New guidelines for the treatment of SSA

Health Care, Medicine 150 Comments

The SpondyloArthritis International Society working group has updated its guidelines for use of tumor necrosis factor (TNF) inhibitors in patients with axial spondyloarthritis, including ankylosing spondylitis.

There are three important changes in the updated guidelines.

  • The new ASAS criteria for axial spondyloarthropathy allow for the use of these agents in patients without radiographic changes who meet magnetic resonance imaging criteria for sacroiliitis.
  • The updated guidelines continue to recommend that TNF inhibitors be used only after an inadequate response to NSAIDs, although the duration needed to establish lack of efficacy of NSAIDs was reduced from three months to four weeks.
  • Patients with peripheral arthritis (but not those with axial disease alone) should have also had an inadequate response to another disease-modifying drug (DMARD) before using a TNF inhibitor.
  • Drugs other than sulfasalazine can now also be considered in establishing that the patient has had an inadequate response.


van der Heijde D, Sieper J, Maksymowych WP, et al. 2010 Update of the international ASAS recommendations for the use of anti-TNF agents in patients with axial spondyloarthritis. Ann Rheum Dis 2011;70:905.

Make beetroot a part of any pre workout diet

Health Care, Medicine 122 Comments

Eating beetroot before any workout helps. Baked beetle root in one of the study at St. Louis University Chicago gave runners a modest edge in speed during a 5K run when they were close to the finish line. With the beetroot, they were 41 seconds faster at the finish.

A study from the UK had also shown that exercisers could work out longer if they drank beetroot juice. Other research has found that beetroot juice can help reduce blood pressure. Beetle root is rich in nitrates. Nitrates are converted into nitric oxide by the body. The nitric oxide dilates blood vessels; this results in improved oxygen delivery.

The study included whole vegetable rather than the juice. In the study of 11 men and women, average age 25, each ate 200 grams of beetroot (500 milligrams of nitrates). After the beetroot, exercisers had overall times that were 3% faster compared to their times after eating cranberry relish, and 5% faster during the last mile, she found. In the study 200 grams of beetle nut was baked at 350 degrees for 90 minutes. The skin was peeled and rest added with a tablespoon of lemon juice, 1/8 teaspoon of cinnamon, and 1/8 teaspoon of nutmeg to make it more palatable. It was consumed about 45 minutes before they jogged or can be eaten two and a half hours before an event.