Monthly Archives: April 2016

Related Recall of Medicines

A recall of certain medicines due to odor problems has been expanded by Johnson & Johnson’s McNeil Consumer Healthcare unit.

On Jan. 15, the company recalled a number of over-the-counter medicines due to consumer complaints about a moldy smell that caused nausea and sickness in some people, the Associated Press reported.

The expanded recall covers four lots of Benadryl Allergy Ultratablets and one lot of Extra Strength Tylenol that were distributed in the United States, Puerto Rico, Bermuda and Tobago.

The odor is from a chemical treatment on wooden pallets used to store and transport packaging materials for medications, the AP reported.

Kidney stones are small chunks of solid material that can form in your kidneys, a pair of organs that filter your blood.

The “stones,” which are usually yellow and brown, vary in size and shape.

For instance, some may be jagged and as small as a grain of sand, while others may be lumpy and the size of golf balls.

A stone may stay in the kidney or travel down the urinary tract — the body’s waste and excess-water drainage system — and get stuck, causing severe pain in the belly or side of the back.

Other symptoms may include nausea, chills, and blood in the urine.

Prevalence and Demographics of Kidney Stones

Kidney stones are one of the most common disorders of the urinary tract, resulting in more than a million visits to health care providers and 300,000 emergency room visits each year in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

About one in 11 people in the United States, or 8.8 percent of the population, have had a kidney stone, according to a 2012 report in the journal European Urology.

Kidney stones affect both men and women, though struvite stones are more common in women and uric acid stones are more common in men.

Overall, however, the prevalence of kidney stones is higher in men than women.

Kidney stones are also more common in obese people than non-obese people, and less common in non-Hispanic African and Mexican-Americans than in non-Hispanic Caucasians, according to the European Urology study.

What Are the Kidneys?

Part of the urinary system, your two kidneys are fist-sized, bean-shaped organs, located just below the rib cage, one on each side of the spine.

They have a number of important functions, mainly filtering the blood to remove waste and excess water, resulting in the formation of urine, which is stored in the bladder and emptied from the body through the urethra.

What You Need to Know

images-23Most people think of rheumatoid arthritis as a joint disease, but like other autoimmune disorders, it can impact different areas of the body as well. One of the more common complications for people with rheumatoid arthritis is eye problems, which can lead to corneal damage and ultimately impact vision if left untreated.

Some common eye conditions, like the ones described below, may affect people with rheumatoid arthritis (RA). But there are steps to take to safeguard eye health and avoid permanent damage.

Dry Eyes

“RA can be associated with extra-articular [meaning outside the joint] manifestations, and dry eyes are one of the most common problems,” says Ana-Maria Orbai, MD, instructor of medicine in the division of rheumatology at the Johns Hopkins University School of Medicine in Baltimore. “A person with dry eyes might experience itching, a sand-like sensation in the eyes, and redness.” They may also notice a lack of moisture or tears in the eyes, as well as blurred vision.

Although many people turn to over-the-counter eye drops for relief, the best treatment for dry eyes is prescription drops, which you can get from your ophthalmologist, Dr. Orbai says. A doctor who specializes in medical care of eyes, whereas an optometrist focuses primarily on vision problems, this eye MD can prescribe the right kind of eye medication for different uses (day versus night, for instance).

If you decide to go the over-the-counter route, avoid eye-drop products that have preservatives or vasoconstrictive agents, such as some from Visine and Clear Eyes, which often promise to relieve redness or “take the red out,” Orbai explains.

If your dry eyes are severe, your doctor might discuss the option of punctal plugs, a minor procedure that entails having a small plug inserted into the tear duct to keep the eye from draining. Your doctor may also prescribe Restasis (cyclosporine) drops.

Scleritis

Scleritis is an inflammation of the sclera, the white outer layer of the eye. Symptoms can include pain (sometimes severe), swelling, redness, blurred vision, tearing, and sensitivity to light. If you experience any of these issues, you should be evaluated by your ophthalmologist, Orbai says. And don’t delay seeking treatment. “Time is of the essence to prevent eye damage and vision loss,” she says. If it ends up being scleritis, your ophthalmologist may prescribe corticosteroid eye drops and possibly immunomodulator medications, she says.

Iritis and Uveitis

A quick anatomy lesson: The uvea is the middle part of the eye between the sclera and retina, which is in the back of the eye. The iris is the colored part of the eye that helps control how much light enters.

Uveitis is an inflammation of the uvea; iritis, a form of uveitis, is an inflammation of the iris. Symptoms include blurred vision; dark, floating spots in your vision; eye pain; redness; and sensitivity to light.

