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Ailmemts & Remedies

Pseudogout

Definition:
Pseudogout is a form of arthritis that occurs when a particular type of calcium crystal accumulates in the joints. As more of these crystals are deposited in the affected joint, they can cause a reaction that leads to severe pain and swelling. The swelling can be either short-term or long-term and occurs most frequently in the knee, although it can also affect the wrist, shoulder, ankle, elbow, or hand. The pain caused by pseudogout is sometimes so excruciating that it can incapacitate someone for days.

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It is a type of arthritis that, as the name implies, can cause symptoms similar to gout, but in reaction to a different type of crystal deposit.

As its name suggests, the symptoms of pseudogout are similar to those of gout (see “Gout“). Pseudogout can also resemble osteoarthritis or rheumatoid arthritis. A correct diagnosis is vital, as untreated pseudogout can lead to joint degeneration and osteoarthritis. Pseudogout is most common in the elderly, occurring in about 3% of people in their 60s and as many as half of people in their 90s.

Causes:
The cause of this condition is unknown. Because risk increases significantly with age, it is possible that the physical and chemical changes that accompany aging increase susceptibility to pseudogout.

Pseudogout develops when deposits of calcium pyrophosphate crystals accumulate in a joint. Crystals deposit first in the cartilage and can damage the cartilage. The crystals also can cause a reaction with inflammation that leads to joint pain and swelling. In most cases it is not known why the crystals form, although crystal deposits clearly increase with age. Because the condition sometimes runs in families, genetic factors are suspected of contributing to the disorder as can a severely underactive thyroid (hypothyroidism), excess iron storage (hemochromatosis), low magnesium levels in blood, an overactive parathyroid gland, and other causes of excessive calcium in the blood (hypercalcemia).

CLICK TO SEE THE PICTURES.>..(1).…...(2).……....(3).……….

Pseudogout also can be triggered by joint injury, such as joint surgery or a sprain, or the stress of a medical illness. If the underlying condition causing pseudogout can be identified and treated, it may be possible to prevent future attacks. Frequently, however, there is no identifiable trigger; in those cases there is no way to prevent pseudogout from recurring.


Who gets pseudogou

The calcium crystal deposits seen in pseudogout affect about 3 percent of people in their 60s and as many as 50 percent of people in their 90s. Any kind of insult to the joint can trigger the release of the calcium crystals, inducing a painful inflammatory response. Attacks of pseudogout also can develop following joint surgery or other surgery. However, not everyone will experience severe attacks.

Symptoms:
* pain, swelling, and stiffness around a single joint
* occasionally, more then one joint affected at a time
* fever, usually low-grade

Diagnosis:

It may be difficult to diagnose pseudogout because it shares so many symptoms with gout, infection, and other causes of joint inflammation. In fact, pseudogout often occurs in people with other joint problems, such as osteoarthritis. Therefore, even when pseudogout is correctly identified, it is important to investigate whether there are other conditions present as well.

Diagnosis is to be done on the basis of symptoms and medical tests. The physician will use a needle to take fluid from a swollen or painful joint to determine whether calcium pyrophosphate crystals are present.This is done with a needle, after applying a numbing medication to the joint.This joint fluid is then analyzed for evidence of calcium crystals, inflammation, or infection. Your doctor may also order tests for other conditions that can trigger pseudogout, including tests of calcium and thyroid function.

An X-ray of the joint may be taken to determine whether calcium-containing deposits are present, creating a condition known as chondrocalcinosis. Other potential causes of symptoms, such as gout, rheumatoid arthritis, or infection, must be ruled out. Pseudogout often is present in people who have osteoarthritis.

Treatment:
To combat joint pain and swelling, your doctor may prescribe NSAIDs such as indomethacin and naproxen, or may give you glucocorticoid injections to keep the swelling down (see “Corticosteroid injections”). Your doctor may also remove fluid from the inflamed joint, a procedure called aspiration, as this may help to ease the pressure and inflammation.

The combination of joint aspiration and medication usually eliminates symptoms within a few days, although the doctor may also recommend treatment with oral corticosteroids over a short period of time. Daily use of a low-dose NSAID or colchicine, a medicine that is also used in the treatment of gout, may help to prevent further attacks. Unfortunately, there is no treatment available that can dissolve the calcium crystal deposits, although the joint degeneration that often goes along with pseudogout may be slowed by treatments that decrease joint swelling. Occasionally, people with recurrent or chronic pseudogout may develop osteoarthritis. In this case, surgery (such as joint replacement) may be the only effective treatment.


Prevention:

It is not known how to prevent pseudogout. If the condition has developed because of some other medical conditions, such as hemochromatosis (too much iron stored in the body), or parathyroid problems, treatment of that condition may prevent progression of other features of that potentially dangerous illness and may, in some cases, slow the development of pseudogout.

