Chronic joint PAIN caused by arthritis affects million of people across the world every year. There are different types of arthritis but in this video, we will discuss the most common form of arthritis known as Rheumatoid arthritis. We will talk about what is RA, what are the signs and symptoms you can develop if you have RA, how is RA diagnosed and what is its treatment.
Rheumatoid arthritis is an autoimmune disease. Autoimmune disorders include diseases like Systemic lupus, multiple sclerosis, psoriasis etc. In these types of diseases, the body’s immune system attacks its own cells mistakenly and damages them.
Treating people with Type 2 diabetes with a new once-a-week injectable insulin therapy proved to be safe and as effective as daily insulin injections, according to the results of two international clinical trials published online today in Diabetes Care. The studies suggest that the once-weekly treatment could provide a convenient alternative to the burden of daily insulin shots for diabetes patients. CREDIT UT Southwestern Medical Center
Treating people with Type 2 diabetes with a new once-a-week injectable insulin therapy proved to be safe and as effective as daily insulin injections, according to the results of two international clinical trials published online today in Diabetes Care. The studies suggest that the once-weekly treatment could provide a convenient alternative to the burden of daily insulin shots for diabetes patients.
Starting and maintaining insulin treatment remain a challenge for millions of patients worldwide with Type 2 diabetes. Fear of injections and the inconvenience and burden of injectable therapy contribute to the barriers against insulin therapy initiation and adherence. The effectiveness and safety of ongoing insulin treatment are also highly dependent on other factors, such as the accuracy of dosages, timing, and glycemic targets. Health care providers believe that reducing the frequency of treatment administration with advances, such as the once-weekly insulin used in these phase 2 trials, may decrease the reluctance to initiate insulin therapy while improving long-term adherence, glucose control, and ultimately, patient well-being.
Insulin, which has been the foundation of diabetes treatment for 100 years, is an effective glucose-lowering agent and is safe when used at the correct dose,” says Ildiko Lingvay, M.D., M.P.H., M.S.C.S., a professor of internal medicine and population and data sciences at UT Southwestern. “Insulin treatment is burdensome, requires frequent injections, and continues to carry a certain stigma. The development of an effective and safe insulin that can be administered once a week is a huge advance in the field.”
Lingvay, who is a consultant for Novo Nordisk, is the lead author of one of the studies, which involved 205 patients from seven countries (the U.S., Croatia, Germany, Hungary, Poland, Slovakia, and Spain). The clinical trial consisted of a two-week screening period, 16 weeks of treatment, and a five-week follow-up to evaluate three different ways to adjust and optimize the insulin dose and determine which one presented the best balance between effectively lowering glucose while minimizing low-glucose events.
She also is an author of the second study that included 154 patients from five countries (the U.S., Canada, the Czech Republic, Germany, and Italy). This trial followed the same 23-week time frame and evaluated practical aspects of insulin use as well as the best ways to transition from a daily regimen to the new weekly insulin injections. The researchers determined that starting with a higher first dose – called a loading dose – allowed patients to reach their optimal glucose target faster.
“These two studies served as the steppingstones for a large phase 3 clinical trial program that is currently ongoing at UT Southwestern and other sites, which is designed to evaluate the efficacy of once-weekly insulin administration in patients with either Type 1 or Type 2 diabetes,” Lingvay says. “A weekly insulin is a game-changer that will decrease the treatment burden for patients while also improving compliance. This treatment will also decrease the burden on those who care for patients with diabetes requiring insulin. For example, for patients who need help injecting, those living in long-term care facilities, and those with memory problems, a once-weekly insulin will facilitate treatment and decrease the burden on the care providers.”
UC Riverside-led national survey of MS specialists finds nearly 10% had been redeployed to the front lines of COVID-19 patient care
Dr. Elizabeth Morrison-Banks is a health sciences clinical professor of neurology at UC Riverside. CREDIT C. Rosema.
A survey of U.S. multiple sclerosis, or MS, specialist clinicians reveals the COVID-19 pandemic has created major changes in how they deliver care.
“Since the pandemic began, more than 95% of our survey respondents reported using telehealth platforms to provide care for their patients,” said Dr. Elizabeth Morrison-Banks, a health sciences clinical professor of neurology in the School of Medicine at the University of California, Riverside, who led the survey reported in the journal Multiple Sclerosis and Related Disorders. “Approximately one half of the respondents were MS specialist neurologists, four out of five of whom indicated that COVID-19 had changed how they were recommending and prescribing MS disease-modifying therapies.”
During the pandemic, the MS specialist neurologists tended to prescribe fewer immunosuppressive agents. Survey respondents also commented on their perceived level of safety and support in the workplace during the pandemic. Most indicated they had access to adequate personal protective equipment, but fewer than 50% reported they had adequate ability to physically distance themselves at work. Nearly 10% of respondents reported they had been redeployed, most commonly to the front lines of COVID-19 care.
“Our findings point to profound changes in MS clinical practice since the onset of the COVID-19 pandemic,” said Morrison-Banks, who directs the Multiple Sclerosis Program at UCR Health. “For better or for worse, when clinical practice patterns change, we should not be surprised to see corresponding changes in patient outcomes.”
