Tuesday

Causes of Unexplained Weight Loss

Unexplained weight loss, or losing weight without trying, can be a cause for concern. It might indicate an underlying condition.
A good rule of thumb is to see your doctor if you’ve lost a significant amount — more than 5 percent of your weight — within 6 to 12 months. In addition, take note of any other symptoms to talk over with your doctor.

Muscle loss, or muscle wasting, can lead to unexpected weight loss. The major symptom is muscle weakness. One of your limbs may even look smaller than the other.
Your body is made of fat mass and fat-free mass, which includes muscle, bone, and water. If you lose muscle, you’ll lose weight.
This can happen if you don’t use muscles for a while. It’s most common in people who don’t exercise, work desk jobs, or are bedridden. Generally, exercise and proper nutrition will reverse muscle loss.
Other possible causes of muscle loss include:
  • injuries, such as broken bones
  • aging
  • burns
  • stroke
  • osteoarthritis
  • rheumatoid arthritis
  • osteoporosis
  • multiple sclerosis
  • nerve damage

Hyperthyroidism, or overactive thyroid, develops when your thyroid gland makes too much thyroid hormone. These hormones control many functions in the body, including metabolism.
If your thyroid is overactive, you’ll quickly burn calories even if you have a good appetite. The result can be unintentional weight loss.
Other symptoms include:
  • fast, irregular heart rate
  • anxiety
  • fatigue
  • heat intolerance
  • sleep troubles
  • hand tremors
  • light periods in women
Possible causes of hyperthyroidism include:
  • Graves’ disease
  • thyroiditis
  • eating too much iodine
  • taking too much thyroid medicine
Treatment of hyperthyroidism depends on your age and severity of your case. Generally, it’s treated with anti-thyroid medications, radioactive iodine, beta-blockers, or surgery.

Rheumatoid arthritis (RA) is an autoimmune disease that makes your immune system attack the lining of your joints, leading to inflammation. Chronic inflammation can speed up metabolism and reduce overall weight.
Symptoms of RA include joint swelling and pain. It usually affects the same joints on both sides of your body. If you have RA, your joints might feel stiff if you don’t move for an hour or more.

Another cause of unwanted weight loss is type 1 diabetes. If you have type 1 diabetes, your immune system attacks cells in your pancreas that make insulin. Without insulin, your body can’t use glucose for energy. This causes high blood glucose.
Your kidneys remove unused glucose through urine. As sugar leaves your body, so do calories.
Type 1 diabetes also causes:
  • frequent urination
  • dehydration
  • fatigue
  • blurry vision
  • excessive thirst
  • excessive hunger

Weight loss may be a side effect of depression, which is defined as feeling sad, lost, or empty for at least two weeks. These emotions interfere with daily activities, such as going to work or school.
Depression affects the same parts of the brain that control appetite. This can lead to poor appetite, and eventually, weight loss.
In some people, depression may increase appetite. The symptoms vary from person to person. Other symptoms of depression include:
  • constant sadness
  • loss of interest in hobbies
  • low energy
  • poor concentration
  • sleeping too little or too much
  • thoughts of death or suicide
  • irritability
Behavioral therapy, psychotherapy, and antidepressants are used to treat depression.

Unexpected weight loss may be a symptom of inflammatory bowel disease (IBD). IBD is a term that encompasses several chronic inflammatory disorders of the digestive tract. The two most common types are Crohn’s disease and ulcerative colitis.
The chronic inflammation of IBD puts your body in a catabolic state, which means that it’s constantly using up energy.
IBD also disrupts ghrelin, the hunger hormone, and leptin, the satiety hormone. This results in decreased appetite and weight loss.
Additional symptoms include:
  • diarrhea
  • stomach pain
  • bloating
  • bloody stools
  • fatigue
These symptoms are triggered by certain foods. If you have IBD, you might be hesitant to eat. Treatment of IBD usually consists of nutritional support, medication, and in some cases, surgery.

