Many people, even if they aspire to it, find it difficult to stay fit and healthy all the time. Eating a balanced diet, playing sports, taking care of oneself, all these tasks are not easy to do in a world where it is urgent. However, it is all about habits and it is quite easy to change them, but it is necessary to do so gradually. Once the right behaviors have been adopted, it is not very difficult to respect them.
Take this quiz to find out if you’re a health nut, a good apple, or a couch potato.
Quiz: How Healthy Are You?
All You Need to Know About Cataract Surgery
Cataract surgery is performed on approximately 700,000 people in UK each year. This operation consists of removing the opaque lens and replacing it to restore vision. How is cataract surgery performed? What are the possible complications? In this article we take stock of the situation.
Cataract surgery has become the most common surgical procedure among the elderly with 700,000 operations each year. The technique is now well mastered and the results are, in the vast majority of cases, very satisfactory. It can be performed under general anesthesia, without hospitalization. There is therefore no age limit to its use, quite the contrary, because the restoration of satisfactory vision often allows very old people to regain a certain degree of autonomy.
What is cataract?
It is estimated that cataracts affect more than one in five people over the age of 65, more than one in three over the age of 75, and nearly two in three over the age of 85. This condition is due to the development of opacities on the crystalline lens, the transparent lens that allows accommodation. These opacities prevent light rays from passing through, resulting in a decrease in vision that can be very significant.
The only treatment is surgery. It consists of removing the crystalline lens that has become opaque and replacing it with an implant.
When is cataract surgery performed?
Cataracts do not develop uniformly. Some stabilize. Others evolve only after many years towards a loss of vision. It is therefore up to the patient, with the help and information of his ophthalmologist, to decide when to have the operation, depending on the discomfort experienced. Studies show that when the loss of visual acuity is significant, the intervention has beneficial effects on quality of life and often also on other age-related illnesses.
How is cataract surgery performed?
The most commonly used technique is extracapsular lens extraction :
- A small incision is made in the cornea;
- Then the nucleus of the lens is removed, leaving the capsule in place;
- The operation usually lasts between 15 and 30 minutes.
This procedure is usually performed under local anesthesia using a method called phacoemulsification. The crystalline lens is fragmented into small pieces by ultrasound and then aspirated through a very small incision. Healing is faster and the risk of complications is lower.
In almost all cases an implant is then inserted inside the capsule to replace the lens. This implant can be folded, allowing it to be inserted through the incision without difficulty. In the case of phacoemulsification, it is not even always necessary to suture.
Focus on cataract implants
These implants made it possible to discard the thick, unsightly glasses that were once worn by cataract surgeons. The most frequently used are monofocal implants. However, they cannot be deformed to allow for accommodation. They are therefore focused on one type of vision, usually distance vision, which requires the use of glasses for reading.
Multifocal lenses are also available. They have the advantage of allowing both near and far vision. The advantage is valuable for people who have had surgery. For some patients, however, with other associated eye diseases, the placement of an implant is contraindicated and the wearing of corrective lenses is still necessary.
Cataract surgery: convalescence
In the majority of cases, the eye is painless after the operation. However, you should not be alone on the first night after the operation, in case of problems. The vision improves quickly, after a few weeks, a correction adapted by glasses can be prescribed. Local care is also prescribed:
- The instillation of drops;
- The application of an ointment;
- Wearing eye protection.
The modalities and duration of these treatments will be specified by your surgeon. It is sometimes necessary to remove sutures. Certain activities will be discouraged for some time after the procedure: driving, professional activity, use of machines or dangerous products. Your ophthalmologist will tell you when these activities can be resumed.
Cataract surgery: Dangers and contraindications
Serious complications of cataract surgery are rare. Intraocular or endophthalmic infections remain exceptional (one case out of several thousand). They can lead to a total loss of vision in the affected eye.
In 2 to 4% of cases, less dramatic complications (glaucoma, macular edema or retinal detachment) occur, but in a certain number of cases they can have serious consequences. They are more frequent in cases of eye disease or other associated conditions (diabetes, heart disease, etc.). Sometimes a new intervention is necessary.
But the most frequent complication is the occurrence of opacifications on the posterior capsule of the crystalline lens left in place. This secondary cataract is responsible for visual discomfort in about half of the patients after two to five years, which justifies regular ophthalmologic follow-up.
Fortunately, when the discomfort is significant, the opacifications can be treated by making an incision in the posterior capsule (capsulotomy) using a Yag laser. This treatment is performed in the ophthalmologist’s office. In about two out of every hundred cases, the retina is detached. It is therefore not recommended as a precautionary measure after removal of the crystalline lens.
Is it necessary to operate on the second eye?
Cataracts almost always affect both eyes. At present, all specialists agree that there is no difference between the first and second eye, because the operation on the second eye is of real benefit to the patient. The second eye is usually operated on a few weeks or months after the first. However, if the first eye is blind, the patient must be warned of the risk of blindness in case of serious complications.
There is currently no preventive treatment for cataracts. However, studies have shown that sun exposure increases the risk of cataract. It therefore seems logical to protect oneself, even though no studies have demonstrated the effectiveness of wearing sunglasses.
This article (Source) on this Web site are provided for education, entertainment, and/or information purposes only and do not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information or product represented on this site. Please consult your health-care provider before making any health-care decisions or for guidance about a specific medical condition.
All You Need to know About Thyroid Eye Disease
Many eye problems occur at any given time for several reasons. One of the main problems is thyroid disease. Yes, it is also an eye problem that has many causes. However, we will review the different causes, symptoms, treatments and prevention measures in this blog.
So, if you’re ready to learn all about thyroid disorders, you should definitely read this Artricle. But first, let us know what a thyroid disorder is.
What Is Thyroid Eye Disease?
Thyroid eye disease is an eye problem in which the eye muscles and fatty tissue behind the eye become inflamed. This pushes the eyes forward and the eyelids and eyes become read and swallowed. In most cases, it has been found that there is stiffness and swelling of the muscles that move the eyes, so that the eyes are no longer aligned. Sometimes this problem also causes double vision.
Very rarely, thyroid eye disease can also cause blindness due to pressure on the nerve at the back of the eye or ulcers forming on the front of the eyes. Thyroid and eye disease is an autoimmune disease that also occurs when the body’s immune system attacks the back of the eyes and causes inflammation of the eyes.
This disease is actually associated with an overactive thyroid because of Graves’ disease. It is the most common cause of an overactive thyroid, also known as hyperthyroidism. Under another term, it is also known as Graves’ Orbitopathy.
What are the symptoms of Thyroid Eye Disease?
There are several common symptoms that can help you identify your thyroid eye disease. Take a look at the symptoms of thyroid disease below.
- dry or watery eyes
- change in eye appearance
- Swelling or feeling of fullness of both upper eyelids
- doesn’t like bright lights
- double or blurred vision
- Bags under the eyes
- Eyelid pain
- Difficulty moving your eyes
- Redness of the eyelids
- inflammation of the eyelids
What causes Thyroid Eye Disease?
A normal immune system distinguishes very clearly between foreign tissue and body tissue or substances. Autoimmune diseases are characterized by the production of antibodies against normal tissue. Basedow’s disease is usually caused by an abnormal attack of antibodies from the thyroid gland, which usually leads to a higher or lower production of thyroid hormones.
This antibody can also attack eye tissue and can also cause several other eye symptoms. People who smoke have a higher risk of thyroid disease. If they have this eye disease, they may then have a more severe and prolonged course of the disease.
Many people ask, “Can a thyroid problem cause mental illness? The answer is no. As I mentioned in the section above, if this blog believes that because of a thyroid eye disorder, people may have a vision problem. But, no one can notice a mental illness due to ASD.
Who gets Thyroid Eye Disease?
Thyroid disease has no age limit; it can occur at any age, but most likely after the age of 45. There are three times as many women with eye disease. Graves’ disease causes droopy eyelids and is actually an autoimmune disease. This eye problem is actually associated with hyperthyroidism caused by Graves’ disease. However, sometimes it can also occur in people who have other types of thyroid such as euthyroid and hypothyroid.
How is Thyroid Eye Disease Treated?
Sometimes people ask, “Is thyroid disease curable? Well, yes, it is curable. When you suspect thyroid disease, proper treatment and assessment is indicated. The first priority is to restore the euthyroid condition. If you are a person with thyroid disease, you must assess and treat eye conditions at the same time. It has been found that most eye problems continue to progress even after the thyroid has returned to normal. You should see an ophthalmologist to assess and treat your vision problems.
Well, the treatment of thyroid disease depends on the severity and degree of the disease. This eye problem can be categorized as follows:
Tissues are usually inflamed as indicated by redness, swelling and pain. Corneal abrasion/exposure/drying usually requires frequent application of artificial tears, scanning of the eyelids, treatment of closed conduit plugs at night, etc.
Your doctor may prescribe steroid treatment after reviewing the level of activity. Some other drugs that regulate immunity may also be added to the treatment.
Vision Threatening Complications
There are two complications that can lead to vision loss. Complications must be carefully researched and then quickly managed to preserve vision. The two complications are:
- Compression of the optic nerve by swollen tissue: This complication can be managed by oral steroids and in cases of non-response. Sometimes surgery can also be performed to remove the bones around the eye to relieve the compression. In addition, orbital radiation may be considered with other treatment modalities.
- Corneal ulcer due to severe dryness usually due to the difficulty and proptosis closing the eyelids completely: This ocular complication can be treated medically by closing the eyelids together to protect the eyes.
Inactive, Fibrosis, Stable phase
This phase usually includes strabismus, proptosis and eyelid retraction. Sometimes an ophthalmologist suggests orbital decompression surgery to disfigure the proptosis, even if the eye’s vision is not compromised. This surgery is preferable for decompression before eyelid surgery or strabismus.
With the help of this surgery, stable diplopia can also be improved with prism glasses or strabism misalignment surgery is much greater.
Strabismus surgery corrects the repositioning of the fibrous eye muscles to better align the eyes. Eyelid retraction can also be improved with surgery that relaxes the eyelid muscles or insect spacing materials to reposition the eyelids.
How to Prevent Thyroid Eye Disease
Many people ask, “Is there anything I can do to prevent ASD from getting worse,” he says. There are a few prevention tips you can follow to prevent thyroid disease. Most likely, there are three things you can do to prevent this eye disorder:
Selenium supplements: Evidence suggests that patients with mildly active thyroid eye disease may benefit from a six-month supplement of selenium supplements at a dose of 100 µg twice a day, which you can buy over-the-counter.
Avoid smoking: if you smoke, you should definitely quit. You can ask your doctor for advice on quitting smoking. Those who suffer from this vision disorder and continue to smoke have a poorer response to treatment. Ex-smokers may also be treated with propylthiouracil (PTU) or carbimazole (CMZ).
Avoid thyroid fluctuations: Always have a regular thyroid test and ask your doctor how and when to take thyroid medication. This will help to keep thyroid levels normal and stable. This will give your eyes the best opportunity to heal and improve your feelings.
Well, thyroid eye disease is a very irritating and painful eye disease that leads you to face many problems. However, some common symptoms and causes are already mentioned in the above sections of this blog. So I hope you have learned very well about them. If your vision problem is not as severe, try to treat the symptoms so that you can be cured of thyroid disease. Or, if it becomes severe, then you should follow the treatment options for thyroid eye disease mentioned in the section above.
This article (Source) on this Web site are provided for education, entertainment, and/or information purposes only and do not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information or product represented on this site. Please consult your health-care provider before making any health-care decisions or for guidance about a specific medical condition.
Thyroid Eye Disease vs. Graves’ Disease : What’s Myth and What’s Fact
TED and Graves’ disease are different conditions that require different doctors and different medicines
If you have Graves’ disease or another thyroid disorder, you may have heard of an eye disease called Thyroid Eye Disease (TED).
Both TED and Graves’ disease are autoimmune diseases. This means that your body’s immune system mistakenly attacks your own tissues. In Graves’ disease, your thyroid is affected. When you have thyroid eye disease, it affects the muscle and fat behind your eyes.
TED often develops in people with Graves’ disease. But they are separate conditions that require different treatment. There is a lot of information about both diseases, but some of it can be confusing. Scroll down the page to find out what is a myth and what is a reality.
Find out the 7 Myths about Thyroid Eye Disease vs. Graves’ Disease You Need to Stop Believing
Don’t forget to check out Myth 1 (you’ll be amazed at how wrong we are)
Please note that the breakdown of the article is as follows: One Myth per Page, you are now on Page 1. You need to open the Next Page (Page 2) to Continue Reading (Myth 7)
MYTH 7 : Thyroid Eye Disease (TED) is a symptom of Graves’ disease.
Open Next Page To Continue Reading
Baby diapers: how to choose them well?
They will accompany your little one for several years, day and night, so it’s best to choose them carefully! Disposable or washable diapers? Which models to adopt and which are the errors to avoid? We take stock.
In the ray “baby” of the supermarkets, the layers occupy a primordial place. Without counting the new biodegradable models, even washable which bloom on Internet. For the young parents, not easy to find there in this jungle of products and marks! We help you to see there more clearly, with councils and tricks of pros.
Disposable or washable diapers?
First question to ask yourself before scouring the brands: what type of diaper will I use? From 0 to 2 and a half years old, your baby will be changed about 5000 times. Currently, there are two main categories: disposable and washable diapers.
- Popular for their practicality, disposable diapers have made the fortune of some leading brands on the market. The only problem is their ecological footprint. They generate about 1 million tons of waste per year.
- Green attitude is required, “hybrids” have even seen the light of day these last few years: so-called ecological diapers, disposable and 50% or even 60% biodegradable. In short, the compromise between disposable and washable.
- As for parents who are organic addicts and/or want to reduce their “diaper” budget, they will opt for cloth diapers, which have nothing to do with the famous diapers of our grandmothers. Ecological and economical, they are available in different models to adapt to the needs and convictions of families (ease of use, quick drying, natural materials…).
