title: Rheumatoid arthritis

text: As the pathology progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity. The fingers may develop almost any deformity depending on which joints are most involved. Specific deformities, which also occur in osteoarthritis, include ulnar deviation, boutonniere deformity (also "buttonhole deformity", flexion of proximal interphalangeal joint and extension of distal interphalangeal joint of the hand), swan neck deformity (hyperextension at proximal interphalangeal joint and flexion at distal interphalangeal joint) and "Z-thumb." "Z-thumb" or "Z-deformity" consists of hyperextension of the interphalangeal joint, fixed flexion and subluxation of the metacarpophalangeal joint and gives a "Z" appearance to the thumb. The hammer toe deformity may be seen. In the worst case, joints are known as arthritis mutilans due to the mutilating nature of the deformities.


title: Rheumatoid arthritis

text: The rheumatoid nodule, which is sometimes in the skin, is the most common non-joint feature and occurs in 30% of people who have RA. It is a type of inflammatory reaction known to pathologists as a "necrotizing granuloma". The initial pathologic process in nodule formation is unknown but may be essentially the same as the synovitis, since similar structural features occur in both. The nodule has a central area of fibrinoid necrosis that may be fissured and which corresponds to the fibrin-rich necrotic material found in and around an affected synovial space. Surrounding the necrosis is a layer of palisading macrophages and fibroblasts, corresponding to the intimal layer in synovium and a cuff of connective tissue containing clusters of lymphocytes and plasma cells, corresponding to the subintimal zone in synovitis. The typical rheumatoid nodule may be a few millimetres to a few centimetres in diameter and is usually found over bony prominences, such as the elbow, the heel, the knuckles, or other areas that sustain repeated mechanical stress. Nodules are associated with a positive RF (rheumatoid factor) titer, ACPA, and severe erosive arthritis. Rarely, these can occur in internal organs or at diverse sites on the body.


title: Rheumatoid arthritis

text: Several forms of vasculitis occur in RA, but are mostly seen with long-standing and untreated disease. The most common presentation is due to involvement of small- and medium-sized vessels. Rheumatoid vasculitis can thus commonly present with skin ulceration and vasculitic nerve infarction known as mononeuritis multiplex.


title: Rheumatoid arthritis

text: Other, rather rare, skin associated symptoms include pyoderma gangrenosum, Sweet's syndrome, drug reactions, erythema nodosum, lobe panniculitis, atrophy of finger skin, palmar erythema, and skin fragility (often worsened by corticosteroid use).


title: Rheumatoid arthritis

text: Diffuse alopecia areata (Diffuse AA) occurs more commonly in people with rheumatoid arthritis. RA is also seen more often in those with relatives who have AA.


title: Rheumatoid arthritis

text: Lung fibrosis is a recognized complication of rheumatoid arthritis. It is also a rare but well-recognized consequence of therapy (for example with methotrexate and leflunomide). Caplan's syndrome describes lung nodules in individuals with RA and additional exposure to coal dust. Exudative pleural effusions are also associated with RA.


title: Rheumatoid arthritis

text: People with RA are more prone to atherosclerosis, and risk of myocardial infarction (heart attack) and stroke is markedly increased.


title: Rheumatoid arthritis

text: Other possible complications that may arise include: pericarditis, endocarditis, left ventricular failure, valvulitis and fibrosis. Many people with RA do not experience the same chest pain that others feel when they have angina or myocardial infarction. To reduce cardiovascular risk, it is crucial to maintain optimal control of the inflammation caused by RA (which may be involved in causing the cardiovascular risk), and to use exercise and medications appropriately to reduce other cardiovascular risk factors such as blood lipids and blood pressure. Doctors who treat people with RA should be sensitive to cardiovascular risk when prescribing anti-inflammatory medications, and may want to consider prescribing routine use of low doses of aspirin if the gastrointestinal effects are tolerable.


