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Arthritis in the Toes: Overview and More

Arthritis in the toes is chronic inflammation of the joints in the forefoot. The joint most often affected is the metatarsophalangeal (MTP) joint, which connects the big toe to the rest of the foot. Symptoms of toe arthritis are similar to those of arthritis that affects other joints: tenderness, swelling, stiffness, and pain. The most common causes of toe arthritis are wear and tear (degeneration) of the cartilage that cushions the bones that form joints, as occurs in osteoarthritis (OA) and rheumatoid arthritis, (RA), an autoimmune disease. Damage caused by an injury or gout also can cause toe arthritis. Treatment depends on the cause and severity: Icing and over-the-counter (OTC) pain medication can relieve swelling and pain, but in severe cases orthotics, physical therapy, or even surgery may be needed to restore loss of function.

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Symptoms of Toe Arthritis

Arthritis symptoms may come and go or be persistent and debilitating. You may wake up one morning with pain and swelling in one or more toes, or you may notice a gradual progression of mild achiness to increasing discomfort and changes in the appearance of your toes over time.

Your symptoms also will depend in part on the type or cause of your toe arthritis, but typically you will experience:

Pain and soreness at the base of the big toe: This is likely to flare up when you’re standing or walking and subside once you get off your feet. After intense activity, it may take hours, or even days, to abate.
Swelling: Toe joints are tiny: The accumulation of even a small amount of fluid may cause toes to feel “full” or be hard to bend.
Restricted movement: Range of motion may be limited because of swelling as well as loss of cartilage between the bones of the joints that allow them to move smoothly. Pain and stiffness may flare up during cold, damp weather.
Redness and warmth: Inflammation causes blood vessels to widen in order to bring more blood to affected areas, causing them to be warm to the touch and reddish in appearance.
Deformities: These include bone spurs (osteophytes), bunions, mallet toes, hammertoes, and others. They can affect how you walk and also, because there’s little soft tissue surrounding the toe joints to hide them, alter the appearance of the foot. In some people, deformities lead to pressure sores, calluses, and blisters.
Numbness: Swelling and changes to structures in the foot can compress nerves, resulting in numbness, burning, or tingling.
Clicking or popping sounds: Toe joints may make sounds as the cartilage that usually cushions the adjoining bones in a joint wears away, allowing hard bone surfaces to clack together.

Types and Causes

There are many different types of arthritis. Among them:

Osteoarthritis: Although considered non-inflammatory, OA does involve some degree of inflammation. It develops when the cartilage that forms a cushion between the bones of joints wears away due to time or injury (such as stubbing a toe). Osteoarthritis of the big toe is called hallux rigidus.
Rheumatoid arthritis: Inflammation, and therefore redness, warmth, and swelling, are more pronounced in RA. Because the entire body is affected, you may experience fatigue and other systemic symptoms.
Gout, also known as gouty arthritis, is caused by the formation of uric acid crystals in a joint (most often the big toe). The condition is associated with genetics and kidney disorders, but diet, alcohol use, and obesity are contributing risk factors.
Psoriatic arthritis: Like RA, psoriatic arthritis is an autoimmune disease in which characteristic skin lesions precede symptoms of arthritis.

Risk factors for toe arthritis include obesity, as excess pounds can stress weight-bearing joints, and frequent and prolonged wearing of tight fitting high-heeled shoes. There also is some indication toe arthritis can run in families.

Diagnosis

If you experience symptoms of toe arthritis, you can see your regular doctor, although an orthopedic specialist may be able to diagnose you most expediently. The diagnostic process will likely involve:

A medical history
A physical examination of your foot
X-rays to observe the bony structures of your toes, evaluate cartilage loss, and visualize bone deformities. It’s possible you’ll have X-rays taken while you’re standing in order to highlight how bodyweight affects the structures in your foot.
Although seldom necessary, in some cases advanced imaging such as computed tomography (CT scans) or magnetic resonance imaging (MRIs) may be used.
Blood tests for certain proteins, antibodies, or uric acid that might suggest rheumatoid arthritis or gout are performed.
Joint aspiration, in which fluid in a joint is obtained to examine for infection or uric acid crystals. The results can rule out other medical conditions or other forms of arthritis.

Treatment

Treatment for arthritis of the toes almost always begins with simple steps. Rarely is it necessary to immediately jump to surgical correction.

Cold and Heat Therapy

For significant inflammation, especially after activity or a long day on your feet, icing can deter blood flow and relieve swelling and redness. Before activity, the application of heat can warm and loosen muscles in the lower foot allowing for easier movement of the toes.

Anti-Inflammatory Medications

Oral non-steroidal anti-inflammatory medications (NSAIDs) can help relieve swelling and also alleviate discomfort associated with toe arthritis. These drugs commonly include over-the-counter medications like Advil (ibuprofen) and Aleve (naproxen) but may sometimes include prescription medications like Celebrex (celecoxib), Voltaren (diclofenac), or nabumetone.

These medications can be taken regularly to prevent and control pain or only when arthritis flares up.

Some studies show that turmeric, an herb from the ginger family, may have powerful anti-inflammatory properties that can help with arthritis pain. Always discuss any new medications or herbs with your doctor as there are always possible side effects.

Cortisone Injection

An injection of cortisone puts a powerful anti-inflammatory medication directly at the site of inflammation. While cortisone injections around the toes are sometimes uncomfortable, they can lead to very rapid and effective pain relief. The results tend not to be permanent, but if you have a significant flare up that does not settle down with other treatment, a cortisone injection may offer dramatic improvement.

Footwear

Invest in high-quality shoes and devices that provide arch support, shock absorption, and other features that can help to protect toes and prevent exacerbtion of toe arthritis symptoms. Consider:

Shoes with rocker soles—thicker-than-normal soles—and a curved heel. A shoe with this type of sole, common in athletic footwear, reduces pressure under the big toe joint by 12% in people with OA, research shows.
Orthotics and inserts that can help reposition the foot in a shoe, thereby relieving pressure on toes. The simplest inserts—accommodative inserts—do not correct a deformity but take pressure off of areas of the foot that are uncomfortable, thereby making normal activities bearable. Gel inserts are one example of inserts that cushion the foot, relieving discomfort.
Custom orthotics. If accommodative inserts don’t get results, semi-rigid and rigid insoles can correct deformities, redistribute weight, and correct mechanics of the foot. These types of orthotics generally need to be custom designed to accommodate your specific anatomy.

By providing a more rigid base, custom orthotics can take pressure off of arthritic joints by controlling how much motion occurs at a specific joint.

The advantage of a custom insert is that it can correct biomechanics at specific problematic joints while allowing as much normal foot movement as possible. Special rocker-bottom soles can be also be attached to shoes and help provide normal movement as you walk.

Lifestyle Modifications

Maintaining a healthy body weight may be key to both preventing and treating arthritis in general: Studies show that people with a relatively high body weight develop arthritis at younger ages are prone to more severe arthritis. Extra pounds put more force on your joints, leading to wear and tear, and can also cause more inflammation throughout the body. For the obese, a weight loss of just 10% of body weight can result in significant improvement in symptoms.

In addition to losing weight, physical therapy and specific exercises can help with foot pain. In general, regular moderate exercise helps maintain joint function while reducing pain and fatigue and relieving stiffness. Talk with your physical therapist to determine what exercise would be best with the least wear and tear.

Surgery

Although seldom necessary, there are a number of surgical procedures for treating arthritis in the toes.

Cheilectomy: Removal of bone spurs that have formed around arthritic joints to improve range of motion. The downside is that the procedure leaves worn-out cartilage in place and bone spurs can return down the road. This procedure is usually performed on the big toe and less commonly on the lesser toes.
Fusion: Also known as arthrodesis, a procedure in which bone growth is stimulated across the joint, leaving it permanently stiff but without pain. This procedure is generally performed on the lesser toes.
Resection: Removal of an entire joint, leaving behind a “floppy” joint that moves easily but has little stability.
Arthroplasty: Total replacement of a troublesome joint

A Word From Verywell

Your toes may seem like minor players in your overall health and well-being, but if you’ve been diagnosed with arthritis in these small joints you’re well aware of how painful and debilitating it can be. Managing toe arthritis may be challenging but is entirely do-able. Because it’s a condition that can get worse with time and inattention, the most important thing you can do is see your doctor as soon as you suspect something is wrong. Prompt diagnosis can get you started on a treatment plan leading toward getting you back on healthy, pain-free feet.

Washington Foot & Ankle Sports Medicine: Podiatry

Pain in the feet and ankles is commonplace for arthritis sufferers, especially as aging causes a progression of the condition. The human foot has 30 joints, and each one can become a source of pain and stiffness.

At Washington Foot & Ankle Sports Medicine in Kirkland, Washington, our podiatrists work with you to help mitigate the effects of arthritis on your feet and ankles. Part of living with arthritis is staying active, so here are seven exercises tips you can implement for better flexibility and reduced inflammation.

Arthritis pain in the feet and ankles

Most arthritic pain in the feet and ankles is caused by the most common form of arthritis, osteoarthritis. Osteoarthritis occurs when the cartilage between bones at pivotal joints wears away. The bones then grind together, causing inflammation, swelling, and pain.

Osteoarthritis foot and ankle pain typically occurs at the ankle joint where the ankle connects to the shinbone, at the joints connecting the three parts of the foot, and in the joint connecting the big toe to the ball of the foot.

How foot and ankle exercises can help

The following exercises can help improve flexibility and mobility in the feet and ankles, strengthen the muscles supporting your ankles, and prevent stiffness and inflammation. They can all be done while sitting straight up in a chair with your feet starting flat on the floor, and should all be done for each foot and repeated 10 times.

1. Toe press, point, and curl

Press down with your toes and raise your heels. Hold for five seconds.
Point your toes and raise your heels until only the tips of the big and second toe touch the floor. Hold for five seconds.
Curl your toes down and raise your heels. Hold for five seconds.

2. Big toe stretch

Bring your foot to rest on the opposite knee.
Use one hand to grasp your instep, and the fingers of the other to grasp your big toe.
Stretch it up, down, and to each side gently for five seconds in each direction.

3. Toe splay

Spread all of your toes as far apart as possible and hold for five seconds.
Concentrate on one foot at a time or do both simultaneously.
Try with a rubber band or elastic hair tie looped around your toes to provide resistance.

4. Marble pickup

Place two bowls in front of the chair on the floor, one in front of the other.
Fill the one furthest away with 20 marbles.
Use your toes to pick up a marble from the full bowl and drop it into the empty bowl.
Switch back and forth between your feet until all marbles are transferred.
Reverse direction and do it again.

5. Ball roll

Place a golf ball or a rubber racquetball on the floor next to your feet.
Place one foot on the ball, rolling from the heel through the instep to the toes.
Switch feet every fifteen seconds.
No ball? Try a cold can with the label peeled off or a frozen water bottle.