The composition of disposable diapers under the microscope
At a time when we are particularly attentive, as consumers, to the composition of products (especially for children), we scrutinize the labels. “A conventional disposable diaper is primarily cellulose, a fiber derived from wood, and various plastics: polypropylene, polyacrylate for the absorbent gel, polyester … “, said Pregnancy And Newborn magazine in its special feature published in February 2017.
So much information invisible on most packages of diapers, except on some stamped Pampers. Explanation: “regulations do not require manufacturers to provide the composition of their products,” laments the magazine.
Even more surprising is the presence of pesticide residues (such as glyphosate) and/or other potentially toxic substances (including Volatile Organic Compounds), in the majority of the 12 samples analyzed during this first test bench.
Without forgetting, the oils from petrochemicals impregnating some diapers, which, however, “do not present major health risks, if they are of good quality.”
While in 2017, the magazine placed “Love & Green”, composed of more than 50% of renewable materials, and “Mots d’Enfants” from Leclerc (A french Brand) at the top of their zero toxic residue ranking, a dramatic turn of events at the start of the 2018 school year! Its new trial³ of 12 diapers (which this time also took into account absorbency) shook things up, confirming the adage “the first will be last.” Indeed, a glyphosate residue was detected in the first brand and VOCs were found in the second. “The consequence of a change of subcontractor in charge of manufacturing?
This is certainly the case of Love & Green, which following the complaints of its customers had changed its supply chain. Today, the brand says that it has just changed (once again!) subcontractor and that the reference that was the subject of complaints is at the end of commercialization…”, mentioned on the magazine’s website.
However, the results are encouraging. Six out of twelve diapers tested do not contain potentially dangerous substances. The new Joone brand (sold exclusively online) does well, with a score of 17/20. The only problem is its price: 0.40 cents per unit. Pampers, the leader of the sector, is back among the good students, with its “Premium Protection” and “Baby-Dry” references ranking second and third with 14.5/20 and 12.5/20.
From now on, Pregnancy And Newborn magazine is convinced: “the objective of zero toxic residues in diapers is achievable, and in a relatively short time. “.
Choosing the right size of disposable diapers
Classic” disposable or biodegradable, the baby’s diaper comes in 6 sizes. An essential criterion to check when buying. Be careful, the size does not correspond to the height or the age, but to the weight of your baby. Don’t worry, the size and the corresponding reference weight are, in principle, clearly indicated on the packages. Depending on the brand, these indications may vary by one or two kg.
- Size 1: 2 – 5 kg (from birth to 2-3 months)
- Size 2: 3- 6 kg (from birth to 3-4 months)
- Size 3: 4- 9 kg (from 3 to 10 months)
- Size 4 : 7- 18 kg (from 6 months to 3 years and +)
- Size 4 + : 9- 20 kg (10 months and more)
- Size 5 : 11- 25 kg (over 18 months)
- Size 6 : 15 kg and more
Your baby is between several sizes? “It is better to take the size above. The diapers are elastic, but they should not be too tight. In fact, a diaper that is too small increases the risk of leaks. And even if it seems a little big, don’t worry, everything will be well maintained with the bodysuit”, advises our childcare assistant.
You should also know that the mention 4 +, corresponds, in general, to a diaper with an absorption capacity higher than the “normal” size 4.
Tip: there are also different sizes for diaper swimsuits, if you want to introduce your little one to the pleasures of water, in the sea or in the pool.
Brands/prices of disposable diapers : how to find your way ?
Once you’ve found the right size of disposable diapers for your baby, you’ll have to decide on the type (classic or eco-friendly), then on the brand.
As for biodegradable disposable diapers, you can find them in supermarkets as well as in specialized stores (Carrefour Eco-Planet, Moltex, Nature Baby Care…).
And of course, many brands, eco-friendly or not, are present on the Web. For the childcare assistant, “it is better to buy them in supermarkets, from professionals (such as Walmart…). Concerning the Internet, especially for little known products, we can have doubts about the quality of the diapers” says our expert.
As for the choice of the brand and the quality-price ratio, in front of the numerous marketing claims put forward on the packets (“dry longer, anti-leak, soft as silk…”), “I advise to try several and to compare. You have to pay attention to the quality of absorption, i.e. whether the diaper leaks or not, but also to the skin reactions of your baby, who may develop an allergy to certain components of the diaper.
In concrete terms, this translates into redness, pimples or fungus. And on this point, the big brands are not better off”, underlines our expert. Indeed, the fragile skin of the toddlers is particularly sensitive at the level of the seat, because of the urine, acid. Moreover, some manufacturers have added a moisture indicator to their diapers that lets you know if your baby is dry or if it’s time to change him. Good trick or gadget? You be the judge…
Pro tip: if a diaper model suits your baby, you can use it both during the day and at night.
As for the budget, the cost per unit of a disposable diaper varies from 0.11dollars to 0.56dollars, depending on the brand and the store. The price of the diaper is also proportional to the size. Good news, the two Pampers references in the trio of the 2018 ranking of Pregnancy And Newborn Magazine are in the average, with a cost per unit of 0.25 and 0.31 cents.
Zoom on disposable diapers
Your toddler has grown up and is starting to potty train? The diapers will be your best ally. And for good reason, they slip on like panties and are also absorbent in case of accident! This way, your child will be able to remove it easily on the potty and become more autonomous when getting dressed.
As for the age of the transition to this new stage, it varies between 18 and 36 months. But there are no set rules, it all depends on your child’s maturity.
As a practical matter, when buying, don’t get confused between the classic diapers and the panty diapers. Both products exist from size 4 (7-18 kg), but also in 4 + and 5.
Of course, you will also have to choose the right size, according to the weight of your child. “Once the diaper is on, check that it is not tight at the top of the thighs”, warns our childcare assistant.
Cloth diapers: Pros and Cons
Let’s face it, cloth diapers are seducing more and more young parents, and even childcare facilities such as the new nurseries that have been using them since they opened, without imposing them on parents.
Among the main arguments invoked to launch into the adventure of cloth diapers, ecology, savings and health of babies.
Studies have shown that a cloth diaper has less impact on the environment than a disposable diaper. In concrete terms, water consumption is divided by two over the entire life cycle, from the production of raw materials to the end of use, including washing.
And that’s not all: electricity consumption is divided by 5, CO2 emissions into the atmosphere are divided by 10 as well as the depletion of non-renewable resources.
So much good news for the planet, as long as you go green at home. That is to say: turn your diapers in a full machine, preferably classified A, at 60 °C (instead of 90 °C), use eco-labelled detergents, and dry your diapers in the open air.
As for the “health” issue related to the composition of cloth diapers, young parents are reassured with organic or OEKO-TEX® certified raw materials, free of chemicals, to respect the fragile skin of toddlers.
As far as savings are concerned, it’s a no-brainer. In “disposable” mode, it will cost you about dollars1,500 per child, from birth to two and a half years. In washable version, you will only pay between 500 and 900 dollars for a complete new kit. Not to mention that if you have other children, you will largely amortize your initial investment.
Pro tip: it is also possible to buy/resell used cloth diapers. This will reduce the bill even more.
For the detractors of cloth diapers, the main argument is that of practicality and time saving. Three years ago, Clara, an educator of young children, tried the experience at the request of a couple of parents. “We used cloth diapers for their child for about 5 months. But the results were not conclusive. The toddler had more diaper rash than with conventional diapers and the parents concerned, although motivated, found the system too restrictive because of the number of washes (and the odors), and the need to invest in several diapers for diaper changes in the community. There was also the problem of how to care for the child in case of gastroenteritis”.
Over the years, brands have adapted and now offer different models to get closer to the classic diapers, with an essential accessory: a disposable (and biodegradable) liner, to be placed at the bottom of the diaper to collect the baby’s stools. At the time of the change, it does not remain any more but to throw the whole with the dustbin. A real “plus” in daily life to reduce odor concerns and limit the number of machines. Some very eco-friendly parents even go as far as washing the disposable cover in the washing machine (in case of pee) and then reusing it.
Which cloth diapers to choose ?
It all depends on your priority : do you want, above all, a quick diaper change ? Do you want to use as few machines as possible ? Are you ready to invest in several batches or on the contrary do you prefer fewer diapers, but which require more handling ? Will your baby be kept in a community or at home? Does the nanny or daycare agree?
So many questions that will determine the choice of the cloth diaper model.
Currently, there are three types, among the most used:
Cloth diaper TE1 (All in 1)
This is the model that is closest to the classic diaper. On some models, called TE1 integral, an insert (the absorbent) is already sewn onto the waterproof diaper (also called a nappy cover). On other models, TE1 pocket, there is a pocket in which we slip an insert (the absorbent), more or less thick, according to the needs…
At the time of the change, one withdraws the disposable veil with the stools (which one throws with the dustbin), and one puts the whole of the washable layer with the machine (with the absorbent, if it is separate).
- Pro tip: in case of a small pee, the cloth diaper can simply be rinsed and reused another time, without going through the washing process.
- Pros of the TE1 : few manipulations and this model is rather well received in community/by the nannies, because simple of use.
- Cons of the TE1: more machines to do because you have to wash everything almost systematically. Moreover, it is preferable to invest in a good batch of cloth diapers to turn. The whole diaper is also longer to dry.
TE2 diaper (All in 2)
In this case, the insert (the absorbent) is systematically removable. It is placed in a waterproof pocket (called a nacelle), inside the pants.
- Pros of the TE2 : only the absorbent is washed, if necessary. If the rest of the diaper is clean, it can be reused immediately. The pocket can also be rinsed if it is not very dirty, and the diaper reused for another change. This means fewer machines and the possibility of adding a thicker absorbent, depending on the situation, to avoid leaks, and therefore reduce the risk of washing everything.
- Cons of the TE2: If the pocket is soiled, it will be necessary to wash the whole diaper + pocket, even if the outer diaper is not dirty.
TE3 diaper (All in 3)
This is the most flexible and eco-friendly model. Here, the waterproof pocket is independent of the pants, as is the absorbent. If some elements are not soiled during the change (outer pants, waterproof pocket), they can be reused immediately, unlike the other models where everything must be washed almost systematically.
- Pro tip: in case of peeing, you can also simply rinse the waterproof carrycot and reuse it very quickly.
- Pros of the TE3 : less machines to make, less diapers to buy because the different elements can be reused. Thanks to this system of thin and removable “layers” to be superimposed, the drying time is also much faster. In short: we invest in only a few models.
- Another advantage : for outings or when travelling, it is even possible to use disposable and biodegradable inserts (absorbents) to avoid storing dirty products and facilitate the use of cloth diapers (0.30 dollars, the unit).
- Cons of the TE3 : there is more handling because of the independent “layers”.
Absorbent cloth diaper covered with a plastic cover
Namely: some die-hards use the most “basic” model, the old-fashioned way: the absorbent diaper is covered with a plastic cover.
- Pros: it is the most economical choice because you only buy a few plastic outer pants, and the diaper has a good absorption capacity (because of its thickness).
- Cons: it is a thick model, the absorbent part is long to dry and voluminous for the buttocks of the toddlers.
Size and composition of cloth diapers : two essential criteria
Once the model is chosen, we have to think about the size. There are two possibilities: either you buy a batch of one size (3 kg to 15-16 kg) with a system of pressures that follow the evolution of your baby, or you prefer “multi-size” batches, which will allow you to have thinner diapers, better adapted to the morphology of your toddler. Everything will also depend on your budget.
“Every 8 to 10 months, approximately, it is necessary to change size of cloth diapers. In case of doubt, it is better to take the one above”, underlines our expert.
You should know that there are also washable diapers, called training pants (2 or 3 sizes are generally proposed : 9-12 kg, 13-16 kg and + of 16 kg) and special “pool/sea” diapers, with removable washable absorbents. Here again, you have to choose the right size.
Next step : the choice of fabrics. In general, we find cotton, bamboo, hemp and microfiber. Each one has its Pros and Cons. Hemp, bamboo and cotton have a better absorption capacity, but take longer to dry, unlike microfiber. Microfiber will also keep its suppleness after many washes.
To remain in adequacy with its ecological principles, we prefer organic fabrics, or if not, certified Oeko-Tex® and “made in USA” in order to limit the carbon footprint of cloth diapers.
Last step: choosing the brand among the models that meet the selected criteria.
Pro tip: for a first experience, don’t hesitate to rent kits to test different models/brands before a final purchase (from 40-45 dollars for 3 weeks/1 month). Another possibility : invest in a second hand kit at a low price.
Choosing your diapers : the golden rules
- Take stock of your priority criteria, your life rhythm (at home/at the nanny’s or in a community) and your budget to define the type of diapers you are considering : disposable and/or washable;
- Take the time to compare brands (quality/price ratio) and to collect opinions from young parents;
- Use reliable labels for cloth;
- Pay attention to mentions such as 0% chlorine, petrolatum, kerosene on disposable diapers;
- Test several models to find the one that best fits your organization and your baby’s skin.
What Happens When breast Cancer Spreads to the Bones?
You may not know it, but most cancers can spread to bone. Once metastases have spread, they can cause unfortunate complications. However, there are different treatments for each type of problem. These include surgery and radiation therapy.
Bone metastases are a common problem in oncology, the specialty of medicine that treats cancers. Every year in United states, 150.000 cancer patients develop bone metastases, i.e. a secondary location of the main cancer in the bones. Bones are the organs most exposed to secondary lesions of a tumor. But some cancers have a higher risk of having bone metastases, with breast cancer, prostate cancer and multiple myeloma being the first to develop.
Complications caused by bone metastases decrease the patient’s autonomy and in some cases require emergency management. They can lead to fractures, severe pain, hypercalcemia (abnormally high levels of calcium in the blood), or spinal cord compression (bone exerting pressure on the spinal cord). But there are different treatments for each complication that can help relieve the patient.
Formation of Bone Metastases
Bone is composed of two types of cells that participate in its renewal: while osteoclasts destroy aging bone tissue, osteoblasts rebuild the skeleton. This process of formation and resorption is necessary for bone growth. But some cancers disrupt the balance maintained by the osteoblasts and osteoclasts, making the bone brittle.