title: Rheumatoid arthritis

text: Anemia is by far the most common abnormality of the blood cells which can be caused by a variety of mechanisms. The chronic inflammation caused by RA leads to raised hepcidin levels, leading to anemia of chronic disease where iron is poorly absorbed and also sequestered into macrophages. The red cells are of normal size and color (normocytic and normochromic). A low white blood cell count usually only occurs in people with Felty's syndrome with an enlarged liver and spleen. The mechanism of neutropenia is complex. An increased platelet count occurs when inflammation is uncontrolled.


title: Rheumatoid arthritis

text: The role of the circadian clock in rheumatoid arthritis suggests a correlation between an early morning rise in circulating levels of pro-inflammatory cytokines, such as interleukin-6 and painful morning joint stiffness.


title: Rheumatoid arthritis

text: Renal amyloidosis can occur as a consequence of untreated chronic inflammation. Treatment with penicillamine or gold salts such as sodium aurothiomalate are recognized causes of membranous nephropathy.


title: Rheumatoid arthritis

text: The eye can be directly affected in the form of episcleritis or scleritis, which when severe can very rarely progress to perforating scleromalacia. Rather more common is the indirect effect of keratoconjunctivitis sicca, which is a dryness of eyes and mouth caused by lymphocyte infiltration of lacrimal and salivary glands. When severe, dryness of the cornea can lead to keratitis and loss of vision as well as being painful. Preventive treatment of severe dryness with measures such as nasolacrimal duct blockage is important.


title: Rheumatoid arthritis

text: Liver problems in people with rheumatoid arthritis may be due to the underlying disease process or as a result of the medications used to treat the disease. A coexisting autoimmune liver disease, such as primary biliary cirrhosis or autoimmune hepatitis may also cause problems.


title: Rheumatoid arthritis

text: Peripheral neuropathy and mononeuritis multiplex may occur. The most common problem is carpal tunnel syndrome caused by compression of the median nerve by swelling around the wrist. Rheumatoid disease of the spine can lead to myelopathy. Atlanto-axial subluxation can occur, owing to erosion of the odontoid process and/or transverse ligaments in the cervical spine's connection to the skull. Such an erosion (>3mm) can give rise to vertebrae slipping over one another and compressing the spinal cord. Clumsiness is initially experienced, but without due care, this can progress to quadriplegia or even death.


title: Rheumatoid arthritis

text: Constitutional symptoms including fatigue, low grade fever, malaise, morning stiffness, loss of appetite and loss of weight are common systemic manifestations seen in people with active RA.


title: Rheumatoid arthritis

text: Local osteoporosis occurs in RA around inflamed joints. It is postulated to be partially caused by inflammatory cytokines. More general osteoporosis is probably contributed to by immobility, systemic cytokine effects, local cytokine release in bone marrow and corticosteroid therapy.


title: Rheumatoid arthritis

text: The incidence of lymphoma is increased, although it is uncommon and associated with the chronic inflammation, not the treatment of RA. The risk of non-melanoma skin cancer is increased in people with RA compared to the general population, an association possibly due to the use of immunosuppression agents for treating RA.


title: Rheumatoid arthritis

text: RA is a systemic (whole body) autoimmune disease. Some genetic and environmental factors affect the risk for RA.


title: Rheumatoid arthritis

text: Worldwide, RA affects approximately 1% of the adult population and occurs one in 1000 children. Studies show RA primarily affects individuals between the ages of 40–60 years and is seen more commonly in females. A family history of RA increases the risk around three to five times; as of 2016, it was estimated that genetics may account for between 40 and 65% of cases of seropositive RA, but only around 20% for seronegative RA. RA is strongly associated with genes of the inherited tissue type major histocompatibility complex (MHC) antigen. HLA-DR4 is the major genetic factor implicated – the relative importance varies across ethnic groups.


title: Rheumatoid arthritis

text: Genome-wide association studies examining single-nucleotide polymorphisms have found around one hundred alleles associated with RA risk. Risk alleles within the HLA (particularly HLA-DRB1) genes harbor more risk than other loci. The HLA encodes proteins which controls recognition of self versus nonself molecules. Other risk loci include genes affecting co-stimulatory immune pathways, for example CD28 and CD40, cytokine signaling, lymphocyte receptor activation threshold (e.g., PTPN22), and innate immune activation appear to have less influence than HLA mutations.


