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Rheumatoid Arthritis Alleviation

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Christopher Cason

on 19 September 2012

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Transcript of Rheumatoid Arthritis Alleviation

Rheumatoid Arthritis
Alleviation Christopher Cason Born Pittsburgh, Pennsylvania on February 28, 1896.
Enrolled in Lafayette College, Easton, PA. where he graduated Bachelor of Arts in 1916.
Enlisted in the Medical Corps of the US Army in 1917.
Doctorate in Medicine. Philip Showalter Hench Intern at St Francis Hospital, Pittsburgh
Became assistant at the Mayo clinic in 1923.
Studied at Freiburg University and at the von Müller Clinic, Munich in 1928.
Became instructor at Mayo Foundation in 1928. In 1942 Dr. Hench entered military service as a lieutenant-colonel in the Medical Corps.
Reached the rank of Colonel in 1946.
Became Consultant to Army Surgeon General. At Mayo Clinic he specialized in arthritic disease.
Effects of pregnancy & jaundice on arthritic patients.
Opened therapeutic possibilities for this new class of pharmaceutical agents. Mayo Clinic Isolation and identification of the cortical hormones, including compound E.
Worked to isolate and investigate the hormones of the adrenal cortex.
Facilitated artificial and large-scale production of cortisol. Dr. Edward C. Kendall Common interests.
'Compound E' first administered to human subject.
Continued Tx to more patients.
November 1948: formal, blinded study approved.
Preliminary Report aimed to present certain physiologic effects, not clinico-therapeutic report.
"Within every Rheumatoid patient corrective forces lie dormant, awaiting proper stimulation." Hench & Kendall Work Together Nobel Prize Laureate.
Heberden Medal (London).
1949 Lasker Award, presented by the American Public Health Association.
Passano Foundation Award.
Criss Award (1951).
He has received honorary doctorates in science from Lafayette College, Washington and Jefferson College, Western Reserve University, the National University of Ireland and the University of Pittsburgh.
A Fellow of the American Medical Association and of the American College of Physicians, a true leader in American rheumatology. He is a founding member of the American Rheumatism Association (President 1940-1941). AWARDS & LEADERSHIP Nobel Prize Laureate.
Lasker Award of the American Public Health Service.
Passano Award of the Passano Foundation in San Francisco.
Page One Award of the Newspaper Guild of New York jointly with Dr. Hench. AWARDS Microbic theory of the origin of Rheumatoid arthritis.
Biochemical disturbance.
Relation of adrenal cortices to temporary Rheumatoid arthritis remissions.
Lecithin experiment.
Compound E administration.
Control
Supply Found that doses under 100mg/day were ineffective.
Speculated small doses could be used for mild forms of RA.
Firstly: reduction of stiffness of muscles and joints.
Lessening of articular aching on motion.
Improvement of articular and muscular function.
Ability to perform common tasks independently.
Improved appetite. Findings Findings 1950-1.5 million TV sets in USA, by 1951 there were 15 million!
1951- Cleveland Dj Alan Freed first coined the term 'rock-and-roll'!
1953- Cigarette smoking causes lung cancer.
1953- Double-helix structure of DNA first reported by Watson and Crick.
Late 1950's: term Autoimmune Disease.
Dr. Kendall showed that Compound E increased the resistance of animals against reactions to Typhoid vaccine.
Pessimism: "one of the most intractable, obstinate, and crippling diseases that can befall the human body (Lane and Griffiths, 1890). Knowledge at this Time ACTH Effects on RA 100mg of ACTH intramuscularly for 12 days.
Clinical improvement comparable to use of Compound E.
Greater sedimentation rate decrease compared to Compound E.
Side-effects. Impact Cortisone injections.
Suppression of immune responses.
ALL (Acute Lymphocytic Leukemia).
Addison's Disease.
Adrenal Hyperplasia.
Crohn's Disease.
Ulcerative colitis.
Many others. Myriad studies in clinical setting.
Pre-injection: Patient education, physical exercise, and NSAIDs including COX-2 inhibitors.
Intraarticular steroid injection was included in the 10 proposed interventions from large study conducted by European League Against Rheumatism (EULAR).
Cortisone steroid injection provides short term alleviation of pain to patients. Local anesthetic showed no alleviation of pain. Cortisone Injections: Primary Literature Shrinkage (atrophy) and lightening of the color (depigmentation) of the skin at the injection site.
Bacterial infection.
Local bleeding within injection site.
Postinjection flare.
Weakened tendons.
Increased blood sugar levels in diabetics.
Long-term use: thinning of skin, weight gain, acne, increased blood pressure, osteoporosis. Side Effects Kruse, DW, "Intraarticular cortisone injection for osteoarthritis of the hip. Is it effective? Is it safe?",Curr Rev Musculoskelet Med. 2008 December; 1(3-4): 227–233.
Rozental TD, Sculco TP. Intra-articular corticosteroids: an updated overview. Am J Orthop. 2000;29:18–23.
Cole BJ, Schumacher HR. Injectable corticosteroids in modern practice. J Am Acad Orthop Surg. 2005;13:37–46.
http://www.shoulderandelbowspecialist.co.uk/elbow-conditions/elbow-osteoarthritis.aspx.
http://www.nobelprize.org/nobel_prizes/medicine/laureates/1950/hench-bio.html.
http://www.nobelprize.org/nobel_prizes/medicine/laureates/1950/kendall.html. References
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