Bone metastases are the main cause of pain in cancer patients, with the greatest intensity at night. Other problems can also arise, such as hypercalcemia, which affects 10 to 15% of patients, especially those with breast cancer, some lung cancers and multiple myeloma. Symptoms can include severe fatigue, loss of appetite, feelings of intense thirst, or the urge to vomit. Hypercalcemia can also lead to major confusion or kidney failure, requiring emergency hospitalization.
Once bone metastases have set in, the risk of pathologic fracture (a fracture that occurs without shock) is higher, sometimes with serious consequences. Indeed, if the vertebrae are affected, they can compress the spinal cord that connects the brain to the entire body and thus cause paralysis. This is called spinal cord compression and this complication requires emergency care of the patient.
For each Complication, its Treatment
Depending on the type of complications encountered, different solutions are available to patients. For example, in the case of localized bone pain, external radiotherapy (the use of radiation produced by a machine on the cancer cells) makes it possible to administer a dose of radiation that will reduce the pain. In 60% of cases, a single session is enough to make the pain disappear, but the irradiation can be repeated if it fails. When the pain is located in several places, metabolic radiotherapy may be considered. This consists of injecting a radioactive product into a vein that penetrates directly into the bone metastases and eliminates the pain. In all pain management situations, pain medication will be combined with pain medication to provide rapid relief to the patient.
Although radiotherapy also reduces the risk of fracture, surgery is sometimes necessary. Indeed, it stabilizes the bone but also prevents spinal cord compression or an imminent fracture. If there is a risk of fracture or in the case of poorly relieved pain, it is possible, under local anesthesia, to inject cement into the weakened bone to consolidate it.
Bone Targeted Medications
Two drugs can also be offered to patients. Administered orally or in the veins, biphosphonates reduce the risk of complications related to bone metastases. They have certain side effects (digestive disorders, renal insufficiency, flu-like symptoms, lower blood calcium levels), but these are well controlled. Another serious but rare complication (1.5% of cases), is necrosis (death of a cell or organic tissue) of the jaw, a risk that is however diminished by an administration generally not exceeding two years. In addition, patients whose kidneys are not functioning well cannot receive this treatment.
Denosumab, on the other hand, helps solidify bone and reduces the risk of complications. Unlike biphosphonates, it can be given to patients with malfunctioning kidneys. Its side effects are similar to those of the first drug.
Both treatments are equally effective in reducing complications related to bone metastases and prolonging the patient’s life. However, they cannot be taken for more than two years, because after that time, the risk of jaw necrosis increases considerably.
The various therapies that can be used to treat complications related to bone metastases are quite effective. In the near future, other solutions will also be offered to patients. Indeed, new therapies targeting the osteoclast are being evaluated while other products seek to treat the bone and the tumor simultaneously.
How long Can you Live with Stage 4 Metastatic Breast Cancer?
The staging of breast cancer makes it possible to determine the degree of extension of the pathology. The stage is determined by the elements of the assessment at the time of diagnosis (clinical examination by the doctor, additional tests such as mammography, ultrasound, MRI…). The staging of breast cancer will allow the disease to be assessed at several levels:
- Local: corresponds to the development of the tumor in the breast (size and infiltration).
- Regional: corresponds to the extension of the disease in the armpit on the same side, and therefore to the existence or not of lymph nodes affected by the disease.
- General or “distant”: corresponds to the extension of the disease outside the breast and armpit, and therefore the existence of metastasis.
What are the signs when breast cancer metastasizes?
Symptoms related to the presence of metastases can go unnoticed for a long time. However, unusual bone pain or headaches may be warning signs that should prompt women to seek help. Explanations by Dr. Mahasti Saghatchian, oncologist and breast cancer practitioner at the Gustave Roussy Institute.
Based on these elements, the stage of the cancer is defined according to the TNM classification (Tumor, Nodes (nodes), Metastasis) defined by the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC).
“The stage is important to assess the extent of the disease, but insufficient on its own to determine the prognosis of the disease and therefore the necessary treatments,” explains Dr. Julien Seror, cancer surgeon at the Clinique St Jean de Dieu in Paris. For this, it will also be necessary to rely on the patient’s field (age, history, other pathologies…) and histology (biopsy result) which is an essential element in the evaluation of a breast cancer. This explains why management must be done on a case-by-case basis, after analyzing all the data, and after discussing the files in a PCR (multidisciplinary consultation meeting)”.
Depending on the extension, it will be possible to establish the “TNM” stage:
- T: the size of the tumor. Specifies the infiltrating or non-invasive character of the lesion (non-invasive lesions are limited to the canal or lobule, unlike infiltrating lesions that invade the fat around, but inside the breast), as well as the size of the lesion.
- N: the lymph node extension. Specifies whether there is an attack on the local-regional lymph nodes.
- M: The remote extension. Existence (M1) or not (M0) of metastases.
The TNM assessment determines a stage of progress in five stages :
- Stage 0 corresponds to a cancer in situ (non-invasive).
- Stage 1 corresponds to a single small tumor,
- Stage 2 corresponds to a more important local invasion,
- Stage 3 corresponds to an invasion of the lymph nodes or surrounding tissues,
- Stage 4 – metastatic cancer – corresponds to a distant extension, thus the existence of metastasis.
The choice of Treatments
The different treatments to treat breast cancer are determined by the stage and type of cancer. They have the following objectives:
- Remove the tumor or metastases
- Reduce the risk of recidivism
- Slow the development of the tumor or metastases
- Treating the symptoms caused by the disease
Sometimes one type of treatment is enough to treat breast cancer. In other cases, a combination of treatments is required. “Each patient’s case must be discussed in a multidisciplinary consultation meeting (MDC), during which at least one surgeon, one oncologist and one histologist meet, to determine a personalized care protocol,” continues the doctor.
The choice of the necessary treatments will be made according to: the patient’s background: age, associated pathologies, history of cancer and treatment…, the stage of the disease, the histological characteristics of the tumor (real identity card of the tumor, allowing to evaluate the potential aggressiveness), the tumor grade (I, II or III), the Ki 67: Index of tumor proliferation, the presence of hormonal receptors, which implies most often, in case of positivity, the introduction of hormone therapy. Overexpression of the HER2 protein, which, in the case of a positive result, usually implies treatment with antibodies (traztuzmab, HerceptinÓ ) combined with chemotherapy.
The Different Treatments of Metastatic Breast Cancer
“This is the treatment most often used in the first instance, its objective is to remove the tissue affected by the cancer cells,” confides Dr. Seror. Two types of surgeries are performed: a conservative breast surgery called lumpectomy or segmentectomy, and a non-conservative breast surgery called mastectomy.
- Conservative surgery involves removing the tumour and a small portion of the tissue surrounding the tumour so that most of the patient’s breast is preserved. This surgery is preferred as soon as possible, and is complemented by radiotherapy to avoid the risk of recurrence.
- Non-conservative surgery consists of removing the entire breast. In this case, if the patient’s condition allows it, breast reconstruction techniques are offered to the patient. In some cases it will be possible to preserve the areola and nipple.
- Surgery of the axillary lymph nodes: in the majority of cases, only removal of the sentinel lymph node, the first relay of the lymph node chain in the armpit, will be preferred. In the case of lymph node involvement, axillary curage, i.e. removal of the lymph node chain, is often required.
Radiotherapy uses high-energy ionizing radiation. This method helps to preserve surrounding healthy tissues and organs. For breast cancer, four areas can be treated according to different cases:
- The mammary gland after conservative surgery;
- The tumor bed after conservative surgery;
- The chest wall after non-conservative surgery;
- The lymph node areas
It is a treatment administered by a general route, usually intravenous, which requires the insertion of a catheter to administer the treatment. Side effects vary according to the treatment protocols.
It is an oral treatment, in tablet form, taken daily for 5 to 10 years. The type of treatment varies according to the patient’s status with respect to menopause.
Stages and life expectancy
“Since 2005, there has been a trend towards earlier detection and improved treatment, which improves survival,” says Dr. Seror. Thus, net survival at 5 years standardized on age has increased from 80% for women diagnosed in 1989-1993 to 87% for those diagnosed in 2005-2010. The 5-year net survival for women with breast cancer diagnosed in 2005-2010 is highest (9,293%) for women aged 45-74, slightly lower (90%) for those aged 15-44 and much lower (76%) for women aged 75 and older.
“Very few registries in the United States, as at the international level, provide data by stage of cancer for survival analyses,” concludes the specialist. Indeed, the stage is difficult to collect routinely, and can also be a source of error”.
Thanks to Dr Julien Seror, cancer surgeon at the Clinique Saint Jean de Dieu in Paris.
13 Shocking Facts About Metastatic Breast Cancer
When cancer cells are identified outside the breast, it is called metastatic breast cancer. Its management and treatments are then very specific. An update with Dr. Cyriac Blonz, medical oncologist at the Western Cancer Institute.
While in the vast majority of cases, breast cancer is detected and treated while it is still localized, sometimes cancer cells can migrate to other parts of the body via the blood and lymph to form metastases. They can be identified at the time of initial diagnosis, but most often they appear later, usually within 5 years of diagnosis. More rarely, a metastatic recurrence can sometimes occur late, sometimes 10 to 20 years after the initial diagnosis.
The 3 main types of cancer – Her2+, RH+ and triple-negative – are potentially metastatic.
Metastatic Breast Cancer Signs
While metastatic breast cancer can go undetected for a long time, metastases sometimes cause signs or symptoms. Identifying them quickly allows for faster and often more effective management of the disease.
The signs depend on the location of the metastases, which in turn depends on the nature of the cancer.
“Each type of cancer has its own tropism, i.e. a tendency to develop in a specific organ. Breast cancer will preferentially metastasize to bones, lungs, liver or brain for example,” Dr. Blonz describes.
> Bone metastases can cause bone pain at night and even fractures;
> Advanced lung metastases can cause shortness of breath;
> Liver metastases can cause jaundice, also known as jaundice;
> And finally, brain metastases can cause severe headaches.
What is the difference between osteoarthritis and rheumatoid arthritis?
Arthritis is a general term used to describe inflammation of the joints. Osteoarthritis and rheumatoid arthritis (RA) are two types of diseases known to affect the musculoskeletal system in many ways. Their prevalence in modern society is quite high, but with timely interventions, the negative impact on quality of life can be eliminated. The main difference between osteoarthritis and rheumatoid arthritis is that osteoarthritis is a degenerative disorder of the wear and tear type, whereas rheumatoid arthritis is an autoimmune disease.
What is osteoarthritis?
Also known as osteoarthritis, osteoarthritis is a degenerative type of disorder known to be the most common form of arthritis in the community.
It occurs as a result of wear and tear on the protective cartilage at the end of the joints over time. This cartilage acts as a cushion that absorbs friction, and its absence can lead to continuous friction generated by the bones rubbing against each other, ultimately resulting in a worn joint. Although this condition can damage all joints in the body, the joints most often affected are the hands, knees, hips and spine.
Advanced age, obesity, joint trauma, genetics, bone deformities (malformed/defective cartilage), long-term weight bearing and weightlifting may be risk factors for osteoarthritis; women are at higher risk than men. This is most often seen in people over the age of 40, but it can also be seen in young people after an accident or trauma.
Osteoarthritis patients usually have pain around the affected joints, difficulty moving them because of stiffness. The pain and stiffness worsens more towards the morning, just after waking up, which usually lasts more than 30 minutes. In addition, these people will also complain of loss of flexibility, limited range of motion, loss of muscle mass, and a grating sensation on moving joints and spurs presenting as hard, bony structures on the skin around the affected joints.
Osteoarthritis must be diagnosed as early as possible and interventions must be timely, as it can lead to a debilitating, lifelong disease in which patients will no longer be able to work.
Your doctor will take a full history and conduct a thorough physical examination to look for signs of inflammation such as pain, tenderness, swelling, redness, and difficulty moving around and make a general diagnosis. However, this will be confirmed by an x-ray (you may see worn bones, missing cartilage and spurs) with or without an MRI. In addition, blood (ESR) and joint fluid tests may also be important to exclude other mimetic conditions such as rheumatoid arthritis and gout.
Although there is no comprehensive treatment for osteoarthritis, lifestyle modifications and pharmacological interventions are known to help alleviate symptoms.
Although there is no complete treatment for osteoarthritis, lifestyle modifications and pharmacological interventions are known to help reduce symptoms.
Lifestyle modification – Regular exercise, maintaining a healthy body mass index, avoiding joint stress by lifting heavy weights
> Pain relief: Acetaminophen can be used to relieve mild to moderate pain, but long-term use may result in liver damage,
> Non-steroidal anti-inflammatory drugs (NSAIDs) – Ibuprofen, Naproxen sodium,
> Antidepressants such as duloxetine – to treat chronic pain,
Surgical procedures – corticosteroid injections to relieve severe pain and inflammation
> Hyaluronic lubrication injections,
> Realign the bones,
Arthroplasty- removal of damaged joint surfaces and replacement with metal or plastic parts
What is rheumatoid arthritis?
Rheumatoid arthritis is a chronic autoimmune disease characterized by pain, tenderness, swelling and stiffness in the affected joints, including the hands, feet and wrists, in a symmetrical fashion. It can also lead to extra-articular manifestations involving the skin, eyes, lungs, blood and nerves.
Although the exact etiology of rheumatoid arthritis is unclear, it is an autoimmune disease in which the body produces antibodies against its own cells. Some scientists suggest that microorganisms such as viruses and bacteria play a major role in pathophysiology.
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Rheumatoid arthritis generally affects people in their early 20s. The majority of patients with rheumatoid arthritis experience pain, tenderness, swelling and lameness of the joints throughout the body, which progresses gradually over the course of weeks. Fever, loss of appetite and weight, generalized body pain, red eyes, rheumatoid nodules on the skin, anemia, etc. can also cause extra-articular symptoms. Patients may also experience aggravated joint pain in the morning, which usually improves within 30 minutes. to arthrosic pain.
Doctors are able to diagnose this disease by analyzing the signs and symptoms derived from a complete history, as well as family history information. This can be further confirmed by imaging studies such as X-rays and MRI, as well as blood tests such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and cyclic anti-citrulline antibody (anti-CCP) testing.