title: Rheumatoid arthritis

text: There are established epigenetic and environmental risk factors for RA. Smoking is an established risk factor for RA in Caucasian populations, increasing the risk three times compared to non-smokers, particularly in men, heavy smokers, and those who are rheumatoid factor positive. Modest alcohol consumption may be protective.


title: Rheumatoid arthritis

text: There are claims that patients that have lower vitamin D levels by 8-10 ng/mL are at risk for rheumatoid arthritis.


title: Rheumatoid arthritis

text: No infectious agent has been consistently linked with RA and there is no evidence of disease clustering to indicate its infectious cause, but periodontal disease has been consistently associated with RA.


title: Rheumatoid arthritis

text: The many negative findings suggest that either the trigger varies, or that it might, in fact, be a chance event inherent with the immune response.


title: Rheumatoid arthritis

text: RA primarily starts as a state of persistent cellular activation leading to autoimmunity and immune complexes in joints and other organs where it manifests. The clinical manifestations of disease are primarily inflammation of the synovial membrane and joint damage, and the fibroblast-like synoviocytes play a key role in these pathogenic processes. Three phases of progression of RA are an initiation phase (due to non-specific inflammation), an amplification phase (due to T cell activation), and chronic inflammatory phase, with tissue injury resulting from the cytokines, IL–1, TNF-alpha, and IL–6.


title: Rheumatoid arthritis

text: Factors allowing an abnormal immune response, once initiated, become permanent and chronic. These factors are genetic disorders which change regulation of the adaptive immune response. Genetic factors interact with environmental risk factors for RA, with cigarette smoking as the most clearly defined risk factor.


title: Rheumatoid arthritis

text: Other environmental and hormonal factors may explain higher risks for women, including onset after childbirth and hormonal medications. A possibility for increased susceptibility is that negative feedback mechanisms – which normally maintain tolerance – are overtaken by positive feedback mechanisms for certain antigens, such as IgG Fc bound by rheumatoid factor and citrullinated fibrinogen bound by antibodies to citrullinated peptides (ACPA – Anti–citrullinated protein antibody). A debate on the relative roles of B-cell produced immune complexes and T cell products in inflammation in RA has continued for 30 years, but neither cell is necessary at the site of inflammation, only autoantibodies to IgGFc, known as rheumatoid factors and ACPA, with ACPA having an 80% specificity for diagnosing RA. As with other autoimmune diseases, people with RA have abnormally glycosylated antibodies, which are believed to promote joint inflammation.


title: Rheumatoid arthritis

text: Once the generalized abnormal immune response has become established – which may take several years before any symptoms occur – plasma cells derived from B lymphocytes produce rheumatoid factors and ACPA of the IgG and IgM classes in large quantities. These activate macrophages through Fc receptor and complement binding, which is part of the intense inflammation in RA. Binding of an autoreactive antibody to the Fc receptors is mediated through the antibody's N-glycans, which are altered to promote inflammation in people with RA.


title: Rheumatoid arthritis

text: This contributes to local inflammation in a joint, specifically the synovium with edema, vasodilation and entry of activated T-cells, mainly CD4 in microscopically nodular aggregates and CD8 in microscopically diffuse infiltrates. Synovial macrophages and dendritic cells function as antigen-presenting cells by expressing MHC class II molecules, which establishes the immune reaction in the tissue.


title: Rheumatoid arthritis

text: The disease progresses by forming granulation tissue at the edges of the synovial lining, pannus with extensive angiogenesis and enzymes causing tissue damage. The fibroblast-like synoviocytes have a prominent role in these pathogenic processes. The synovium thickens, cartilage and underlying bone disintegrate, and the joint deteriorates, with raised calprotectin levels serving as a biomarker of these events. Importantly inflammatory events are not limited to synovium but it appear to be systemic, evidence suggest that alterations in T helper profile favoring inflammation such as inflammatory IL-17A producing T helper cells and pathogenic Th17 cells are come from both memory and effector compartment in RA patients peripheral blood.