You may click to see:->Pseudogout – 10 Things You Should Know

Points to Remember:
When a patient complains of joint pain, physicians often do not consider pseudogout because it can be confused with gout and other types of arthritis. Diagnosis is confirmed by microscopic identification of calcium pyrophosphate crystals. Anti-inflammatory agents can help lessen symptoms but there is currently no way to eliminate the crystals themselves.
The rheumatologist’s role in the treatment of pseudogout

Rheumatologists are actively engaged in research into the causes of pseudogout to better prevent and treat this form of arthritis. Because people with pseudogout tend to be older and more susceptible to side effects from anti-inflammatory medications, they benefit from seeing rheumatologists, who offer valuable expertise in using such drugs.

Rheumatologists are experts at diagnosing pseudogout and direct a team approach to the chronic, degenerative consequences of crystal deposits. This is important because the patient may need advice about surgery or may require additional information and support from physical and occupational therapists and nurses.
To find a rheumatologist

For a listing of rheumatologists in your area, click here.
For more information

The American College of Rheumatology has compiled this list to give you a starting point for your own additional research. The ACR does not endorse or maintain these Web sites, and is not responsible for any information or claims provided on them. It is always best to talk with your rheumatologist for more information and before making any decisions about your care.

The Arthritis Foundation
www.arthritis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse
www.niams.nih.gov

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.rheumatology.org/public/factsheets/pseudogout_new.asp
http://www.everydayhealth.com/publicsite/index.aspx?puid=a2579e6f-f790-4eed-ad5e-e59719b4bff6&p=2

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News on Health & Science

Cod oil ‘Cuts Arthritis Drug Use’

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A daily dose of cod liver oil can cut painkiller use in patients with rheumatoid arthritis, a study suggests.

.Cod liver oil can be taken in capsule or liquid form

Taking 10g of cod liver oil a day reduced the need for non-steroidal anti-inflammatory drugs (NSAIDs) by 30%, Dundee University researchers say.

Concerns about side-effects of NSAIDs has prompted research into alternative.

Rheumatologists said the study, in Rheumatology journal, funded by Seven Seas, was small but showed fish oil could benefit some patients.

Patients in the trial were either given cod liver oil or placebo and after 12 weeks asked to gradually reduce their use of NSAIDs, such as ibuprofen.

Almost 60 patients completed the nine-month trial which found 39% taking cod liver oil reduced their daily dose of NSAIDs compared with 10% taking a placebo.

The reduction in drug use was not associated with any worsening of pain or the disease, the researchers reported.

The research team at the University of Dundee have now completed three studies which have all shown patients are able to cut down their NSAID use when taking cold liver oil.

It is thought fatty acids in the fish oil have anti-inflammatory properties.

Side-effects

Some side-effects of NSAIDs, such as an increased risk of stomach bleeding have been known for a long time.

But more recently, concerns have been raised about an apparent increased risk of heart attacks and strokes in those taking the drugs.

Study leader Professor Jill Belch said the study offered hope to many rheumatoid arthritis patients who wanted to reduce the amount of pain medication they take.

“Every change in medication should be discussed with a GP but I would advise people to give cod liver oil a try for 12 weeks alongside their NSAIDs and then try to cut it down if they can manage it but if they don’t manage it, that’s fine.

“If you can get off NSAIDs it will be much safer.”

National Rheumatoid Arthritis Society chief executive Ailsa Bosworth said: “People with rheumatoid arthritis still rely heavily on NSAIDs, even though the safety of these drugs is under scrutiny.

“We look forward to more research in this area.”

British Society for Rheumatology president Dr Andrew Bamji said it was a small study so difficult to draw firm conclusions.

But he added: “Anything that can help to reduce NSAID use is going to be safer for patients.

“It does look as if the results are positive and that is quite interesting.

“I would say to patients by all means take cod liver oil and when you feel ready start to reduce your NSAID dose.”

But he stressed that patients must discuss plans with their doctor because it was important that physicians were aware of all medications and supplements the patient was taking.

“Anything that can help to reduce NSAID use is going to be safer for patients”..says
Dr Andrew Bamji, British Society for Rheumatology

Click to see also :->

Cod Liver Oil Cuts the Need for Arthritis Drugs
Cod liver oil ‘treats depression’
Fish oil urged for heart patients
Cod liver oil benefits confirmed
Cod liver oil ‘slows arthritis’
Sources: BBC NEWS:25Th. March.’08

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News on Health & Science

Gene ‘linked to higher gout risk’

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A reason why millions worldwide fall prey to the painful joint condition gout may have been uncovered.

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..Gout can be disfiguring and painful

A rise in UK gout cases has been blamed on increasingly unhealthy lifestyles.

