Warnings From Health Canada:
Most strong pain medicines last only about four hours. Oxycontin gives a steady 12-hour release and has fewer side effects,but
to addicts who chew the pill or crush and snort or inject the powder. OxyContin produces a quick, herion-like
high that can kill. Since 1998,OxyContin and oxycodone,the narcotics active ingrediant,have been linked to more than 100 deaths
The drug's maker,Purdue Pharma,pulled it's strongest dosage off the market in May and issued tamperproof prescription
pads, but pharmacies are still being robbed for the drug. OxyContin is still being abused One pharmacy in St. Albans,Vt.,
stopped stocking the painkiller after thieves broke in four times this summer looking for OxyContin. "The problem is not with
the drug...it is with our society", said Dr. Gladstone McDowell of the Grant Pain Management Centre in Columbus.
Acetaminophen has an excellent track record and benefit-versus-risk ratio. Currently,acetaminophen is a first-line choice
for pain and fever in a variety of patients,including children,pregnant women,the elderly and those with osteoarthritis (ACR/recommends
for OA). In 1966,researchers learned that acetaminophen can cause liver damage when taken in overdose.
Recent medical literature reviews report that liver problems in those using acetaminophen are rare and can be explained.
In some cases,there was gross overdosing-- >10 g(10,000 mg) per day. In other cases,the culprit was alcoholism or a pre-existing
An individual's genetric makeup can also account for a variation in response. To reduce the risk of the rare side effect
of liver damage,it's important to keep within the maximum doseage range per dose and per day (up to 4,000 mg or 4 g daily).
All acetaminophen products have the suggested number of tablets per dose and per day on the container. One researcher
said people tend to take too little acetaminophen (not enoughh to get the best benefit) rather than too much. Currently there
is a large clinical trial in progress coducted by NAIM in the U.S.A. in reference to kidney damage.
Health Canada is advising Canadians that specific lots of zirconia ceramic femoral head hip replacement devices manufactured
by Saint Gobian Advanced Ceramics Desmarquest of France are being recalled by Canadian distributors due to a high rate
of failure in the implants.
It is important to note,that not all patients who have these zircona ceramic fenoral heads made after 1998 will fail.
In Canada of the approximately 20,00 implants done of this type less than 5% are made of this material.
Health Canada is informing hospitals and orthopaedic surgeons to inform patients of the recall. The recall is being done
in other countries,including the U.S. There will be continued monitoring of the recall by Health Canada.
The defect in the identified lots is in the femoral head,which is the ball portion of the ball-and-socket joint that
makes up the zircona ceramic device. This appears to be the result of a change mde in the manufacturing process. According
to information received so far, the failure tends to between 13 to 27 months after implantation.
Shared epitope levels of HLA-DRB1 genes are increased in both young-and elderly-onset RA patients researchers report.
However,HLA-DRB1*04 alleles are underrepresented in elderly-onset compared with young-onset RA, suggesting a lesser importance
of these genes in RA susceptibility in elderly patients.
Investigators from France in Montpellier,France--Federation de Rhumatologie, the Laboratoire d'Immunologie.obtained these
results from studying the clinical,biological and HLA-DRB1 typing characteristics. in the two group of patients. there were
262 young onset (60 years or younger at the time of onset) and 60 elderly-onset patients compared with 40.1 % for normal controls.
No significant differences were found for separate disease related alleles between the two groups,but when HLA-DRB1*04
alles were evaluated as a group,the reserchers found these alleles were underrepresented in the elderly onset compared with
the young onset group (37% VS. 52%). Biological characteristics and extra-articular manifestations were similar between the
A number of autoimmune diseases have been linked to one or more alleles of the major histocompatibility complex (MHC).
In 1970,investigators noted that RA patients of nothern European origin exhibited an increased prevalence of the MHC Class II
gene, DR4,compared to control subjects. In southern European patients with RA,DR1 was the predominant HLA haplotype.
Only specific subtypes of DR4 and DR1 were associated with development (or severity) of RA,however. For example,the specific
DR4 subtypes DRB1* 0401 ( Dw4),DRB1*0404 and *0408 (Dw14) and DRB1*0405 (Dw15) appeared to convey susceptibility to development
of RA,while subtypes (e.g.. DRB1*0402 (Dw10) and DRB1*0403 (Dw13) did not.
This led to the search for a common sequence among the different HLA DRB1 alleles that were associated with RA---DR4
susceptibility explanation--(some highly paid and uninformed medical trained "experts" on the web are unaware of some basic
This item was recently,widely published,mainly through the news media, I believe it may not be bad as it sounds,(partly
known) but it is included as a awareness guide, (news) no comment,at this point in time. How large was the study,by whom,and
what type of people where involved in the study ? The study it seems was done on people already having bleeding ulcers.
Background: The widespread use of NSAIDs (nonsteroidal antiinflammatory drugs) among older people has resulted
in a large number of persons at risk for ulcers. The COX-2 inhibitors such as Celebrex and Vioxx were introduced in
the hope that they would ease the pain of arthritis but not cause ulcers.
