Reaching New Heights with Joint Disease

 

Patient doesn’t let rheumatoid arthritis slow her down

BJ Pessia is a jack of all trades and master of all.

A real estate agent, carpenter, painter, landscaper, ski instructor, soccer coach, and caregiver, she is always engaged in a hands-on project or busy caring for someone.

Physical work hasn’t always been easy for BJ. She was diagnosed with rheumatoid arthritis (RA) 24 years ago, when she was 30 years old.

“One day I noticed I had wrist pain. The pain moved to my other wrist and would fluctuate from each wrist with no consistency,” she says.

Health care providers told her it was carpal tunnel syndrome, but she didn’t do any repetitive work and was not convinced that was the problem.

After several blood tests and a visit to a rheumatologist, BJ was diagnosed with RA. By then the inflammation symptoms were also in her shoulders and her hips—but again, never consistent, and always moving from one side to the other with no pattern.

The original RA medications she was prescribed had serious side effects, including stomach issues and liver damage. Eventually she found a medication that worked for her.

Now, BJ rarely has big flare-ups.

“The new medication changed my life, and I can usually feel inflammation coming on when it does happen,” she says. “I can paint and do light construction to get houses ready to go on the market to sell.”

BJ says RA can be as much of a mind problem as it is a physical problem.

“I got tired of people telling me that my pain was caused by me doing too much—or people would try to figure out what I did wrong to make my wrists or shoulders hurt,” she says. “It’s nothing that I did. It’s my body reacting to an autoimmune disease and attacking a joint.”

In addition to finding the right medication to treat her RA, BJ also attributes her wellness to sticking to a healthy diet, keeping her weight down, and staying active.

She is currently training for the Pan Mass Challenge fundraiser, a 191-mile bicycle ride across Massachusetts that raises money for cancer research. She also plans to hike all the 4,000-foot mountain peaks in New Hampshire.

Her advice to those who have or suspect they have RA: “Go to a major rheumatology treatment center and talk to a rheumatologist who will really listen to you. Know your body and stay active.”

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10 Minute Body Weight Workout

Boost your energy and build lean muscle with this full-body fitness routine. It only takes 10 minutes and is perfect for early mornings!

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Researchers Extend Lifespan by as Much as 35 Percent in Mice

Researchers at Mayo Clinic have shown that senescent cells – cells that no longer divide and accumulate with age – negatively impact health and shorten lifespan by as much as 35 percent in normal mice. The results, which appear today in Nature, demonstrate that clearance of senescent cells delays tumor formation, preserves tissue and organ function, and extends lifespan without observed adverse effects.

“Cellular senescence is a biological mechanism that functions as an ‘emergency brake’ used by damaged cells to stop dividing,” says Jan van Deursen, Ph.D., Chair of Biochemistry and Molecular biology at Mayo Clinic, and senior author of the paper. “While halting cell division of these cells is important for cancer prevention, it has been theorized that once the ‘emergency brake’ has been pulled, these cells are no longer necessary.”

The immune system sweeps out the senescent cells on a regular basis, but over time becomes less effective. Senescent cells produce factors that damage adjacent cells and cause chronic inflammation, which is closely associated with frailty and age-related diseases.

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It’s a Kid’s Job | NIH News in Health

 

Playing Helps Kids Learn and Grow

What would childhood be without time to play? Play, it turns out, is essential to growing up healthy. Research shows that active, creative play benefits just about every aspect of child development.

“Play is behavior that looks as if it has no purpose,” says NIH psychologist Dr. Stephen Suomi. “It looks like fun, but it actually prepares [kids] for a complex social world.” Evidence suggests that play can help boost brain function, increase fitness, improve coordination, and teach cooperation.

Suomi notes that all mammals—from mice to humans—engage in some sort of play. His research focuses on rhesus monkeys. While he’s cautious about drawing parallels between monkeys and people, his studies offer some general insights into the benefits of play.

Active, vigorous social play during development helps to sculpt the monkey brain. The brain grows larger. Connections between brain areas may strengthen. Play also helps monkey youngsters learn how to fit into their social group, which may range from 30 to 200 monkeys in 3 or 4 extended families.