title: Rheumatoid arthritis

text: Cytokines and chemokines attract and accumulate immune cells, i.e. activated T- and B cells, monocytes and macrophages from activated fibroblast-like synoviocytes, in the joint space. By signalling through RANKL and RANK, they eventually trigger osteoclast production, which degrades bone tissue. The fibroblast-like synoviocytes that are present in the synovium during rheumatoid arthritis display altered phenotype compared to the cells present in normal tissues. The aggressive phenotype of fibroblast-like synoviocytes in rheumatoid arthritis and the effect these cells have on the microenvironment of the joint can be summarized into hallmarks that distinguish them from healthy fibroblast-like synoviocytes. These hallmark features of fibroblast-like synoviocytes in rheumatoid arthritis are divided into 7 cell-intrinsic hallmarks and 4 cell-extrinsic hallmarks. The cell-intrinsic hallmarks are: reduced apoptosis, impaired contact inhibition, increased migratory invasive potential, changed epigenetic landscape, temporal and spatial heterogeneity, genomic instability and mutations, and reprogrammed cellular metabolism. The cell-extrinsic hallmarks of FLS in RA are: promotes osteoclastogenesis and bone erosion, contributes to cartilage degradation, induces synovial angiogenesis, and recruits and stimulates immune cells.


title: Rheumatoid arthritis

text: X-rays of the hands and feet are generally performed when many joints affected. In RA, there may be no changes in the early stages of the disease or the x-ray may show osteopenia near the joint, soft tissue swelling, and a smaller than normal joint space. As the disease advances, there may be bony erosions and subluxation. Other medical imaging techniques such as magnetic resonance imaging (MRI) and ultrasound are also used in RA.


title: Rheumatoid arthritis

text: Technical advances in ultrasonography like high-frequency transducers (10 MHz or higher) have improved the spatial resolution of ultrasound images depicting 20% more erosions than conventional radiography. Color Doppler and power Doppler ultrasound are useful in assessing the degree of synovial inflammation as they can show vascular signals of active synovitis. This is important, since in the early stages of RA, the synovium is primarily affected, and synovitis seems to be the best predictive marker of future joint damage.


title: Rheumatoid arthritis

text: When RA is clinically suspected, a physician may test for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs measured as anti-CCP antibodies).


title: Rheumatoid arthritis

text: The test is positive approximately two thirds of the time, but a negative RF or CCP antibody does not rule out RA, rather, the arthritis is called "seronegative", which occurs in approximately a third of people with RA. During the first year of illness, rheumatoid factor is more likely to be negative with some individuals becoming seropositive over time. RF is a non-specific antibody and seen in about 10% of healthy people, in many other chronic infections like hepatitis C, and chronic autoimmune diseases such as Sjögren's syndrome and systemic lupus erythematosus. Therefore, the test is not specific for RA.


title: Rheumatoid arthritis

text: Hence, new serological tests check for anti-citrullinated protein antibodies ACPAs. These tests are again positive in 61–75% of all RA cases, but with a specificity of around 95%. As with RF, ACPAs are many times present before symptoms have started.


title: Rheumatoid arthritis

text: The by far most common clinical test for ACPAs is the anti-cyclic citrullinated peptide (anti CCP) ELISA. In 2008 a serological point-of-care test for the early detection of RA combined the detection of RF and anti-MCV with a sensitivity of 72% and specificity of 99.7%.


title: Rheumatoid arthritis

text: To improve the diagnostic capture rate in the early detection of patients with RA and to risk stratify these individuals, the rheumatology field continues to seek complementary markers to both RF and anti-CCP. 14-3-3η (YWHAH) is one such marker that complements RF and anti-CCP, along with other serological measures like c-reactive protein. In a systematic review, 14-3-3η has been described as a welcome addition to the rheumatology field. The authors indicate that the serum based 14-3-η marker is additive to the armamentarium of existing tools available to clinicians, and that there is adequate clinical evidence to support its clinical benefits.


title: Rheumatoid arthritis

text: Other blood tests are usually done to differentiate from other causes of arthritis, like the erythrocyte sedimentation rate (ESR), C-reactive protein, full blood count, kidney function, liver enzymes and other immunological tests (e.g., antinuclear antibody/ANA) are all performed at this stage. Elevated ferritin levels can reveal hemochromatosis, a mimic of RA, or be a sign of Still's disease, a seronegative, usually juvenile, variant of rheumatoid arthritis.