6. Achilles stretch

Rest your foot on the opposite knee.
Grasp the instep and ball of the foot in one hand, and the toes in your other hand.
Press back until you can feel the pull from your heel up the back of your calf.
Hold for five seconds.

7. Ankle rotation

Rest your foot on the opposite knee.
Grasp just above your ankle with one hand, and the ball of your foot with the other hand.
Rotate the ankle joint gently in a circular motion for five seconds.

These exercises can help you keep your feet and ankles from being painful and stiff and can strengthen them to more easily bear your weight. If you have arthritic foot and ankle pain, call 425-899-3234 or book your visit online today.

Psoriatic arthritis: MedlinePlus Genetics

Psoriatic arthritis is a condition involving joint inflammation (arthritis) that usually occurs in combination with a skin disorder called psoriasis. Psoriasis is a chronic inflammatory condition characterized by patches of red, irritated skin that are often covered by flaky white scales. People with psoriasis may also have changes in their fingernails and toenails, such as nails that become pitted or ridged, crumble, or separate from the nail beds.

Signs and symptoms of psoriatic arthritis include stiff, painful joints with redness, heat, and swelling in the surrounding tissues. When the hands and feet are affected, swelling and redness may result in a “sausage-like” appearance of the fingers or toes (dactylitis).

In most people with psoriatic arthritis, psoriasis appears before joint problems develop. Psoriasis typically begins during adolescence or young adulthood, and psoriatic arthritis usually occurs between the ages of 30 and 50. However, both conditions may occur at any age. In a small number of cases, psoriatic arthritis develops in the absence of noticeable skin changes.

Psoriatic arthritis may be difficult to distinguish from other forms of arthritis, particularly when skin changes are minimal or absent. Nail changes and dactylitis are two features that are characteristic of psoriatic arthritis, although they do not occur in all cases.

Psoriatic arthritis is categorized into five types: distal interphalangeal predominant, asymmetric oligoarticular, symmetric polyarthritis, spondylitis, and arthritis mutilans.

The distal interphalangeal predominant type affects mainly the ends of the fingers and toes. The distal interphalangeal joints are those closest to the nails. Nail changes are especially frequent with this form of psoriatic arthritis.

The asymmetric oligoarticular and symmetric polyarthritis types are the most common forms of psoriatic arthritis. The asymmetric oligoarticular type of psoriatic arthritis involves different joints on each side of the body, while the symmetric polyarthritis form affects the same joints on each side. Any joint in the body may be affected in these forms of the disorder, and symptoms range from mild to severe.

Some individuals with psoriatic arthritis have joint involvement that primarily involves spondylitis, which is inflammation in the joints between the vertebrae in the spine. Symptoms of this form of the disorder involve pain and stiffness in the back or neck, and movement is often impaired. Joints in the arms, legs, hands, and feet may also be involved.

The most severe and least common type of psoriatic arthritis is called arthritis mutilans. Fewer than 5 percent of individuals with psoriatic arthritis have this form of the disorder. Arthritis mutilans involves severe inflammation that damages the joints in the hands and feet, resulting in deformation and movement problems. Bone loss (osteolysis) at the joints may lead to shortening (telescoping) of the fingers and toes. Neck and back pain may also occur.

Dactylitis: A hallmark of psoriatic arthritis

Abstract

Objective

Dactylitis—long considered a hallmark clinical feature of psoriatic arthritis (PsA)—occurs in 16–49% of patients with PsA. In this review, we discuss the pathology of dactylitis in PsA and clinical and imaging tools used to diagnose and monitor dactylitis.

Methods

PubMed literature searches were conducted using the terms psoriatic arthritis, dactylitis, pathology, imaging, ultrasound, magnetic resonance imaging, clinical, and indices. Articles were deemed relevant if they provided insight into the pathology, diagnosis, and/or monitoring of dactylitis in PsA, or if they discussed clinical or imaging indices used to assess dactylitis.

Results

Dactylitis in PsA often occurs asymmetrically, involves the feet more than the hands, and affects multiple digits simultaneously. Although dactylitis can be assessed clinically, imaging (radiography, ultrasound, magnetic resonance imaging, and bone scintigraphy) has provided key insights by documenting the various anatomic targets affected. Although inflammation can occur in most of the digital compartments, the nail has not been as well studied in dactylitic digits. Outcome measures for dactylitis range from dichotomous documentation to the Leeds dactylometer. Imaging outcome tools utilizing magnetic resonance imaging or ultrasound are under development.

Conclusion

Dactylitis, which is associated with more erosive forms of PsA, is often the inaugural feature of PsA and may be the only feature for months to years. Early diagnosis and treatment of PsA favors better outcomes, possibly mitigating radiographic progression and destructive changes. Ultrasound and magnetic resonance imaging are useful tools that have not only shed light on the diverse tissues affected in dactylitis but can also be used to document ongoing inflammation. Ultrasound imaging dactylitis scores are being developed that will assist in diagnosing and documenting which compartments optimally respond to various treatment modalities.

Keywords

Psoriatic arthritis

Dactylitis

Imaging

Ultrasound

Magnetic resonance imaging

Citing articles

When lupus affects the feet

Jacklyn Cantu’s lupus symptoms began in her feet, when they swelled and turned blue six years ago. “It was mainly in the evenings after a day of work, and I really didn’t think much of it, but it gradually got worse and worse,” says the 26-year-old human resources associate from Bryan, TX.

She tried to ease her discomfort with over-the-counter medications for six months or so. But eventually, “was at the point where I couldn’t do anything on my own anymore,” she says. “My boyfriend at the time was having to dress me [and] drive me to work. We lived in a second-floor apartment, and I could barely get up and down the stairs.”

She eventually saw a doctor and was diagnosed with lupus, and she’s been in remission for four years. Even though treatment has helped, her feet won’t let her forget that she has lupus. Every day, they swell and ache due to arthritis and turn blue from sensitivity to cold—a marker of a vascular disorder called Raynaud’s phenomenon, which is fairly common in people with lupus. The autoimmune system attacks small blood vessels, causing them to constrict with exposure to cold.

David Baek, DPM, a podiatrist who specializes in wound care at Shady Grove Podiatry in Gaithersburg, MD, sees many people with lupus or other autoimmune diseases. Their most common symptoms, he says, are swelling and pain from arthritis in the foot and ankle.

The second most common complication is Raynaud’s. “The smaller digital vessels—fingers and toes—are very sensitive to temperature changes,” Baek says. “Even in cases where on hot days we have the AC running, we’ll take a patient’s socks off, and in front of my eyes, I can see their toes blanching and turning white, turning purplish from the constriction of the vessels.”

Besides numbness and discomfort, those with more severe cases of Raynaud’s may develop ulcers on their toes. In the most extreme cases, a person can develop gangrene, Baek says.

With the lesser forms of Raynaud’s, the treatment is mostly palliative. “We tell them to watch the temperature, especially in the wintertime,” Baek says. “In the summer, watch the amount of exposure in air-conditioned rooms. Wear socks in the evening. Obviously, watch for any type of skin breaks, signs of infection, and severe redness.”

Common foot problems for people with chronic illnesses

People with chronic health conditions need to be especially careful about foot problems. “For healthy people, a blister is going to heal fine, but for anyone else, it’s usually recommended that they see their general practitioner. If they’re on an immunosuppressant, they’re at high risk for developing a worse infection because their immune system is suppressed,” Baek says.

Karin Ewing, 26, an e-learning and instructional specialist in Cincinnati, OH, was diagnosed with lupus six years ago and has had Raynaud’s phenomenon in her hands for some time. About nine months ago, it showed up in her feet.

“It just started off as an intense pain on the balls of my feet and my toes,” she says. “Then I started to get ulcers on the tips of my toes, and those became very deep and very painful.” Ewing says that her ulcers don’t heal quickly. “What might take one person a week to heal, it takes me two months. They become infected and my toes swell,” she explains.

Her feet also swell and hurt from arthritis. “One of the biggest things is trying to find a balance between being able to go on with my daily life but also being able to manage the pain,” she says.

Medications (she takes Aleve and sometimes Vicodin) don’t always help. And she often has trouble sleeping because the pain is worse at night. “You kind of have to take it day by day and manage the pain as best you can,” she says. “That’s what gets me through.”

Ewing tries to limit her walking on bad days and sometimes takes the morning off from work. She also leans on family members and a few close friends. On a recent fairly bad morning, her boyfriend took her dog for a walk, made her a pot of coffee, and packed her a breakfast to help her get going. “He takes such good care of me,” she says.

Cantu’s family helps her, too. She also plans ahead for days that require lots of walking—like a recent trip to Sea World—by resting for a day or two afterward.

But she only has to travel as far as her closet to see the adjustments she’s made for her feet. It used to be filled with high heels and now is full of flat styles.

To her dismay, her younger sister was recently diagnosed with lupus—so she tries to share everything she has learned so far. “We had no idea what lupus was when I was diagnosed,” she says. “But my sister has me, so it’s been a little easier for her.”

Psoriatic Arthritis Symptoms & Pictures

Sources: 1. Comparing rheumatoid arthritis and osteoarthritis. University of Wisconsin School of Medicine and Public Health. Updated December 9, 2019. Accessed August 10, 2020. https://www.uwhealth.org/health/topic/special/comparing-rheumatoid-arthritis-and-osteoarthritis/aa19377.html. 2. Difference between osteoarthritis and rheumatoid arthritis. University of Michigan Health. Accessed August 10, 2020. https://www.uofmhealth.org/conditions-treatments/cmc/difference-between-osteoarthritis-and-rheumatoid-arthritis. 3. Gottlieb A, Korman NJ, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol. 2008;58(5)851-864. doi: 10.1016/j.jaad.2008.02.040. 4. Gottlieb A, Merola JF. Psoriatic arthritis for dermatologists. J Dermatolog Treat. 2019;1-18. doi: 10.1080/09546634.2019.1605142. 5. Hammadi AA. Psoriatic arthritis. Medscape. Updated July 15, 2020. Accessed August 10, 2020. https://emedicine.medscape.com/article/2196539-overview. 6. Lee S, Mendelsohn A, Sarnes E. The burden of psoriatic arthritis: a literature review from a global health systems perspective. P T. 2010;35(12):680-689. 7. McKenna SP, et al. Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis. Ann Rheum Dis. 2004;63:162–169. doi: 10.1136/ard.2003.006296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1754880/pdf/v063p00162. 8. Psoriatic arthritis. American College of Rheumatology. Updated March 2019. Accessed August 10, 2020. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis. 9. Psoriatic arthritis. Arthritis Foundation. Accessed August 10, 2020. https://www.arthritis.org/diseases/psoriatic-arthritis. 10. Psoriatic arthritis: symptoms & causes. Mayo Clinic. September 21, 2019. Accessed August 10, 2020. http://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/dxc-20233899.

