PSORIATIC ARTHRITIS MEDICAL NEWS

It's hard to believe that our first newsletter was just published on
September 3rd, and here we are with our seventh and final edition for
2001. I
thought it would be good to take a quick look at just some of the
topics that
I chose as both newsworthy and educational this year.

During the last 4 months of 2001, we published information on the
following:

Biotechnology companies Biogen Inc., Genetech Inc., Immunex Corp.,
Idec Pharmaceuticals Inc., all have Psoriasis drugs under development.

Warnings from England, (Vioxx & Celebrex) COX-2 Inhibitor side
effects.

FDA warnings that pain killer Oxycontin can cause addition.

Treatment options for severe Rheumatoid Arthritis.

TNF Inhibitors Infliximab and Etanercept approved for arthritis
treatment.

Amevive from Biogen helps chronic plaque psoriasis.

The surprising relationship between smoking, and Psoriasis.

Patients who contemplate using Remicade must have initial test for TB.

Amgen's new drug Kineret, (interlukin-1 blocker) FDA approved.

Antioxidant supplements reduce Lipid-lowering drug effect.

Cholesterol drug warnings related to muscle pain and weakness
(rhabdomyolysis).

Why Chocolate is good for your heart because of flavonoids.

Enbrel from Immunex will be marketed as treatment for Psoriatic
Arthritis.

Vitamins repair damage from pollution through use of antioxidants.

Three part series;
(1) How to measure the severity of your Psoriasis.
(2) Current traditional therapies of Psoriasis treatment.
(3) Alternative methods of Psoriasis therapies.

Skin cancer risk potential with cyclosporine and PUVA treatments.

The "Caryn Goldstein"story, and inherent risk factors with the newest
drugs.

The fight to be your "Arthritis Drug"and how to be a smart shopper.

Multi-part series on less common forms of arthritis. So far I have
dealt with
Ankylosing Spondylitis and Infectious Arthritis. More to come in
future
issues, including this one.

How simple aspirin may extend your life.

FDA approves Bextra (Cox-2 inhibitor) for osteoarthritis and
rheumatoid
arthritis.

The latest in research from the NIH: Arthritis, Musculoskeletal, and
Skin
Diseases.

New England Journal of Medicine: Americans stressed by September 11th
events.

Top 10 list of $ spent by drug companies on advertising, and top 10
Companies

ranked by drug sales.

For 2002, I hope to again publish 2 newsletters per month with the
exception
of February. Please think about what subjects you would like me to
cover that
are of importance to you. Everyone's ideas are crucial to an ongoing
and
successful publication.
Your opinions and feedback are greatly appreciated, so please sit
down and
send me an E-mail with your thoughts.

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OVERWEIGHT AND OBESITY THREATEN U.S. HEALTH GAINS
December 13, 2001 WASHINGTON (HHS) -- Health problems resulting from
overweight and obesity could reverse many of the health gains
achieved in the
U.S. in recent decades, according to a Surgeon General's "call to
action"
issued today.

The report, entitled "The Surgeon General's Call to Action to Prevent
and
Decrease Overweight and Obesity," outlined strategies that
communities can
use in helping to address the problems. Those options included
requiring
physical education at all school grades, providing more healthy food
options
on school campuses, and providing safe and accessible recreational
facilities
for residents of all ages.

"Overweight and obesity are among the most pressing new health
challenges we
face today," HHS Secretary Tommy G. Thompson said. "Our modern
environment
has allowed these conditions to increase at alarming rates and become
a
growing health problem for our nation. By confronting these
conditions, we
have tremendous opportunities to prevent the unnecessary disease and
disability they portend for our future."

"Overweight and obesity may soon cause as much preventable disease
and death
as cigarette smoking," Surgeon General David Satcher said. "People
tend to
think of overweight and obesity as strictly a personal matter, but
there is
much that communities can and should do to address these problems."

Approximately 300,000 U.S. deaths a year currently are associated
with
obesity and overweight (compared to more than 400,000 deaths a year
associated with cigarette smoking). The total direct and indirect
costs
attributed to overweight and obesity amounted to $117 billion in the
year
2000.

In 1999, an estimated 61 percent of U.S. adults were overweight,
along with
13 percent of children and adolescents. Obesity among adults has
doubled
since 1980, while overweight among adolescents has tripled. Only 3
percent of
all Americans meet at least four of the five federal Food Guide
Pyramid
recommendations for the intake of grains, fruits, vegetables, dairy
products,
and meats. And less than one-third of Americans meet the federal
recommendations to engage in at least 30 minutes of moderate physical
activity at least five days a week, while 40 percent of adults engage
in no
leisure-time physical activity at all.