title: Rheumatoid arthritis

text: The new criteria are not diagnostic criteria, but are classification criteria to identify disease with a high likelihood of developing a chronic form. However a score of 6 or greater unequivocally classifies a person with a diagnosis of rheumatoid arthritis.


title: Rheumatoid arthritis

text: These new classification criteria overruled the "old" ACR criteria of 1987 and are adapted for early RA diagnosis. The "new" classification criteria, jointly published by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) establish a point value between 0 and 10. Four areas are covered in the diagnosis:


title: Rheumatoid arthritis

text: The new criteria accommodate to the growing understanding of RA and the improvements in diagnosing RA and disease treatment. In the "new" criteria, serology and autoimmune diagnostics carries major weight, as ACPA detection is appropriate to diagnose the disease in an early state, before joints destructions occur. Destruction of the joints viewed in radiological images was a significant point of the ACR criteria from 1987. This criterion no longer is regarded to be relevant, as this is just the type of damage that treatment is meant to avoid.


title: Rheumatoid arthritis

text: Several other medical conditions can resemble RA, and need to be distinguished from it at the time of diagnosis:


title: Rheumatoid arthritis

text: Sometimes arthritis is in an undifferentiated stage (i.e. none of the above criteria is positive), even if synovitis is witnessed and assessed with ultrasound imaging.


title: Rheumatoid arthritis

text: Rheumatoid arthritis (D2T RA) is a specific classification RA by the European League against Rheumatism (EULAR).


title: Rheumatoid arthritis

text: Genetic factors such as HLA-DR1B1, TRAF1, PSORS1C1 and microRNA 146a are associated with difficult to treat rheumatoid arthritis, other gene polymorphisms seem to be correlated with response to biologic modifying anti-rheumatic drugs (bDMARDs). Next one is FOXO3A gene region been reported as associated with worst disorder. The minor allele at FOXO3A summon a differential response of monocytes in RA patients. FOXO3A can provide an increase of pro-inflammatory cytokines, including TNFα. Possible gene polymorphism: STAT4, PTPN2, PSORS1C1 and TRAF3IP2 genes had been correlated with response to TNF inhibitors.


title: Rheumatoid arthritis

text: The "HLA"-"DRB1" gene is part of a family of genes called the human leukocyte antigen (HLA) complex. The HLA complex is the human version of the major histocompatibility complex (MHC). Currently, have been identified at least 2479 different versions of the "HLA"-"DRB1" gene. The presence of HLA-DRB1 alleles seems to predict radiographic damage, which may be partially mediated by ACPA development, and also elevated sera inflammatory levels and high swollen joint count. HLA-DR1 is encoded by the most risk allele HLA-DRB1 which share a conserved 5-aminoacid sequence that is correlated with the development of anti-citrullinated protein antibodies. HLA-DRB1 gene have more strong correlation with disease development. Susceptibility to and outcome for rheumatoid arthritis (RA) may associate with particular HLA-DR alleles, but these alleles vary among ethnic groups and geographic areas.


title: Rheumatoid arthritis

text: MicroRNAs are a factor in the development of that type of disease. MicroRNAs usually operate as a negative regulator of the expression of target proteins and their increased concentration after biologic treatment (bDMARDs) or after anti-rheumatic drugs. Level of miRNA before and after anti-TNFa/DMRADs combination therapy are potential novel biomarkers for predicting and monitoring outcome. For instance, some of them were found significantly upregulated by anti-TNFa/DMRADs combination therapy. For example, miRNA-16-5p, miRNA-23-3p, miRNA125b-5p, miRNA-126-3p, miRNA-146a-5p, miRNA-223-3p. Curious fact is that only responder patients showed an increase in those miRNAs after therapy, and paralleled the reduction of TNFα, interleukin (IL)-6, IL-17, rheumatoid factor (RF), and C-reactive protein (CRP).


title: Rheumatoid arthritis

text: It is not always a reliable indicator of treatment effect. One major limitation is that low-grade synovitis may be missed.