Imaging illustrates severity, long-term prognosis of COVID-19-related muscle, joint pain — ScienceDaily

Muscle soreness and achy joints are common symptoms among COVID-19 patients. But for some people, symptoms are more severe, long lasting and even bizarre, including rheumatoid arthritis flares, autoimmune myositis or “COVID toes. “

A new Northwestern Medicine study has, for the first time, confirmed and illustrated the causes of these symptoms through radiological imaging.

“We’ve realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management,” said corresponding author Dr. Swati Deshmukh.

The paper will be published Feb. 17 in the journal Skeletal Radiology. The study is a retrospective review of data from patients who presented to Northwestern Memorial Hospital between May 2020 and December 2020.

“Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, are deeply concerning to the patient or impact their quality of life, which leads them to seek medical attention and imaging,” said Deshmukh, an assistant professor of musculoskeletal radiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine musculoskeletal radiologist. “That imaging allows us to see if COVID-related muscle and joint pain, for example, are not just body aches similar to what we see from the flu — but something more insidious.”

Imaging (CT, MRI, ultrasound) can help explain why someone might have prolonged musculoskeletal symptoms after COVID, directing them to seek the right physician for treatment, such as a rheumatologist or dermatologist.

In some cases, radiologists may even suggest a COVID diagnosis based on musculoskeletal imaging in patients who previously didn’t know they contracted the virus, Deshmukh said.

What does the imaging look like?

“We might see edema and inflammatory changes of the tissues (fluid, swelling), hematomas (collections of blood) or devitalized tissue (gangrene),” Deshmukh said. “In some patients, the nerves are injured (bright, enlarged) and in others, the problem is impaired blood flow (clots).”

How can imaging lead to better treatment?

“I think it’s important to differentiate between what the virus causes directly and what it triggers the body to do,” Deshmukh said. “It’s important for doctors to know what’s happening in order to treat correctly.”

For example, Deshmukh said, if a patient has persistent shoulder pain that started after contracting COVID, their primary care provider might order an MRI/ultrasound. If a radiologist knows COVID can trigger inflammatory arthritis and imaging shows joint inflammation, then they can send a patient to a rheumatologist for evaluation.

“Some doctors request imaging for patients with ‘COVID toes,’ for example, but there wasn’t any literature on imaging of foot and soft tissue complications of COVID,” Deshmukh said. “How do you find something if you’re unsure of what to look for? So in our paper, we discuss the various types of musculoskeletal abnormalities that radiologists should look for and provide imaging examples.”

Other Northwestern authors on the paper were Santhoshini Leela Ramani (Northwestern University medical student), Dr. Jonathan Samet (radiology), Dr. Colin Franz (PMR and neurology), Dr. Christine Hsieh (rheumatology), Dr Cuong Nguyen (dermatology) and Dr. Craig Horbinski (pathology).

Story Source:

Materials provided by Northwestern University. Original written by Kristin Samuelson. Note: Content may be edited for style and length.

Osteoarthritis, arthritis

Degenerative-dystrophic diseases (arthrosis-arthritis)

Arthrosis (osteoarthritis) is a degenerative joint disease associated with slow degeneration and destruction of intra-articular cartilage. Over time, there is a restructuring of the articular ends of the bones, inflammation and degeneration of the periarticular tissues. The concept of “arthrosis” (deforming osteoarthritis) includes a group of joint diseases of a degenerative-inflammatory nature, which have different origins and similar mechanisms.

Causes
Primary arthrosis against the background of age-related and / or biomechanical changes. Secondary, occurs after an injury, against the background of diabetes mellitus or thyroid disease, due to vascular disorders, etc. Contributes to damage to the joints of the legs and the development of arthrosis of flat feet, which disrupts the shock-absorbing functions of the foot. Timely application of specially selected orthopedic insoles allows you to correct the deformity of the foot and reduce the stress on the joints.

Osteoarthritis is the most common joint disease and its frequency increases with age. But this disease occurs not only in the elderly, which determines its social significance.

Symptoms:

pain on exertion, subsiding at rest;
Limitation of mobility and crunching of the joint;
Muscle tension in the joint area;
periodic appearance of swelling, gradual deformation of the joint is possible.

Primary arthrosis – 40-50% of arthrosis cases. The disease develops on a previously healthy joint, and its cause is not damage to the joint, but, for example, hard physical work.

Secondary arthrosis – 50-60% of cases. The joint prone to arthrosis was deformed even before the disease – for example, as a result of trauma.

Which joints are affected by arthrosis?
Most often arthrosis develops in the joints of the lower half of the body (hip, knee, first metatarsophalangeal).On the hands, the joints of the phalanges of the fingers are most often exposed to arthrosis. Osteoarthritis usually occurs first on one joint, and then on the second – symmetrical to the first.

COXARTHROSIS

Coxarthrosis (arthrosis of the hip joint) is characterized by a progressive course and impaired statodynamic function of the musculoskeletal system. It occupies one of the first places among degenerative-dystrophic diseases of the musculoskeletal system. The dystrophic process begins with the articular cartilage – its thinning, dissociation, fragmentation occur, and its cushioning properties are lost.As a compensatory reaction of the articular surfaces of the hip joint, marginal bone growths are formed. In the future, sclerosis develops and cysts are formed in the articulating sections of the femoral head and acetabulum.

GONARTHROSIS

Gonarthrosis (arthrosis of the knee joint) occupies a leading place in the group of arthrosis lesions of the joints of the extremities. Patients with gonarthrosis constantly prevail among patients attending polyclinics, but, unfortunately, they are few among those who are treated in our hospitals.Inpatient treatment could have a much greater effect than on-the-job outpatient therapy. Known to doctors for over 100 years, this disease in everyday life is called “salt deposition”.

Psoriatic arthritis – treatment, symptoms, photo

In the photo psoriatic arthritis

Usually appears 10 years after the onset of psoriasis, which can appear at any age. Most often, the age of patients is 15-35 years old.

Psoriatic (psoriasis) arthritis – symptoms

joint pain and swelling
Sensation at the junction of muscles with bones (especially heels and lower legs)
back pain
Changing the appearance of nails, separation from the skin
Morning stiffness
general fatigue
decrease in the volume of movements
conjunctivitis

Psoriatic arthritis – consequences and diagnosis

Psoriatic arthritis or as it is also called psoriatic arthritis is an autoimmune disease that, for unknown reasons, attacks its own immune system. Inflammation can occur, causing the synovium that lubricates the joints to thicken and swelling of the joints. Over time, the destruction of cartilage occurs, the bones begin to rub against each other, the muscles surrounding the joint, ligaments and tendons weaken. Such serious consequences can occur even at an early stage of the disease, which is why timely diagnosis of arthritis is so necessary.

Signs of psoriatic arthritis may not appear immediately, as the disease often develops slowly.There is no easy way to diagnose the disease. If you have psoriasis and joint pain develops, you should definitely see your doctor. The difficulty is that the symptoms of psoriatic arthritis can be exactly the same as those of rheumatoid, osteoarthritis, or gout. Various tests are done, such as blood or joint fluid tests, and may also require an MRI or CT scan.

Psoriatic arthritis – treatment

It is impossible to completely cure this disease.Usually, treatment is to reduce joint pain and swelling. Therapies can preserve joint function, slow or prevent joint damage, and control psoriasis on the skin. There is medical treatment for psoriatic arthritis. Non-sterile anti-inflammatory drugs work well at preventing pain, swelling, and inflammation, but they also have side effects such as upset stomach and ulcers. Long-term injections of drugs are undesirable. Treatment is carried out with the help of physiotherapy devices.Separately and in combination, they can show positive results in the fight against the symptoms of arthritis.

Doctors named the first symptoms of gout – Yulia Nachalova’s disease

What is the danger of gout, which became one of the reasons for the tragic death of singer Yulia Nachalova, what are its main symptoms and how to reduce the frequency of seizures, said the experts at the American Mayo Clinic.

On March 16, Russian singer Yulia Nachalova passed away. One of the reasons for her serious condition, which led to her death, was gout – the singer fought with it for the past eight years.

At the heart of the occurrence of gout is the accumulation of uric acid and a decrease in its excretion by the kidneys, which leads to an increase in the concentration of the latter in the blood. Urate crystals in the form of uric acid are deposited in various tissues of the body.

Clinically, gout is manifested by recurrent acute arthritis and the formation of gouty nodes – tophus.

Kidney damage is also one of the main clinical manifestations of gout along with arthritis.

Specialists of the American clinic Mayo told what symptoms should be paid attention to in order to diagnose the disease in time, and what measures should be taken to avoid relapses and complications.

Severe joint pain is the main symptom of gout. Most often it affects the joint of the big toe, less often the ankles, knees, elbows, wrists. The pain is most pronounced in the first 4-12 hours. But after it subsides, joint discomfort can last for weeks. As the disease progresses, the attacks last longer and affect more joints.

The affected joints become red and swollen, and their movements are limited. If left untreated, symptoms will only get worse over time.The clinic’s specialists strongly recommend that you consult a doctor as soon as possible in case of joint pain, swelling and redness.

Risk factors for gout include a diet rich in meat and seafood and drinking fructose drinks, all of which increase uric acid levels. Excess alcohol, especially beer, also provokes gout.

People with obesity are at risk – their body produces more uric acid, and the kidneys excrete it worse.

Gout can be provoked by some diseases – diabetes, heart and kidney disease, metabolic syndrome. A number of drugs can also contribute to its development – thiazide diuretics (used for hypertension), low doses of aspirin: all this contributes to an increase in the level of uric acid. The risk is also influenced by drugs that prevent organ rejection during transplantation. Basically, any surgery or injury increases the risk of developing gout.

The risk is also increased in people with a family history of gout.The disease is more common in men, as they generally have higher uric acid levels, but after menopause it rises in women as well. In men, gout develops at an earlier age – 30-50 years, while in women – mainly after menopause.

In some people, the manifestations of gout may be isolated, while others encounter them several times a year. If left untreated, the joints gradually deteriorate. In addition, if left untreated, gout can lead to the formation of gouty tophus – the deposition of uric acid crystals in soft tissues.By themselves, they are painless, but during attacks, their contents can liquefy and go out through the fistulas. Also, tophus can cause inflammation in the periarticular bags and tendons. Untreated gout is dangerous and an increased risk of kidney stones.

For those who are not fortunate enough to receive such a diagnosis, doctors advise to drink more fluids during periods of remission, limiting themselves in drinks containing fructose. You should also reduce alcohol consumption, and it is better to completely abandon it.Protein is best obtained from low-fat dairy products, and consumption of meat, fish and poultry will have to be limited. It is worth maintaining a healthy weight, however, drastic weight loss is best avoided – it can temporarily increase the level of uric acid in the body.

One of the most powerful kings suffered from gout – Charles V.

This was established by researchers from the University of Barcelona, analyzing the mummified royal pinky finger. Tissue analysis showed the presence of needle-shaped crystals – uric acid deposits.

Charles V, apparently, had an excellent appetite, had a particular weakness for meat dishes and drank a huge amount of beer and wine during his life. He died, it is believed, of malaria. But before that, gout had tormented him so much that the king abandoned his far-reaching plans and crown. In particular, an attack of gout forced the emperor to abandon attempts to return the city of Metz to France, where the royal army was later defeated.