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease. This includes emphysema and chronic bronchitis. Many people with COPD have both.
Emphysema slowly damages the air sacs in your lungs, making it hard to breathe. Chronic bronchitis causes inflammation of the airways that bring air to your lungs. This produces mucus, coughing, and breathing issues.
Early COPD is mild. Some people may not show symptoms but those that may appear include:
  • shortness of breath
  • wheezing
  • chest tightness
  • mild coughing, with or without mucus

The main cause of COPD is cigarette smoking. Long-term exposure to irritants such as air pollution and dust can also lead to COPD. Treatment includes medications, such as bronchodilators, and lung therapies, like oxygen therapy.

Endocarditis causes inflammation of your heart’s inner lining, or endocardium. It develops when germs —usually bacteria — enter the bloodstream and collect in your heart.
Most people with endocarditis have a fever. This may come along with a poor appetite. Elevated body temperature also increases metabolism and burns fat, causing weight loss.
Other symptoms include:
  • heart murmur
  • coughing, with or without blood
  • abdominal pain
  • chest pain
  • difficulty breathing
  • night sweats
  • back pain
  • headache
  • red or purple spots on the skin

Another cause of unexplained weight loss is tuberculosis (TB), a contagious condition that usually affects the lungs. It’s caused by Mycobacterium tuberculosisbacteria. Weight loss and decreased appetite are major symptoms of TB, but the reasons aren’t fully understood.
TB spreads through the air. You can catch TB without getting sick. If your immune system can fight it, the bacteria will become inactive. This is called latent TB.
Over time, it can turn into active TB. Symptoms include:
  • bad cough that lasts 3 weeks or more
  • chest pain
  • coughing up blood or phlegm
  • fatigue
  • night sweats
  • chills
  • fever

TB is typically treated with a course of antibiotics for six to nine months.

Cancer is the general term for diseases that cause abnormal cells to quickly divide and spread. According to the American Cancer Society, one of the first signs may be unexplained weight loss of 10 pounds or more. This is common with cancers of the pancreas, lung, stomach, and esophagus.
Cancer increases inflammation. This promotes muscle wasting and disrupts appetite-regulating hormones. A growing tumor may also increase your resting energy expenditure (REE), or how much energy your body burns at rest.
Early symptoms of cancer also include:
  • fever
  • fatigue
  • pain
  • skin changes
Many conditions can cause these symptoms. 

Addison’s disease develops when the immune system attacks the adrenal glands. In turn, the adrenal glands can’t make enough hormones like cortisol and aldosterone. Cortisol regulates many functions, including metabolism and appetite. Low levels of cortisol may lead to poor appetite and weight loss.
Other symptoms of Addison’s disease include:
  • low blood pressure
  • chronic fatigue
  • muscle weakness
  • salt cravings
  • hyperpigmentation
Addison’s disease is rare, affecting roughly 1 in 100,000 people in the United States. Treatment includes medications that’ll regulate your adrenal gland.

Monday

Cyclosporine A for treatment of moderate to severe dry eye disease?

treatment of dry eye disease
Efficacy and safety of using topical cyclosporine A for treatment of moderate to severe dry eye disease


Objective
To investigate and evaluate the efficacy and safety of topical cyclosporine A for treatment of moderate to severe dry eye disease.

Materials and methods

This is a prospective study of patients with moderate to severe dry eye syndrome were recruited. All cases were selected from patients attending the ophthalmic outpatient clinic of Research institute of ophthalmology. Eligible patients were at least 21 years of age with a confirmed diagnosis of keratoconjunctivitis sicca with or without Sjogren's syndrome refractory to conventional management.
The medication used in this study were unit dose vials of unpreserved cyclosporine A 0.05% used twice daily.
The protocol was composed of a 2-week washout phase, a 12-week treatment phase, and a 4-week post treatment phase. Patients were evaluated at weeks 4, 8, 12 during the treatment phase. During these visits patients were evaluated for changes from base line in Schirmer test, rose Bengal staining, superficial punctuate erosions, BUT, impression cytology, symptoms of ocular discomfort and visual acuity. After completion of the treatment phase, patients were also evaluated at post treatment week 4, during this visit patients were assessed for Schirmer test, rose Bengal staining, superficial punctuate erosion, BUT, impression cytology, symptoms of ocular discomfort and visual acuity.