However, genetic analysis of more than 12,000 people, published in the journal Nature Genetics, has found that a gene variant may also raise the risk.

Researchers at the MRC Human Genetics Unit, in Edinburgh, said the gene, and the protein it controls, might one day be targeted by new gout drugs.

In a healthy body, uric acid, a waste product found in the blood, is removed by the kidneys and passes out of the body in urine.

However, in some people the kidney cannot get rid of it properly and it builds up in the blood, forming crystals in the joints, leading to inflammation, stiffness and pain.

Various food types have been blamed, with the consensus that diets rich in refined sugars, protein and alcohol increase the risk.

Many thousands of people have a diet which appears to increase the risk of gout, but far fewer actually develop the illness.

Now scientists at the MRC Human Genetics Unit may have worked out why that is.

The gene variation they found, in the SLC2A gene, appears to make it harder for the body to remove uric acid from the blood.

Testing and treatment

Professor Alan Wright, who led the research, said: “The gene is a key player in determining the efficiency of uric acid transport across the membranes of the kidney.”

His colleague Harry Campbell said: “Some people will have higher or lower risk of gout depending on the form of the gene they inherited.

“This discovery may allow better diagnostic tools for gout to be developed.”

At the moment, drug treatment for patients is limited.

Although gout is a disease more usually found in a historical textbook, it is estimated that one million people in the UK suffer from it in some form.

Professor Stuart Ralston, from the British Society for Rheumatology, said that he often came across patients whose lifestyles did not fit the traditional view of over-consumption.

“Until recently you would associate gout with boozing and rich food, but there are plenty of other patients who are quite abstemious. This might be a genetic marker for gout risk.

“What is exciting is that it could be a target for new gout drugs.”

Dr Andrew Bamji, president of the British Society for Rheumatology, said that the research supported a recent study which suggested that too many sugary soft drinks could trigger gout.

He said: “It appears that this gene also plays a role in the control of levels of fructose sugar in the body, which would explain the finding that soft drinks were linked to attacks.”

Click to learn more about:->

What is Gout

Gout surge blamed on sweet drinks

Lower gout risk for coffee lovers

Gout treatments ‘remain unproven’

Sources:BBC NEWS: 10Th.March.’08

Categories
Ailmemts & Remedies

Gout

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Gout is a form of arthritis that is a painful inflammation and swelling of the joints caused by the buildup of uric acid in the body. Certain foods cause gout so diet plays a role. Treatment of gout can be acheived through medication and proper diet.

At least one male in a hundred over age 40 suffers from gout. Women can develop it too, mainly after menopause. Though people with gout feel fine much of the time, an attack can occur without warning, bringing on breath-catching joint pain that demands fast-acting, effective relief.

click to see the pictures of gout

Symptoms:

The most common gout symptom is sudden, severe attacks of pain, tenderness, redness, warmth and swelling in some joints. It usually affects one joint at a time, especially the joint of the big toe, but can also affect the knee, ankle, foot, hand, wrist and elbow. Redness and swelling in affected joint or joints.
Kidney stones develop occasionally, causing fever, severe low back pain, nausea, vomiting, or a swollen abdomen. Deposits of uric acid, called tophi, can appear as lumps under the skin around the joints and at the rim of the ear. In addition, uric acid crystals can also collect in the kidneys and cause kidney stones.

What It Is
Gout is a metabolic disorder linked to high levels of uric acid in the blood. Uric acid, a by-product of various body processes, is also formed after eating certain foods. The body rids itself of uric acid through the urine. But some people produce too much uric acid — or can’t dispose of it fast enough — and levels build up. Often, the excess uric acid is converted into needle-shaped crystals that settle in and around joints and other tissues, triggering inflammation and the excruciating pain associated with gout.

Causes of Gout
This is one of the few types of arthritis where the cause is known. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. Normally this is a byproduct of the breakdown of purines or waste products in the body. Normally uric acid breaks down in the blood and is eliminated in urine. When the body increases its production of uric acid or if the kidneys do not eliminate enough of it from the body, levels build up. This is called hyperuricemia. Hyperuricemia is not a disease and is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop.

Gout does have a genetic basis in 20 per cent of cases, and does tend to cluster in families. It is inherited through the X chromosome. Women are carriers of the defective gene, but seldom develop the disease as they have two X chromosomes. The normal chromosome suppresses the defective one. Men develop the disease.

Environment and diet also play an important role. Not everyone with a high uric acid level develops joint pain. Also, not everyone with the gene develops gout.