While the prevalence of overweight and obesity has increased for both
genders
and across all races, ethnic and age groups, disparities exist. In
women,
overweight and obesity are higher among members of racial and ethnic
minority
populations than in non-Hispanic white women. In men, Mexican-
Americans have
a higher prevalence of overweight and obesity than non-Hispanic men,
while
non-Hispanic white men have a greater prevalence than non-Hispanic
black men.

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THE HARDEST PART OF EXERCISE December 10, 2001 WASHINGTON (AP) - For
most
new exercisers, it's easier to quit than to get fit. Keeping the will
to
stick with a program can be the hardest exercise.

"Most people who adopt exercise will quit within a short time - 50
percent
within 6 to 8 weeks, another 25 percent by the end of the year," said
sports
psychologist William F. Morgan of the University of Wisconsin-
Madison. "We
must be doing something wrong," Morgan said.

How to set things right vexes researchers as well as workers in the
exercise
training field. Their responses include changing the nature of
exercise,
changing its structure and changing the way exercisers think about
what they
want to do.

Morgan focuses on changing the nature. The current approach - health
clubs,
weight training, running and the like - doesn't motivate people
because it's
artificial, he said.

"The reason for the dropouts in these programs is that exercisers
have been
employing non-purposeful physical activity - riding bicycles to
nowhere,
running treadmills to nowhere," Morgan said.

What people need is not exercise programs but physical activity that
is part
of their daily lives and has purpose, Morgan said. "If you want to
buy an
exercise machine, go to the local dog pound and adopt a dog," he
said.
"That's one of the best exercise machines you can find. They have to
go on
their daily walk."

Similarly, people who walk so they can go to work will get their
healthful
activity even though they may not think of it as exercise, Morgan
said.

Some people can stick with conventional exercise programs, but they
have
managed to make the workouts an important part of their personal
identity,
Morgan said. "A daily jog might become ritualized to where it has
deep
meaning for you as an individual - but most people quit long before
that," he
said.

Conventional exercise also can be purposeful, said researcher Rod K.
Dishman
of the University of Georgia. Exercising to lose weight, avoid
weakening of
the bones or add a bit to a person's lifespan can impart lots of
personal
meaning, he said.

The problem is to overcome the initial tedium and discomfort, to get
to the
point where the benefits kick in, and a good way to do this is to
minimize
discomfort and accentuate enjoyment of the activity, Dishman said. He
advises
people to find an activity they like, do it with a person they like,
and keep
doing it regularly until it becomes a habit.

Getting support from the community can provide the personal meaning
that
translates to motivation, said Dr. Jon L. Schriner, who is trying to
build
such support in Flint, Mich.

Schriner is medical director of the Crim Festival of Races, a series
of
events that range from a one-mile fun walk to an internationally
competitive
10-mile race.

The Crim tries to make even beginners see themselves as members of a
group
that runs, Schriner said. "Training for the Crim goes on all year
long," he
said. "We have classes. We bring in a sports psychologist. We talk to
them
about buying shoes, equipment, how they should be running. And we
socialize."
Beginning exercisers will be less likely to drop out if they think
they will
lose standing in their group, Schriner said. "The group method has
worked for
us much more strongly than the individual method," he said.
"If you take an individual, and he is going to motivate himself, he
has to
have a lot of goals - and most of the time, they are pie-in-the-sky
ideas,"
Schriner said.

Personal trainers make their livings from those individuals, so they
look for
ways to keep beginners motivated. Fitness consultant Daniel Ball
wrote about
it in the November-December issue of IDEA Personal trainer, a
publication of
IDEA Health and Fitness Assocation, a fitness professionals group.

Trainers must help exercisers keep their goals positive and in line
with
reality, Ball advised. Instead of "I'm never going to lose weight,"
the
exerciser should be encouraged to think, "I will eventually lose
weight, it
just may take more time and work," he said.

Trainers also must help exercisers to build confidence, by targeting
small
but achievable increases and discouraging lofty goals that will be
tough to
achieve, Ball wrote. Exercisers also can talk themselves into success
if they
are guided away from focusing on their failures, the article said.
Copyright
2001 The Associated Press. All rights reserved.

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OPTIMISM MAY PROTECT MEN AGAINST HEART DISEASE
WESTPORT, CT (Reuters Health) Dec 06 - People who blame themselves
for bad
events and believe that things will never change are more likely to
develop
heart disease than their more optimistic peers, study findings
suggest.