Results

Thirty two cases in the mean age of 47 (12.9), range [20–67] years; four (13%) male and 28 (87%) female were recruited in the current study. Out of them, 12 (38%) cases had Sjogren syndrome. Visual acuity improved significantly (p = 0.012), BUT (p < 0.0001) for both eyes, Schirmer measurements (p < 0.0001 and p = 0.029 for OD and OS, respectively).

Conclusions

Cyclosporine A ophthalmic emulsion 0.05% has been demonstrated to be effective and safe in human clinical trials. It reduces signs and symptoms of dry eye disease, with the fact that its effect continued to occur significantly within the treatment periods as well as improvement of ocular condition kept on, actually more slowly towards stability, despite the drug has already stopped.

Wednesday

Organs may be Active Participants in Fighting Autoimmune Disease



Organs may be Active Participants in Fighting Autoimmune Disease

9/24/2018

Organs affected by autoimmune disease could be fighting back by “exhausting” immune cells that cause damage using methods similar to those used by cancer cells to escape detection, according to a study by researchers at the University of Pittsburgh School of Medicine published in the Journal of Clinical Investigation.

The conclusions, based on studies in mouse models of systemic lupus erythematous (SLE) – referred to as lupus – could explain why autoimmune diseases may take a long time to cause significant organ damage. They could also explain how widely used cancer immunotherapy drugs can have deleterious autoimmune side effects on normal organs.

 “These findings really turn our current understanding of autoimmune tissue damage on its head and suggest that we could more effectively treat these diseases if we can develop targeted methods to enhance the body’s natural ability to tune down the immune system,” said senior author Mark Shlomchik, M.D., Ph.D., UPMC endowed professor and chair, Department of Immunology, Pitt School of Medicine, and an investigator at the UPMC Immune Transplant and Therapy Center.
In autoimmune diseases like lupus, immune cells that normally protect against invaders, such as bacteria or cancer cells, instead begin to recognize the body’s own cells as foreign and attack them. In lupus nephritis, a kidney disease associated with SLE, a large number of these autoreactive cells – called kidney infiltrating T cells (KITs) – were thought to be activated, causing damage over time.

Wondering how exactly these cells cause kidney damage, Jeremy Tilstra, M.D., Ph.D., an assistant professor of medicine at Pitt and a researcher in Shlomchik’s lab, began to study them in three different mouse models of lupus nephritis. 

As the researchers expected, there were millions of KITs in the kidney, but surprisingly, they were not highly active as had previously been thought. 


“The T cells were there, but they weren’t aggressively active, in fact, it was the exact opposite,” said Tilstra. “They were sluggish, ineffective killers and didn’t divide very well, which was completely unexpected.”

Experiments showed that these KITs did not respond to stimulation like normal T cells – they neither released characteristic inflammatory proteins, nor did they reproduce very well. The cells also took up and used much less energy, displaying signs of metabolic exhaustion. 

Interestingly, the exhausted KITs were quite similar to T cells found inside tumors. The affected kidney cells also resembled tumor cells in certain ways, as they expressed higher levels of a protein called PD-L1, which cancer cells use to suppress T cells that enter the tumor. 

“Our findings suggest that the body is capable of actively fighting back against autoimmune diseases, not sitting idly by. The similarity between T cells in lupus-affected kidneys and in tumors has important implications,” noted Shlomchik. “It suggests that the ability to suppress T cells is not an abnormal mechanism that cancer cells have somehow developed to defeat the immune system, rather it’s an existing natural mechanism against autoimmune disease that tumors have adopted to their advantage.” 
FULL REPORT 

Monday

Ocular Signs and Symptoms of Dry Eye Associated With Depression

This study 'How Are Ocular Signs and Symptoms of Dry Eye Associated With Depression in Women With and Without Sjögren Syndrome?' was published in The American Journal of Ophthalmology in July 2018.


Purpose

To determine whether features of keratoconjunctivitis sicca (KCS) and/or symptoms of dry eye disease are associated with depression in women participants enrolled in the Sjögren’s International Collaborative Clinical Alliance (SICCA).

