Rheumatic Disease : Article and Solution

Julie T. Li-Yu, MD, FPCP, FPRA
University of Santo Tomas Hospital
Manila, Philippines

Musculoskeletal complaints among patients undergoing hemodialysis are commonly encountered. These appear to be major limiting factors in the quality of life in long term survivors. It might be considered a trade off for prolonged lifespan of patients kept on chronic hemodialysis that bone abnormalities are considered important in clinical management of these patients.
The variation as to the nature and type of bone disease is related to patient’s age, duration of renal disease, variation of the pathogenic processes involved, type of therapy, differences in diet, and type and duration of dialysis therapy.Abnormal metabolism or action of vitamin D is responsible for defective mineralization of bone in renal failure. Read the rest of this entry »

Chung-Tei Chou
Division of Allergy-Immunology-Rheumatology, Department of Medicine
Veterans General Hospital, Taipei, Taiwan

Prevalence of hyperuricemia and gout among Taiwan Aborigines. Two major studies have been conducted on gout in Taiwan Aborigines. Chou et al. spent one year examining 342 indigenous people of the Atayal tribe in aboriginal villages in central Taiwan. Gout was confirmed in 40 subjects, 95% of whom were male. We found the prevalence of hyperuricemia and gout in Atayal Aborigines to be 41.4% and 11.7%, respectively. Of the 40 gouty patients, 54% had tophi and 35% of their first-degree relatives had gout. The other epidemiological study focusing on the prevalence and risk factors of gout was completed by Chang et al. Unlike Chou’s study, the sample Aborigines in Chang’s study were older than 40 years and originated from 3 different tribes (Atayal, Paiwan, Bunun, and mixed). The findings showed 15.2% of males and 4.8% of females had gout, did not differ much from Chou’s study. Of the 3 tribes studied by Chang et al, prevalence was highest in Bunun men (28.1%), followed by Atayals (12.5%) and Paiwans (5.5%). In this study, no data regarding the hyperuricemia of different tribes was collected. However, in a previous study, Chang et al. showed 27% to 45% of aboriginal boys and 13% to 41% of aboriginal girls had hyperuricemia. Taken together, Chou and Chang confirmed the hypothesis that hyperuricemia and gout were frequent among indigenous people. Read the rest of this entry »

Richard Travers
Senior Rheumatologist and Head of Rheumatology Unit
Western Hospital, Footscray, Australia

This brief talk is aimed at the general physician whose opinion has been sought about a patient with joint pains. Rheumatology is a clinical specialty. There are a limited number of ways that a joint can react to noxious stimuli, and the answers to questions generated by the history and physical examination will nearly always point you in the right direction, and examples of the common entities will be given. The exceptions are those rare periodic syndromes (palindromic rheumatism and FMF, for example) where the joints and back movements may look normal at the first visit. The joints will also look normal in the common, but distressing, fibromyalgia, in some viral syndromes and in statin-related myalgia. Read the rest of this entry »

Audience: Healthcare professionals
FDA notified healthcare professionals of a Class I Recall of the Vibe Technologies Vibrational Integrated Bio-photonic Energizer Machine Multi-Frequency Field Generator. This device has not been approved by FDA, lacks safety and effectiveness data, and is not manufactured under current good manufacturing practices. The manufacturer has submitted no evidence to FDA to support any of their claims that the product could treat or cure such diseases as cancer, depression, infection and pain. Individuals with the device should stop using it immediately and contact the manufacturer to make arrangements to return the device.

Read the entire 2008 MedWatch Safety Summary, including a link to the FDA Recall notice regarding this issue at:

http://www.fda.gov/medwatch/safety/2008/safety08.htm#Vibe

FDA has asked that a boxed warning be added to the prescribing information for fluoroquinolone antibiotics. The warning will remind healthcare professionals that patients taking these drugs may experience an increased risk of tendinitis and tendon rupture. Fluoroquinolones include Cipro (ciprofloxacin), Factive (gemifloxacin), Levaquin (levofloxacin), Avelox (moxifloxacin), Noroxin (norfloxacin), Floxin (ofloxacin) and Proquin (ciprofloxacin hydrochloride). Read the rest of this entry »