Both monkeys and humans live in highly complex social structures, Suomi says. “Through play, rhesus monkeys learn to negotiate, to deal with strangers, to lose gracefully, to stop before things get out of hand, and to follow rules,” he says. These lessons prepare monkey youngsters for life after they leave their mothers.

Play may have similar effects in the human brain. Play can help lay a foundation for learning the skills we need for social interactions. If human youngsters lack playtime, says Dr. Roberta Golinkoff, an infant language expert at the University of Delaware, “social skills will likely suffer. You will lack the ability to inhibit impulses, to switch tasks easily, and to play on your own.” Play helps young children master their emotions and make their own decisions. It also teaches flexibility, motivation, and confidence.

Kids don’t need expensive toys to get a lot out of playtime. “Parents are children’s most enriching plaything,” says Golinkoff. Playing and talking to babies and children are vital for their language development. Golinkoff says that kids who talk with their parents tend to acquire a vocabulary that will later help them in school. Let kids guide the conversation. When you take over the conversation, you may shut it down.

Unstructured, creative, physical play also lets children burn calories and develop all kinds of strengths, such as learning how the world works. In free play, children choose the games, make the rules, learn to negotiate, and release stress. Free play often involves fantasy. If children, say, want to learn about being a fireman, they can imagine and act out what a fireman does. And if something scary happens, free play can help defuse emotions by working them out.

“Sports are a kind of play,” Golinkoff says, “but it’s not the kids calling the shots.” It’s important to engage in a variety of activities, including physical play, social play, and solitary play. “The key is that in free play, kids are making the decisions,” says Golinkoff. You can’t learn to make decisions if you’re always told what to do.

Some experts fear that free play is becoming endangered. In the last two decades, children have lost an average of eight hours of free play per week. As media screens draw kids indoors, hours of sitting raise the risk for obesity and related diseases. When it comes to video games and other media, parents should monitor content, especially violent content, and limit the amount of time children sit.

There’s also been a national trend toward eliminating school recess. “Thousands of children have lost recess altogether,” says child development expert Dr. Kathryn Hirsh-Pasek of Temple University. “Lack of recess has important consequences for young children who concentrate better when they come inside after a break from the schoolwork.”

Many kids, especially those in low-income areas, lack access to safe places to play. This makes their school recess time even more precious. In response to these changes, some educators are now insisting that preschool and elementary school children have regular periods of active, free play with other children. The type of learning that happens during playtime is not always possible in the classroom. School recess is also important because of the growing number of obese children in the United States. Running around during recess can help kids stay at a healthy weight.

Play also may offer advantages within the classroom. In an NIH-funded study, Hirsh-Pasek, Golinkoff, and their colleagues found a link between preschoolers’ math skills and their ability to copy models of two- and three-dimensional building-block constructions. Play with building blocks—and block play alongside adults—can help build children’s spatial skills so they can get an early start toward the later study of science, technology, engineering, or math.

“In a way, a child is becoming a young scientist, checking out how the world works,” says Hirsh-Pasek. ”We never outgrow our need to play.” Older children, including teens, also need to play and daydream, which helps their problem-solving and creative imagination. Adults, too, need their breaks, physical activity, and social interaction.

Play can also be important for medical care. At the NIH Clinical Center in Bethesda, Maryland, “Recreation therapy services are seen as essential to the patients’ recovery,” says Donna Gregory, chief of recreational therapy. She and her team tailor activities for both children and adults. Games can get patients moving, even for just minutes at a time, which improves their functioning.

Medical play helps children cope with invasive procedures. A 2-year-old can be distracted with blowing bubbles; older kids can place their teddy bear in the MRI machine or give their doll a shot before they themselves get an injection. It gives kids a sense of control and supports their understanding in an age-appropriate, meaningful way.

Without play and recreation, people can become isolated and depressed. “There’s therapeutic value in helping patients maintain what’s important to them,” says Gregory. “When you are physically and socially active, it gives life meaning.”

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Fecal Transplants for Ulcerative Colitis? – IBD in the News

Edward Loftus Jr., M.D., a gastroenterologist at Mayo Clinic, talks about two newly published studies in the July 2015 issue of Gastroenterology; the studies examine the efficacy of fecal microbiota transplantation (FMT) in ulcerative colitis.

For more information, visit: http://ibdblog.mayoclinic.org/?mc_id=us&utm_source=youtube&utm_medium=sm&utm_content=video&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100504

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What’s the Difference Between Soluble and Insoluble Fiber?