Rheumatoid arthritis

Olga Beklemishcheva: Today we will tell you about rheumatoid arthritis.Fortunately, this is not the most common disease, but it illustrates the thesis that not everything is subject to prevention, and some diseases are a fate that must be accepted with courage and patience. This topic made me turn to a letter from one of our listeners from Crimea, whose daughter has been suffering from rheumatoid arthritis for 20 years. This is a serious, disabling disease, which women suffer more often, and there are certainly some successes in the treatment of which, but it is still far from complete victory over it.And I am glad to introduce our guest, who has achieved impressive success in the treatment of this and other collagen diseases with her unconventional method, but approved for use by the Ministry of Health. Today our guest is: Lyudmila Grigorievna Lapa – an immunologist and a patient with a 30-year remission of rheumatoid arthritis. She heads the Khodanova Immunocorrection Center in Moscow. From the American side, Professor Daniil Borisovich Golubev is participating in our conversation. And we start.

Lyudmila Grigorievna, probably for those listeners who, fortunately, do not know what rheumatoid arthritis is, we need to describe it a little.How did you get sick? What was the beginning – acute, subacute? And what was the reason, in your opinion?

Lyudmila Lapa: In my opinion, my illness was preceded by a serious cold, it was a sore throat, untreated, as always, or improperly treated – it’s hard to say. I was discharged, went to work – a new exacerbation, and after that inflammation of all blood vessels began, and then inflammation of the joints. Diagnosed with rheumatoid arthritis.

Olga Beklemishcheva: Is this a typical situation with rheumatoid arthritis?

Lyudmila Lapa: Often typical.Often the disease is preceded by a cold disease, hypothermia is very strong, everything that can cause inflammation of any connective tissue, and connective tissue is everything for us, this is our vessels, this is muscle tissue, this is bones, this is joints, this is , which just applies to rheumatoid arthritis.

Olga Beklemishcheva: Connective tissue really permeates all other tissues in our body, which is why it is called connective tissue.Well, the largest accumulations are, of course, in the joints, in the cartilage, in the tendons, and this is where this rheumatoid arthritis nests or, as I think earlier, they called a group of such diseases, collagenoses, right?

Lyudmila Lapa: Yes.

Olga Beklemishcheva: In fact, the cause of rheumatoid arthritis is not clear, as far as I understand.

Lyudmila Lapa: Well, as they always write in all the recipes, it is not clear, but on this score it was before … As I always say, the new is the well forgotten old … Since 1880, it was known about the side effects of drugs …

Olga Beklemishcheva: Medicines.

Lyudmila Lapa: In 1968 there were a lot of studies devoted to just this question: how does aspirin work for us, as antibiotics, as antimicrobial drugs? And just then there were works that indicated that the side effect of these drugs just leads to rheumatoid arthritis, all systemic diseases – lupus erythematosus and the like.

Olga Beklemishcheva: That is, obviously, one of the triggering factors of these collagen diseases and rheumatoid arthritis, in particular, is the side effect of those drugs that are used to treat primarily infectious or colds.

Lyudmila Lapa: Yes.

Olga Beklemishcheva: Well, now I have a question for Daniil Borisovich Golubev: how do American doctors imagine the nature of rheumatoid arthritis? How relevant is this disease in the United States?

Daniil Golubev: American doctors understand the nature of this disease, I believe, in the same way as Russian doctors: rheumatoid arthritis is considered an autoimmune disease, the main element of the pathogenesis of which is the attack of the body’s immune system on its own tissues.Basically, people of the so-called “young middle” age are ill, and women are 2-3 times more likely than men. The disease is widespread in different regions of the country, and in some of them a relatively high frequency is recorded. In particular, for unknown reasons, such a trend takes place in the seemingly favorable climatic conditions of Northern California. There is no rational and effective prevention. It is difficult to name the exact number of patients, but it is quite obvious that many tens of thousands of patients are affected by rheumatoid arthritis, under the supervision of therapists, rheumatologists, and allergists.In advanced cases, severe disability often develops.

Olga Beklemishcheva: And it really is. Observing patients at your center, I saw people who have great limitations in joint mobility.

Lyudmila Lapa: You don’t see this with me. And so I want to dwell mainly on such a question that among rheumatologists there is actually an opinion that if rheumatoid arthritis is diagnosed correctly and on time (there is only a month when a patient can be treated with good drugs, and now such drugs are already available), then remission may occur for many, many years.In my case, such drugs, although I was young enough, and did not use, for example, the same hormones, but used, I agreed to this, and the inflammation was removed. And then my follow-up treatment just went on the method that we are working with, this is the method of hemopuncture, which, I think, was invented by the great, outstanding Soviet scientist Raisa Nikitichnaya Khodanova, Doctor of Science, and it was patented in Russia and abroad. But the attitude towards her is not very unambiguous. I consider myself a fruit and a result of this technique, which helps us to heal.

Olga Beklemishcheva: I would even say an illustration of the success of the method.

Lyudmila Lapa: Yes, an illustration of the success of this method. I am not talking about the success of the method in the treatment of various other diseases. I only touch on autoimmune diseases, because rheumatoid arthritis is actually an autoimmune disease, I completely agree with our colleague from abroad. Therefore, I can only say that this is a treatment … For 30 years I have not taken any hormones or any other drugs, understanding the harmfulness of their action, and only dealt with the fact that we did the correction of the immune system by the method of hemopuncture.

Olga Beklemishcheva: We will definitely consider this method in more detail. But now I would like to dwell on the standard of treatment for rheumatoid arthritis, so that the difference in approaches in one case or another is clear. First, I will ask Daniil Borisovich: how is rheumatoid arthritis treated in America?

Daniil Golubev: The leading method of treating rheumatoid arthritis is drug therapy.Drugs of several different groups are widely used: anti-inflammatory nonsteroidal dosage forms that reduce the intensity of the inflammatory reaction and have analgesic activity; antirheumatic drugs that slow down the progression of the disease process; immunosuppressants, in particular corticosteroids, which suppress the activity of immune responses. They are used in cases where antirheumatic treatment does not give tangible results or in the presence of pronounced adverse reactions from their use.In severe cases, corticosteroids are used for intra-articular injections to relieve acute pain.

In addition to drugs for the treatment of rheumatoid arthritis, various physiotherapy methods are used that do not cause a local increase in temperature in the joints. Low-frequency magnetotherapy and low-frequency laser therapy are especially effective. Physical therapy, massage and so-called occupational therapy are also used. Often, joints destroyed by arthritis (especially often the small joints of the hands and knees) have to be operated on and even replaced.Joint replacement is a well-established branch of American medicine.

Olga Beklemishcheva: In addition to what Professor Golubev said, it remains to add that in Russia cytostatics are sometimes added to standard therapy when there is nowhere to go.

Lyudmila Lapa: Cytostatics and drugs – now I want to especially dwell on this, because few patients with rheumatoid arthritis know that remakeate is included in the list of free drugs for the treatment of this disease.That is, all people who are entitled to such free medical care can turn to their doctors and specialists and receive this treatment. The only problem is that remakeate is also not shown to everyone, and be very careful with this, because all people who have some kind of hypersensitivity or allergic diseases should use this drug with caution.

Olga Beklemishcheva: Because these are, in principle, recombinant monoclonal antibodies, and they are made using proteins of the same mice, and, naturally, they have a high allergic potential, like any foreign protein.

Lyudmila Lapa: Like any foreign protein, they can cause an allergic reaction.

Olga Beklemishcheva: But we are getting a little ahead of ourselves. And all this complex treatment is quite difficult, as far as I understand it. And hormones, and hormonal therapy, and cytostatics, and anti-inflammatory therapy, especially intra-compound injections, are, in fact, a serious and difficult therapy. And as far as I was able to get to know each other in your center, your technique allows a person, or something, to leave on the sly, including from hormone therapy, which, of course, made me extremely happy and interested.Let us, we will tell you in detail what this method of Raisa Khodanova consists of, how it appeared and how it works at the present time.

Lyudmila Lapa: I have already told a little about the history of the method, I will not return to this.

Olga Beklemishcheva: But you told me that. And the listeners?

Lyudmila Lapa: What is the situation here? The method was actually developed … from the 80th year, development began on the basis of the Institute of Immunology.

Olga Beklemishcheva: It was just then just being created.

Lyudmila Lapa: Yes, it was just created then. And the 10th Medsanchati.

Olga Beklemishcheva: This is the former Medical Unit of the 3rd Main Directorate, that is, those who treated our nuclear scientists and cosmonauts.

Lyudmila Lapa: Raisa Nikitichna was the chief ENT doctor in the cosmonaut corps.She often observed not only cosmonauts, but also ordinary people, everyone who worked in the 3rd headquarters.At the dawn of her career, she performed many operations for the removal of both tonsils and adenoids, and saw all the inflammatory reactions of the mucous membranes that passed. At some point, she began to think that it was necessary to look for methods that would allow without the use of drugs … She had already seen that, for example, taking antibiotics causes swelling of the mucous membranes. Since it causes swelling of the mucous membranes, there are such patients, which means that we must look for some alternative …

Olga Beklemishcheva: A roundabout way.

Lyudmila Lapa: Yes. And at this moment she just began to use various options, empirically choosing how to process the blood, what to do with it. For some reason, she settled on such a substance, a well-known immunomodulator – our own blood, which contains all the antibodies, allergens, cells of the immune system, and lymphocytes, and leukocytes, everyone knows that protect us in the first place. And when she applied this technique, even at the beginning it was simple, for example, autologous blood, there were positive results, but then she met the work of the scientist Baranov, who at that time was practicing in Mineralnye Vody, and she began to activate the cells of the immune system, blood cells with various drugs.Distilled water is best suited for this. For 10 years, immunologists have been researching this technique and for a long time could not understand why the blood is activated in this particular technique. It turned out that, in general, hypoosmosis is a decisive factor that allows you to activate the membranes of all cells, restore the immune status of a person, a patient who turned to us for treatment.

Olga Beklemishcheva: I’ll decipher a little.It seems to me that we have not conveyed everything. That is, the Khodanova method assumes that a person takes his own blood, it is taken from a vein, where our pressure is about 3 atmospheres, into a syringe, where the pressure is 1 atmosphere, in addition, water is added there, and under the influence of this pressure drop most of the blood cells – erythrocytes – are destroyed, but leukocytes and lymphocytes remain intact. And this autologous blood is injected back to a person, but not into a vessel, but subcutaneously. There was another very interesting step taken by Raisa Mikhailovna.It consists in the fact that this blood is injected subcutaneously, not just anyhow, but at certain points. How?

Lyudmila Lapa: Paravertebral. This is what is called paravertebral administration of autologous blood. This is along the meridian of the bladder, where we have concentrated …

Olga Beklemishcheva: That is, according to acupuncture points.