The treatment plan for rheumatoid arthritis consists primarily of lifestyle modifications and pharmacological interventions.
Lifestyle modifications – Regular exercise when inflammation is controlled and appropriate rest during severe attacks.
> Anti-inflammatory agents,
> Analgesics (Narcotics),
Disease-modifying anti-rheumatic drugs (DMARDs) – Hydroxychloroquine, immunosuppressants such as methotrexate,
Although rheumatoid arthritis is not cured for life, timely interventions can certainly prevent disability.
Difference between osteoarthritis and rheumatoid arthritis
Type of diseases
The main difference between osteoarthritis and rheumatoid arthritis lies in the nature of its natural evolution. Although both conditions affect our musculoskeletal system, Osteoarthritis is a degenerative disorder of the wear and tear type, whereas rheumatoid arthritis is an autoimmune condition.
Both conditions have a significant female predominance, but osteoarthritis generally affects people over 40 years of age, while the incidence of rheumatoid arthritis is higher in young people around 20 years of age.
Osteoarthritis is the result of long-term pressure on large joints such as the hips, knee, elbow, causing wear and tear, while the exact etiology of rheumatoid arthritis is not very clear, suggesting the influence of genetic predisposition and long-term smoking.
Signs and symptoms
Joint pain, tenderness and stiffness around the hands, fingers and knees,
One side is more affected than the other,
Morning stiffness for more than 30 minutes,
Multiple joint pain, stiffness and tenderness,
Morning stiffness that improves within 30 minutes of activity,
Extra-articular manifestations such as fatigue, fever, weight loss and malaise,
A clear history can easily be diagnosed between these two conditions, but XRAY, MRI and blood tests can be used to confirm the diagnosis. X-rays of a patient with joint damage, missing cartilage and spurs are visible. Osteoarthritis.ESR, CPR, anti-CCP may be elevated in rheumatoid arthritis while there will be no change in osteoarthritis.
Pain relief, symptom management and prevention of destruction are the main goals of management. In particular, rheumatoid arthritis must be treated with immunosuppressants. Osteoarthritis and rheumatoid arthritis have no long-term curative treatment, but with timely interventions, complications can be stopped.
How to Prevent Arthritis? 6 Exercises to Prevent Arthritis
Arthritis pain is experienced differently from one person to another. Its intensity depends largely on the severity and extent of the disease. Sometimes the pain temporarily subsides. Daily activities often need to be reorganized accordingly.
We do not yet understand all the biological mechanisms involved in the genesis of arthritis pain. However, it appears that tissue oxygen depletion plays a major role. This lack of oxygen is itself caused by inflammation in the joints and tension in the muscles. That’s why anything that helps to relax muscles or promotes blood circulation in the joints relieves pain. On the other hand, fatigue, anxiety, stress and depression increase the perception of pain.
Moving around on a regular basis can help prevent and improve many health problems, including arthritis. Physical activity, such as swimming, walking and bicycling, also helps protect joints while strengthening muscles and building fitness. Strengthening your muscles provides support for your joints and reduces your risk of developing arthritis. Tai chi chuan and yoga also help reduce stress on your joints and improve your balance.
Here are 6 exercises to perform to keep arthritis at bay.
Target: knees and hips
A. Lie on your left side with your left leg bent and your right leg straight. Place your elbow on the floor and your head on the palm of your hand.
B. Lift your right leg and hold for a short moment while exhaling. Slowly lower the leg without letting go. Inhale. Do the exercise with the left leg.
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Lateral deltoid lift – standing
A. With a medium dumbbell in each hand, move the right foot forward 60 cm (at the next session, move the left foot forward). Bend the advanced leg and slightly bend the chest from the waist. Keep your back straight, abdominals contracted and body weight forward. Keep your shoulders low and backwards.
B. Extend your arms toward the ground, hands and dumbbells parallel to your shoulders. Slowly raise your arms at your sides, palms down and elbows slightly bent, to shoulder height (see illustration).
C. Return the arms to the starting position. Repeat 8 to 12 times.
A. Lie on your back with your legs extended and your hands behind your ears (or touching them lightly).
B. Contract your abdominal muscles. Raise your head and move your left knee toward your head, stopping when your knee is at your waist and your thigh is perpendicular to the ground. At the same time, bring your right elbow towards your high knee (your trunk will be slightly twisted) so that your elbow and knee are as close to your stomach as possible.
C. Slowly return to the starting position. Rest for one second and repeat with opposite limbs. Always begin your abdominal strengthening exercises by pushing your abdominal muscles towards your tailbone and keeping your back flat. Avoid arching your back. Use your stomach muscles rather than your neck muscles to lift your trunk.
Tip: This exercise should take about 5 seconds: 2 seconds to bring the knee and elbow together, and 3 seconds to return to the starting position. As you get stronger, reduce the rest time. All movements must be controlled, which will keep your muscles strong for a long time.
Do a series of 8 repetitions two to three times a week. Hold the position for 15 to 30 seconds.
Target: back and spine
A. Lie on your stomach, arms stretched out over your head, legs straight and the tops of your feet touching the floor.
B. Raise your feet, arms and shoulders at the same time off the floor, contracting the muscles of your lower back. Avoid making sudden movements or lifting your head during the exercise; in other words, keep your neck in line with your spine.
C. Hold the contraction for 2 seconds and then return to the “up” position.
Sweater over with dumbbells
A. Place your head and shoulders on the ball, lifting the basin.
B. Take the weight with both hands and slowly lower the arms until they are parallel to the ground.
C. The arms are slightly bent; begin the movement at the shoulders to return to the original position.
Tip: This exercise can be performed on a weight bench.
Forearm flexion in standing position
A. In the standing position, the feet are at shoulder height and the resistance band passes under both feet. Grasp the handles, palm forward.
B. Bend your arms, bringing your hands together at shoulder level. Elbows are glued to the body throughout the exercise.
C. Slowly return to the original position. Avoid immobilizing the shoulder.
What Does Arthritis Feel Like?
There are many diseases that can cause joint and bone disease. While they are known to affect the elderly, more and more young people are also suffering from these conditions. The causes of these disorders are very varied and it is essential to know them in order to better avoid and prevent them. In addition to consulting doctors and specialists, other methods can greatly help, especially in the prevention of disorders such as hernia, arthritis and gout problems.
Arthritis, a disease affecting more and more young people
When discussing joint disorders, arthritis is often mentioned. It is a general name for many diseases that affect muscles, joints and also bones. While some diseases, such as osteoarthritis, usually affect adults and the elderly, other forms are more common in young people, often from the age of 12.
How do you recognize an arthritis infection?
It is not easy to recognize this disease. In fact, symptoms differ from one form to another. While in most cases, the best known signs are inflammation, it is possible that some forms of infection do not have these symptoms. Therefore, consulting a specialist remains the best way to detect the disease.
What causes arthritis?
Despite much research in the field, the exact origins of this disease are not completely known. However, scientists have been able to determine some of the most common causes of arthritis. According to studies, trauma and infections are at the origin of this disease.
Natural wear and tear on certain parts of the body can also cause the disease. It is mostly a result of repeated physical exertion that strains the muscles and skeletal system.
Finally, arthritis can be the consequence of autoimmune diseases such as type 1 diabetes, thyroid disease, or rheumatoid arthritis.
Manifestations of arthritis
There are several forms of arthritis. They are categorized according to their manifestations and the parts of the body affected. In this case, there are two main forms of arthritis.
It is the most common manifestation of this disease. It is also known as degenerative arthritis because it is caused by the wear and tear of cartilage due to age. Osteoarthritis is most often located in the joints that support a large part of the body’s weight, such as the hip, knees, spine and feet.
Although it rarely appears before the age of 40, factors such as excess weight, repeated use of a joint or the practice of sports can promote its early onset.
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This inflammatory disease occurs mostly around the age of 40 to 60. It is initially characterized by inflammation of the joints in the hands, wrists and feet. If no measures or treatments are applied, the inflammation can affect other organs and then the entire body. Its cause is not yet known, but it is hypothesized to be hereditary and autoimmune in origin. However, this does not explain the fact that it is more common in women than in men.
Other common forms of arthritis
Other forms can also characterize an arthritis condition. While they are rarer, they are no less important and can lead to complications of varying degrees of severity.
Infectious arthritis: occurs when any infection directly affects a joint, which can lead to inflammation.
Gout: it is characterized by the deposition of materials from uric acid and calcium phosphate in the joints. This inevitably causes inflammation and pain.
Ankylosing Spondylitis: is a joint inflammation that affects the back and, in particular, the vertebrae. It is characterized by lumbar and hip pain that can gradually lead to back stiffness.
What is Rheumatoid Arthritis? – Symptoms and treatment
Rheumatoid arthritis is the most common form of chronic inflammatory rheumatism. This pathology leads to inflammation of several joints. It most often affects the hands, wrists and knees, but can extend to the shoulders, elbows, neck, hips, ankles, etc. It evolves in flare-ups and can be very painful and disabling. Early diagnosis is necessary in order to initiate treatment that will limit the evolution of the disease and relieve symptoms.
Rheumatoid arthritis: what is it?
Rheumatoid arthritis (RA) is a systemic connective tissue disease characterized by chronic joint inflammation that progresses in relapses. It gradually causes symmetrical deformities of the affected joints, with various manifestations affecting organs other than the joints.
The joints are lined by the synovial membrane, which secretes a lubricant: the synovium. Inflammation flushes out this layer of cells, causing the tissue to sprout and then erode the cartilage in the joint, which is no longer normally lubricated by the synovium. The joint is thus gradually destroyed and replaced by coarse tissue that almost welds the two ends of the bones together. This is what causes the more or less tight ankylosis of the joint.
Rheumatoid arthritis in figures
It is the most common chronic inflammatory rheumatic disease in adults. It affects about 0.5% of the population in the wrold, i.e. 200,000 people, with a clear predilection for women, who are three times more affected than men.
All ages are concerned, but the term rheumatoid arthritis only applies to patients over 15 years of age. Before this age, chronic joint inflammation takes several forms (ACJ or juvenile chronic arthritis, Still’s disease). Most often, however, the disease begins between 30 and 60 years of age, with a peak around the age of 45.
Rheumatoid arthritis is favored by the presence of the HLA-DR1 antigen found in 60% of patients and HLA-DR4 which is found in 30% of them.
Causes and risk factors of rheumatoid arthritis
Rheumatoid arthritis is first and foremost a chronic inflammatory rheumatism likely to develop into very disabling joint deformities and destruction linked to rheumatoid synovitis. Rheumatoid synovitis determines the formation of a pannus (thickening of the membrane) which can be assimilated, by its consequences, to the localized proliferation of an inflammatory tissue. It is a polyfactorial autoimmune disease, which may be due to :
A genetic factor: there are predisposition genes (such as HLA-DR1 or HLA-DR4) but they only represent 30% of the determinism of the disease;
Environmental factors: in particular, tobacco plays a very important role in the onset, severity of RA and response to treatment;
Infectious factors: Certain viruses and bacteria can be implicated, such as Porphiromonas gingivalis, but their role remains to be confirmed;
Psychological factors: in 20 to 30% of cases, RA occurs after a shock or significant event, such as bereavement, surgery, childbirth, etc.
Hormonal factors: it appears more often at the time of menopause.
The combination of several of these factors considerably increases the risk of developing the disease.
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Symptoms of rheumatoid arthritis
An evolution by pushes
The first joints affected are usually those of the hands and knees. The pain is permanent but often subsides at the beginning of the night, allowing the patient to fall asleep. The pain reappears in the second half of the night and wakes the patient up. On waking, the joints are stiff, swollen, warm and the morning “rusting” is painful. These symptoms persist for a few weeks or months, then subside and may even disappear…before coming back. Relapses and remissions then follow one another, but, without treatment, the joints become deformed and the disease spreads: shoulders, elbows, ankles, feet are affected.
The evolution is very variable and the severity of the disease is unpredictable, differing from one patient to another. In the majority of cases, the disease is of average severity, compatible with a tolerable life.
In some cases, it stabilizes, with or without joint deformities. In other, more severe cases, it leads to deformity and permanent ankylosis of several joints and thus to disability.
Signs of the disease
To facilitate this difficult diagnosis, the American Rheumatology Association (ARA) has developed criteria.
The presence of the first 4 criteria allows the diagnosis of rheumatoid arthritis to be retained:
- Morning stiffness of a joint lasting more than 1 hour for at least 6 weeks;
- Inflammation of at least 3 joints for more than 6 weeks;
- Inflammation of the wrist, metacarpophalangeal or interphalangeal joints for at least 6 weeks;
- Symmetrical joint inflammation for at least 6 weeks;
- Radiological signs on the hands;
- Subcutaneous nodules;
- Presence of rheumatoid factor in the blood.
The European League Against Rheumatism (EULAR) has developed and published a series of criteria which, if present, are scored. When the total score is equal to or greater than 6, the clinical diagnosis of rheumatoid arthritis can be made.
In practice, the diagnosis of rheumatoid polyarthritis is often difficult during the first year of evolution.
The extra-articular manifestations (affecting organs other than joints) of the disease are numerous:
- An alteration of the general state is noted during the outbreaks, with a fever of 38°, 38°5 ;
- Firm, subcutaneous nodules are seen especially on the extensor surfaces of the limbs;
- Renal damage is possible, but less frequent than in lupus;
- Cardiac, pleuro-pulmonary and ocular damage is possible;
- Sometimes there are adenopathies (lymph nodes).
Additional examinations and tests
Specific biological tests (rheumatoid serology) are often negative at the beginning and become secondarily positive during the first year: latex test, Waaler-Rose, presence of antibodies against citrullinated proteins. 15% of rheumatoid arthritis patients remain seronegative.
Conversely, many diseases that are not rheumatoid arthritis are accompanied by the presence of rheumatoid factors in the blood: Osler’s endocarditis, systemic lupus, various connective tissue diseases, Gougerot-Sjogren syndrome, syphilis, tuberculosis, leprosy, viral infections, tropical parasitosis, chronic bronchitis, pulmonary fibrosis, pneumoconiosis with fibrosis, lymphomas, Waldenstrom’s disease, hepatitis, cirrhosis, sarcoidosis. .. This presence is also possible during kidney transplants, in drug addicts (heroin), in elderly subjects.