These two types of fiber are an important part of your diet. What are the benefits and differences of each?

High-Fiber Super Foods: http://wb.md/2mjln2F

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Keeping Up in School? | NIH News in Health

Identifying Learning Problems

Reading, writing, and math are the building blocks of learning. Mastering these subjects early on can affect many areas of life, including school, work, and even overall health. It’s normal to make mistakes and even struggle a little when learning new things. But repeated, long-lasting problems may be a sign of a learning disability.

Learning disabilities aren’t related to how smart a child is. They’re caused by differences in the brain that are present from birth, or shortly after. These differences affect how the brain handles information and can create difficulties with reading, writing, and math.

“Typically, in the first few years of elementary school, some children, in spite of adequate instruction, have a hard time and can’t master the skills of reading and writing as efficiently as their peers,” says Dr. Benedetto Vitiello, a child mental health expert at NIH. “So the issue is usually brought up as a learning problem.”

In general, the earlier a learning disability is recognized and addressed, the greater the likelihood for success in school and later in life. “Initial screening and then ongoing monitoring of children’s performance is important for being able to tell quickly when they start to struggle,” explains Dr. Brett Miller, a reading and writing disabilities expert at NIH. “If you’re not actively looking for it, you can miss opportunities to intervene early.”

Each learning disability has its own signs. A child with a reading disability may be a poor speller or have trouble reading quickly or recognizing common words. A child with a writing disability may write very slowly, have poor handwriting, or have trouble expressing ideas in writing and organizing text. A math disability can make it hard for a child to understand basic math concepts (like multiplication), make change in cash transactions, or do math-related word problems.

Learning difficulties can affect more than school performance. If not addressed, they can also affect health. A learning disability can make it hard to understand written health information, follow a doctor’s directions, or take the proper amount of medication at the right times. Learning disabilities can also lead to a poor understanding of the benefits of healthy behaviors, such as exercise, and of health risks, such as obesity. This lack of knowledge can result in unhealthy behaviors and increased risk of disease.

Not all struggling learners have a disability. Many factors affect a person’s ability to learn. Some students may learn more slowly or need more practice than their classmates. Poor vision or hearing can cause a child to miss what’s being taught. Poor nutrition or exposure to toxins early in life can also contribute to learning difficulties.

If a child is struggling in school, parents or teachers can request an evaluation for a learning disability. The U.S. Individuals with Disabilities Education Improvement Act requires that public schools provide free special education support to children, including children with specific learning disabilities, who need such services. To qualify for these services, a child must be evaluated by the school and meet specific federal and state requirements. An evaluation may include a medical exam, a discussion of family history, and intellectual and school performance testing.

Many people with learning disabilities can develop strategies to cope with their disorder. A teacher or other learning specialist can help kids learn skills that build on their strengths to counter-balance their weaknesses. Educators may provide special teaching methods, make changes to the classroom, or use technologies that can assist a child’s learning needs.

A child with a learning disability may also struggle with low self-esteem, lack of confidence, and frustration. In the case of a math learning disability, math anxiety may play a role in worsening math abilities. A counselor can help children use coping skills and build healthy attitudes about their ability to learn.

“If appropriate interventionsActions taken to prevent or treat a disorder or to improve health in other ways. are provided, many of these challenges can be minimized,” explains Dr. Kathy Mann Koepke, a math learning disability expert at NIH. “Parents and teachers should be aware that their own words and behavior around learning and doing math are implicitly learned by the young people around them and may lessen or worsen math anxiety.”

“We often talk about these conditions in isolation, but some people have more than one challenge,” Miller says. Sometimes children with learning disabilities have another learning disorder or other condition, such as attention deficit hyperactivity disorder (ADHD).

“ADHD can be confused with a learning problem,” Vitiello says. ADHD makes it difficult for a child to pay attention, stay focused, organize information, and finish tasks. This can interfere with schoolwork, home life, and friendships. But ADHD is not considered a learning disability. It requires its own treatments, which may include behavior therapy and medications.

“Parents play an important role in treatment, especially for children in elementary school,” Vitiello says. Medications and behavioral interventions are often delivered
at home. Teachers can usually advise parents on how to help kids at home, such as by scheduling appropriate amounts of time for learning-related activities. Parents can also help by minimizing distractions and encouraging kids to stay on task, such as when doing homework. Effective intervention requires consistency and a partnership between school and home.

