-drug therapies are more effective in combating MS-related fatigue
- Reasons why people with MS fall more frequently
- Other studies of interest
Hot Topics and MS Research News for October 2014
Tuesday, October 28, 2014
October 2014 Round-Up of MS News and Research
Hot Topics and MS Research News for October 2014
Sunday, October 26, 2014
Early Signs of RA
Fatigue. One of the most common symptoms of several
autoimmune diseases is fatigue; RA is no exception. You may experience
fatigue before any other symptoms become obvious. In a 2013 survey of
more than 1,000 RA patients in the U.S. (conducted by HealthUnion),
fatigue was exceeded only by hand/wrist pain as one of the most
significant initial symptoms of RA in 56.3 percent and 69.6 percent of
survey respondents, respectively.
Morning stiffness. People with RA often experience early morning stiffness that lasts for hours. Stiffness may also occur throughout the day following periods of stillness or inactivity. Osteoarthritis may also cause morning stiffness; however, it will usually last 30 minutes or less.
Joint swelling and tenderness. Mild inflammation which accompanies stiffness may cause joints to appear larger than normal. The inflammation and swelling may also make joints feel warm to the touch and appear red. However, joint swelling may be so subtle as to make it difficult to identify, especially in obese patients.
Joint pain. The pain of early RA frequently involves specific joints of the hands or feet, including the metacarpophalangeal joint (MCP) at the base of each finger, the proximal interphalangeal joint (PIP), or the metatarsophalangeal joint (MTP) at the base of each toe. Keep in mind, however, that early RA pain is not limited to the hands and feet; larger joints may be involved.
Decreased range of motion, numbness, or reduced grip strength. Inflammation can affect tendons and ligaments as well as synovium, restricting range of motion, fluidity of motion, or physical function. Inflamed tendons may put pressure on nerves leading to numbness or weakness. In the 2013 survey mentioned above, 39.9 percent of respondents included reduced grip strength as an early symptom of RA, while 32.7 percent noted general weakness.
Low-grade fever. Often accompanied by general malaise, and in the presence of other symptoms, a low-grade fever may be an early warning sign of RA or a flare-up. However, a temperature above 100°F (38°C) is more likely to signal some other illness or, possibly, an infection.
Abnormal laboratory results. Studies show that anti-cyclic citrullinated peptide (anti-CCP) antibodies may be detected in healthy individuals years before the clinical onset of RA. Most, but not all, people with RA test positive for rheumatoid factor (RF). Nonspecific inflammatory markers, such as erythrocyte sedimentation rate (ESR or sed rate) or C-reactive protein (CRP), are often elevated, but test within normal ranges in about 60 percent of patients with early RA. Additional abnormal blood tests may include high platelet count, low albumin, raised alkaline phosphatase (a liver enzyme), or normocytic-normochromic anemia.
Firm lumps of tissue located under the skin. Rheumatoid nodules tend to grow close to joints affected by RA, such as elbows or wrists. They may be as small as a pea or grow to the size of a walnut. Nodules can also form on vocal cords, or appear in the lungs, heart or other organs.
Extra-articular symptoms. Patients with early RA may develop vasculitis, inflammation of the blood vessels, or serositis, which involves inflammation of the tissue lining the lungs (pleura), heart (pericardium), or inner lining of the abdomen (peritoneum). Pleurisy (inflammation of the lungs) can cause chest pain when you breathe.
Read this post in its entirety:
What are Early Signs of Rheumatoid Arthritis?
Morning stiffness. People with RA often experience early morning stiffness that lasts for hours. Stiffness may also occur throughout the day following periods of stillness or inactivity. Osteoarthritis may also cause morning stiffness; however, it will usually last 30 minutes or less.
Joint swelling and tenderness. Mild inflammation which accompanies stiffness may cause joints to appear larger than normal. The inflammation and swelling may also make joints feel warm to the touch and appear red. However, joint swelling may be so subtle as to make it difficult to identify, especially in obese patients.
Joint pain. The pain of early RA frequently involves specific joints of the hands or feet, including the metacarpophalangeal joint (MCP) at the base of each finger, the proximal interphalangeal joint (PIP), or the metatarsophalangeal joint (MTP) at the base of each toe. Keep in mind, however, that early RA pain is not limited to the hands and feet; larger joints may be involved.
Decreased range of motion, numbness, or reduced grip strength. Inflammation can affect tendons and ligaments as well as synovium, restricting range of motion, fluidity of motion, or physical function. Inflamed tendons may put pressure on nerves leading to numbness or weakness. In the 2013 survey mentioned above, 39.9 percent of respondents included reduced grip strength as an early symptom of RA, while 32.7 percent noted general weakness.
