July 29, 2014
April 20, 2014
Based on epidemiologic cohorts, osteoarthritis was diagnosed at a mean age of 69.4 years in the 1990s. This, however, shifted to 55.8 years in 2010. The younger age was driven by the problem of obesity which had become more prevalent in the latter years. 40% of the risk for developing OA is due to being overweight or obese followed by occupation and injury to the joints. Interventions directed at treating obesity may then significantly impact on the outcome of OA management.
December 22, 2013
Image from altamarkings.blogspot.com
Heavy alcohol consumption has long been associated with increased risks of developing gout. Likewise, it is recognized that alcohol can trigger recurrences of the disease. That’s why a lot of old doctors advise against ANY alcohol intake when a patient is diagnosed with gout.
But cardiologists would be quick to argue that there is a J-curve in terms of cardiovascular events (strokes, heart attacks) and alcohol intake – that is, moderate amounts of alcohol is actually good for the heart.
June 29, 2013
I was recently asked to present something on Fibromyalgia. Since the audience would be colleagues "familiar" with this disease (Rheumas, Rehabs, Neuros), I opted to present updates - the updated definition (which now includes symptoms other than pain and tenderness), the evolution of diagnostic criteria (from 1990 ACR to the latest 2010 ACR), and synthesized some aspects of several guidelines. I had foregone presenting efficacy data on pregabalin, duloxetine and milnacipran because they have already been specifically approved for fibromyalgia - meaning they work and (I feel) there's no need to add to that. Instead, I presented what fibromyalgia patients experience as far as the two most common drugs used in terms of efficacy and safety. The last slide is actually a reminder why fibromyalgia is difficult to manage - and why the 2012 guidelines had to specify the behavioral "requirements" for those managing fibromyalgia.
May 3, 2013
I was recently asked to discuss the latest ACR guidelines on the management of rheumatoid arthritis with the fellows. In the course of the discussion, a comment made by one of the attendees struck me, "Too much to absorb in a short amount of time." Well, this made me work again on the slide set I made. There are now three additional slides that simplifies the schema and makes it more applicable to the Philippine setting.