Foods that Cause Gout
Some people may benefit from a reduction of purine rich foods. These include beer and other alcoholic beverages, anchovies, sardines (in oil), fish roes, herring, yeast, organ meats (e.g., liver, kidneys), legumes (e.g., dried beans, peas, and soybeans), meat extracts, consommé, gravies, mushrooms, spinach, asparagus, cauliflower, and poultry. Weight loss can help reduce uric acid levels in those people that are overweight.
Modern Gout Treatment

Although there is no cure, most people with gout can keep it under control and lead normal lives. Treatment may consist of one treatment or a combination of treatments.

Gout Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain. They are taken orally at their highest safe dosage as long as symptoms persist and for three or four days after. There are dozens of NSAIDs. Indomethacin (Indocin) is the usual choice.

Colchicine, a derivative of the autumn crocus, has been used to treat gout for thousands of years. This drug relieves the pain and swelling and can help prevent future attacks. Although highly effective, it is no longer the first treatment choice due to the potential for unpleasant side effects.

Corticosteroids may be used if NSAIDs are not tolerated.

Allopurinol (Lopurin, Zyloprim) blocks uric acid production and is the drug most often used in long-term treatment for older patients and those with high levels of excreted uric acid.
How is it diagnosed?
Standard diagnostic tools for gout may include a medical history and physical examination, a blood test for hyperuricemia, and urine sample. For a definitive diagnosis, a sample of synovial fluid from the affected joint is required. X-rays can provide helpful information in some cases.

What research is being done?

Scientists are studying whether other NSAIDs are effective in treating gout and are analyzing new compounds to develop safe, effective medicines to treat gout and other rheumatic diseases. For example, researchers are testing to determine whether fish oil supplements reduce the risk of gout. They are also studying the structure of the enzymes that break down purines in the body, in hopes of achieving a better understanding of the enzyme defects that can cause gout.
Click for more Gout web link

When to Call Your Doctor :If you experience symptoms of an acute gout attack — your doctor can prescribe medications to ease the initial pain.If you suffer the severe pain of passing a kidney stone.
Reminder: If you have a medical condition, talk to your doctor before taking supplements.
How Supplements Can Help
Uric acid can accumulate in the blood for years with no symptoms. An acute attack often happens suddenly and is best treated with conventional drugs. The main supplement that seems to help during an acute attack is bromelain. The others, taken together, may prevent future attacks. All can be safely used for long periods, though cherry extract, vitamin C, and nettle may be the simplest regimen to follow for long-term maintenance.

What Else You Can Do

Drink at least eight glasses of water a day to dilute the urine and help lower uric acid levels. Stay away from alcohol, which can trigger attacks.
Keep weight down. Obesity may play an important role in gout attacks.
Avoid fats, refined carbohydrates, excess protein, and, if you’re sensitive to purines, foods containing them (including organ meats, anchovies, legumes, oatmeal, spinach, asparagus, cauliflower, and mushrooms).
One of the oldest known remedies for gout — a drug called colchicine — is derived from the autumn crocus, also known as meadow saffron. Unfortunately, colchicine in pill form causes severe cramping and diarrhea in up to 80% of those who take it in the high doses needed to combat gout attacks. An injectable form of colchicine administered by your doctor, however, appears to work quickly and without side effects.
Eating fresh or canned cherries (a half pound a day) may help keep gout at bay by reducing levels of uric acid. Some people swear by them; and a small study conducted many years ago found that eating cherries may indeed lower uric acid levels. An easier way to get the benefits of cherries is to take 1,000 mg daily of cherry fruit extract pills (available at health-food stores). Strawberries, blueberries, celery, or celery seed extracts may have a similar beneficial effect.

Supplement Recommendations

Bromelain
Quercetin
Cherry Fruit Extract
Vitamin C
Nettle
Flaxseed Oil

Bromelain
Dosage: 500 mg every 3 hours during an attack; reduce to twice a day to help prevent further attacks.
Comments: Each dose should provide 2,000 GDU or 3,000 MCU.

Quercetin
Dosage: 500 mg twice a day between meals.
Comments: Take with bromelain to help prevent gout attacks.

Cherry Fruit Extract
Dosage: 1,000 mg 3 times a day following an acute attack.
Comments: Reduce dosage to 1,000 mg a day for maintenance.

Vitamin C
Dosage: 500 mg a day.
Comments: Add 500 mg every 5 days until you reach 1,000 mg twice a day. Reduce dose if diarrhea develops.

Nettle
Dosage: 250 mg standardized extract 3 times a day.
Comments: Also effective as a nettle tea compress applied to sore joints. (Use 1 or 2 tsp. dried herb per cup of hot water.)

Flaxseed Oil
Dosage: 1 tbsp. (14 grams) a day.
Comments: Can be mixed with food; take in the morning.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Reources:

Your Guide to Vitamins, Minerals, and Herbs (Reader’s Digest)

andhttp://www.arthritisinsight.com/medical/disease/gout.html

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