Low-grade fever. Often accompanied by general malaise, and in the presence of other symptoms, a low-grade fever may be an early warning sign of RA or a flare-up. However, a temperature above 100°F (38°C) is more likely to signal some other illness or, possibly, an infection.
Abnormal laboratory results. Studies show that anti-cyclic citrullinated peptide (anti-CCP) antibodies may be detected in healthy individuals years before the clinical onset of RA. Most, but not all, people with RA test positive for rheumatoid factor (RF). Nonspecific inflammatory markers, such as erythrocyte sedimentation rate (ESR or sed rate) or C-reactive protein (CRP), are often elevated, but test within normal ranges in about 60 percent of patients with early RA. Additional abnormal blood tests may include high platelet count, low albumin, raised alkaline phosphatase (a liver enzyme), or normocytic-normochromic anemia.
Firm lumps of tissue located under the skin. Rheumatoid nodules tend to grow close to joints affected by RA, such as elbows or wrists. They may be as small as a pea or grow to the size of a walnut. Nodules can also form on vocal cords, or appear in the lungs, heart or other organs.
Extra-articular symptoms. Patients with early RA may develop vasculitis, inflammation of the blood vessels, or serositis, which involves inflammation of the tissue lining the lungs (pleura), heart (pericardium), or inner lining of the abdomen (peritoneum). Pleurisy (inflammation of the lungs) can cause chest pain when you breathe.
Read this post in its entirety:
What are Early Signs of Rheumatoid Arthritis?
Friday, October 24, 2014
Nicotine May Improve MS Symptoms, Research in Mice Demonstrates
We know that cigarette smoking is bad for our health. The Centers for Disease Control and Prevention (CDC) states that more than 16 million Americans suffer from a disease caused by smoking,
such as cancer, heart disease, stroke, lung diseases, or diabetes. In
the United States, cigarette smoking is responsible for more than
480,000 deaths per year, including an estimated 41,000 deaths in persons
exposed to secondhand smoke. Worldwide, tobacco use kills more than 5
million people annually with numbers growing each year.
Epidemiological studies have reported that cigarette smoking increases the risk of developing multiple sclerosis and accelerates disease progression (Sundstrom, 2008). A recent study demonstrated that in a large population of MS patients in England, current smoking behavior was associated with more than 2.5-fold increased risk of death. In addition, the life expectancy of current smokers with MS was reduced by about 10 years as compared to non-smokers with MS (Manouchehrinia, 2014).
It is logical that smokers who understand the increased risk of tobacco would want to do what they can to limit their exposure to nicotine or other harmful chemicals while smoking. Hence the tobacco industry has developed “reduced exposure” or “light” products containing lower levels of nicotine, nitrosamines, or other chemicals deemed to be potentially toxic. However, these ultralow nicotine or tobacco-free cigarettes may be worse than their full flavor versions.
Researchers comparing the effects of exposure to full flavor, nicotine-free, or ultralow nicotine products on the integrity of the blood-brain-barrier (BBB) found that nicotine-free and ultralow nicotine cigarettes are potentially more harmful to the BBB endothelium than regular tobacco products. This study demonstrates that the detrimental effect of tobacco smoke on the BBB is strongly correlated to the tar and nitric oxide levels in the cigarettes rather than the nicotine content (Naik, 2014).
Meanwhile, a different team of researchers have assessed the effects of nicotine and non-nicotine components of cigarette smoke on experimental autoimmune encephalomyelitis (EAE), a form of MS induced in mice. They found that nicotine significantly improved the severity of EAE, as shown by reduced demyelination, increased body weight, and attenuated microglial activation. Nicotine administration after the development of EAE symptoms prevented further disease exacerbation, suggesting that it might be useful as an EAE/MS therapeutic agent (Gao, 2014).
Read this post in its entirety:
Could Nicotine Be Used to Treat MS Someday?
Epidemiological studies have reported that cigarette smoking increases the risk of developing multiple sclerosis and accelerates disease progression (Sundstrom, 2008). A recent study demonstrated that in a large population of MS patients in England, current smoking behavior was associated with more than 2.5-fold increased risk of death. In addition, the life expectancy of current smokers with MS was reduced by about 10 years as compared to non-smokers with MS (Manouchehrinia, 2014).