Lyudmila Lapa: … acupuncture points, reflexology points, to which all organs of our body go and with which you can work.This technique, therefore, of course, with the introduction of the drug, allows you to simultaneously diagnose: where it hurts, there the organ is affected, the patient. Thus, the doctor is still able to diagnose.

Olga Beklemishcheva: To correct the technique in the process of its implementation, which is also very important.

Lyudmila Lapa: What can be assigned. Because this technique also allows you to apply additional therapy that is needed.Basically, which is needed. Basically, we use natural drugs, we try to use less chemical drugs. But nevertheless, we work most often with allergy sufferers and are forced to focus on this, we do not prescribe additional drugs to this patient.

Olga Beklemishcheva: How can you describe the patient who is, as they say, “doomed” to your method?

Lyudmila Lapa: First of all, all people who have hypersensitivity to any chemical drugs that produce unpredictable allergic reactions at least once to penicillin or any other drugs, often and long-term ill patients, are “doomed” to our method with immune deficiency, such patients, who in fact do not heal well with conventional methods, do not go well.But I always emphasize that our methodology does not contradict, but complements traditional approaches to treatment, and we do not exclude the use of drugs, but, on the contrary, we supplement them if it is indicated for this patient. And in the complex we achieve good results. I am always pleased to hear when every patient comes and says: you helped us. It really pleases me. Therefore, the situation is like this. So we didn’t talk much about the second feature of this technique, because the question is often asked in rheumatoid arthritis: is the joint affected, deformed, can we restore it or not? They ask such questions.Patients come, sometimes they are brought in, they are brought in, all sorts of serious diseases such as the same scleroderma, this, again, is a violation of the same collagenoses, only in the opposite direction: here there is inflammation, and here there is cell necrosis. And I always clearly explain that all this is possible, but the younger the patient, the faster it happens.

Olga Beklemishcheva: Is it younger in terms of age or length of illness?

Lyudmila Lapa: Both by age and by the length of the disease.

Olga Beklemishcheva: That is, the sooner you start treatment, the better.

Lyudmila Lapa: Yes, so much the better. You just saw a patient who showed in your presence that these rheumatoid nodes all went away precisely during the treatment. Although she understands, we still prescribed her therapy – methotrexate. And so she accepts both therapy and our treatment. She comes to us every six months. We carry out a certain correction, and it comes with good results and quality of life, the main thing.We are talking about disability, but her quality of life is good, that is, she can …

Olga Beklemishcheva: Yes, and at least she had mobility in small joints.

Lyudmila Lapa: Yes, everything has been restored. For nine procedures we have practically recovered, you saw it … Nine procedures are enough to restore joint mobility.

Olga Beklemishcheva: I hope this is good news for those with rheumatoid arthritis and their relatives.The fact is that a number of diseases are arranged in such a way that there is no fault of a person that he fell ill, there is no fault of relatives and doctors, it is simply, indeed, such a fate. But this does not mean that you need to humble yourself. I think that you always need to look for such a method, such a way that would allow you to defeat the disease. And it seems to me that he can always be found. And now I want to ask just our American colleague: are there any fundamentally new drugs in American medical practice, perhaps drawn from foreign (for the USA) experience?

Daniil Golubev: This type of drug can be attributed to the drug humaira, originally widely and comprehensively studied by the British National College of Rheumatoid Arthritis in the city of Berkshire.Humaira is a product of genetic engineering technology, the use of which resulted in a preparation of recombinant monoclonal antibodies that destroy the so-called human tumor necrosis factor. This factor is an important link in the pathogenesis of rheumatoid arthritis, the suppression and destruction of which causes a decrease in inflammation and pain in the affected joint. In the United States, this drug and its analogues, in particular Enbrel, are approved for practical use, so that humaira now occupies a firm place in the arsenal of official medicines for the treatment of rheumatoid arthritis.

Olga Beklemishcheva: Well, our guest, Lyudmila Grigorievna, has already said that an analogue of humaira or Enbrela is allowed for use in Russia, this is a remake. And it is not only allowed, but also included in the list of drugs that are subject to free issuance if you are a member of the privileged category of the population. Well, there are, unfortunately, the majority of those with rheumatoid arthritis. Well, you can write it out and use it.

Lyudmila Lapa: But only in the hospital.I want to say that this is only in the hospital. Therefore, you need to consult a doctor, prescribe this drug and drip it in the hospital.

Olga Beklemishcheva: Because you need to remember what Lyudmila Grigorievna said about the danger of anaphylactic reactions when using it. Lyudmila Grigorievna, we have already described the technique itself, but I will summarize again. It consists in the fact that a person is injected with his own, slightly processed blood, moreover, it is injected subcutaneously, at the acupuncture points included in the paravertebral system, the system that manages the genitourinary, lymphatic and others …

Lyudmila Lapa: Basically, after all, the lymphatic system.

Olga Beklemishcheva: Lymphatic system. How do you think, why, after all, such a strange return of one’s own blood to a person gives such an unconditional clinical effect?

Lyudmila Lapa: I already said that new is well forgotten old. Everyone forgot that stem cells were invented … the discovery was registered in the USSR. This is precisely the discovery of stem cells by Rem Viktorovich Petrov, our academician, a great immunologist.

Olga Beklemishcheva: And the director of your Institute of Immunology, right?

Lyudmila Lapa: Former director. Now Khaitov is our director. And Leah Sergeevna Seslavina. And it was an invention, too, somewhere in 1986, if my memory serves me right. Because this drug … when they prepared a modified autologous blood preparation and introduced it in experiments with rats, mice, of course, not with people, it was clearly proved that stem cells are formed, cloned and cloned in the spleen, and then, apparently, the body is used already for recovery.It was just then that the fundamental conclusions were made on this method, that after all, the effect of restoring the skin, what we see in the treatment of atopic dermatitis, joints, restoration of blood vessels, just play the role of peripheral blood stem cells. But research on this was stopped sometime in 1986, and no additional research was carried out using this technique. But what we know, I told you, that cellular immunity is restored, this is a population of cells of the lymphatic system, and it is most likely that it is restored at the expense of stem cells.This drug has a powerful anti-inflammatory and immunomodulatory effect, which we see, because the immune status of almost the patient is restored. They come completely broken – there is a failure in one link of immunity, a failure in another link of immunity, and when they leave us, we do an immunogram (now, thank God, these tests are done calmly) and we get the patient healthy, from an immunological point of view.

Olga Beklemishcheva: What was a model of immunological diseases in mice? That is, how was the effect of autologous blood tested on mice? What did they hurt?

Lyudmila Lapa: They were not sick.They were just irradiated. You said on this topic that we worked in the 3rd head office, this is the head office that dealt with the nuclear industry, and this method was like treating occupational patients who were exposed to radiation. And just these poor mice, not people, specifically mice were irradiated with a lethal dose. Then this autologous blood was injected, and all the mice survived. And they began to see how they survived. And they survive at the expense of just those stem cells that are formed.

Olga Beklemishcheva: Very interesting.Well, the mice recovered. You count and demonstrate on immunograms that the person’s immune status is being restored. But, perhaps, then the same technique can be applied to treat all kinds of allergic reactions?

Lyudmila Lapa: Of course. I have patented it as a method of treating allergic diseases. Therefore, we use for the treatment of atopic dermatitis, dusty disease, now …

Olga Beklemishcheva: It will start soon.

Lyudmila Lapa: No, not just soon, according to the diary of an immunologist, it already started two weeks ago in Moscow. Therefore, we are already beginning to receive patients who are prone to dusty disease and in a very acute stage. Because there are a lot of antihistamines, but not all of them work. On those who are not affected, I always say: you are welcome to us.

Olga Beklemishcheva: That is, you have not just an immunocorrection center, but an immunocorrection center using hemopuncture.

And now – news from Evgeny Muslin.

American researchers from the Massachusetts Institute of Technology and Harvard University in Boston have developed an effective new method of targeted destruction of cancer cells. To do this, the patient will need to inject a portion of the smallest, so-called nanoparticles, coated with a lethal dose of chemotherapy drug molecules. These “chemical projectiles” selectively attack diseased cancer cells without causing any harm to healthy ones.

The new method was first experimentally tested on cancer cells in test tubes, and then successfully tested on mice inoculated with human prostate tumors. Under the influence of nanoparticles, the tumors in the mice almost disappeared, and all the mice survived, while the animals of the control group that did not receive treatment died.

“One injection of nanoparticles was enough to kill tumors,” said Harvard medical professor Dr. Omid Farokhzad.

Although this method appears to be safe, it still needs to be tested in larger animals and then in humans.

To increase the anticancer effectiveness of nanoparticles, additional genetic material, the so-called “targeting molecules”, is applied to them, allowing them to recognize cancer cells and avoid attacks on healthy ones.

The work in question is published in the Proceedings of the American National Academy of Sciences.

A common angiographic technique, which has been successfully used to diagnose heart disease in men, is most often not able to warn about the danger when examining women in time.An extensive study conducted under the auspices of the National Institutes of Health has shown that this is because men tend to clog the main arteries, while in women, fatty plaques tend to clog mostly small blood vessels. This so-called “coronary microvascular syndrome” or ischemia, in the United States alone, increases the risk of heart attack and even sudden death for more than three million women.

Ischemic heart disease is the leading cause of death in America, and since 1984 more women have died from it than men, and neither conventional coronary angiography, nor x-rays of blood vessels or ventricles of the heart provide an opportunity to detect danger in time.

“Since we do not yet have reliable objective methods for diagnosing specifically female cardiac problems,” says New York cardiologist Dr. Nika Goldberg, “we should immediately begin treating women based on subjective symptoms of heart disease.”

Many bookstores in Japan have new departments selling exercise, puzzle and crossword books specifically for the elderly. These aids are necessary for the so-called “mental gymnastics”, which helps the elderly to preserve their memory, intelligence and mental acuity as long as possible, and even to protect them from senile dementia.

The concept of “mental gymnastics,” a daily brain exercise, is based on the theories of neuroscientist professor Ryuta Kawashima of Tohoku University. Based on the same theories, Sony has developed special electronic games for adults and seniors.

The real boom in brain hygiene in Japan is largely due to the aging of the Japanese population. Now, one in five Japanese people have crossed the 65-year mark, but the proportion of older people continues to grow rapidly due to low fertility and increasing longevity.

And a listener called us. This is Maria Ivanovna from Moscow.

Listener: Where can I go for treatment with this method of hemopuncture?

Olga Beklemishcheva: Well, Lyudmila Grigorievna, tell me how to get to you?

Lyudmila Lapa: It’s very easy to get to us. You can call 445-40-83 by phone. We are located at 6 Davydkovskaya Street.This street is located behind Poklonnaya Gora. This is important for Muscovites, whether it is far away or not, this is Kutuzovsky Prospect, behind Poklonnaya Gora.

Olga Beklemishcheva: So call, sign up. And one more question, this is not on the air, but just a person on a pager asked. He asked for a better name for this drug, which is now included in our free list.