The Study: Two treatments were compared in people already afflicted with arthritis and a bleeding ulcer. Treatment
(1) was the COX-2 inhibitor celecoxib (Celebrex) and treatment (2) was the combination of the common painkiller diclofenac
(Voltaren, Cataflam) + the proton-pump inhibitor omeprazole (Prilosec). The rates of recurrent ulcer bleeding during
6 months of follow-up were appreciable and similar in the two groups.
Expert Comment: "....neither (treatment) regimen provided a good or even acceptable level of protection from recurrent
ulcer bleeding." (David Y. Graham, MD, editorial, The New England Journal of Medicine)--one man's opinion at this time (there
was previous studies done and published in the JAMA journal,therefore we remain cautious,until more,in depth,studies,is published.
The JAMA study was comparing apples to oranges and did not disclose the full story,until later.
There is no good evidence that glucosamine up to 1500 mg per day will cause diabetes in humans. In rats given very high
intravenous doses of glucosamine continuously, resistance to insulin developed. However, rats and humans are different
and the method of administration of the glucosamine in the rats is certainly not the way it is taken by humans.
Furthermore, glucosamine is different from the sugar, glucose. Even if it were the same, 1500 mg of glucose is not a
large amount of sugar (1 serving of a soft drink, for example, may contain more than 20,000 mg of glucose). Some people with
diabetes have noticed a rise in their blood sugars while taking glucosamine, but many others have not. A definitive answer
about the relationship of glucosamine and diabetes is not available at present but so far the proof is slim . More long-term
studies and observation are needed.
I would recommend weight control, dietary measures and regular exercise as
being more important for the control and prevention of diabetes at this time. If someone has risk factors for diabetes, then
it might be possible to reduce the daily dose of glucosamine while maintaining the chondroitin at the same dose. In diabetic
persons taking glucosamine, the blood sugars and Hb A-1-C could be followed closer.
Diabetic cheiroarthropathy causes tightness of the skin and limited mobility of the hands but it is not painful. If there
is pain, it may be due to tendonitis of the flexor tendons of the hands, reflex sympathetic dystrophy, diabetic neuropathy
or some form of arthritis. It is associated with either type I or type II diabetes and correlates with the duration of the
diabetes, elevation of the hemoglobin A1C and cigarette smoking. Treatment includes better control of the blood sugars, physiotherapy,
occupational therapy and no smoking.
The rotator cuff tendonitis, calcification and bursitis refer to the soft
tissue structures around the shoulder rather than to arthritis in the shoulder joint. Periarthritis of the shoulder is an
overall name for such problems and is commoner in people with diabetes. Treatment includes trying different nonsteroidal anti-inflammatory
drugs (NSAIDs), cortisone injections (which may cause a transient rise in the blood sugars) and physiotherapy.
addition, it appears that you have an inflammatory arthritis that is possibly due to rheumatoid arthritis. Gout should be
ruled out as it can be associated with diabetes. If indeed the diagnosis is rheumatoid arthritis, you may require aggressive
combination therapy with agents such as gold injections, methotrexate, sulfasalazine, infliximab or etanercept and leflunomide.
Minocycline needs about 3 to 6 months to work and can be used in combination with most of these other agents,but others
are preferable. Oral corticosteroids like prednisone should be avoided because they worsen diabetes. NSAIDs need to be limited
by controlling the arthritis with these other agents because NSAIDs can have negative effects on blood pressure and kidneys
in diabetics. Glucosamine may raise the blood sugar in diabetics. Physiotherapy and pain killers may help the pain as well.
This may help someone who reads about iron deficiecy anemia or "anemia" in general;Oral iron supplements are not generally
associated with worsening joint pains in any type of arthritis. However, intravenous infusions of iron are. In some patients
with rheumatoid arthritis or ankylosing spondylitis, involved joints may flare-up 24-48 hours after an infusion of intravenous
iron. Rarely, persons without any arthritis may get transient joint symptoms after intravenous iron therapy.
One might try different iron preparations: ferrous ascorbate (eg. Ascofer), ferrous fumarate (eg. Palafer), ferrous gluconate,
ferrous sulfate (eg. Slow Fe which is absorbed slowly and Fer-in-sol which is liquid). Check with a health food store about
other iron preparations.
If still a problem, eat foods containing iron eg. liver, oysters and other shellfish, kidney, heart, lean red meat,
turkey and chicken, fish like tuna and salmon, lima and dried beans, dried fruit like prunes, whole grain bread, iron-enriched
cereal, egg yolks and dark green vegetables. Also take vitamin C to enhance the iron absorption from your gastrointestinal
However, it is most important to find the cause of the low iron. The commonest causes are bleeding from the upper and
lower gastrointestinal tract and from the uterus. Unusual bleeding from the vagina is fairly obvious and should be investigated
by a gynecologist. Bleeding from the gut may not be obvious. It should be investigated by a gastroenterologist. Gastroscopy
(looking into the esophagus, stomach and duodenum with a special tube and light source) and colonoscopy (looking into the
large bowel) may be necessary.
Nonsteroidal anti-inflammatory drugs used for arthritis are a common cause of occult bleeding from stomach erosions,
stomach and duodenal ulcers and small intestinal ulcers. There are often no other symptoms except for the iron deficiecy anemia.
Once the cause of the iron loss is found, it will be treated so that iron supplements are no longer necessary.