It is logical that smokers who understand the increased risk of tobacco would want to do what they can to limit their exposure to nicotine or other harmful chemicals while smoking. Hence the tobacco industry has developed “reduced exposure” or “light” products containing lower levels of nicotine, nitrosamines, or other chemicals deemed to be potentially toxic. However, these ultralow nicotine or tobacco-free cigarettes may be worse than their full flavor versions.
Researchers comparing the effects of exposure to full flavor, nicotine-free, or ultralow nicotine products on the integrity of the blood-brain-barrier (BBB) found that nicotine-free and ultralow nicotine cigarettes are potentially more harmful to the BBB endothelium than regular tobacco products. This study demonstrates that the detrimental effect of tobacco smoke on the BBB is strongly correlated to the tar and nitric oxide levels in the cigarettes rather than the nicotine content (Naik, 2014).
Meanwhile, a different team of researchers have assessed the effects of nicotine and non-nicotine components of cigarette smoke on experimental autoimmune encephalomyelitis (EAE), a form of MS induced in mice. They found that nicotine significantly improved the severity of EAE, as shown by reduced demyelination, increased body weight, and attenuated microglial activation. Nicotine administration after the development of EAE symptoms prevented further disease exacerbation, suggesting that it might be useful as an EAE/MS therapeutic agent (Gao, 2014).
Read this post in its entirety:
Could Nicotine Be Used to Treat MS Someday?
Monday, October 13, 2014
I Hate "Good Enough"
Growing up, I learned several things: take care and pride in the
things that you do, pay attention to details, follow established or
recommended procedures, but be creative and flexible enough to find more
efficient and effective ways of accomplishing tasks. In other words,
don’t expect things to just happen on their own and be willing to
improve upon past efforts.
Each of us have responsibilities and must take an active role in the world around us. No matter what that role is, it’s nice when everybody is able to do their best and helps to make things work well together. But sometimes, aiming for “your best” can lead to a distraction called perfectionism.
I have to admit that I’m somewhat of a perfectionist, in an all or nothing sort of way. It’s always been difficult for me to accept something as being satisfactory, good enough, or almost right. And when I do make a conscious decision to simply do what needs to be done, and no more, I find it challenging when others around me may want to go back to the planning stages and do the work over again. Argh, once I’ve let something go, physically and emotionally, I don’t want to revisit it.
But one thing which I’ve had a really hard time learning to accept is the concept of good enough. When living with chronic disease, sometimes you don’t have the luxury of spending tons of energy perfecting every little detail. Sometimes you just have to simply ensure that things are okay, safe, or clean.
In my previous life, when I used to live alone, I was entirely responsible for everything that happened at home. If the floor needed to be vacuumed, I did it. I even moved light furniture so that I could run the vacuum wand along the floorboards to remove the cat-fur dust bunnies before they grew to adulthood. A bit of prevention helped to keep things from getting out of control.
If the dishes needed to be washed, I did them by hand and scrubbed every metal surface till it shined. If the cat became unsatisfied with the condition of his litter box, he was not shy about letting me know by doing his business on the floor of the bathroom. In that case, I needed to focus more on the prevention stage. Although I was swamped with graduate classes, working two library jobs, and performing in at least four ensembles, I was able to stay on top of routine household chores most of the time.
Now that there are three of us in the house, in addition to our three loving fur babies, and I do not need to do everything all on my own, it seems that nothing is quite as clean as it used to be. Items are often not where I left them and there’s always a pile of dishes to be cleaned.
Face it, I no longer live alone, nor do I have complete control over my surroundings which I’ve come to accept. But that’s not all, I also don’t live alone in more ways than one. My roommates now include multiple sclerosis and rheumatoid arthritis.
These roommates, MS and RA, are messy slobs. They don’t do their own laundry, nor do they sleep when I’m tired or get out of the way when I’m busy working. But these roommates are doing their darndest to teach me patience, to teach me how to accept “good enough” when it really is enough, and to learn how to appreciate imperfections. It makes me appreciate a freshly washed countertop, or a pile of clean laundry which I didn’t have to fold myself, all the more.
What types of things have you learned, or are learning, to accept after living with chronic illness for any period of time? Please share your stories in the comments section below.
Read this post in its entirety:
Acceptance: A Tough Lesson to Learn
Each of us have responsibilities and must take an active role in the world around us. No matter what that role is, it’s nice when everybody is able to do their best and helps to make things work well together. But sometimes, aiming for “your best” can lead to a distraction called perfectionism.