Lyudmila Lapa: Remake.

Olga Beklemishcheva: And returning to dust and other allergies, in fact, as far as I understand, what is rheumatoid arthritis and other immune diseases? It is a person’s own immunity that suddenly begins to perceive some of his own organs and tissues, as strangers, and begins to jam them, that is, to fight them as with a tumor, as with some such nasty thing. That is, it happens to him … “something has become with his memory.” How is this expressed if we consider it by the blood formula, by the immunogram, and how are the results of your method confirmed in precisely such biochemical analyzes?

Lyudmila Lapa: Let’s start with a routine clinical blood test, this increases ESR.

Olga Beklemishcheva: And it is very significant.

Lyudmila Lapa: Very significant. And, as a rule, with a long-term inflammatory process … Rheumatoid arthritis is still a long-term disease, it often proceeds latently. I have already said, I want to repeat, that if only the hands become ill, the hands and feet are disturbed, one should immediately rush to the doctor, because remission can take six months. It is during this period that you need to be treated, then the remission will be for 30 years.If it goes away on its own, then it can hit the body very hard, and an acute process begins, which is even harder to stop, because immunity is a very self-regulating system that keeps all inflammatory processes and protects it to the last. But if the inflammation is strong, it is precisely the failure of the immune system that occurs, and the aggression of one’s own cells against one’s own cells begins. And aggression begins against any reactive proteins – either C-reactive protein or rheumatic factor, because these are all proteins that the body begins to perceive as foreign, produces immunoglobulin G against them, and all these inflammatory processes begin, which we then see in patients …

Olga Beklemishcheva: That is, in the blood test there is a shift in ESR and a shift, probably, according to the blood formula?

Lyudmila Lapa: And according to the blood formula. Anemia is the first thing, I have already said this, I will repeat it again, because a prolonged inflammatory process in the body means that hemoglobin also falls down, the number of leukocytes and erythrocytes – who falls, who grows, also have different forms. But this is also a violation of the blood count, so you need to talk about it too.Things like monocytosis shouldn’t be overlooked at all. If at least once you paid attention to this, passed a blood test, you showed monocytosis, you need to look for where the inflammations in the body go, because this is also sometimes a prerequisite for some kind of immune changes.

Olga Beklemishcheva: Are there many of these autoimmune diseases?

Lyudmila Lapa: Yes, there are a lot of them. Already now, if my memory serves me correctly, up to 30 autoimmune diseases are being identified.

Olga Beklemishcheva: And they are all treated approximately the same as rheumatoid arthritis?

Lyudmila Lapa: If you look from the point of view of our technique, hemopuncture, they are treated in the same way. But the foci of destruction in the body are different. And so I just said: where there is more pain, there we see whether there is a problem or not. And then we repeat this treatment in these areas, because we do not treat rheumatoid arthritis in its pure form, we treat the body.Since we are treating the body, we go through every system, and where there is pain, it is found there, and then we send, if a narrow specialist is needed, if a hormonal imbalance, if there is a problem with the thyroid gland, this is immediately revealed in the course of treatment and a small survey. We always do this. Of course, if there are absolutely clear problems, there, with the thyroid gland, with the hormonal system, we immediately refer to the following narrow-profile specialists who prescribe a specific therapy, if such is indicated after treatment.

Olga Beklemishcheva: We have the next listener on the line. This is Ella Georgievna from St. Petersburg.

Listener: I am very glad to hear your program, because these are the very questions that bother me very much, and for many years I have not been able to find an answer. I am a very old allergy sufferer, for many years, and now my allergy has almost turned into asthma. It’s the drugs that don’t help me. I also have a problem with small joints in my hands and feet.I wanted to know if I could address these complaints of mine, and if the Immunocorrection Center has a branch in St. Petersburg?

Lyudmila Lapa: We have no branch in St. Petersburg. Another rather serious problem that we faced when we moved from the 10th Medical Unit, we do not have a hospital now. Therefore, we are happy to receive everyone on an outpatient basis, and we can only agree with the hospital in a military hospital with which we have an agreement, and there is a doctor there who treats.This is the question of treatment. And in St. Petersburg we do not have such a center.

Olga Beklemishcheva: Nevertheless, you can probably still come to Moscow if the issue is acute. And, Vladimir Nikolaevich from Moscow, we are listening to you.

Listener: Good afternoon, colleagues! I am a doctor by profession. I would like to know, because the osmotic resistance of erythrocytes and leukocytes is very close, how do you manage to separate them, in what ways do you dilute the blood with distilled water?

Lyudmila Lapa: We dilute blood 1: 5.And erythrocytes … it was evident that the lysis of erythrocytes occurs almost immediately. Leukocytes and lymphocytes do not suffer at such a ratio when we dilute … We do not use water for dilution, I emphasize, but precisely in order to create this effect of hypoosmosis. And those cells that have been activated in our country are enough for paravertebral administration and for obtaining a clinical effect.

Listener: So one part blood and five parts water?

Lyudmila Lapa: Yes.

Listener: Thank you very much.

Lyudmila Lapa: Please.

Olga Beklemishcheva: Well, the doctors are already interested. This makes me happy. And the next listener is Lyubov Semyonovna from Moscow.

Listener: I recently had tests for autoimmune status, anti-infectious immunity. And I have such numbers here that bother me, in particular, antibodies to staphylococcus a thousand times here, I get it … To E. coli, to purulent bacillus … Anti-infectious immunity – your technique can somehow help in this matter?

Lyudmila Lapa: It can help, but this is also an integrated approach, and this technique helps in this matter.We deal with infectious problems, but the only thing, I always say, is not acute, namely chronic, subacute problems, because acute problems – sanitation will still be necessary, if it is needed – antibacterial therapy will be needed here. This doctor will assess your well-being if you come.

Listener: So I understood correctly that first I need to contact you, and then you will refer me to the right doctor.

Lyudmila Lapa: Yes, of course.

Listener: Thank you very much.

Olga Beklemishcheva: I would like to emphasize what Lyudmila Grigorievna Lapa said a little earlier. Just because an autoimmune disease is most likely caused by a side effect of antibiotics or other chemotherapy drugs does not mean that they should not be used if indicated. Another thing is that you cannot apply it yourself, you still need to get a prescription, get a doctor’s prescription.And the next listener is Viktor Nikolaevich from Moscow.

Listener: Please, Lyudmila Grigorievna, tell me, please, does your technique help with allergic dermatitis?

Lyudmila Lapa: Yes, of course.

Olga Beklemishcheva: This is exactly allergic dermatitis – it is clearly visible.

Lyudmila Lapa: Allergic dermatitis is our patent for this.

Olga Beklemishcheva: And Nikolai Vasilyevich from Zelenograd.

Listener: Maybe I’m not quite on the topic, I have this question. There is such a procedure for plasmapheresis. Can this procedure be used to treat rheumatoid arthritis? My question arises from a purely personal plan: my sister died from this disease three months ago, she had already spread to her lungs, and doctors in Nizhny Novgorod gave her this procedure.Is it correct?

Lyudmila Lapa: You see, it is very problematic to say so unambiguously about plasmapheresis. It is sometimes prescribed to lower the rheumatoid factor. But the fact is that the rheumatoid factor is not always an indicator of just rheumatoid arthritis, it is an indicator of any chronic process that goes on in the body. And often the rheumatic factor rises in people for no reason, we do not know what exactly this reaction of the immune system is from.

Olga Beklemishcheva: There is also seronegative rheumatoid arthritis, when the rheumatological factor simply does not increase.

Lyudmila Lapa: And plasmapheresis is not always indicated, but for some patients it is very helpful precisely in order to remove the rheumatic factor.

Olga Beklemishcheva: Therefore, Nikolai Vasilyevich, Lyudmila Grigorievna did not see your sister … Please accept our condolences.But she cannot judge the actions of the doctors who saw your sister.

And the next listener is Nikolai Alexandrovich from Moscow.

Listener: Be kind, Lyudmila Grigorievna, can your technique help in the treatment of dysbiosis caused by the indiscriminate massive administration of obsolete antibiotics?

Lyudmila Lapa: Maybe, but only with an additional complex correction, and our technique … we do it.

Listener: Dysbacteriosis led to severe intestinal disruption.

Lyudmila Lapa: Yes, come, please, we will help you.

Olga Beklemishcheva: And the next listener is Nelly Nikolaevna.

Participant: Can your technique help in the treatment of coxarthrosis?

Lyudmila Lapa: In the complex for the treatment of coxarthrosis, we prescribe drugs very often and our method.The thing is that, it has not yet been said, the technique allows you to return resistance to all drugs that are. Because, often using drugs, the body is not sensitive to them. Just when we do the correction of immunity, this sensitivity is restored, so we even like to prescribe drugs more often after treatment. Like even chemotherapy … After chemotherapy, we take any patients, treat them, then after about two weeks we carry out chemotherapy, and the blood test remains clinically good.This is also an indicator that the immunity is already resistant to this drug, and he takes it well and does not even reduce it …

Olga Beklemishcheva: Well, rather, not resistant, but sensitive.

Lyudmila Lapa: Sensitive.

Olga Beklemishcheva: And the next one is Inna Alexandrovna from Moscow.

Listener: Can I contact you with my problem? I have autoimmune thyroiditis.At the same time, antibodies to pyroxidase are nine times higher. At the same time, my joints hurt: 30 years ago I was traumatic … I want to ask, firstly, with the correction of the immune system, can you help me with the problem of autoimmune thyroiditis? Maybe you will correct it. Because his immunologist, the one who works in an ordinary clinic, says that it is more difficult to deal with this than just endure it.

Lyudmila Lapa: No, there is a certain correction here, and we are working with an immunologist from our endocrinology center who deals with thyroiditis.If any therapy is needed, they will pick it up then. We just do not have our own endocrinologist, but then we refer. And when we do immunological correction, after that, of course, it gets better and better. Most importantly, the quality of life is improving. I’m explaining to everyone that we may not always be able to heal from some kind of disease … They say to me: how often do I need to come to you? I always say: according to my state of health. If you do not feel well, come, we will help you, put you on your feet. And then you will already decide for yourself what you need in order for your body to work as it should.But what is remission? I always say: this is a change in lifestyle. And often in our recommendations it is precisely prevention due to our laziness, I do not even know any other factors, many do not observe it … And sometimes they return with rather acute cases, because, for example, we say – come then – to the patient. There are such conditions in every disease when exacerbations can be.

Olga Beklemishcheva: Say, once every six months?

Lyudmila Lapa: Once every six months, or after a month and a half, we assign someone, or after three months, it all depends on the disease we are dealing with.And the patient feels good during this period, and he does not come. And immunity … just at this moment there is a failure. We need to help him. We do not just appoint. That is why all the doctors work for us to deal with any problem with which a person turns to us. Therefore, in this situation, we will carry out immunocorrection for you. Antibodies they first grow up (there is even a period, I just know what it is), then they decrease. It is different here. It all depends on how your body reacts to this correction.And there is control for this. Control – blood test. We take hormones with you, take tests for antibodies and check. And if everything is moving in the normal direction, then everything is fine, if not, then a specialist will prescribe hormone replacement therapy for you.