Methods

Women enrolled in the SICCA registry from 9 international research sites. 
Participants met at least 1 of 5 inclusion criteria for registry enrollment including:
  •  complaints of dry eyes or dry mouth
  • a previous diagnosis of Sjögren syndrome (SS)
  • abnormal serology (positive anti–Sjögren syndrome antigen A and/or B [anti-SSA and/or anti-SSB]), or elevated antinuclear antibody and rheumatoid factor 
  • bilateral parotid gland enlargement, or multiple dental caries. 

Results

Dry eye complaints produced a 1.82-fold (95% confidence interval [CI] 1.38-2.40) higher odds of having depression compared to being symptom-free (P < .001). 
Additionally, complaints of specific ocular sensations were associated with a higher odds of depression including burning sensation (odds ratio 2.25, 95% CI 1.87-2.72, P < .001) compared to those without complaints. 
In both women with and without SS, the presence of symptoms of dry eyes and/or dry mouth rather than SS itself resulted in higher odds of depression. 

Saturday

Clary Sage benefits for chronic conditions

What are the possible benefits of clary sage oil?

Clary sage, also known as Salvia sclarea, is a plant native to the northern Mediterranean Basin. It is widely used for medicinal purposes and as a spice.
Clarry Sage benefits for chronic conditions

In this article, we take a look at the uses and suggested health benefits of clary sage oil. We will also look at whether there is any scientific evidence to back these claims up. We also examine how the oil is used, and what side effects could occur.

Uses for clary sage oil
People may use the oil for one or more of its potential properties, including:
  • antidepressant effects
  • anti-inflammatory effects
  • improved digestion
  • antibacterial effects
  • stress relief
  • improved circulation
Clarry Sage benefits for chronic conditions

Possible health benefits

Antidepressant effects

2010 study published in the Journal of Ethnopharmacology investigated the antidepressant and stress-fighting effects of several different essential oils in rats. The oils used included clary sage, chamomile, rosemary, and lavender.
The study found that out of all the oils tested, clary sage oil had the most potent anti-stress effect.
The researchers concluded that clary sage oil could be an effective treatment for people experiencing depression. They also suggested that the effect of the oil was closely linked to the feel-good hormone dopamine.

Blood-pressure-lowering and anti-anxiety effects

study published in 2013 in the Journal of Alternative and Complementary Medicine found that inhaled clary sage oil significantly lowered blood pressure and calmed the breathing of women with urinary incontinence undergoing assessment. The paper includes the suggestion that inhaled clary sage oil may be an effective way of promoting relaxation.

Anti-inflammatory effects
Research published in the Journal of Ethnopharmacology in 2017 found that an extract of clary sage had significant anti-inflammatory effects in rats. The researchers concluded that the clary sage extract could be an effective treatment for the inflammatory gum condition periodontitis.

Improved mental function

A 2017 review looked at the effects of various sage plants, including clary sage. The author found that sage plants seem to be associated with improved memory, greater alertness, and potential Alzheimer's-fighting effects.
The same review also noted the anti-depressant and anti-stress effects of clary sage mentioned above.
How to use clary sage oil


How to use clary sage oil
Aromatherapy: Around 2 to 3 drops of clary sage oil can be mixed with water and other essential oils and diffused into the air via an essential oil burner. When vaporized, clary sage oil can help to fight bacteria and other germs in the air
Skin: Add about 6 drops of clary sage oil to 1 oz. of carrier oil, such as coconut oil, and rub directly onto a wounded area, or massage into skin. Add 3 to 5 drops of essential oil to the bathwater to soothe sore muscles and improve mood. When rubbed onto an injured area, it can have a direct antiseptic, anti-inflammatory, and anesthetic effect.
READ FULL ARTICLE

Purchasing Clary Sage
After much research I discovered Clary Sage 100% Pure, Best Therapeutic Grade Essential Oil - 10ml which was the best recommended Clary Sage in the Amazon best sellers list. I have tried their products and recommend them highly and they are also one of the least expensive in this essential oil.
I am an Amazon affiliate, only recommending products I have tried, and if you purchase through my linkI do receive a small % at no extra cost to you. Thanks.