I have to admit that I’m somewhat of a perfectionist, in an all or nothing sort of way. It’s always been difficult for me to accept something as being satisfactory, good enough, or almost right. And when I do make a conscious decision to simply do what needs to be done, and no more, I find it challenging when others around me may want to go back to the planning stages and do the work over again. Argh, once I’ve let something go, physically and emotionally, I don’t want to revisit it.
But one thing which I’ve had a really hard time learning to accept is the concept of good enough. When living with chronic disease, sometimes you don’t have the luxury of spending tons of energy perfecting every little detail. Sometimes you just have to simply ensure that things are okay, safe, or clean.
In my previous life, when I used to live alone, I was entirely responsible for everything that happened at home. If the floor needed to be vacuumed, I did it. I even moved light furniture so that I could run the vacuum wand along the floorboards to remove the cat-fur dust bunnies before they grew to adulthood. A bit of prevention helped to keep things from getting out of control.
If the dishes needed to be washed, I did them by hand and scrubbed every metal surface till it shined. If the cat became unsatisfied with the condition of his litter box, he was not shy about letting me know by doing his business on the floor of the bathroom. In that case, I needed to focus more on the prevention stage. Although I was swamped with graduate classes, working two library jobs, and performing in at least four ensembles, I was able to stay on top of routine household chores most of the time.
Now that there are three of us in the house, in addition to our three loving fur babies, and I do not need to do everything all on my own, it seems that nothing is quite as clean as it used to be. Items are often not where I left them and there’s always a pile of dishes to be cleaned.
Face it, I no longer live alone, nor do I have complete control over my surroundings which I’ve come to accept. But that’s not all, I also don’t live alone in more ways than one. My roommates now include multiple sclerosis and rheumatoid arthritis.
These roommates, MS and RA, are messy slobs. They don’t do their own laundry, nor do they sleep when I’m tired or get out of the way when I’m busy working. But these roommates are doing their darndest to teach me patience, to teach me how to accept “good enough” when it really is enough, and to learn how to appreciate imperfections. It makes me appreciate a freshly washed countertop, or a pile of clean laundry which I didn’t have to fold myself, all the more.
What types of things have you learned, or are learning, to accept after living with chronic illness for any period of time? Please share your stories in the comments section below.
Read this post in its entirety:
Acceptance: A Tough Lesson to Learn
Friday, October 10, 2014
Trigger Finger and RA
Trigger finger (also called stenosing tenosynovitis or stenosing
tendovaginitis) is a painful condition in which a finger or thumb
becomes “locked” in place after it has been flexed. There may be
clicking, popping, or a catching sensation in the affected finger, which
becomes difficult to straighten without assistance. Some patients may
experience stiffness and reduced motion without the characteristic
catching or locking.
Stenosing tendovaginitis (i.e., narrowing inflammation of the tendon sheath) can affect any of 23 extrinsic tendons that power the wrist and hand. However, trigger finger most commonly affects the little finger, ring finger, or thumb. Additional symptoms include a bump or lump (nodule) at the base of a finger near the palm, tenderness, or lingering soreness at the base of a finger or thumb.
What causes trigger finger?
Trigger finger is caused by inflammation and/or hypertrophy (enlargement) of the tendon sheath. This inflammation narrows the space in the tendon sheath, which acts like a tunnel through which the tendon glides, and progressively restricts the motion of the flexor tendon passing through the wrist or hand.
A tendon is the strong tissue that attaches muscle to bone and helps us move parts of our body. When a muscle in the forearm contracts and pulls on the tendon attached to a finger, it causes that finger to bend (flex). A tendon which travels through a narrowed sheath may be able to move in one direction but be unable to slide back into its original, neutral position. This causes the finger to remain in a flexed position.
Who gets trigger finger?
Although anyone can develop trigger finger, it occurs more frequently in women than men (4:1 ratio), especially in women over the age of 40, and in people diagnosed with diabetes, rheumatoid arthritis, hypothyroidism, amyloidosis, or carpal tunnel syndrome. More than 65% of patients with rheumatoid arthritis will develop some form of tenosynovitis of the hand or wrist (Skirven, 2011).
Research shows increased risk of developing problems with tendons in the hand and wrist in people who perform highly repetitive and forceful jobs. For example, musicians, such as piano players and guitarists, exert significant stress on multiple tendons in the wrist and fingers. They are prone to developing tendonitis, especially if they dramatically increase their practice time (Amadio, 1990), and are at risk for developing trigger finger.