Olga Beklemishcheva: That is, this is not an alternative method, but a complementary one, but with a very good effect. And the next listener is Irina from Odintsovo.

Listener: Lyudmila Grigorievna, the child has had chronic tonsillitis since the age of seven, at 10 he underwent surgery, the causative agent of klepsiella.Now he has chronic sinusitis. Every month – this is snot, snot, the general condition is poor. And in the family we, too … infected my mother with a sore throat.

Lyudmila Lapa: Come. Children are our joy, because children use our method … even with juvenile rheumatoid arthritis, we observe children, we do not observe, but treat, our preparation for them is the basic one that we prepare. We treat these patients according to a certain scheme. And even juvenile rheumatoid arthritis with deformity, with inflammation, with contractures, all this is gradually corrected.And we will cope with sinusitis. This treatment was invented by the ENT doctor in order to help with chronic inflammatory processes, and you just have one.

Listener: We have another problem. I, father, mother, grandmother, we all have everything that a child begins, in a week we all get sick with this, for five years now we have been suffering. What does it mean? Intrafamilial infection, right?

Lyudmila Lapa: Yes, there is this, because even with furunculosis we often encounter, there is some kind of focus somewhere you have, and you carry it.For this we do certain examinations. You have to sow phlegm, sow what bothers you, exactly what you have … Often Staphylococcus aureus is like this …

Listener: No, we don’t have Staphylococcus aureus, we have klepsiella.

Lyudmila Lapa: This is a little different, but this is also, in general … I always say: this must and can be fought.

Olga Beklemishcheva: Well, then, of course, you have a rather similar mucous membrane if you are one family.

Lyudmila Lapa: Genetic similar.

Olga Beklemishcheva: And, accordingly, a natural reaction to the same stimulus. And the last question we have time to answer is Alevtina Sergeevna from Moscow.

Listener: In addition to osteoarthritis, osteochondrosis, degenerative-dystrophic changes, all sorts of nodal changes in small joints of hands and feet and knee joints, I also have Forestier disease.

Lyudmila Lapa: Contact us, we will help!

Olga Beklemishcheva: I say goodbye to you. Try not to get sick!

“That still disgusting.” The doctor spoke about the torment of post-like patients

https://ria.ru/20210513/vaktsinatsiya-1731922348.html

“That still disgusting.” The doctor told about the suffering of post-like patients

“That still disgusting.” The doctor spoke about the torment of postcoid patients – RIA Novosti, 13.05.2021

“That still disgusting.” The doctor spoke about the torment of postcoid patients

Doctors all over the world warn of the insidiousness of COVID-19. This infection is often difficult, even in young people, and is fraught with many complications. Consequences … RIA Novosti, 13.05.2021

2021-05-13T08: 00

2021-05-13T08: 01

science

health

biology

covid coronavirus -19

coronavirus in russia

satellite v vaccine

epivaccoron vaccine

covid-19 vaccination of Russians

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MOSCOW, 13 May – RIA Novosti, Tatyana Pichugina. Doctors around the world are warning of the insidiousness of COVID-19. This infection is often difficult, even in young people, and is fraught with many complications. The consequences are felt several months after recovery. “During the day, half of the patients were ill,” says rheumatologist Alexander Shishkin, professor, head of the Department of Faculty Therapy of the Medical Faculty of St. Petersburg State University.In an interview with RIA Novosti, he told what a post-covid is and why it is important to get vaccinated. – Alexander Nikolaevich, you do not work in the red zone, but observe those who have been ill. Do they come to you after a severe form of COVID-19? – Absolutely not necessary. There are even asymptomatic patients. For example, my colleague, a doctor, got the infection relatively easily, followed all the instructions, and now she has myocarditis, which is a very unusual coronavirus. In a flu epidemic, people get sick almost the same – runny nose, throat, as a complication – pneumonia.Everything is typical. And COVID-19 has different clinical manifestations, often a discrepancy between the state of health and the degree of lung damage, many consequences, including neurological disorders: insomnia, irritability, memory impairment. My sick colleague described and photographed all the stages. On the first day, smells disappeared for him, and this is a brain damage. On the second day, a skin rash popped out, then the veins on the head swelled up like in vasculitis, weakness appeared, and then he went on the mend. Symptoms so different over several days are extremely unusual.In general, it’s disgusting. ”“ What do your patients complain about? ”“ I deal mainly with autoimmune diseases, so people come to me with various arthralgias, myositis, general weakness, changes in the tests that speak of an autoimmune trace after COVID-19 – high indicators of rheumatoid factor, C-reactive protein. There are patients with arterial hypertension, hand tremors like in parkinsonism. This wears off as treatment progresses, indicating a stress factor. Some people note pain in muscles and joints like with the flu, and it lasts for a long time.Several times there was deep vein thrombosis against the background of covid, including from improper treatment. The problem is that covid is treated by doctors of any profile, although this is the case of infectious disease specialists, and they do not always know how to do it correctly. On the other hand, diverse, polymorbid manifestations may require the participation of different specialists. In addition, approaches to therapy are changing very quickly. Judging by the latest scientific literature, antibiotics are far from always effective, because the pneumonia that occurs with COVID-19 is more often not bacterial, but autoimmune.Antiviral drugs have shown themselves to be ambiguous, as well as a new class of biological products based on antibodies to interleukins used in rheumatology. Now, in fact, the only thing that helps in severe cases is dexamethasone. Medicine must be personalized. Especially when we know very little about the disease. ”“ What do you think about the effectiveness of vaccines? ”“ It is a great boon that they were developed so quickly. It’s great that there are several options, so you can choose.There are some concerns that drugs will have to be changed because the virus is rapidly mutating. In India, a variant with three mutations at once was recently identified. The vaccine of the Center for them will soon be massively available. Chumakov, made using traditional technology from a killed virus. In principle, it is suitable for people with autoimmune and severe chronic diseases, oncology. There are many innovative works in this direction. At the Institute of Experimental Medicine in St. Petersburg, RAS Corresponding Member Alexander Suvorov invented a microbiota-based vaccine that must be taken orally.There are options in the form of nasal drops. Now, during a pandemic, you need to vaccinate with what you have. We have it mainly “Sputnik V”. People with diabetes, obesity, coronary heart disease are vaccinated, and I still have not observed any serious side effects. – If we compare the risks from COVID-19 and vaccination … – They are not comparable. The risk from the disease is much higher, and it is completely unclear how it will behave. And there are a lot of post-ovarian complications. Of course, some people with good cellular immunity will easily undergo infection or avoid infection.There are also means to further strengthen the immune system. In the 90s, my colleagues from the Research Institute of Influenza and I studied the role of viruses in the development of internal diseases, in particular, autoimmune kidney diseases. In response to infection, the body produces interferon. In some severe diagnoses, such as lupus or nephritis, interferon is low or nil, so viral infections develop quickly and with severe consequences. Genetically engineered preparations of interferon with antiviral action were developed and used as substitution therapy.Vitamin D is also actively involved in the formation of anti-infectious immunity. In autumn and winter, Petersburgers need to take it for prophylaxis. “Do the elderly need to be vaccinated?” Therefore, there is less risk of infection. Young people flaunt, without a mask ride in the subway. But the elderly tolerate COVID-19 harder, because they have worse cellular immunity, they do not spend much time in the sun, hence the deficiency of vitamin D, stress. Vaccinating the elderly is the right thing to do.First, you need to consult a doctor in order to exclude the exacerbation of chronic diseases, including autoimmune ones, such as rheumatoid arthritis, lupus, nephritis, bronchial asthma. “The population is not very willing to get vaccinated. What do you think is the reason? – Perhaps they are waiting for the “KoviVac” vaccine with a “killed virus”, because they trust more proven technologies. Some scientists have expressed concern that subsequent Sputnik V vaccinations will not be as effective due to the development of antibody immunity to adenovirus and revaccination with another drug will be required.The developers have a different opinion. But there is also cellular immunity … It is difficult for ordinary people to understand all this. Yes, and there are many white spots – how many times do you need to be vaccinated, after what time, when collective immunity is formed, whether it is necessary to vaccinate children, pregnant women. We need a global epidemiological study. “Is the requirement to wear masks after vaccination justified?” “I think so. After the first dose, people develop euphoria, a desire to actively communicate. But the risk of getting sick remains. Such cases have already been described, albeit in a mild form, but still.It is possible to catch an infection after the second. I believe that by the summer the wave of incidence will subside. In the fall, COVID-19 will return, possibly becoming a seasonal illness. Influenza, too, has not been canceled. I hope that by that time the clinical trials of “KoviVac” and “EpiVacCorona” from “Vector” will be completely finished. They are believed to have a lower risk of side effects. In general, let’s be optimists.

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health, biology, covid coronavirus -19, coronavirus in Russia, satellite v vaccine, epivaccorona vaccine, vaccination of Russians against covid-19, kovivac vaccine

MOSCOW, May 13 – RIA Novosti, Tatyana Pichugina. Doctors around the world are warning of the insidiousness of COVID-19. This infection is often difficult, even in young people, and is fraught with many complications. The consequences are felt several months after recovery. “During the day, half of the patients were ill,” says rheumatologist Alexander Shishkin, professor, head of the Department of Faculty Therapy of the Medical Faculty of St. Petersburg State University. In an interview with RIA Novosti, he told what a postcovid is and why it is important to get vaccinated.

– Alexander Nikolaevich, you are not working in the red zone, but watching those who have been ill. Do they come to you after a severe form of COVID-19?

– Completely optional. There are even asymptomatic patients. For example, my colleague, a doctor, had an infection relatively easily, followed all the prescriptions, and now she has myocarditis.

This coronavirus is very unusual. In a flu epidemic, people get sick almost the same – runny nose, throat, as a complication – pneumonia.Everything is typical. And COVID-19 has different clinical manifestations, often a discrepancy between the state of health and the degree of lung damage, many consequences, including neurological disorders: insomnia, irritability, memory impairment.

My sick colleague described and photographed all stages. On the first day, smells disappeared for him, and this is a brain damage. On the second day, a skin rash popped out, then the veins on the head swelled up like in vasculitis, weakness appeared, and then he went on the mend.Symptoms so different over several days – are extremely unusual. In general, the same disgusting.

– What are your patients complaining about?

– I deal mainly with autoimmune diseases, so people come to me with various arthralgias, myositis, general weakness, changes in the tests that speak of an autoimmune trace after COVID-19 – high levels of rheumatoid factor, C-reactive protein. There are patients with arterial hypertension, hand tremors like in parkinsonism.This wears off as treatment progresses, indicating a stress factor. Some people note pain in muscles and joints like with the flu, and it lasts for a long time. Several times there was deep vein thrombosis on the background of covid, including from improper treatment.