How I use Clary Sage
I use it in my diffuser to relieve stress and to help me sleep.
I put 3 drops in my foot bath for a relaxing soak.
I mix it in sorbelene cream and massage it into my feet - somehow this really ensures a great sleep.
I add 10 drops to a spray bottle of water as a room diffuser for that refreshing musky smell.

Stigmatizing views and myths about psoriasis are pervasive in the United States

Penn study examines public perceptions of common skin disease.


Stigmatizing views and myths about psoriasis

The stigma associated with the autoimmune disease psoriasis may lead people to avoid patients who show signs of the condition, including not wanting to date, shake hands, or have people in their homes if they suffer from the disease. 

New multidisciplinary research involving both psychologists and dermatologists from the Perelman School of Medicine at the University of Pennsylvania is the first to examine how common this stigma may be among the general population of the United States as well as among medical students. The study also found false perceptions about psoriasis continue to persist, including the belief that psoriasis is contagious and that it is not a serious illness. Researchers published their findings in the Journal of the American Academy of Dermatology today.

Psoriasis is a common, chronic autoimmune disease affecting more than eight million Americans, causing painful, thick, red patches on the skin that often itch and bleed. It also has profound effects on health-related quality of life, and in moderate to severe cases, it carries an increased risk of heart attack, stroke, and premature death. It is not contagious, and while it is treatable, there is currently no cure.

"It's possible that better education about the disease, as well as contact with individuals with psoriasis, may help to dispel myths and stereotypes and reduce negative perceptions," Pearl said. Rebecca L. Pearl, PhD, an assistant professor of Psychology in Psychiatry, was the lead author of the study.
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Friday

Dry eye found in over 85% of Sjogren’s patients

REPORTING FROM ISSS

Over one-third of 28 outcomes identified to be important to Sjogren’s patients with dry eye are not commonly found in existing research, according to a study presented at the International Symposium on Sjogren’s Syndrome.
With dry eye found in over 85% of Sjogren’s patients, pinpointing important outcomes accurately can help researchers and physicians focus their efforts and be more cost effective when developing clinical trials, systematic reviews , practice guidelines, and evidence-based health care, according to presenter Ian J. Saldanha, MBBS, MPH, PhD, of the department of epidemiology at Johns Hopkins, Baltimore.
“When designing clinical trials, if you are trying to incorporate the views of patients, this can help more accurately depict what you should be measuring and in what time frame,“ Dr. Saldanha said to attendees. This can be important as agencies such as the Food and Drug Administration have absolved to be more committed to bringing the patient perspective to drug development, according to Dr. Saldanha.
When ranked, the top 10 outcomes chosen were ocular burning, ocular discomfort, ocular pain, ocular dryness, visual acuity, overall assessment of surface symptoms, ocular foreign body sensation, tear film stability, artificial tear use, and adverse events.
Of the 28 outcomes deemed “important” by the surveyed population, 10 were found to be uncommon in current research.
When asked when patients would like these outcomes to be measured if they were to participate in a clinical trial, over 75% preferred a 3-month period for ocular burning, discomfort, pain, and foreign body sensations, as well as impact of dry eye in daily life, tear film stability, and costs of treatment. In comparison, a majority of patients agreed that outcomes such as satisfaction of treatment, ocular fatigue, and vision-related quality of life should be measured between 3 and 6 months.
With these data, according to Dr. Saldanha, researchers can maximize consistency across trials as well as contribute to better evidence-based medicine.

Sunday

Things Doctors Tell Their Friends About Autoimmune Diseases

Things Doctors Tell Their Friends About Autoimmune Diseases

1 HOW THEY MAY START. 
"The immune system is like the body's army — it spends the earliest years of your life distinguishing friends from enemies so it can protect you from invaders. Our culture has become so fastidious about hygiene, however, that doctors worry the immune system may not encounter many threats until adolescence or beyond, when it's more likely to make a mistake. It's not uncommon for an autoimmune attack on, say, your joints or thyroid to first happen or flare after an unrelated virus or infection. And an autoimmune attack can come seemingly out of nowhere, possibly due to a combination of genetics and the environment."
— Anca Askanase, M.D., associate professor of medicine at Columbia University's Irving Medical Center and director of the Columbia Lupus Center

What you can do: If you have symptoms of something new shortly after you've recovered from an infection, see your doctor. 