Read this post in its entirety:
Trigger Finger: A Complication of RA and Diabetes
Stenosing tendovaginitis (i.e., narrowing inflammation of the tendon sheath) can affect any of 23 extrinsic tendons that power the wrist and hand. However, trigger finger most commonly affects the little finger, ring finger, or thumb. Additional symptoms include a bump or lump (nodule) at the base of a finger near the palm, tenderness, or lingering soreness at the base of a finger or thumb.
What causes trigger finger?
Trigger finger is caused by inflammation and/or hypertrophy (enlargement) of the tendon sheath. This inflammation narrows the space in the tendon sheath, which acts like a tunnel through which the tendon glides, and progressively restricts the motion of the flexor tendon passing through the wrist or hand.
A tendon is the strong tissue that attaches muscle to bone and helps us move parts of our body. When a muscle in the forearm contracts and pulls on the tendon attached to a finger, it causes that finger to bend (flex). A tendon which travels through a narrowed sheath may be able to move in one direction but be unable to slide back into its original, neutral position. This causes the finger to remain in a flexed position.
Who gets trigger finger?
Although anyone can develop trigger finger, it occurs more frequently in women than men (4:1 ratio), especially in women over the age of 40, and in people diagnosed with diabetes, rheumatoid arthritis, hypothyroidism, amyloidosis, or carpal tunnel syndrome. More than 65% of patients with rheumatoid arthritis will develop some form of tenosynovitis of the hand or wrist (Skirven, 2011).
Research shows increased risk of developing problems with tendons in the hand and wrist in people who perform highly repetitive and forceful jobs. For example, musicians, such as piano players and guitarists, exert significant stress on multiple tendons in the wrist and fingers. They are prone to developing tendonitis, especially if they dramatically increase their practice time (Amadio, 1990), and are at risk for developing trigger finger.
Read this post in its entirety:
Trigger Finger: A Complication of RA and Diabetes
Thursday, October 2, 2014
Carnival of MS Bloggers #160
Welcome to the Carnival of MS Bloggers, a monthly compendium of thoughts and experiences shared by those living with multiple sclerosis.
by Lisa Emrich
Each of us have responsibilities and must take an active role in the world around us. No matter what that role is, it’s nice when everybody is able to do their best and helps to make things work well together. But sometimes, aiming for “your best” can lead to a distraction called perfectionism.
I have to admit that I’m somewhat of a perfectionist, in an all or nothing sort of way. It’s always been difficult for me to accept something as being satisfactory, good enough, or almost right. And when I do make a conscious decision to simply do what needs to be done, and no more, I find it challenging when others around me may want to go back to the planning stages and do the work over again. Argh, once I’ve let something go, physically and emotionally, I don’t want to revisit it.
But one thing which I’ve had a really hard time learning to accept is the concept of good enough. When living with chronic disease, sometimes you don’t have the luxury of spending tons of energy perfecting every little detail. Sometimes you just have to simply ensure that things are okay, safe, or clean.
In my previous life, when I used to live alone, I was entirely responsible for everything that happened at home. If the floor needed to be vacuumed, I did it. I even moved light furniture so that I could run the vacuum wand along the floorboards to remove the cat-fur dust bunnies before they grew to adulthood. A bit of prevention helped to keep things from getting out of control.
If the dishes needed to be washed, I did them by hand and scrubbed every metal surface till it shined. If the cat became unsatisfied with the condition of his litter box, he was not shy about letting me know by doing his business on the floor of the bathroom. In that case, I needed to focus more on the prevention stage. Although I was swamped with graduate classes, working two library jobs, and performing in at least four ensembles, I was able to stay on top of routine household chores most of the time.
Face it, I no longer live alone, nor do I have complete control over my surroundings which I’ve come to accept. But that’s not all, I also don’t live alone in more ways than one. My roommates now include multiple sclerosis and rheumatoid arthritis.
These roommates, MS and RA, are messy slobs. They don’t do their own laundry, nor do they sleep when I’m tired or get out of the way when I’m busy working. But these roommates are doing their darndest to teach me patience, to teach me how to accept “good enough” when it really is enough, and to learn how to appreciate imperfections. It makes me appreciate a freshly washed countertop, or a pile of clean laundry which I didn’t have to fold myself, all the more.
What types of things have you learned, or are learning, to accept after living with chronic illness for any period of time? Please share your stories in the comments section below.
This concludes the 160th edition of the Carnival. The next Carnival of MS Bloggers will be hosted here on November 6, 2014. Please remember to submit a post (via email) from your blog of which you are particularly proud, or which you simply want to share, by noon on Tuesday, November 4, 2014.
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