In addition, 15 to 30% of rheumatoid arthritis patients have antinuclear antibodies (as in lupus), which is far from facilitating the diagnosis!
X-rays of the joints at the beginning of the course of rheumatoid arthritis are normal. Bone erosions often appear after one year of evolution.
Examination of the synovial fluid and biopsy of the synovium can provide interesting information.
Treatment of rheumatoid arthritis
The global management of rheumatoid arthritis combines:
- Medications for the basic treatment,
- Symptomatic or crisis treatments (analgesics, non-steroidal or steroidal anti-inflammatory drugs),
- local therapeutics (evacuating punctures, corticoid infiltrations, synoviorthesis with osmic acid…),
- functional rehabilitation measures (resting devices, occupational therapy, physiotherapy, etc.),
- psychological care,
- sometimes surgical procedures.
Overall, the objectives of rheumatoid arthritis management are to relieve pain, stabilize existing lesions and prevent the occurrence of new ones, limit damage and disease progression, and improve the patient’s quality of life. For this reason, it is recommended that this management and follow-up be carried out in a specialized setting with the inclusion of specialists and a multidisciplinary team of health professionals.
Pregnancy often leads to an improvement of the disorders but substantive treatments must be discontinued due to the risks to the fetus.
Tips for living better with rheumatoid arthritis
Various advice as well as information and education facilitate the daily life of the patients:
- Rest, especially during relapses;
- To be helped at home;
- At work, a reclassification procedure can be considered or a workstation layout can be negotiated;
- Designing the house with hand ankylosis in mind: modifications to doors, locks, faucets, toilets, washroom
- Use adapted instruments: brush and comb with long handles, cutlery with large handles, pencils and pens of large diameter
- Remove buttons on clothes and replace them with Velcro fasteners;
- Use shoes without laces and devices to put stockings on…
What is Psoriatic Arthritis?
Medically verified by Daniel Koch, Senior Specialist Medical Affairs, MSD Switzerland
What is psoriatic arthritis? Who is most often affected by this disease? How does psoriatic arthritis develop and progress? What is a flare-up? Can psoriatic arthritis be treated well? You will find the main information on this subject in this article.
Psoriatic arthritis is a chronic inflammatory disease affecting both the skin (psoriasis) and the joints. The term “chronic” means that the disease is long-lasting and can recur.
Most people first develop psoriasis before being diagnosed with psoriatic arthritis. But joint problems may also occur before pathological changes in the skin and nails.
Psoriatic arthritis is an autoimmune disease and belongs to the group of spondylitis (along with ankylosing spondylitis). The term “spondylitis” simply refers to a chronic inflammatory disease of the joints and spine.
Skin Changes in Psoriasis
Skin changes are triggered by a strongly accelerated growth of skin cells. While this process normally takes 28 days, the renewal of affected skin cells takes only one week in the case of psoriasis. The incomplete keratinization process leads to the formation of scales. The affected skin areas dry out and may bleed. Acute flare-ups may be accompanied by severe itching.
Joint changes in arthritis
In affected joints, the synovial membrane is inflamed and secretes more synovial fluid. This leads to an effusion. This inflammatory process leads to redness, excessive heat and swelling.
Read More : About Arthritis: What is Arthritis?
If the process becomes chronic, i.e. the inflammation does not stop, more connective tissue, called pannus, is formed. This connective tissue first covers the joint surfaces and can then proliferate into cartilage and bone, eventually destroying the joint structure.
Structures close to the joints such as capsules, tendons and ligaments can also be affected by inflammation, which can contribute to instability and misalignment of the joint.
How does psoriatic arthritis progress?
In psoriatic arthritis, skin changes usually appear first. Joint inflammation usually occurs later. It appears rather insidiously and is mainly limited to one side of the body. In rheumatoid arthritis, on the other hand, both sides of the body are usually affected in the same way. However, it is also possible that joint inflammation occurs first and psoriasis later.
Psoriatic arthritis usually progresses in flare-ups. About 5-20% of patients have severe joint damage and about 30% have milder damage.
What is a “Flare-Up”?
With current treatment options, psoriatic arthritis can generally be well controlled, and patients can live for longer periods of time without symptoms. A “flare-up” means that the disease suddenly reappears after an asymptomatic phase. The intervals without joint symptoms do not necessarily correspond to those without skin symptoms.
5 typical forms of psoriatic arthritis
Asymmetrical oligoarticular arthritis. Asymmetrical involvement of small finger or toe joints or large joints such as knee, shoulder or ankle joints. All joints of a finger or toe may be affected (“sausage attack”).
Distal interphalangeal arthritis (DIA). The end joints of the fingers and toes are more affected.
Symmetrical polyarthritis. Inflammatory changes in the joints are symmetrical: the same joints are often affected on the left and right sides of the body.
Spondylitis (spinal inflammation). This condition can lead to pain and stiffness in the spine or in the joint with the pelvis.
Mutilating arthritis. Mainly affects the small joints of the hands and feet.
Transitional and mixed forms are possible.
Who can suffer from psoriatic arthritis?
Psoriasis is a disease that can cause pathological changes in the skin and nails. It affects between 85,000 and 255,000 people in Switzerland. It is estimated that about 30% of these patients also develop psoriatic arthritis. Psoriatic arthritis affects women and men equally.
What Causes Arthritis Pain?
Arthritis is simply defined as an inflammation of the joint. People with arthritis may experience more than one inflamed joint. There are many types of arthritis, but the two most common types are rheumatoid arthritis and osteoarthritis. Joint stiffness and joint pain are the two most common symptoms of arthritis. Pain appears to be the most common, and there are many different causes of arthritis pain, including synovial inflammation of the membrane, fatigue, muscle tension, and inflammation of tendons and ligaments.
Synovial Membrane Inflammation
The synovial membrane is a tissue that lines the joints. When this tissue becomes inflamed, there is mild to severe pain and the result is stiffness. In some cases, it can limit a person’s mobility.
Inflamed Tendons and Ligaments
Tendons and ligaments connected to an affected joint can become inflamed in this way. Pain can result from this inflammation. Like the pain associated with an inflamed synovial joint, it can be mild to severe.
Straining the muscles around or near an affected joint can increase the pain of arthritis. Muscle strain can also lead to a temporary decrease in mobility, which can add stiffness, which in turn can lead to more pain. The increase in pain due to a tense muscle can be mild to severe.
Read More : About Arthritis: What is Arthritis?
Fatigue can increase the feeling of pain. Many people with arthritis are older, and therefore experience more fatigue and in turn more pain from arthritis. Often, reducing fatigue can reduce the pain associated with arthritis.
Damage, Heat and Swelling
When an arthritic joint is damaged, swollen or hot, the more pain it can cause. Many times, swelling is due to edema (water retention), so taking steps to reduce this factor can reduce swelling and pain. Heat can occur in joints affected by arthritis and often goes away on its own. The damage caused by the pain of arthritis can be due to a number of things, such as trauma and degeneration. Trauma, such as falls and traffic accidents, can lead to further damage to arthritic joints. Joint degeneration due to aging can also contribute to injury.
Physical, Emotional and Other Factors
Emotional factors such as anxiety and depression are thought to aggravate the pain of arthritis. These conditions can lead to decreased tolerance to pain and fatigue, which can make arthritis pain worse. Some people are simply more sensitive to pain and will automatically experience more. Some people develop hypersensitivity to the pain of arthritis due to tissue damage and inflammation in the affected joints.
About Arthritis: What is Arthritis?
Arthritis is a common disease that includes many inflammatory diseases and its prevalence increases with age. The following is an update on the most common manifestations of this pathology, its different forms, causes and diagnosis. (Source)
Arthritis corresponds to a set of inflammatory phenomena that affect the joint and the bones, and which are accompanied by more or less severe pain. Acute or chronic and progressive pathologies related to arthritis primarily concern adults over 40 years of age, although some forms can affect children and young adolescents.
Definition: What is Arthritis Pain?
Arthritis is a term for more than 100 diseases characterized by inflammation of the joints and other parts of the body. Inflammation is a medical term for pain, stiffness, redness and swelling. If left unchecked, inflammation can cause significant, often permanent, damage to the affected areas, resulting in loss of function and disability.
Arthritis (from the roots “arthro,” meaning joint, and “itis,” meaning inflammation) can affect almost any part of the body, but most often affects the hips, knees, spine or other weight-bearing joints. The disease can, however, affect the fingers and other non-load-bearing joints.
Arthritis is a chronic disease, which means that it affects people who have it continuously, permanently or recurrently for periods ranging from several months to a lifetime.
Best Arthritis Pain Relief Cream
The swelling of the joints caused by arthritis can cause a lot of pain and limit your ability to move. If you have arthritis, you probably want as many options as possible for pain relief.
You may have already tried over-the-counter pain medications that you take by mouth. These include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Another option is to try one of the many over-the-counter topical creams that can help relieve arthritis pain. Here’s the bottom line on these products to help you decide which arthritis cream might be best for you.
How Arthritis Creams Work
Arthritis creams help relieve joint pain causes when applied to the skin. They can provide short-term but effective relief. These creams tend to work best on joints that are close to the surface of the skin, such as the joints of the hands or knees.
The main analgesic ingredients in arthritis creams are salicylates, counter-irritants and capsaicin.
Salicylates reduce inflammation (swelling and irritation). This helps reduce pressure and pain in the joints.
Some brands of salicylate products also contain other ingredients such as menthol, camphor, eucalyptus oil and cinnamon oil. These substances are called counter-irritants. They warm or cool the skin and distract the brain from pain.
Capsaicin is a natural and odourless element found in hot peppers. It reduces pain by blocking pain receptors in the skin.
Safe Use Of Arthritis Pain Relief Cream
Although arthritis creams are over-the-counter products, you still need to use them properly. Follow these steps to help ensure the safe and effective use of your arthritis cream:
> Always follow the directions on the package when applying an arthritis cream.
> Wash your hands before and after applying the cream. Never touch your eyes or mucous membranes when you have arthritis cream on your hands.
> Limit your use to four times a day, unless the packaging suggests otherwise.
> Stop using the cream if it causes irritation or if you notice that your skin is sensitive to the product.
> If you are sensitive or allergic to aspirin, ask your doctor if you should avoid salicylates. You may also need to avoid them if you are taking prescription blood thinners.
> To avoid side effects, use salicylate creams only occasionally, unless your doctor tells you otherwise.
Talk to Your Doctor
With so many arthritis pain relief creams on the market, it can be difficult to know what’s good for you. Keep trying different products until you find one you like. If you have any questions or concerns, talk to your doctor. They can help you find the arthritis pain relief product that is best for you.
Home Remedies For Arthritis
On many occasions, it is normal and more recommended to go to a doctor when this type of condition occurs since, in the majority of cases, it causes unbearable pain. It is usual that after a visit to the doctor, they prescribe medications and therapies to improve his conditions.
In this case, these remedies will serve you in a complementary way to obtain better and faster results so that you can carry out the movements of daily life without any complications.
Some of these remedies are :
Turmeric For Arthritis
Turmeric has analgesic properties, which will help relieve pain, and also anti-inflammatory, which will promote good circulation in the joints.
> A spoonful of ground turmeric (15 g)
> One cup of water (250 ml)
What do you need to do?
> Heat the water until it boils and pour it into a cup where you have previously added the turmeric.
> Stir, then let it stand for 3 minutes and consume.
> Take this drink once a day to feel better.
Arnica, like turmeric, has analgesic and anti-inflammatory properties that will help improve the symptoms of arthritis. We have two ways to enjoy the benefits of this plant.
Infusion of Arnica
> 2 arnica flowers
> 1 cup of water (250 ml)
What do you need to do?
> Heat the water and then add the arnica flowers to make a decoction of 3 or 4 minutes.
> Stir a little and let it rest for 10 minutes.
> Take this drink once a day.
> You should try not to consume this plant for more than three weeks because it can be toxic to the body.
It is recommended to take it for two weeks and take a break for two more weeks.
What do you need to do?
> Pour hot water on the arnica flowers to release some of their properties.
> Once they are moist, place them on painful joints.
> Using a clean bandage, then wrap the flowers to secure them in place.
> Apply this treatment twice a day, in the morning and in the evening. Remove the bandage after one hour.
Apple Cider Vinegar
This product is very effective in relieving inflammatory conditions.
> 1 cup of water (250 ml)
> 1 tablespoon apple cider vinegar (15 ml)
What do you need to do?
Mix the two ingredients together and drink twice a day.
We can also take advantage of its topical properties to improve arthritis symptoms with compresses.
What should you do?
> In a bowl, first boil the cider vinegar and water in equal parts.
> Then moisten a clean compress with the mixture and, using a bandage, secure it to the painful area.
Repeat the application of this bandage until the symptoms disappear.
Celery For Arthritis
Celery brings an important quantity of nutrients and vitamins to the body. Thanks to its medicinal properties, it is used to cleanse and detoxify. It is also a good element to reduce blood pressure. By improving circulation, celery will help relieve the symptoms of arthritis.
> 5 stalks of celery
> Honey (to taste)
What do you need to do?
> Squeeze the juice from 5 celery stalks using a blender or juice extractor.
> If you wish, you can also add a little honey.
> Then take the celery juice before each meal and you will notice the results.
Other Home Remedies For Arthritis recommendations
Try to include fresh fruit such as papaya and melon in your daily diet. These will help your body improve certain processes such as digestion or circulation. You, in turn, will feel better and full of energy.
Walking more will also help you give your body the mobility it needs without having to make an effort that you can’t handle. Walking greatly helps to improve the activity of the cardiovascular system and in turn strengthens your body.
Remember that the remedies mentioned are complementary to the treatments prescribed by a doctor and should not replace them in their entirety.
Difference Between Arthritis and Osteoarthritis
Arthritis can cause pain at rest while osteoarthritis is caused by an alteration of the cartilage that will gradually wear out and disappear, leaving the bones in contact with each other causing pain during movement. Osteoarthritis is characterized by the crumbling of the cartilage surface of the joints concerned.