The problem is that covid is treated by doctors of any profile, although this is the business of infectious disease specialists, and they do not always know how to do it correctly. On the other hand, diverse, polymorbid manifestations may require the participation of different specialists. In addition, approaches to therapy are changing very quickly.Judging by the latest scientific literature, antibiotics are far from always effective, because the pneumonia that occurs with COVID-19 is more often not bacterial, but autoimmune. Antiviral drugs have shown themselves to be ambiguous, as well as a new class of biological products based on antibodies to interleukins used in rheumatology. Now, in fact, the only thing that helps in severe cases, – dexamethasone.

Cannot be treated according to the guidelines. Medicine must be personalized.Especially when we know very little about the disease.

April 22, 08:00 Science “Made from wheels”. Scientist compared influenza and COVID-19 vaccines

– What do you think about the effectiveness of vaccines?

– It is a great boon that they were developed so quickly. It’s great that there are several options, so you can choose. There are some concerns that drugs will have to be changed because the virus is rapidly mutating. In India, a variant with three mutations at once was recently identified. The vaccine of the Center for them will soon be massively available.Chumakov, made using traditional technology from a killed virus. In principle, it is suitable for people with autoimmune and severe chronic diseases, oncology. There are many innovative works in this direction. At the Institute of Experimental Medicine in St. Petersburg, RAS Corresponding Member Alexander Suvorov invented a microbiota-based vaccine that must be taken orally. There are options in the form of nose drops.

Now, during a pandemic, we need to vaccinate with what we have. We have it mainly “Sputnik V”.People with diabetes, obesity, coronary heart disease are vaccinated, and I still have not observed any serious side effects.

April 9, 15:16 Infographics Vaccination against COVID-19 in Russia

– If we compare the risks from COVID-19 and vaccination …

– Not comparable. The risk from the disease is much higher, and it is completely unclear how it will behave. And there are a lot of postcoid complications.

Of course, some people with good cellular immunity will easily get the infection or avoid infection.There are also means to further strengthen the immune system. In the 90s, my colleagues from the Research Institute of Influenza and I studied the role of viruses in the development of internal diseases, in particular, autoimmune kidney diseases. In response to infection, the body produces interferon. In some severe diagnoses, such as lupus or nephritis, interferon is low or nil, so viral infections develop quickly and with severe consequences. Genetically engineered preparations of interferon with antiviral action were developed and used as substitution therapy.

Vitamin D is also actively involved in the formation of anti-infectious immunity. In autumn and winter, Petersburgers need to take it for prophylaxis.

April 21, 08:00 Science And the whole Sun is not enough. How to Replenish Vitamin D Deficiency Without Drugs

– Must the Elderly Be Vaccinated?

– The elderly, on the one hand, are less mobile, hang out less, and are more careful. Therefore, there is less risk of infection. Young people flaunt, without a mask ride in the subway. But the elderly tolerate COVID-19 harder, because they have worse cellular immunity, they do not spend much time in the sun, hence the deficiency of vitamin D, stress.Vaccinating the elderly is the right thing to do. First, you need to consult a doctor in order to exclude an exacerbation of chronic diseases, including autoimmune ones, such as rheumatoid arthritis, lupus, nephritis, bronchial asthma.

– The population is not very willing to get vaccinated. What do you think is the reason?

– Perhaps they are waiting for the “KoviVac” vaccine with a “killed virus”, because they trust more proven technologies. Some scientists have expressed concern that subsequent Sputnik V vaccinations will not be as effective due to the development of antibody immunity to adenovirus and revaccination with another drug will be required.The developers have a different opinion. But there is also cellular immunity … It is difficult for ordinary people to understand all this. Yes, and there are many white spots – how many times do you need to be vaccinated, after what time, when collective immunity is formed, whether it is necessary to vaccinate children, pregnant women. We need global epidemiological studies.

– Is the requirement to wear masks after vaccination justified?

– I think so. After the first dose, people develop euphoria, a desire to actively communicate.But the risk of getting sick remains. Such cases have already been described, albeit in a mild form, but still. You can catch an infection after the second.

I believe that by the summer the wave of morbidity will subside. In the fall, COVID-19 will return, possibly becoming a seasonal illness. Influenza, too, has not been canceled. I hope that by that time the clinical trials of “KoviVac” and “EpiVacCorona” from “Vector” will be completely finished. They are believed to have a lower risk of side effects. In general, let’s be optimists.

April 16, 08:00 Smirnov A.V., Karateev D.E.

The osteoarticular system of the hands and distal parts of the feet is the main object of research for the diagnosis and determination of the stage of rheumatoid arthritis (RA) and the differential diagnosis with other diseases of rheumatic and non-rheumatic nature.

The synovium of peripheral joints is a target organ, where chronic autoimmune inflammation develops in RA, which subsequently leads to multiple and symmetric joint lesions characteristic of RA.Symmetry of changes in the joints of the hands and feet is a distinctive feature of RA. Typical signs of RA are symmetric lesions of the metacarpophalangeal and metatarsophalangeal joints, wrist joints, and proximal interphalangeal joints of the hands. The first radiological symptoms of arthritis, including the appearance of the first erosions, can be found in 2 and 3 metacarpophalangeal joints, 3 proximal interphalangeal joints of the hands, wrist joints, wrist joints, styloid processes of the ulna, 5 metatarsophalangeal joints.In more advanced stages of RA, changes can be found in the distal interphalangeal joints of the hands and feet. RA never begins with lesions of the distal interphalangeal joints of the hands and feet, the proximal interphalangeal joints of the feet.

Most often in everyday practice, an X-ray classification is used, based on the division of RA into modified stages according to Steinbrocker using plain radiographs of the hands and distal parts of the feet in frontal projection.

There are 4 radiological stages of RA, reflecting the progression of arthritis symptoms in the joints of the hands and distal feet.

Stage 1 (early X-ray changes) of RA includes periarticular thickening and thickening of soft tissues, periarticular osteoporosis (increased radiolucency of bone tissue), single cystic lumens of bone tissue, and narrowing of individual joint spaces in joints typical of initial RA.Stage 1 X-ray symptoms are nonspecific for RA and can be detected in other rheumatic diseases, which requires mandatory registration of clinical and laboratory parameters of the disease.

Stage 2 is characterized by an increase in periarticular osteoporosis, the appearance of multiple cystic lumens of bone tissue in the epiphyses of short tubular bones and wrist bones in combination with multiple narrowing of the joint spaces, erosive changes in the joints and small marginal deformities of the bones.This stage is divided into non-erosive and erosive forms, depending on the absence or presence of destructive changes in the joints. As a rule, the first erosions appear in 2-3 metacarpophalangeal, 5 metatarsophalangeal joints, wrist bones, in the area of the styloid process of the ulna. A distinctive feature of the 2nd stage of RA is the absence of moderate or severe deformation changes, subluxations, dislocations and bone ankylosis of the joints.

Stage 3 is characterized by an increase in radiological symptoms detected in stage 2.Destructive changes are pronounced, determined in many joints of the hands and distal parts of the feet. Dominated in joints typical of RA. A distinctive feature of the 3rd stage is moderate and pronounced deformities of the epiphyses of the bones, subluxations and dislocations in some or many joints.

Stage 4 is characterized by stage 3 symptoms and the appearance of bone ankylosis of the joints. Ankylosis in the joints of the wrists (intercarpal, 2–5 carpal-metacarpal joints) is typical for RA. Ankylosis is extremely rare in the proximal interphalangeal joints of the hands and wrist joints.Severe destructive changes in the bones of the wrists can lead to collapse of the wrists, which is characterized by a decrease in the height of the wrists, severe deformities, a decrease in the size or osteolysis of the wrist bones. Osteolytic changes can be detected in the metacarpophalangeal and, less often, metatarsophalangeal joints. X-ray stages of RA are shown in Figures 1-11.

	ARTHRITIS	ARTHROSIS
Definition	Arthritis – inflammatory process in the joint.This disease affects the entire body and, if there is a tendency to inflammation, it can flare up in any joint or in several at once. The catalyst for inflammation is immune failure, for example, due to hypothermia, flu, psycho-emotional stress. The inflammation itself is caused by an infectious agent, dysfunction of the immune system or metabolic disorder.	Osteoarthritis – deformity of the joint , which most often occurs in old age. The development of arthrosis before the age of 40, often occurs as a result of a fracture or severe injury to the joint.It is typical for people who are professionally involved in sports.
SYMPTOMS
Pain	Arthritis pain is felt both in movement and at rest. Night pains are typical (especially from 3:00 to 5:00 in the morning)	In arthrosis, pain usually occurs only with heavy exertion and movement.As the disease progresses, painful sensations arise even with low-intensity exertion and at rest, and decreases when a person takes a comfortable position.
Crunch	–	Osteoarthritis can cause crunching. It arises as a result of the destruction of cartilage tissue and friction of bone structures. The crunching sound is accompanied by a dry and harsh sound, which intensifies as the disease worsens.
Joint deformity	In the case when joint bleaching is arthritis, deformation of the inflamed joint occurs, redness and swelling occur, the patient feels severe pain on palpation, and nodules may occur.The place of inflammation is hot to the touch.	In the case when the disease of the joints is arthrosis, the joint is gradually deformed. During the period of exacerbation, there may be swelling, accompanied by aching pain.
Reduced joint mobility	For arthritis, a joint or whole body is constrained	With arthrosis, there is a decrease in the range of motion
Blood test parameters	With arthritis, the level of ESR significantly increases, which indicates the presence of an infectious and inflammatory process in the body	Osteoarthritis does not affect blood counts
Localization	Arthritis has a specific localization. Wrist joints, fingers and toes, knee joints, ankle joints are often affected. Stiffness of the hands after sleep, inflammation and swelling of the joints at the base of the fingers (rheumatoid, psoriatic arthritis). Often, infectious arthritis is accompanied by the classic symptoms of an infectious disease: fever, weakness, excessive sweating, chills, and body aches.	Most often, arthrosis affects the hip, knee, and toe joints.Sometimes arthrosis affects the joints of the fingers and ankle joints.

Arthritis toes images: The request could not be satisfied

Arthritis in the Toes: Overview and More

Symptoms of Toe Arthritis

Types and Causes

Diagnosis

Treatment

Cold and Heat Therapy

Anti-Inflammatory Medications

Cortisone Injection

Footwear

Lifestyle Modifications

Surgery

A Word From Verywell

Washington Foot & Ankle Sports Medicine: Podiatry

Arthritis pain in the feet and ankles

How foot and ankle exercises can help

1. Toe press, point, and curl

2. Big toe stretch

3. Toe splay

4. Marble pickup

5. Ball roll

6. Achilles stretch

7. Ankle rotation

Psoriatic arthritis: MedlinePlus Genetics

Dactylitis: A hallmark of psoriatic arthritis

Abstract

Objective

Methods

Results

Conclusion

Keywords

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