Many complex factors can contribute to development of learning disabilities. Learning disorders tend to run in families. Home, family, and daily life also
have a strong effect on a child’s ability to learn starting from a very early age. Parents can help their children develop skills and build knowledge during the first few
years of life that will support later learning.

“Early exposure to a rich environment is important for brain development,” Mann Koepke says. Engage your child in different learning activities from the start. Before they’re even speaking, kids are learning. “Even if it’s just listening and watching as you talk about what you’re doing in your daily tasks,” she says.

Point out and talk with children about the names, colors, shapes, sizes, and numbers of objects in their environment. Try to use comparison words like “more than” or “less than.” This will help teach your child about the relationships between things, which is important for learning math concepts, says Mann Koepke. Even basic things, like getting enough sleep and eating a healthy diet, can help children’s brain development and their ability to learn.

NIH is continuing to invest in research centers that study learning challenges and their treatments, with a special focus on understudied and high-risk groups.

Although there are no “cures,” early interventions offer essential learning tools and strategies to help lessen the effects of learning disabilities. With support from caregivers, educators, and health providers, people with learning disabilities can be successful at school, work, and in their personal lives.

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Mayo Clinic SURF program: Tamiel Turley’s Story

Meet Tamiel Turley, a senior at Texas Woman’s University who spent 10 weeks away from her family this past summer as a participant in the prestigious Mayo Clinic Summer Undergraduate Research Fellowship (SURF).

Developed by Mayo Graduate School, Mayo’s school for Ph.D. training, SURF is the first-of-its-kind initiative in the nation to bring together diverse college students from across the country for summer research apprenticeship training with Mayo Clinic scientists.

Learn more about Tamiel’s experience with the program, which exists on all Mayo campuses and receives nearly 1,200 applicants per year.

Learn more about SURF by visiting www.mayo.edu.

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What’s Living on Your Skin?

Take a closer look at the human body and the billions of bacteria that live on our skin.

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Safeguarding Our Health | NIH News in Health

Vaccines Protect Us All

We share more than food and culture within our homes and communities. We can also spread disease. Luckily, we live in a time when vaccines can protect us from many of the most serious illnesses. Staying current on your shots helps you—and your neighbors—avoid getting and spreading disease.

Vaccines have led to large reductions in illness and death for both kids and adults, says Dr. David M. Koelle, a vaccine expert at the University of Washington in Seattle. One study estimated that, among U.S. children born from 1994 to 2013, vaccines will prevent about 322 million illnesses, 21 million hospitalizations, and 732,000 deaths.

Vaccines harness your immune systemA collection of specialized cells and organs that protect the body against infectious diseases.’s natural ability to detect and destroy disease-causing germs and then “remember” the best way to fight these germs in the future. Vaccination, or immunization, has completely eliminated naturally occurring smallpox worldwide—to the point that we no longer need to get shots against this fast-spreading, deadly disease. Polio has been eliminated in the U.S. and most other nations as well, thanks to immunizations. Poliovirus can affect the brain and spinal cord, leaving people unable to move their arms or legs, or sometimes unable to breathe.

“These childhood diseases used to be dreaded problems that would kill or paralyze children,” says Koelle. “In the 1950s, it was a common occurrence for kids to be fine in the spring, get polio over the summer, and then have to go back to school in the fall no longer able to walk.”

Experts recommend that healthy children and teens get shots against 16 diseases (see Wise Choices box). With these shots, many disabling or life-threatening illnesses have significantly declined in the U.S., including measles, rubella, and whooping cough. But, unlike smallpox, these disease-causing germs, or pathogens, are still causing infections around the world.

“These days, the risks of not being vaccinated in a developed country, like the United States, may seem superficially safe because of low rates of infection due to vaccination and other advances in public health,” Koelle says. “But we live in an era of international travel where we can be exposed to mobile pathogens.” So even if you don’t travel, a neighbor or classmate could go overseas and bring the disease back to your area.

“When the rates of vaccination drop, there can be a resurgence of the disease,” explains Dr. Saad Omer, a global health researcher at Emory University in Atlanta. For instance, measles was completely eliminated in the U.S. in 2000. But since then, thousands of cases have occurred, mostly related to travel.