Different Types of Arthritis
The major pathologies related to arthritis can be classified into several types:
– Rheumatoid Arthritis
Etiology of Rheumatoid Arthritis: Rheumatoid arthritis is an autoimmune disease that affects 0.5 to 1% of the population and is characterized by inflammation of various joints, but also of certain internal organs. See our fact sheets :
“Gout is characterized by an excessively high level of uric acid in the blood, causing characteristic acute pain, particularly in the big toe,” reports Dr. Jacques Amselem, a general practitioner in Seine-et-Marne.
– Systemic lupus Erythematosus
Systemic lupus erythematosus is an autoimmune disease that affects different organs of the body, and the joints.
Infantile arthritis or juvenile idiopathic arthritis
Infantile arthritis or juvenile idiopathic arthritis is a fairly common disorder in children, observed particularly during growth.
– Infectious Arthritis
Infectious arthritis is a form of inflammatory arthritis caused by an infectious agent (virus, bacteria, fungus) that, once introduced into the body, penetrates the joints. Infection usually occurs as a result of injury or surgery. This type of arthritis can occur at any age. Samples of synovial fluid (joint fluid) can be taken to identify the germ responsible. Treatment with medication (antibiotics if necessary) must be started quickly, even before the diagnosis is confirmed, says the general practitioner.
– Reactive Arthritis
Reactive (or reactive) arthritis is a form of arthritis that occurs as a result of infection. However, unlike infectious arthritis, it is not characterized by the presence of the infectious agent inside the joint. Therefore, no germ is found when joint fluid is removed from the joint. The legs, fingers and wrists are often the first parts affected. The joint becomes swollen, warm and painful. Reactive arthritis usually fades after a few weeks. Anti-inflammatory drugs help to relieve joint pain causes.
– Septic Arthritis
Septic arthritis is a rare, serious, sometimes fatal disease, secondary to the invasion of the joint by a bacterial germ. Contamination of the joint can occur directly through a wound, for example, or through the bloodstream. Only one joint is affected. The affected joint is hot, inflamed, causing severe pain and preventing normal movement. The patient is tired, pale, has fever, chills. A sample of the joint must be taken very quickly for analysis and research of the bacteria involved and an antibiotic treatment must be started even before the results of these tests. Imaging exams, such as X-rays or ultrasounds for deep joints, can help in the diagnosis.
– Other Common Pathologies
Psoriatic arthritis, scleroderma and ankylosing spondylitis are other pathologies that fall into the category of arthritis.
What Causes Arthritis Pain?
Aging, the after-effects of joint or ligament trauma, a genetic predisposition in the family (in the case of inflammatory diseases known as autoimmune diseases), overweight and obesity, intensive sports practice and episodes of bacterial or viral infections are risk factors.
The most common symptoms of arthritis are acute or chronic pain in one or more joints, stiffness or limited joint movement, joint effusion, warmth in the limbs, fatigue, inflammation and fever. The manifestations of arthritis are those of any inflammation: redness, heat, swelling, pain.
Symptoms then vary depending on the condition in question. Generally speaking, we find :
> Tendon pain that may tend to disappear with movement in case of benign evolution;
> Joint stiffness;
> A joint effusion, indicating the presence of fluid in the joint;
> An important tiredness; the appearance of skin nodules at an advanced stage;
> An inflammation of the big toe is suspected of gout.
The joints most often affected are the hands, wrists, elbows, knees, hips, ankles, spine, cervical region and shoulders.
Diagnosis is based primarily on questioning and clinical examination (inspection of joints, verification of joint amplitudes, movements), medical imaging (standard X-rays and in some cases ultrasound, CT scan or MRI). These exams make it possible to visualize and evaluate the degree of joint damage (calcifications). In case of effusion, an examination of the synovial fluid is performed.
Arthritis Treatments : How is Arthritis Treated?
The specific treatment of the cause is an indispensable prerequisite in the event of a diagnosis accessible to a specific treatment. In addition, there are several methods to relieve arthritis. On the one hand, a physiotherapist is often called in to help reduce joint stiffness and relieve pain. The resting of the joint is recommended to fight against pain. Cold can also be applied to the joint for a short period of time to relieve inflammation. Medications exist to fight pain, including pure pain killers, anti-inflammatory drugs, and when these are not enough, corticosteroid injections are offered.
Regardless of the type of arthritis diagnosed, the same type of prescriptions will generally be found with :
– Symptomatic treatments aimed at acting on the symptoms of the disease:
> Analgesics (paracetamol type),
> Anti-inflammatory drugs (non-steroidal anti-inflammatory drugs or NSAIDs),
> Antibiotics sometimes (penicillin or amoxicillin),
– Corticosteroid Infiltration :
> Useful when the treatment is effective, but some joints remain painful and for large joints,
> Should bring lasting relief (6 months) ;
– In-depth treatments, specific to each type of arthritis.
Surgery, on the other hand, either relieves pain or avoids joint destruction. Only very rarely does it make it possible to repair destroyed joints.
Note: these treatments are not without all sorts of side effects.
Warning! NSAIDs can cause hemorrhages, ulcers, abdominal pain, bone damage, diabetes, hypertension, etc… For this reason, as of January 15, 2020, drugs containing paracetamol and certain non-steroidal anti-inflammatory drugs (ibuprofen and aspirin) – although still available without a prescription – can no longer be sold over the counter in pharmacies.
To prevent arthritis, the first thing to do is to maintain a proper weight, which prevents joint pain reason, especially in the lower limbs. In addition, in certain types of arthritis such as gout, certain foods such as beer should be avoided, and others such as meat, fish or dairy products should not be abused.
The Worst Food for Arthritis and What Supplements to Take
Some foods rich in anti-inflammatory compounds, especially fish fat, help relieve the inflammation and pain that accompany arthritis. Let’s look at what foods to avoid and what supplements to take.
This is not surprising since, in both osteoarthritis and rheumatoid arthritis (an inflammatory autoimmune disease), the joint tissues are inflamed – which is why anti-inflammatory drugs are normally prescribed to treat them.
Although the causes of arthritis are not well understood, it is known that it is not caused solely by wear and tear on the cartilage.
Researchers have discovered that free radicals, unstable molecules that attack healthy cells, aggravate inflammation and accelerate the aging process, including the deterioration of joints and cartilage.
The Worst Food For Arthritis
1) Corn oil, fatty meats, whole milk products, trans fats
> Omega-6 fatty acids found in corn, safflower and sunflower oils, as well as saturated fats in meat and whole milk products, promote the production of eicosanoids, hormone-like inflammatory substances.
> In addition, the arachidonic acid in red meats, egg yolks and offal also leads to the formation of eicosanoids.
> Finally, ban from your diet any product that contains hydrogenated oils, or trans fats.
2) Allergy Triggers
> Studies indicate that there is a link between the consumption of dairy products, corn and wheat and inflammation resulting from arthritis.
> According to the researchers, dietary proteins trigger the production of antibodies in a small percentage of the population. When they combine, proteins and antibodies irritate the joints.
> Another theory is that antibodies directly attack the joint membrane.
> To find out if you are allergic to any of these foods, talk to your doctor or a dietitian, who will have you tested.
Nutritional Supplements for Arthritis
1) Omega-3 fatty acids. Many doctors recommend taking an omega-3 supplement, whether you are a fish lover or not.
> These fatty acids are sensitive to heat, light and oxygen, keep them refrigerated.
> Opt for a supplement that also contains vitamin E because it protects against rancidity.
Burps with a fishy smell indicate rancidity.
> DOSE: One to three grams (1/4 to 3/4 teaspoon) per day as a maintenance dose, three to six grams (3/4 teaspoon to one and 1/4 teaspoon) for the relief of morning pain and stiffness caused by rheumatoid arthritis.
> Do not exceed nine grams per day, and if you are prone to bleeding, consult a doctor before taking this type of supplement.
2) Bromelain. It comes in tablet or capsule form. DOSE: 500 to 2,000 milligrams per day, in two parts.
3) Ginger, turmeric and cloves. Unless these spices are used extensively in cooking, it is difficult to reach therapeutic doses. Ask your doctor if such supplements would be helpful.
> Aware that ginger supplements can irritate the stomach.
> Also, since this food, along with cloves, can thin the blood, consult your doctor if you are taking blood thinners.
> If stomach discomfort occurs or if you do not see results after 10 days, discontinue all supplementation.
> DOSE: Ginger: 500 milligrams per day (capsules) or 100-300 milligrams (extract), three times daily. Turmeric: 400 to 600 milligrams three times daily with meals. Clove: According to one study, a daily dose of two to three grams would relieve inflammation.
In short, it is therefore important to consume fruits and vegetables rich in antioxidants and to drink tea regularly.
Osteoarthritis or Arthritis? We Teach You to Make the Difference
Osteoarthritis and arthritis are two diseases of the rheumatic family. But they should not be confused: arthritis is an inflammation of the joints, whereas osteoarthritis is a so-called “mechanical” disease. We will explain.
It is not easy to differentiate osteoarthritis from arthritis. And with good reason: both pathologies belong to the family of rheumatisms, they both concern the joints and both cause pain that can sometimes be disabling. However, they are very different: osteoarthritis is a “mechanical” disease whereas arthritis is an articular inflammation. The physical and biological signs, causes and treatments of these two diseases are therefore very different.
Arthritis: an Inflammation of the Joint
Arthritis is an inflammation of the joint, which leads to the secretion of quinines, substances that gradually destroy the joint. It causes pain especially at rest (especially at night), which may decrease during physical activity or morning “rusting”. It mainly affects the joints of the hands and feet.
Arthritis can have an infectious (septic arthritis), immune (rheumatoid arthritis) or even metabolic (gout) cause. Sometimes, it also accompanies psoriasis: it is called psoriatic arthritis. The deformity of the joint is called “hot” because it is accompanied by physical signs such as redness or local heating.
How is it Treated?
The treatment of arthritis aims to target the cause of the pain. Antibiotics are therefore prescribed in the case of arthritis of an infectious nature, biotherapies (based on the use of living microorganisms or substances taken from living organisms) are used for immune arthritis, and biological abnormalities are treated in arthritis of metabolic origin.
Osteoarthritis: A Mechanical Alteration of The Joint
Osteoarthritis is a so-called “mechanical” pathology: the articular cartilage is gradually damaged and even disappears, leaving the bones bare against each other.
While osteoarthritis is a disease that can be linked to age, there are also factors favoring its appearance in younger people (one in three patients is under 40 years old). Anatomical abnormalities, traumas related to extensive sports practice and overweight (obesity and overweight) can be the cause of osteoarthritis. The joints most affected are those of the knee, hip or spine (especially the neck).
In contrast to arthritis, osteoarthritis is more likely to cause pain during movement, which diminishes at rest. The deformity of the joint is called “cold” because it is not accompanied by any signs of local inflammation and is not visible.
How is it Treated?
Treatment is mainly aimed at reducing the risk factor, for example with a diet in the case of obesity, or preventive surgery in the case of an anatomical abnormality. However, once installed, osteoarthritis requires a heavier treatment, with analgesics, anti-inflammatory and anti-arthrosic drugs.
To delay the installation of a prosthesis and relieve the patient, hyaluronic acid infiltrations may be prescribed to consolidate the cartilage. However, he informs that they are no longer reimbursed. And if intense sport is to be avoided, the practice of moderate physical activity remains important to avoid weight gain that weighs on the joint and accelerates the phenomenon of osteoarthritis.
Thank You For Your Time!
See the Articles Below to Learn More about Arthritis
The articles on this Web site are provided for education, entertainment, and/or information purposes only and do not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information or product represented on this site. Please consult your health-care provider before making any health-care decisions or for guidance about a specific medical condition.
Test: Are You at Risk for Diabetes?
1 in 11 people worldwide is estimated to have diabetes. It is an extremely common disease, but what are the risks?
Like cholesterol and obesity as well as smoking, diabetes is a risk factor for cardiovascular disorders. In fact, diabetes causes plaque to form in the arteries; these are patches of fat that will harden over time. This can result in the clogging of an artery leading to the brain or heart and cause a heart attack or stroke.
This disease is serious and frequent, it is indeed the first cause of blindness before the age of 65 in France. Diabetic retinopathy is caused by excess sugar in the vessels of the retina. This has the consequence of weakening the walls and can cause an edema of the macula which results in a decrease in vision.
In diabetic women, side effects such as vaginal dryness and a tendency to fungus may occur. In men, erectile dysfunction and ejaculation disorders can be reported. These symptoms are often hidden from their doctor by diabetic patients, however, drug solutions exist to solve sexual problems. Therefore, do not hesitate to contact your practitioner.
One of every four people with diabetes doesn’t know they have it. Are you at risk?
Quiz: Are You at Risk for Diabetes?
Test: How Well do you Know Health, Food, and Nutrition?
One of every four people with diabetes doesn’t know they have it. Are you at risk?
The basic nutritional needs to know can be divided into two categories that we will develop below: macronutrients (proteins, lipids, carbohydrates) which provide energy, and micronutrients (vitamins, trace elements …), which are essential for the assimilation, processing and proper use of macronutrients.
Quiz: ow Well do you Know Health, Food, and Nutrition?
Test: What type of Mom Are You?
Am I a good mother? This question, whether conscious or not, lives in the heart and mind of every mother. For giving life and passing it on is both a great joy and a great responsibility (which is also incumbent on fathers!). But, we should not be under any illusion: there is no definitive answer to this question.
On the other hand, there are many different profiles of mothers. Some adjust to their child’s constantly changing needs, others are more distant or, on the contrary, omnipresent. In this adventure of motherhood, childhood, and in particular the figure of one’s own mother, plays a decisive role… For, to be able to welcome your child in complete freedom, you must be clear with the child you have been.
To see more clearly and know which mother you are, answer the following questions spontaneously and discover which large family you belong to.
Find out what type of mom you are, based on your parenting choices.
Quiz: What type of Mom Are You?
Test: Well Do You Understand Your Cat?