Survey respondents included some of the most highly trained MS specialists in the country, considered to be thought leaders for other clinicians in their disciplines.
“Their collective shift, on average, in prescribing fewer of the highest-efficacy immunosuppressive therapies could potentially translate into patients experiencing more MS disease activity,” Morrison-Banks said. “We don’t, however, have enough information yet about COVID-19 outcomes in patients receiving immunosuppressive treatments. We suspect many respondents were decreasing use of certain MS disease-modifying therapies that suppress the immune system — for example, B-cell modulating agents — because they were concerned these agents could trigger severe complications from COVID-19.”
Shortly after the COVID-19 pandemic began, Morrison-Banks attended a virtual MS meeting in which the discussion turned to how MS specialists were responding to the pandemic.
“Sharing our mutual interest in how our colleagues around the country were dealing with the challenges of COVID-19 led to this national survey,” she said. “We did our best to collect and disseminate the survey’s data as early as possible during the COVID-19 pandemic with the hope that the results will be of use to clinicians and people living with MS. Our finding that nearly 10% of survey respondents reported being redeployed because of the viral pandemic led us to consider the extent to which the pandemic has challenged the capacity of the MS health care work force.”
Morrison-Banks stressed that people living with MS need consistent support from their clinicians to ensure they receive the best possible health care.
“We hope people living with MS will not avoid seeing their clinicians because they’re afraid of getting exposed to COVID-19,” she said. “Our survey suggests the vast majority of MS specialists are offering at least some telehealth services so their patients can feel safer as they continue receiving care.”
Next, the team plans to study how clinical practice patterns in MS care will change as more research data are published over the upcoming months, including from ongoing studies exploring how various MS disease-modifying therapies affect outcomes from SARS CoV-2 infection.
Individualized training is key for autistic adolescents learning to drive
A collaborative study from the Center for Injury Research and Prevention (CIRP) and the Center for Autism Research (CAR) at Children’s Hospital of Philadelphia (CHOP) identified clear strengths and a series of specific challenges autistic adolescents experience while learning to drive. The findings were recently published by the American Journal of Occupational Therapy.
Researchers conducted in-depth interviews with 17 specialized driving instructors who were trained as occupational therapists, driving rehabilitation specialists, or licensed driving instructors and who had completed additional training related to teaching autistic individuals to drive. Their insights stress the importance of providing specialized, scaffolded instruction where skills are taught one at a time, allowing students to develop mastery before adding new skills. These approaches help young autistic drivers develop driving skills over time supported by plenty of caregiver-supervised practice.
Instructors described specific behind-the-wheel challenges among young autistic drivers, including being overly rule-bound, becoming easily distracted, and having difficulty integrating what other drivers are doing with their own hand-eye-foot coordination required to drive. Instructors believed many of these challenges could be overcome through careful skill-building instruction over a prolonged period of time.
Observed strengths of young autistic drivers included carefully following the rules of the road, paying close attention to their driving environment, and limiting risk-taking. Instructors believed these clear strengths help students become competent drivers.
“Through our interviews with specialized driving instructors who worked specifically with young autistic drivers, we learned about teaching strategies perceived to be effective and recommendations to improve the learning-to-drive process for these adolescents and young adults,” said Rachel K. Myers, PhD, lead author of the study and a scientist at CIRP. “Rigorous, individualized training is needed for their behind-the-wheel instruction. More research is needed to standardize best practices for autistic adolescent driver instruction.”
Besides breaking down driving tasks into discrete learning goals, instructors used a variety of strategies to build driving skills, including having teens sit in the passenger seat and describe what the driver is doing, and repeated practice on the same driving routes to reduce anxiety.
Instructors also stressed that young autistic drivers should be prepared for experiences they may encounter outside the vehicle, such as changing a tire or interacting with law enforcement. After getting licensed, some instructors may recommend autistic adolescents drive only with supervision or restrictions, such as only traveling on familiar routes.
“According to the specialized driving instructors we interviewed, autistic adolescents who had limited experience with other forms of transportation or vehicle use, such as bicycling, before learning to drive had a harder time learning to control the vehicle,” said Benjamin E. Yerys, PhD, study author and a clinical psychologist at CAR. “This difficulty could contribute to challenges in controlling speed, maintaining lane position, and managing oncoming traffic. Caregivers should find ways to promote these life skills and hand-eye-foot coordination skills before beginning the learning-to-drive process.”
Recent research conducted at CHOP found that newly licensed young autistic drivers have similar to lower crash rates than their non-autistic peers. Additionally, young autistic drivers are much less likely to have their license suspended or to receive a traffic violation than their non-autistic peers.
Driving is an important part of leading an independent life and is one option for ensuring safe mobility for autistic adolescents and young adults. Resources for families to help with the transition to adulthood are available at TeenDriverSource.org and CAR Autism Roadmap.
‘Don’t give up:’ Retired Raleigh officer with multiple sclerosis skydives with a Golden Knight
We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