According to a recent report in Psychosomatic Medicine, people with a
pessimistic explanatory style were more likely to develop heart
disease and
to die of a myocardial infarction than those who shrugged off bad
news with a
view that things were bound to improve.

The findings support the results of previous research linking
pessimism with
higher levels of anger, anxiety and depression -- emotions that may
be risk
factors for heart disease.

"Because optimistic individuals actively engage in planning and
problem
solving, they may experience fewer stressors, or they may have more
resources
with which to deal with stress," Dr. L. Kubzansky from Harvard School
of
Public Health in Boston, Massachusetts, and colleagues suggest.

They note that optimists tend to be more social, a quality that has
been
linked with better health. These individuals may also be more likely
to adopt
healthy behaviors such as exercising, drinking in moderation and not
smoking.

The results are based on information from more than 1300 healthy,
white men
between the ages of 21 and 80 years who were followed over an average
of 10
years. Researchers used a standardized scale to rank study volunteers
on
their level of optimism.

There were few differences in lifestyle behaviors between optimists
and
pessimists, although pessimists were more likely to consume more than
two
drinks of alcohol per day and to have a lower level of education.

Overall, about 12% of the subjects developed heart disease over a
decade, and
19% of these individuals died of a MI. Each increase in the level of
optimism
on the scale was associated with a roughly 25% lower risk of
developing chest
pain and heart disease. The most optimistic men also had a lower risk
of
having a nonfatal MI and dying from heart disease compared with the
most
pessimistic men.

The findings suggest that an optimistic explanatory style may be
protective
against coronary heart disease in men, the authors conclude.
Psychosom Med 2001;63:910-916. Copyright © 2001 Reuters Ltd. All
rights
reserved.

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DRUG COMPANIES SPEND TWO BILLION TO ADVERTISE DIRECTLY TO CONSUMERS
The
Lancet October 6, 2001;358:1141-1146
Magazine ads for prescription drugs are high on emotional appeal, but
short
on evidence that they work.
Urging consumers to help their children fight allergies or to
question
whether their memory lapses might be Alzheimer's, most drug ads
favor "vague"
claims over clinical data.
Looking at ads in 70 issues of 10 leading US consumer magazines,
researchers
found that 87% chose "vague, qualitative terms" to describe the
medication's
benefits rather than providing research evidence.
These advertisements rarely quantify a medication's expected benefit,
and
instead make an emotional appeal. This strategy probably leaves many
readers
with the perception that the drug's benefit is large and that
everyone who
uses the drug will enjoy the benefit.
The authors also argue that a key danger is that many of these ads
may
"medicalize" run-of-the-mill problems in the public's mind. A runny
nose all
of a sudden becomes allergic rhinitis.
The first direct-to-consumer advertisement for a prescription drug
appeared
in Reader's Digest in 1981 in USA. Over the next few years, other
such
advertisements were published, and the US Food and Drugs
Administration (FDA)
became worried that little was known about the potential effect of
such
advertisements on the public.
Consequently, in 1983, the FDA initiated an advertising moratorium
while it
studied the issues and considered the regulatory options. Although
they
concluded that "direct to the public prescription advertising was not
in the
public interest," the FDA lifted the moratorium in 1985 because of
concerns
about freedom of speech and a general consensus that regulations
already in
place were sufficient to protect the consumer.
After the moratorium had been lifted, direct- to-consumer advertising
was
permitted provided that the advertisements met certain criteria;
specifically, that they presented true and balanced information about
the
side-effects of the drugs, and their contraindications and
effectiveness. The
FDA monitors compliance with these criteria. However, prior approval
of drug
advertisements is not required.
Opponents of direct-to-consumer advertisements are worried that
direct-to-consumer advertisements might inappropriately increase
patient
demand for specific, and generally costly, agents, and that this
demand might
have a negative effect on medical practice and on the physician-
patient
relationship.
Pharmaceutical companies spent $1.8 billion on direct-to-consumer
advertisements for prescription drugs in 1999.
Concurrently, many pharmaceutical companies have reduced the amount
spent on
direct-to-physician advertising, which suggests a tactical shift in
their
focus from physicians to patients. Last year, for example, drug
companies
spent more on advertisements in newspapers and popular magazines than
they
did in medical journals ($685 million vs $473 million, respectively)
(www.imshealth.com accessed on Aug 25, 1999).
Direct-to-consumer advertisements are common in popular magazines,
particularly in those aimed at women. Furthermore, they all share a
similar
structure: they link the advertised product with its target condition
and
invite consumers to share in their own health management.
Although most advertisements addressed the relief of common symptoms
that
many consumers would normally treat themselves with over-the-counter
remedies
(eg, runny nose), a substantial number targeted more complex
treatment
decisions usually made by physicians (e.g., choice of antibiotic or
type of
insulin).
Additionally, many of the advertisements presented quantitative data
about
potential side-effects, but very few provided any such data about
benefit
In a nationally representative survey, two thirds of adult Americans
recalled
seeing a prescription advertised, and about 10% asked their doctor
for that
prescription (of these, 73% said the prescription was made).
Direct-to-consumer advertisements for prescription drugs undoubtedly
help to
educate consumers about available options. At the same time they
encourage
consumers to believe that a problem might exist where they previously
would
not and that a pharmacological solution is the appropriate way to
deal with
it.