When it comes to letting us know how they feel about us, cats aren’t as expressive… How well do you understand cats?
Who has never wondered about their cat’s behavior? If they have been with us every day for thousands of years, our domestic felines are still a source of mystery.
And yet, it is essential to understand your pet tiger on a daily basis in order to know how to meet its needs. Meowing, purring or tilting of the ears, are indeed as many attitudes that we must know how to decipher …
So, do you think you know your cat on the tip of your fingers? To find out if you are on the same wavelength or rather as a dog and cat, take the test!
Quiz: How Well Do You Understand Your Cat?
Test: Are You A Cat Or A Dog?
When it comes down to it, there are two kinds of people in the world. Time to find out which you are.
It is well known that dogs and cats are not made to get along… When one is faithful against all odds, the other fiercely cultivates his independence. And you, are you canine, feline or a bit of both?
Quiz: Are You A Cat Or A Dog?
The popular belief is that cat lovers are reserved and introverted while dog lovers are sociable and extroverted. Recent studies have been able to test these hypotheses. The conclusion is indisputable: our preference for dogs or cats would determine our character, and even our physique!
Test: Kind of Pet Should I Get?
Choosing a pet is not always easy. You must take into consideration your schedule and home situation. Take this quiz to find out which pet is right for you!
If you have just had a child, the question of the pet will inevitably arise sooner or later. Dog, cat, rabbit, hamster… Chances are that your little one will one day ask you for one of these cute pets. Yes, but these animals have a price, and require daily attention.
Essential questions before choosing a pet
An animal is a living being that must be cared for throughout its life. That’s why we must ask ourselves the right questions before starting:
- What is the life expectancy of the chosen companion?
- How much time do you have to devote to it?
- Do you have the necessary budget (veterinarian, food, flea treatment, deworming)?
- What will we do with the animal when we go on vacation or on weekends?
- Are all family members ready to welcome him?
- Is any member of the family allergic?
Don’t forget that a child’s promises only last for a short time? Parents usually end up taking care of the most demanding tasks, such as taking the dog out in the rain, emptying the litter box, cleaning the crate or feeding the dog. Your child will have to be taught that his pet is not a toy, that he must take care of it and educate it.
Quiz: What Kind of Pet Should I Get?
The Ultimate Chakra Test
According to Indian philosophy, our body has 7 chakras (energy points). How much do you know about them?
What is a chakra?
Literally the term “chakra” (derived from the Sanskrit language “chakram”) means: disc, wheel or whirlpool.
According to Buddhist philosophy, chakras represent major hot spots that are made of circular energy, along the axis of our body. They balance, unbalance and fluctuate naturally according to our state of the day. Our vital energy and therefore our chakras are influenced by our thoughts, emotions and actions in our daily life.
The chakras act as gates to centralize and circulate our vital energy (the IQ or Chi in Chinese culture) through the meridians (the interconnected channels through which this energy flows). The Tantric Indian lineage and Tibetan Vajrayana Buddhism have fully adopted the 7 chakra system used to date.
There are thus 7 main chakras, 3 of which are in the lower part of our body regulating our instinctive physical characteristics and 4 in the upper part of our body for our intellectual and spiritual capacities.
Quiz: The Ultimate Chakra Test
Chakras are centers of spiritual power in the body. The word literally means “wheel” or “disk” and represents energy. But you already knew this right? We won’t give away too much about them right here, but you should take this chakra test if you really want to find out how much you know. Are you ready to ace this quiz?
Test: Type of Exercise is The Best For Me?
Think one type of exercise will meet all your needs? These quiz can help you develop a comprehensive fitness plan that’s right for you.
How to make the most of your time
Even when you understand how regular exercise can improve your mental and physical health – and you’ve managed to save time in your busy day to train – the question remains: How can I make the best use of the time I have?
You can still sign up for personal workouts at a gym or find a number of workouts online or on a fitness application, but developing an exercise plan doesn’t have to be as complicated or expensive.
Regardless of your current fitness level, the key is to combine different types of physical activity, including cardiovascular, strength, flexibility and balance exercises. This will keep your workouts interesting and maximize the health benefits – reducing your waist circumference, improving your sleep, mood and energy, and alleviating the symptoms of stress, anxiety and depression.
Quiz: Which Type of Exercise is The Best For Me?
Lyme Disease – All you Need to know
Lyme Borreliosis, more commonly known as Lyme disease, is a bacterial infection that can be transmitted to humans through tick bites. This infection is widespread throughout the world and there are a few thousand cases per year in France. When left untreated, the disease can take several years to develop. Researchers speak of an emerging disease, as the number of cases is increasing.
Symptoms of Lyme Disease
Tick bites most commonly occur in the lower limbs. It can also occur on the child’s face. The disease progresses in three phases, the duration of which can vary greatly from one individual to another. The symptoms of Lyme disease are therefore numerous and spread over several phases.
In addition, the periods between phases may be asymptomatic from one individual to another. Nevertheless, several symptoms will help you detect the presence of this infection.
First Phase of the Disease
The skin lesion represents the so-called primary phase of Lyme disease. You should be able to visually diagnose the infection since the most common features appear on the skin. A more or less red spot, very similar to a mosquito bite, should appear very quickly on your skin. The bite of a tick, however, evolves over time, since after 3 days, this spot can spread and have a diameter of two centimetres.
After a month, the bite will continue to grow and should reach 10 centimetres in diameter. In some cases, it can even exceed 45 centimetres in diameter. This spot, called chronic erythema (or ECM), does not itch and always progresses centrifugally. The ECM may sometimes be surrounded by a red ring. Be careful, inflammation may be present if this area is hot.
During this first phase, you may notice some :
Joint and muscle pain.
It should be noted that 20% of people affected by this disease, the ECM remains very discreet, disappears after a month and the individual will not have noticed its presence. Lyme disease will go totally unnoticed and no treatment will have been taken. These cases can be serious, since the disease may become more complicated during the second phase.
Second Phase of the Disease
The second stage of Lyme disease may occur a few weeks or even months after the first stage, when a tick bite is given and no treatment has been taken by the individual. This second phase can be defined by several points as dizziness associated with general fatigue. But it is important to watch the following points:
An appearance, as in the first phase, of skin lesions, or red blotches;
Pain in the joints will begin to appear, with arthritis in the large joints such as knees, shoulders, elbows, etc. ;
Neurological disorders, meningitis, even facial paralysis;
Cardiac disorders in some cases, syncopations, palpitations, etc. have already been observed.
It becomes essential to treat the disease, otherwise the third phase could develop, years later for some individuals, in conditions that can be very serious.
Third Phase of the Disease
If Lyme disease has not been treated in the first two phases, the third phase could prove fatal to the infected individual. All of the above symptoms will slowly worsen, becoming chronic, during this last phase, which can occur years after infection.
All organs may be infected and will spread to nerves, eyes, joints, and even the heart and spleen. In addition, atrophy of skin patches may be observed. The skin will become very thin, even transparent and will give a crumpled paper effect with a reddish-violet tinge. The cardiac consequences can also be serious depending on the infection.
It should be noted that the evolution towards this third phase remains extremely rare, even if the individual has not taken any treatment.
Causes, Transmissions and Recommendations
Lyme disease is transmitted through the bite of ticks. It is transmissible in humans but also in many animals. There are a very large number of forms of the Borrelia bacteria.
Unfortunately, there is no real way to avoid being bitten outside of places where ticks might be present, such as forests etc. In addition, their presence and the incidence of infection may vary depending on where you are.
The only solution therefore remains to be vigilant. When working in the wilderness, or taking your Sunday walk in the forest, try to favour long clothing for example. Ticks generally attack the lower limbs, so pants should be sufficient. Beware of children, who can be bitten on the upper limbs. You will therefore have to be very careful. Once your activity is over, it is strongly advised to inspect yourself meticulously to see if a tick has hooked on. They are fairly simple to identify with their four pairs of legs and their eyeless head. The tick’s swollen belly means that it has stung you, since it has started to drink your blood.
Do not try to remove it by scratching. We advise you to use tweezers as close to the skin as possible and avoid the ether. Once the tick has been removed, disinfect the area.
How is it Diagnosed?
As we have seen above, it is very difficult to diagnose Lyme disease. Symptoms can be very numerous but can also be painless or even almost “invisible”. In addition, it is very easy to confuse the symptoms described with other diseases. When you notice these symptoms, it is advisable to go to the doctor quickly and tell him or her if you have been bitten by a tick. When the individual does not know if he or she has been bitten by a tick, he or she will be able to tell the doctor if he or she has been in places that are likely to contain ticks; for example, during walks in the forest. It should be noted that blood tests do not always validate the presence of the infection, especially if the patient is still in the early stage of the disease. The doctor may also perform an electrocardiogram to check for possible atrioventricular disorders. In these cases, the patient will have to be hospitalized.
In advanced cases of Lyme disease, i.e. from the second stage onwards, neurological examinations will be necessary. They will reveal a decrease in sensations, muscular strength and possible nerve inflammation.
Treatment of Lyme Disease
Antibiotics are mandatory to treat the infection caused by ticks. These antibiotics will completely eliminate the presence of Borrelia bacteria anywhere in the body. The complications of Lyme disease can be multiple.
However, depending on the time since the infection, and therefore the phase of the disease, the treatment and dosage may be completely different. Antibiotics should be taken for a minimum of two weeks and up to three weeks depending on the areas affected by the infection. The symptoms should therefore begin to disappear and any complications can be avoided.
In the most advanced cases of the disease, class 3 antibiotics should be prescribed by the doctor. These drugs will have to be taken intravenously over a period of time that can be much longer. In cases of hospitalization, a corticoid is often administered. Fortunately, most of the symptoms can be eradicated.
Complications towards the third phase are extremely rare, but they do occur. It is therefore important to consult a doctor immediately if you think you have been bitten by a tick. In addition, not all of the symptoms described above will always disappear completely. Treatment for Lyme disease will therefore have to be taken to try to alleviate the symptoms that have become chronic.
The Mysteries of the Thyroid: The 8 Symptoms That Can Reveal a Thyroid Problem
By Dr Jacques Amselem – General practitioner
Many people suffer from thyroid dysfunction. It is often a specific symptom that prompts patients to consult their doctor. Dr. Jacques Amselem, a general practitioner, reminds us of the signs that should alert us.
What is the thyroid?
The thyroid is a butterfly-shaped gland, located at the base of the neck, which produces hormones necessary for the regulation of the whole body. A malfunction can cause many inconveniences on general health. For example, when the thyroid gland produces too many hormones it is called hyperthyroidism, often associated with autoimmune Basedow’s disease.
Conversely, when the gland slows down, the patient suffers from hypothyroidism. Often, alerted by certain signs, patients consult their general practitioner. The latter will then prescribe, depending on the case, a blood test with thyroid hormone dosage, an ultrasound or a scintigraphy.
Extreme Fatigue, a Sign of Hypothyroidism
General fatigue is often the first sign of hypothyroidism. This is because the lack of hormones causes the body to function in slow motion. The patient then suffers from sleep disorders and muscle fatigue. This tiredness is also accompanied by concentration and memory problems.
Thyroid dysfunction often leads to weight fluctuations. In the case of hyperthyroidism, patients often experience weight loss while eating normally. Conversely, those with hypothyroidism often report weight gain, even though they do not eat more.
Problems With Temperature Regulation
The thyroid also controls body temperature. Hypothyroidism is manifested by coldness and lower temperatures on the extremities (toes, nose, etc.).
Conversely, hyperthyroid people often feel too hot, sweat with the slightest effort and complain of sweaty hands.
A Skin and Sander Modification
In hypothyroidism patients experience dry skin, hair falling out and fingernails turning.
Mood disorders, a sign to be taken into account
Nervousness, anxiety, persistent depression for no apparent reason or emotional instability are also signs of thyroid dysfunction.
An Accelerating Heart Rate
An increased or decreased heart rate may be a sign of thyroid problems. In detail, a slower heart rate is a sign of hypothyroidism, while a faster heart rate is often a sign of hyperthyroidism.
Among the symptoms of hypothyroidism, the lack of hormones can manifest itself as constipation or bloating. Conversely, hyperthyroidism can cause diarrhea.
A Palpated Nodule
If you notice a small lump in your thyroid gland, whether painful or not, you should consult a doctor. The doctor will look for clinical signs of a thyroid disorder and will prescribe additional tests.
If you think you have a hypothyroid or hyperthyroid profile, you should first talk to your doctor (GP, gynaecologist, endocrinologist), as the symptoms of thyroid dysfunction can vary from person to person and may also be an expression of other diseases. A complete check-up will allow you to know for sure and, if necessary, to undertake an appropriate treatment.
Weight and Diabetes: Dangerous Connections!
Being overweight and diabetes are intimately linked. Three-quarters of type 2 diabetics are obese. What are the causal links between these two diseases? What influence do diabetes treatments have on kilos? Can new drugs act on both levels? Answers to your questions.
Diabetes and obesity are two major epidemics on the march around the world. The fact is simple: there are 400 million obese adults on Earth, and there will be more than 700 million by 2025. Obesity could become the leading cause of death in the USA in the near future.
As for diabetes, there are 246 million diabetics in the world. Every year, 7 million people develop diabetes, that is two every second! There will be 380 million in 2025. While the number of cases is increasing in Europe and America, there is a real explosion in China and India. Diabetes doubles the risk of death and is responsible for 3 million deaths and 1 million amputations.
Obesity and Diabetes: Strongly Linked Diseases
If the epidemics of diabetes and obesity seem to follow the same progression, it is not by chance: these two diseases are so closely linked that we often speak of an epidemic of “diabetes”.
First of all, a distinction must be made between diabetes types 1 and 2: it is the latter, which accounts for 90% of diabetics, which is directly linked to being overweight. “While not all obese people become diabetics, conversely, three-quarters of diabetic patients are obese,” emphasises Prof. Michel Pinget, head of the endocrinology department at Strasbourg University Hospital.
Obesity and Diabetes: Common Causes?
