Better get a receipt from the IRS when you do something good.

Heaven might be just like that agency.

JAMA NOTES

1.         26 March 2019 Volume321 Number 12  Page1146

FOOD ALLERGIES: NOT JUST KID’S STUFF

Rita Rubin MA

This is a synopsis of an article by Ruchi Gupta MD MPH discussing the idea that even though we most often think of food allergies affecting children, that in reality it is just as serious a  problem when some are not afflicted until they become adults.  He suggests that the old argument over “nature vs. nurture” inherited versus environmentally caused, (think climate change, food intake or behavior patterns), may be as significant.   It appears that Dr. Gupta thinks that it is important that each new case be thoroughly evaluated to avoid people unnecessarily removing various dietary choices.

DMARDS AND BRM’S

Today is the last in the series of discussions about the autoimmune disorders, particularly Rheumatoid Arthritis. Almost all of the compounds discussed previously, appear to work by attacking the symptoms of the problem such as the progression of joint erosion and or pain, swell etc.  The DMARDS (Disease  Modifying Anti-Rheumatic Drugs), also some known as  BRM’s ( Biologic Response  Modifiers) approach the problem by attempting to STOP or at least slow down the progression of the problem .The DMARDS and other biologics have been so successful that their use has spread, to the benefit of the patient.

The results being achieved differ by compound. However, the bottom line is that they appear to be working.  Unfortunately like almost all newer meds that come to market there are downsides and drawbacks. Some require injection administration. Some have to be taken daily. Some are used monthly, and some have severe side effects such as nausea, vomiting pain etc.  For these reasons, there is no “ONE SIZE FITS ALL”.Following is a list of some of these pharmaceuticals.. Please note that some are older, and have more detailed classifications, and those ending in “mab” appear to have similar mechanisms of actions.  It is beyond the scope of this piece to be more specific and the reader is referred as always to his/her own medical provider.

Chemical name                                                 Retail name

hydroxychloroquine                                                      Plaquennil

leftunomide                                                                   Arava

methotrexate                                                                 Trexall

sulfasalazine                                                                  Azulidine

minocycline                                                                   Minocine

abatocept                                                                     Orencia

rituximab                                                                      Rituxan

tocioizumab                                                                  Actemra

anakinra                                                                       Kineret

adalimmab                                                                    Humira

etanercept                                                                    Embrel

infliximab                                                                      Remicade

certolizumab     pegol                                         Cimzia

gulimumab                                                               Simponi

This concludes the coverage on the Auto Immune maladies. Next week starts a sharing of notes from the Journal of the American Medical Society. (JAMA.)                                                                     

Consider this……….

Even if you think your kid is a genius, YOU might still be an idiot !

SMILE

NSAIDS Said What ?

The NSAIDS

The medical field loves acronyms as you may have already noticed.   Drugs, medicines, pharmaceuticals are notorious in this respect. This next group of drugs follows the pattern and the letters NSAIDS  stand for NON STEROIDAL ANTI-INFLAMMATORY DRUGS. They are almost miraculous in decreasing inflammation and with that goes pain and swelling in most instances. They are so good at what they do, that they are often thought to be harmless by the public. They are not.

The main problem is that some people cannot tolerate these chemicals in any amount and others run into problems with long term or high dose use.  I have seen these problems most often in patients hospitalized with acute kidney failure.  These drugs have also been known to cause liver failure.  They do best in calming symptoms but are not known to alter the course of the RA.  Examples of NSAIDS are: Ibuprofen (Advil, Motrin), Naproxen(Aleve, Anaprox, Naprosyn), Celecoxib (Celebrex), Indomethacin( (Indocin), Diclofenac (Voltaren-xr), and Piroxicom ( Feldene). Are you taking one of these?……tell me about it.

Next up. Dmards and biologics…….stay tuned.  Talk to me  .Dr. M Listens .

Happy holidays to all. I hope this is the beginning of a good year. I am returning to continue the discussion about Rheumatoid Arthritis. I have been slow in doing this due to discouragement over the lack of a response from anyone to date. It has not been my intention to pontificate about things medical that are of no interest to any one. The entire idea of this site is for inter-active comments or questions. After all, I can’t nor wish to try to out do any of the sources for information now available online.

Today I will however continue about the pharmeuticacl that have been used for RA. Today’s topic are the SALICYCLATES. Subsequent POSTS will cover the NSAIDS, DMARDS AND BIOLOGICS

The SALICYLATES.

The MOST commonly known product of this group is Acetyl Salicylate Acid (ASA) and the most commonly known brand name for this is a product called ASPIRIN. One should know that ASPIRIN is actually the registered trade name from the company called BAYER. It is so well known by this company that people just speak and think of all products with this formulation as ASPIRIN.

These drugs are known for their ability to subdue pain and to decrease fevers. They have been used for so long in so many maladies that many think they can cure any ill. They do not. ASPIRIN does   help to lower temperatures temporarily. and is known as an analgesic. It is not known known to help in sleeping. Those drugs are called anesthetics. The kind used to put one to sleep in surgery. Salicylates have been around for a long time and were often the initial drugs used in RA. These can usually be purchased in any pharmacy or even grocery store under the store name as Acetyl Salicylate. They seems to be most helpful in the early stages of RA but do nothing to alter the progression of the disorder.

.

Happy Holiday and the best of the season’s greetings. May the Coining New Year bring all you wish..

From all of us at Thoughts-n-things……..!!

SMILE

The one who reads is the one who leads

Rheumatoid Arthritis

Out of over 1 million people there are probably more women than men who succumb to this disorder. Unfortunately this often occurs as early as 30 years of age. Years ago in  the natural progression  eventually mobility was lost and deformity occurred mainly in the hands .  In fact,a severely affected individual could even today be readily diagnosed by anyone by looking at the hands. The tendons and ligaments become inflamed and the cartilage and bone is destroyed.

What is unique is that BOTH sides of the body are affected in contrast to the condition known as osteoarthritis in which often only one side is abnormal. In fact, I have heard some colleagues say that if you DON’T see bilateral signs, think of something else!. The hands , wrists and feet are the most commonly affected areas. Sometimes in advanced cases the internal organs are also

Today there is GOOD news, technology and medications have changed the prognosis. Some of the newer pharmaceuticals have done wonders and problems such as erosion and disability are not as prominent. In the next posts, I will share with you information about some of these newer meds.  Stay tuned.

So-o-o if you have concerns about you own joint issues or that of others……talk to me……Dr. M. Listens….Leave a comment.

Driving advice………When driving, forget about World Peace….Next time use the turn signal