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CHOLESTEROL LEVELS INVERSELY RELATED TO FREQUENCY OF EATING - London
(Reuters
Health) Nov 30 - Controlling cholesterol levels may be a case of not
only
what is eaten but how often, according to a report in the December
1st issue
of the British Medical Journal. Men and women who eat six or more
times a day
have cholesterol levels that are about 5% lower than those of less
frequent
eaters.
"If you are already eating well and want to have further benefit, at
least
for cholesterol, dividing what you eat into more frequent meals may
have
additional benefit," said Dr. Kay-Tee Khaw of the University of
Cambridge in
eastern England.

"The more frequently the better - four, five or six [meals] spread
out over
the day so smaller amounts are eaten more frequently," Dr. Khaw told
Reuters.

Dr. Khaw and her colleagues surveyed more than 14,000 people, 45 to
75 years
of age, about how often they ate. They also measured the subjects'
cholesterol levels.
The researchers found lower levels of cholesterol in the frequent
eaters
regardless of their body mass, physical activity or whether they
smoked. But
Dr. Khaw added that people who eat more frequently tend to be more
physically
active than others.

Although the 5% reduction in cholesterol levels may seem trivial, it
could
have a large impact on heart disease risk. "From other studies we
know 5%
lowering of cholesterol may be associated with a 10% reduction in
coronary
heart disease risk," Dr. Khaw added.

Findings from animal and laboratory studies suggest that eating large
meals
after long periods without eating changes how fat is stored and
increases
peaks of insulin.

"It suggests that if you eat more frequently you don't have such big
insulin
peaks and therefore enzymes responsible for the production of
cholesterol may
work differently and you don't have such high cholesterol levels,"
Dr. Khaw
explained.
Copyright © 2001 Reuters Ltd. All rights reserved

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This is the third in our series on less common forms of Arthritis.

INFLAMMATORY BOWEL DISEASE
WHAT IS IT? - Inflammatory Bowel Disease consists of two separate
diseases
that cause inflammation of the bowel and can cause arthritis or
inflammation
in joints:

Crohn's Disease (Crone's disease) involves inflammation of the colon
or small
intestines.
Ulcerative Colitis (UL-sir-a-tive coh-lie-tiss) is characterized by
ulcers
and inflammation of the lining of the colon.

The amount of the bowel disease usually influences the severity of
arthritis
symptoms. Other areas of the body affected by inflammatory bowel
disease
include ankles, knees, bowel, liver, digestive tract, skin, eyes,
spine and
hips.
TREATMENT OPTIONS
Diet
Exercise
Medication: Corticosteroids, Immunosuppressants, NSAIDs,
Sulfasalazine
Surgery
WHO IS AT RISK?
Inflammatory bowel diseases most commonly affect adults between the
ages of
25 and 45.
RESOURCES
Crohn's & Colitis Foundation of America, Inc.
386 Park Ave., South
17th Floor
New York, NY 10016-8804
1-800-932-2423 - 212-685-3440 http://www.ccfa.org/
Copyright 2000 - Arthritis Foundation

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May this holiday season be truly reflective of how wondrous life can
be in
spite of our never ending battle with chronic diseases. We have all
experienced a year of change, great sadness, and much hope. Men and
women
with chronic illnesses, who day in and day out fight the good fight,
are
people equally determined to pursue any reasonable means possible to
bring
relief from this disease and seek a permanent answer to Psoriatic
Arthritis.
Don't ever give up that hope.

Happy Holidays and a Healthier New Year

Jack Nicholas - Editor
Cornishpro@a...

Issue 2001-12/22/01-7