So how can we explain these links between the two diseases? The observation is simple: 90% of type 2 diabetes appears after weight gain. But as Prof. Pinget points out: “Being overweight alone is not enough to cause the disease. If you are not predisposed, even if you weigh 200 kg, you will never get diabetes”.
It is therefore necessary to have a prior genetic terrain, which will lead to diabetes in the event of an unbalanced diet and significant weight gain. In this case, it is the mechanism at the origin of diabetes that is directly linked to kilos: insulin resistance. Because before real diabetes appears, the disease develops insidiously, with a progressive resistance to the action of insulin (a hormone that reduces the level of sugar in the blood and stores it). The body is forced to produce more and more of it, until it is no longer sufficient, and that is diabetes.
The causes of insulin resistance are: ageing (including age-related muscle wasting); fatty and sweet foods; sedentary lifestyles; and urbanisation and stress. The observation is therefore simple: two of the four causes of insulin resistance are common to obesity: diet and sedentary lifestyle.
Treating overweight to cure diabetes
When diabetes is managed, treatment should prevent complications, especially cardiovascular complications. This is based on various factors: control of glycemia, cholesterol and blood pressure (70% of diabetics are hypertensive). But above all, the diabetic must lose 10% of his weight and must practice regular physical activity. Overweight greatly increases the risk of complications.
“The problem is that 80% of patients who are told to eat better and exercise do not follow their recommendations,” says Prof. Pinget.
The problem is that 80% of patients who are told to eat better and exercise do not follow their recommendations,” says Prof. Pinget, which means that patients must be put on oral antidiabetic drugs and then on insulin.
Anti-Diabetic Treatments That Promote Weight Gain
In addition to diet and physical activity, type 2 diabetics can be put on treatment (oral antidiabetic drugs or insulin). However, there is a real paradox, as Prof. Pinget points out: “The better you treat diabetes, the more you control blood sugar levels, and the more people gain weight”! This phenomenon is notably linked to a better glycemic balance: no more sugar is lost in the urine…but the calories are better stored, and we regain a few kilos… This is particularly true for oral antidiabetic drugs (except for Metformin, which has a “fat-burning” effect).
But when patients switch to insulin, they also gain a few kilos (5 on average in the first year). In fact, weight gain on insulin is the second most important concern for patients, after the fear of hypoglycemia. There are many reasons for this weight gain:
A “defensive” food intake, to avoid the hypoglycemia that can occur with insulin injections;
An effect of insulin on the central nervous system;
An anabolic effect of insulin, which promotes fat storage.
This weight gain under treatment can have a deleterious effect in patients who are already overweight or obese, in particular by making it more difficult to achieve the goals set. And this may reduce compliance…
However, it should be noted that not all insulins have the same effect, and the most recent ones do not have the same impact on weight. In particular, the insulin Detemir (Levemir ®) leads to less weight gain in diabetics.
Anti-diabetic and anti-kilos treatments
Today, treatments have targeted actions on both overweight and diabetes.
One example is Xenical, which the Xendos study has shown to be able to help lose weight while reducing the incidence of diabetes.
And today, a new drug still being tested seems particularly effective against both diabetes and obesity: Novo-Nordisk’s Liraglutide, which acts on both insulin production and appetite. Not only does it reduce blood sugar levels, but it also causes weight loss. In trials on patients with a body mass index of 35 (often more than 100 kg), an average of 7 kg was lost: 75% lost more than 5% of their weight, 25% even lost more than 10%.
It will be necessary to wait for further trials to see if this new treatment keeps all its promises.
But whatever the treatment, the recommendation to eat a more balanced diet remains essential. And physical activity is also a must to help control both weight and blood sugar levels.
Whether you are overweight or not, whether you are diabetic or not, eating and being active remain the keys to health. Because it’s never too late to do the right thing…
Cervical Cancer: Symptoms, Screening, Treatment
By: Dr. Jean C., Pharmacist
Cervical cancer is the development of a malignant tumour of the lining of the cervix. It is considered a slowly progressing tumour disease of infectious origin. In the majority of cases, cervical cancer occurs after prolonged exposure to human papillomavirus (HPV).
This is because the long-term presence of the virus in the mucous membrane has a deleterious effect on healthy cells that can develop into cancer cells. It is the proliferation of these cancerous cells, which are initially few in number, that leads to the appearance of a more or less organised mass known as a tumour.
Since tumours appear in the mucous membrane, they are also called squamous cell carcinomas and account for almost 85% of cervical cancer cases.
In 2015, nearly 2,797 new women were newly diagnosed with cervical cancer. This low annual number of new cases makes it the 12th most common cancer in women. This cancer is, on average, diagnosed at the age of 51 and was responsible for 1,092 deaths in 2015 in France. It is a cancer qualified as having a good prognosis, as its 5-year survival rate is 67%, i.e. 67% of cervical cancer patients are alive 5 years after diagnosis. Improved screening through regular cervical smear testing (UTC) has almost halved both the number of new cases and the number of cervical cancer-related deaths. It is estimated that with optimal screening, the number of cervical cancers could be reduced by almost 90%.
Having one or more risk factors does not necessarily lead to the development of cancer. They increase the likelihood of developing cancer compared to an unexposed person. However, a cancer can develop without any risk factors being present.
Namely! A risk factor is an element that can promote the development of cancer.
Human Papillomavirus (HPV)
It is the main inducer of cervical cancer. Indeed, a prolonged infection of 10 to 15 years by the human papillomavirus is responsible for nearly 70% of cervical tumours.
HPV is transmitted by contact with the skin and mucous membranes, most often during sexual intercourse. Infection with this virus is very common and mostly cures spontaneously. However, in 10% of cases, the virus persists in the lining of the cervix, which can lead to precancerous lesions that can develop into cancer.
To know! There are more than 80 strains of papillomavirus and only a small number of them cause cervical cancer.
Since 2007, there are two vaccines against HPV types 16 and 18. It is a very good means of prevention for this type of cancer, but it does not replace gynaecological monitoring.
Other risk factors
A scientific link has been established between factors other than HPV and the development of cervical cancer:
Early sexual debut;
Multiple sexual partners: The more different partners you have, the greater the chance of being exposed to HPV, and therefore the greater the risk of developing cancer;
HIV infection (AIDS) or taking an immunosuppressive treatment: because in both cases our immune system is less efficient, which leads to a loss of efficiency in the fight against HPV viruses.
Having several children ;
Taking birth control pills;
Sexually transmitted diseases: such as genital herpes and Chlamydia.
Precancerous Lesions of the Cervix
Precancerous lesions are changes in the cells of the epithelium of the cervical mucosa (cells covering the mucosa) that are not yet cancerous, i.e. the tissue is abnormal but not yet cancerous. The precancerous lesion is not designated as a cancer because it does not have all the criteria for malignancy of a cancer. These disorders are most often caused by the long-term presence of the human papillomavirus (HPV) in the cervix. The viral infection leads to cellular suffering that reflects the evolution of the tissue into cervical cancer. Precancerous lesions may spontaneously regress or progress to cancer.
Precancerous lesions are also called cervical intraepithelial neoplasia or CIN. They exist in more or less severe forms. A classification allows us to distinguish three main types of lesions according to their severity:
CIN 1: the abnormal cells affect 1/3 of the thickness of the epithelium;
CIN2: the abnormal cells affect 2/3 of the thickness of the epithelium;
CIN3: the abnormal cells affect the entire epithelium.
Depending on the grade of precancerous lesion, there is a probability of progression to higher grade CIN, cervical cancer or spontaneous regression.
Probabilities of regression, persistence and progression of CIN (Ostor, 1993)
|Lesions||Regression||Persistence||Progression to higher CIN||Progression to invasive cancer|
| CIN1|| 57%|| 32%|| 11%||1%|
| CIN2|| 43%|| 35%|| 22%||5%|
| CIN3|| 32%|| 56%|| –||>12|
We can retain from this table that:
Low-grade precancerous lesions (CIN 1) are more likely to regress than to progress to a higher grade. The higher the CIN, the greater the risk of progression to cancer and the more limited the likelihood of spontaneous regression.
The evolution of these precancerous lesions into cancer is a slow, progressive phenomenon that can be demonstrated by a cervico uterine smear (UCS). It is therefore possible to identify and treat them before they become cervical cancers.
Because of its slow progression and the presence of curable precancerous lesions, cervical cancer can be detected at an early stage, and can even be completely prevented by detecting precancerous lesions.
Screening is mainly based on a cervical smear, which is a collection of cells from the surface of the cervix that are then analysed using a microscope. The appearance of the cells as well as the organization of the tissue allows biologists to observe possible precancerous lesions or the presence of cervical cancer.
To know! It is recommended every three years, after 2 normal smears spaced one year apart for all women aged 25 to 65.
Cervical cancer often develops without causing any particular symptoms, especially at an early stage. This is why it is essential to have a gynaecological follow-up with cervico uterine smears in order to detect it as early as possible.
There is also a set of symptoms that are not specific to cervical cancer, but whose persistence or intensity may suggest a tumour:
Induced metrorrhagia: which is low grade bleeding caused by sexual intercourse;
Spontaneous metrorrhagia: Bleeding that occurs without apparent cause;
Pain during intercourse;
White vaginal discharge;
Pain in the lower abdomen with difficulty in urinating, a continual urge to have a bowel movement;
Lower back pain.
These symptoms can be found in the disease other than cervical cancer, but it is important to report them to your doctor so that he or she can determine their origin.
The diagnostic work-up for cervical cancer begins after an abnormal screening test or the appearance of suggestive symptoms. Complementary examinations are then set up with the aim of :
Confirm the diagnosis of cancer and define the type of cells involved.
Determine the stage of the disease in order to propose an appropriate treatment.
Identify possible contraindications to certain treatments
Definitive confirmation of the diagnosis of cervical cancer is only possible after analysis of a biopsy (removal of a fragment of tissue).
This assessment takes place in a gynaecological practice. The doctor examines the surface of the cervix and vagina using a coloscope, which is a powerful magnifying glass with a light at its tip. This exam examines the abnormal areas, deposits liquids that reveal precancerous lesions, and takes biopsies (samples of a thin fragment of the cervix). Colposcopy is not painful but may cause discomfort during the procedure.
Conical biopsy or conization
This examination consists of removing a conical fragment of the hard-to-reach lesions of the cervix. The conization is performed under local or general anaesthesia. The aim is essentially diagnostic, but in some cases the conical biopsy removes all the cells presumed to be cancerous and in this case no further treatment will be necessary.
It is the microscopic examination of tissue fragments obtained by biopsy or conization. It is the standard test to confirm the diagnosis of cervical cancer.
The analyses performed on the cells help to define the cancer-causing cell and its characteristics.
Therapeutic Management of the cervix
The choice of treatment in cervical cancer depends on 2 criteria:
Characteristics of the tumor: including size, location, stage and grade of tumor;
The general condition of the patient.
Using these criteria, health professionals develop a protocol of care in a multidisciplinary consultation meeting (MDC). The opinion of the RCP is then submitted to the patient by the referring physician. It is therefore a consultation between patient and doctor that gives the “green light” to therapeutic management. The patient validates the opinion of the RCP by his or her informed consent, i.e. by having understood the issues and risks related to the proposed treatments.
The treatment of cervical cancer is organized around 3 axes: surgery, radiotherapy and chemotherapy. The protocols can be used alone or in combination and aim, depending on the case, to: destroy the tumour(s), reduce the risk of relapse, slow down the development of the tumour and treat the symptoms linked to the disease.
This therapeutic axis is mainly used to treat local and small tumours of the cervix. Surgery removes the entire tumour and thus cures the disease. Several interventions exist. The choice is made according to the extent of the cancer, but also according to the age and the patient’s possible desire for pregnancy.
It is the most performed surgical procedure for the treatment of cervical cancer. During this operation, the surgeon removes the entire uterus and the upper part of the vagina. In addition, the ovaries are also frequently removed. This treatment is only possible for patients with a limited cervical tumour smaller than 4 cm.
The removal of ganglionic networks
Cancers can spread throughout the body through the lymph nodes. The removal of the lymph nodes near the uterus limits the risk of spreading the disease as well as the risk of relapse.
During this operation, the surgeon removes only the uterus, leaving the upper part of the vagina intact. Hysterectomy is a treatment indicated for small tumours that are very limited to the cervix.
A trachelectomy involves removing only the cervix. Once the removal is complete, the surgeon uses special sutures called cerclage to partially close the uterus where the cervix used to be. This new opening allows blood to drain out during menstruation. [/column]
This operation is only possible in tumours that are limited to the cervix and do not exceed 2 centimetres in size. This surgery is called conservative because it preserves the uterus and therefore the fertility of young women wishing to become pregnant in the future.
Radiotherapy is a local treatment using high-energy ionizing radiation to destroy cancer cells. This therapeutic method makes it possible to very precisely target an area to be treated in order to irradiate the tumour while preserving the surrounding healthy tissue as much as possible. Two types of radiation therapy can be used in cervical cancer.
External radiotherapy: is a technique in which the source of the radiation is outside the patient. The radiation beam is directed against the patient’s tumour, guided by landmarks. Several sessions per week are necessary, spread over a few months.
Internal radiotherapy or brachytherapy: consists of placing an applicator containing the radiation source in the vagina and in contact with the tumour. The irradiation of the cancer is therefore continuous. This therapy can be used in cervical cancer, especially before surgery to reduce the size of the tumour. During brachytherapy, the patient is considered “radioactive” because the source of radiation is in her body.
Chemotherapy comprises all the drug therapies acting on cancer cells with the aim of either destroying them or limiting their multiplication. It is the only therapeutic axis that acts on the whole organism. Chemotherapy treatments can be used by the venous or oral route depending on the molecules used.
In cervical cancer, chemotherapy is indicated either to reduce the size of a tumour in order to increase the success of a surgical operation, or in the treatment of cancers at high risk of spreading or metastatic. The most commonly used molecules are :
5-FluoroUracil (5-FU): which is an anti-cancer agent that blocks the tumour’s DNA synthesis, preventing it from multiplying.
Platinum salts: which are anti-cancer drugs that can bind to DNA and stop the proliferation of cancer cells.