GET A SECOND OPINION.
Many autoimmune diseases — including lupus, rheumatoid arthritis, multiple sclerosis, and Hashimoto's thyroiditis — have symptoms in common, and that's just one reason diagnosis is so difficult. Often one of the first clues is extreme fatigue, which might be dismissed by doctors as simply a consequence of motherhood or being overworked. Also, there's no one blood test for these diseases, and the ones that exist aren't foolproof. One woman I know was tired and stressed and losing her hair, but her doctor thought her levels of ANA — the rogue antibodies in the blood of patients with lupus or rheumatoid arthritis — were relatively normal. A year later, she had developed the classic lupus butterfly rash on her face as well as painful, swollen joints, and her ANA levels were much higher."
—Dr. Askanase

What you can do: Push for answers. "If you're chronically tired, to the point that everyday activities wipe you out, that's not normal," she says. "And fatigue accompanied by muscle or joint pain, recurring fever, rashes, swollen glands, hair loss, or mouth sores is a red flag — get checked."

TUMMY TROUBLE MAY BE A SIGN.
"A friend recently asked if her cramps and frequent trips to the bathroom could be serious. I explained that inflammatory bowel disease (IBD) — a group of autoimmune disorders that cause chronic inflammation of the digestive tract — has symptoms that set it apart from stomach bugs. Your stools may be bloody, and you might also rush to the bathroom in the middle of the night or suffer from night sweats, chills, and fever."
—Neilanjan Nandi, M.D., the Center for Inflammatory Bowel Diseases at Drexel University College of Medicine in Philadelphia

What you can do: Dr. Nandi's friend, since diagnosed with the common IBD disorder Crohn's disease, has changed her diet and exercise routine. "Fiber can help suppress gut inflammation between flares; light exercise triggers the release of feel-good endorphins and helps relieve stress. I also recommend 2,000 to 3,000 IUs of vitamin D daily," Dr. Nandi says.

How drugs could repair damage from multiple sclerosis

How drugs could repair damage from multiple sclerosis

NIH August 14, 2018

At a Glance

  • Drugs that help repair the nerve cell lining that’s damaged in multiple sclerosis were found to target certain enzymes.
  • The finding could help researchers develop new treatments for multiple sclerosis.


The team used a series of laboratory techniques to examine how drugs interact with the molecules in the body that are involved in myelin production. They found that miconazole and eight other related drugs all blocked an enzyme called CYP51. Blocking CYP51 encouraged stem cells to form new oligodendrocytes. These are the cells that create the myelin coatings around nerve cells.

CYP51 is part of the molecular pathway that produces cholesterol. The researchers discovered that blocking two other enzymes in that pathway also promoted oligodendrocyte production.
The boost in oligodendrocyte production appeared to be due to buildup of a specific type of cholesterol precursor (called 8,9-unsaturated sterols) when any of the three enzymes was blocked. When the researchers treated stem cells with 8,9-unsaturated sterols, they saw oligodendrocyte production rise.

The team next screened over 3,000 approved drugs and other small molecules for their ability to promote oligodendrocyte production. The top ten all caused a buildup of 8,9-unsaturated sterols.
When tested on human stem cells grown in the laboratory, drugs or genetic manipulations that targeted any one of the three enzymes caused oligodendrocytes to form and start laying down myelin. In mice with damage to myelin in their spinal cords, injection of drugs that targeted one of the enzymes caused restoration of myelin in the damaged tissue.



“We were shocked to find that almost all of these previously identified molecules share the ability to inhibit specific enzymes that help to make cholesterol. This insight reorients drug discovery efforts onto these novel, druggable targets,” Adams says.

The researchers have formed a company to build on these findings and develop therapeutics to promote myelin repair.

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