Omer and colleagues examined U.S. reports on measles outbreaks since 2000. “We found that measles cases have occurred mostly in those who are not vaccinated and in communities that have lower rates of vaccination. And that’s true for many vaccine-preventable diseases,” he says. Most of the unvaccinated cases were those who chose not to be vaccinated or not have their children vaccinated for non-medical reasons.

When enough people are vaccinated, the entire community gains protection from the disease. This is called community immunity. It helps to stop the spread of disease and protects the most vulnerable: newborns, the elderly, and people fighting serious illnesses like cancer. During these times, your immune system is often too weak to fend off disease and may not be strong enough for vaccinations. Avoiding exposure becomes key.

“There’s a huge benefit to all of us getting the recommended vaccines,” explains Dr. Martha Alexander-Miller, an immune system expert at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “Number one, vaccines protect you. But they also limit the presence of disease-causing entities that are circulating in the community. So, you’re helping to protect individuals who may not be capable of protecting themselves, for example because they are too young to get vaccinated.”

When expectant moms are vaccinated, immune protection can pass through the placenta to the fetus. “Early on, the baby’s immune system is immature. So there’s a period of vulnerability where disease and death can occur,” Omer explains. “But the mother’s own antibodies—proteins formed by her immune system—can protect the baby.”

Doctors recommend that moms-to-be get both flu and Tdap (tetanus, diphtheria, and whooping cough) shots. A mother’s antibodies can help protect the newborn until they can receive their own vaccinations.

Some vaccines must be given before pregnancy. Rubella, for instance, can cause life-altering birth defects or miscarriage if contracted during pregnancy. There’s no treatment, but the measles, mumps, and rubella (MMR) vaccine offers prevention. Vaccines for many other common diseases that put newborns at risk are being studied.

“We’ve made amazing progress in the development of effective vaccines,” says Alexander-Miller. “Our ability to have such breakthroughs is the end result of very basic research that went on for years and years.” NIH-funded scientists continue to search for new ways to stimulate protection against various diseases.

Koelle studies how our bodies fight herpes viruses. There are eight related herpes viruses, but the body responds differently to each one. So far, we only have vaccines for one: varicella-zoster virus, which causes chickenpox and shingles.

Koelle’s team is comparing how our immune system responds to chickenpox and the herpes simplex viruses, which cause mouth and genital sores. “We’re hoping to harness the success that has been possible with the chickenpox vaccine and see if we can create a vaccine that would work for both chickenpox and shingles and also herpes simplex,” he says.

Researchers are also working to improve existing vaccines. Some vaccines require a series of shots to trigger a strong immune response. The protection of other vaccines can fade over time, so booster shots may be needed. Some, like the flu vaccine, require a shot each year because the virus changes so that the vaccine no longer protects against new strains. So keeping up with the latest flu vaccines is important.

Ask your doctor’s office whether your vaccinations are current. You may also find records of vaccinations at your state health department or schools. If you can’t find your records, ask your doctor if it’s okay to get a vaccine you might have received before.

Most side effects of vaccines are mild, such as a sore arm, headache, or low-grade fever.

“It can be easy to take vaccines for granted, because you’ll never know all the times you would’ve gotten really sick had you not been vaccinated,” says Alexander-Miller.

Help your community keep diseases at bay: Stay up-to-date with vaccines.

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Somatic Symptom Disorders Part I: New Terminology for New Concepts

Dr. Jeffrey Staab, Mayo Clinic Psychiatrist, discusses the concepts that led to the development of the new terminology for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In DSM-4 somatic symptom disorders were defined negatively, by what they were not. Conversely, the DSM-5 emphasizes a couple core somatic symptom disorders and identifies the key features that can help determine the presence of these disorders. The DSM-5 looks to identify patterns of symptoms that can be identified positively, not the absence of a medical explanation or presumption of a psychological conflict. The change in nomenclature is the next step in the ever-evolving definition of these disorders.

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What Is Type 2 Diabetes?

Diabetes is when your body doesn’t process sugar the right way. But what does that mean exactly? When you have type 2 diabetes, your blood sugar level is too high. Here’s how it works.

Quiz: Myths and Facts About Type 2 Diabetes http://wb.md/2iCvBKv

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