Treatment for either condition depends on the symptoms, Orbai explains. “Some options include corticosteroids, Trexall (methotrexate), Humira (adalimumab), and Remicade (infliximab). Your ophthalmologist will determine the right course of treatment for you based on your symptoms.

Medication Complications

Some of the medications used to treat rheumatoid arthritis, such as prednisone (a corticosteroid) and Plaquenil (hydroxychloroquine), can actually trigger eye problems. “Plaquenil, on rare occasions, can cause retinopathy,” says Orbai — an inflammatory disease of the retina that can lead to impairment or loss of vision. And prednisone can cause cataracts or glaucoma, or worsen these conditions if you already have them.

“People who need to take medications that have side effects that impact the eye should see an ophthalmologist who can monitor for adverse effects,” says Orbai. “For example, patients using Plaquenil should be seen yearly to rule out retinopathy.” If they do develop the condition, the doctor may decrease the dosage or stop the medication. “The most important precaution is to minimize duration of treatment: Take the least amount for the shortest time,” Orbai says.

Weight Loss Plan

If you have rheumatoid arthritis (RA), it’s important to maintain a healthy weight.

The reason: Obesity can worsen RA and make its treatments less effective, according to a 2014 review published in Autoimmunity Reviews. As for people who don’t have RA, obesity can increase their risk for developing both this condition and other autoimmune diseases, the researchers found.

Another review, published in May 2016 in Arthritis Care & Research, found that people with RA who were obese were less likely to reach remission than those who were at a normal weight.

Losing weight can lower the levels of inflammation in the body — the cause of RA-related joint pain and swelling. That’s because fat cells produce hormones called leptins, which aggravate inflammation, says Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, Maryland. “Regardless of what kind of arthritis you have, losing weight is a good thing for lowering inflammation,” he says.

A lower body weight can also help relieve pressure on your joints, which can reduce pain. In addition, losing weight can help reduce the risk of complications from RA, such as heart attack and stroke, Dr. Wei says.

Weight loss also generally helps improve your self-image, which can encourage you to make more healthy lifestyle choices. “It becomes a self-fulfilling prophecy,” Wei says.

Create Your RA Weight Loss Plan

Ready to get started? Follow these steps.

Reach out to professionals. A good starting place is to talk with your doctor — but don’t stop there. Seek out a nutritionist to help you plan meals and set a daily calorie intake goal. You can also see a physical therapist or personal trainer to help get your exercise routine on track.

Set specific goals. Weight-loss goals should be SMART — specific, measurable, attainable, relevant, and timely, says April Miller, RD, CPT, a clinical dietitian at the Healthy Living Center at the University of Rochester Medical Center in New York. For instance, a good goal might be to lose 5 pounds in a month by keeping a food journal and working out three times a week.

Start a journal. Before you even begin to make any changes to your diet, you should keep track of the foods you eat. This can help you see how you’re currently eating and look for places you can make improvements. A food journal can also help you meet your calorie goals and see which foods may cause inflammation and worsen your RA symptoms, Miller says. You can use a pen and paper or an electronic food tracker to keep track of what you’re eating, and also record the times of the day when your symptoms are worse.

Stock up on RA-friendly foods. The same foods that can help you lose weight may also help minimize symptoms of RA. Fruits and vegetables are high in fiber, which helps you feel fuller and may help reduce inflammation. Aim for 25 to 30 grams of fiber a day, Miller says. Other foods to include in your RA-friendly diet are cold-water fatty fish like salmon, tuna, trout, herring, and mackerel — aim for two weekly servings — and extra-virgin olive oil, which you can use for salad dressings, marinades, and roasting vegetables. “The easiest way to make healthy food choices is to look at your plate,” Miller says. “If half of it is filled with fruits and vegetables, you’re in good shape.” The rest should be split between lean protein and whole grains.

Choose an exercise to try. If you’re out of shape, start by slowly incorporating exerciseinto your routine and be gentle on your joints. Try low- or no-impact activities like swimming, water exercises, and cycling. Also be sure to do a mix of cardiovascular exercise, resistance training, and stretching, says Wei.

Put it on your calendar. Physically allotting time for exercise, grocery shopping, and cooking can help you achieve your goals. Miller says some of her clients add in exercise as a private appointment on their work calendars. It helps them commit to it and communicates to co-workers that they’ll be unavailable during that time, she explains.

Reward yourself for progress. Being able to move with less pain and stiffness might be reward enough. But for extra motivation, try planning a spa day or another healthy indulgence after reaching weight-loss milestones.

Overcome weight-loss plateaus. When you find yourself hitting a roadblock, it may be time to lower your daily calorie goal or change up your workout routine. Incorporating more strength training is a good way to mix up your level of physical activity. “It’s one of the last things people try,” Miller says. And it might be just the thing you need to get over a hump.