Osteoarthritis (OA) affects more than 27 million people in the U.S., causing joint pain and stiffness. This new study shows that chondroitin sulfate significantly decreased pain and improved hand function in patients with OA of the hand. In addition, chondroitin sulfate improved grip strength and relieved morning stiffness. 

Approximately 10% of the world population, 60 years and older, have symptomatic osteoarthritis according to the Global Burden of Disease 2000 report from the World Health Organization (WHO). Prior studies have found that 20% to 30% of adults have OA of the hand, with the prevalence rising to more than 50% after 60 years of age. 

"Although hand OA is highly prevalent among adults and can significantly impact the quality of life for suffers, therapeutic options are still limited," Cem Gabay, M.D., with University Hospitals of Geneva in Switzerland and lead investigation of the Finger osteoArthritis Chondroitin Treatment Study (FACTS), was quoted as saying. "There are few trials examining therapeutic approaches specific to hand OA and much of the available evidence has been extrapolated from studies investigating other forms of OA." 

The single-center, placebo-controlled FACTS trial included 162 patients with radiographic hand OA who met the criteria-spontaneous hand pain on the visual analogue scale (VAS) of 40 mm (scale 0-100) or more and Functional Index for Hand OA (FIHOA) level of 6 (scale 0-30). Participants received either 800 mg of chondroitin sulfate (80 patients) or placebo (82 patients) once daily for 6 months. 

Results showed that patients in the chondroitin sulfate group had significant decrease in global hand pain compared with the placebo group, reflecting an 8.7 decrease on the VAS. Hand function also improved significantly for those taking chondroitin sulfate, decreasing more than 2 points on the FIHOA. Researchers also reported significantly improved hand function and reduction in morning stiffness for participants taking chondroitin sulfate versus placebo. 

"Our findings show chondroitin sulfate is a safe and effective treatment for patients with hand OA," Dr. Gabay explained. "Alternative therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), provide similar pain reducing effects, but with considerably more long-term toxicities." Chondroitin sulfate is a naturally occurring molecule and a main component of joint cartilage. 

(American Health Newswire) -- Cognitive impairment, even when detected at an early, mild stage, is a significant predictor of decreased life expectancy.  

According to a new, long-term study from Regenstrief Institute and Indiana University, researchers found that cognitive impairment, especially at the moderate to severe stages, has an impact on life expectancy similar to chronic conditions such as diabetes or chronic heart failure. 

"Previous studies have associated cognitive impairment with an increased risk for death, but most of this work focused on patients with Alzheimer disease and subjects in research centers. The patients in our study better reflect the general public, displaying no indications of disease or mild, moderate or severe cognitive impairment," Regenstrief investigator Greg A. Sachs, M.D., professor of medicine at the Indiana University School of Medicine, where he is the division chief of general internal medicine and geriatrics, was quoted as saying. "We found that even mild cognitive impairment, as determined by a simple screening tool in a primary care physician's office, has a strong impact on how long individuals survive on the same order as other chronic diseases."

The study followed 3,957 patients for 13 years. At screening, 3,157 had no cognitive impairment, 533 had mild impairment, and 267 had moderate to severe impairment. During follow-up, 57 percent of patients with no impairment died, compared with 68 percent of those with mild impairment and 79 percent of those with moderate to severe impairment. Median survival time was 138 months for patients with no impairment, 106 months for those with mild impairment, and 63 months for those with moderate to severe impairment.

Study participants were screened for cognitive impairment using an easy-to-administer 10-question mental status questionnaire. On the basis of the number of errors patients made on this test, they were categorized as having no, mild, or moderate to severe cognitive impairment. 
Cognitive impairment affects memory and thinking. Approximately 4 million to 5 million people in the United States have dementia, and the number of individuals affected is significantly higher if individuals with milder forms of cognitive impairment are included. The prevalence of cognitive impairment at all stages is expected to increase as the population ages. 

The study findings have important clinical and prognostic implications beyond dementia detection, treatment and support for affected patients and their families. Reduced life expectancy in patients with cognitive impairment should be factored into medical decisions, such as advance care planning, cancer screening and prescribing of medications, especially in patients with severe impairment, the authors state.

Given that the magnitude of the risk of mild and moderate to severe cognitive impairment is similar to that of many life-limiting diseases, as well as the ease of identifying cognitive impairment by using a short screening tool, recognition of cognitive impairment in primary care practices should be given a higher priority.

SOURCE: Annals of Internal Medicine, August 6, 2011.

A strain of bacteria that specifically targets tumors could be used as a transporter to deliver drugs in frontline cancer therapy. The harmless soil-dwelling strain is expected to be tested in cancer patients in 2013. 

The spores of Clostridium sporogenes are injected into patients and only grow in solid tumors, where a specific bacterial enzyme is produced.  An anti-cancer drug is injected separately into the patient in an inactive 'pro-drug' form. When the pro-drug reaches the site of the tumor, the bacterial enzyme activates the drug, allowing it to destroy only the tumor cells in its vicinity. 

A fundamental requirement for any new cancer therapy is the ability to target cancer cells while excluding healthy cells. Professor Nigel Minton, who is leading the research, explained how this therapy naturally fulfills this need. "Clostridia are an ancient group of bacteria that evolved on the planet before it had an oxygen-rich atmosphere and so they thrive in low oxygen conditions. 

When Clostridia spores are injected into a cancer patient, they will only grow in oxygen-depleted environments, i.e. the center of solid tumors. This is a totally natural phenomenon, which requires no fundamental alterations and is exquisitely specific. We can exploit this specificity to kill tumor cells but leave healthy tissue unscathed," Minton was quoted as saying.

The research may ultimately lead to a simple and safe procedure for curing a wide range of solid tumors. "This therapy will kill all types of tumor cell. The treatment is superior to a surgical procedure, especially for patients at high risk or with difficult tumour locations," explained Professor Minton. "We anticipate that the strain we have developed will be used in a clinical trial in 2013 led by Jan Theys and Philippe Lambin at the University of Maastricht in The Netherlands. A successful outcome could lead to its adoption as a frontline therapy for treating solid tumors. If the approach is successfully combined with more traditional approaches this could increase our chance of winning the battle against cancerous tumors."