title: Rheumatoid arthritis

text: Evidence suggests that increasing vitamin D levels to the range of  40–60 ng/mL could reduce the risk of rheumatoid arthritis.


title: Rheumatoid arthritis

text: There is no cure for RA, but treatments can improve symptoms and slow the progress of the disease. Disease-modifying treatment has the best results when it is started early and aggressively. The results of a recent systematic review found that combination therapy with tumor necrosis factor (TNF) and non-TNF biologics plus methotrexate (MTX) resulted in improved disease control, Disease Activity Score (DAS)-defined remission, and functional capacity compared with a single treatment of either methotrexate or a biologic alone.


title: Rheumatoid arthritis

text: The goals of treatment are to minimize symptoms such as pain and swelling, to prevent bone deformity (for example, bone erosions visible in X-rays), and to maintain day-to-day functioning. This is primarily addressed with disease-modifying antirheumatic drugs (DMARDs); dosed physical activity; analgesics and physical therapy may be used to help manage pain. RA should generally be treated with at least one specific anti-rheumatic medication. The use of benzodiazepines (such as diazepam) to treat the pain is not recommended as it does not appear to help and is associated with risks.


title: Rheumatoid arthritis

text: Regular exercise is recommended as both safe and useful to maintain muscle strength and overall physical function. Physical activity is beneficial for people with rheumatoid arthritis who experience fatigue, although there was little to no evidence to suggest that exercise may have an impact on physical function in the long term, a study found that carefully dosed exercise has shown significant improvements in patients with RA. Moderate effects have been found for aerobic exercises and resistance training on cardiovascular fitness and muscle strength in RA. Furthermore, physical activity had no detrimental side effects like increased disease activity in any exercise dimension. It is uncertain if eating or avoiding specific foods or other specific dietary measures help improve symptoms. Occupational therapy has a positive role to play in improving functional ability in people with rheumatoid arthritis. Weak evidence supports the use of wax baths (thermotherapy) to treat arthritis in the hands.


title: Rheumatoid arthritis

text: Educational approaches that inform people about tools and strategies available to help them cope with rheumatoid arthritis may improve a person's psychological status and level of depression in the shorter-term. The use of extra-depth shoes and molded insoles may reduce pain during weight-bearing activities such as walking. Insoles may also prevent the progression of bunions.


title: Rheumatoid arthritis

text: Disease-modifying antirheumatic drugs (DMARDs) are the primary treatment for RA. They are a diverse collection of drugs, grouped by use and convention. They have been found to improve symptoms, decrease joint damage, and improve overall functional abilities. DMARDs should be started early in the disease as they result in disease remission in approximately half of people and improved outcomes overall.


title: Rheumatoid arthritis

text: The following drugs are considered DMARDs: methotrexate, sulfasalazine, leflunomide, hydroxychloroquine, TNF inhibitors (certolizumab, adalimumab, infliximab and etanercept), abatacept, and anakinra. Additionally, rituximab and tocilizumab are monoclonal antibodies and are also DMARDs. Use of tocilizumab is associated with a risk of increased cholesterol levels.


title: Rheumatoid arthritis

text: The most commonly used agent is methotrexate with other frequently used agents including sulfasalazine and leflunomide. Leflunomide is effective when used from 6–12 months, with similar effectiveness to methotrexate when used for 2 years. Sulfasalazine also appears to be most effective in the short-term treatment of rheumatoid arthritis.


title: Rheumatoid arthritis

text: Hydroxychloroquine, in addition to its low toxicity profile, is considered effective for treatment of moderate RA treatment.


title: Rheumatoid arthritis

text: Agents may be used in combination, however, people may experience greater side effects. Methotrexate is the most important and useful DMARD and is usually the first treatment. A combined approach with methotrexate and biologics improves ACR50, HAQ scores and RA remission rates. Triple therapy consisting of methotrexate, sulfasalazine and hydroxychloroquine may also effectively control disease activity. Adverse effects should be monitored regularly with toxicity including gastrointestinal, hematologic, pulmonary, and hepatic. Side effects such as nausea, vomiting or abdominal pain can be reduced by taking folic acid.


title: Rheumatoid arthritis

text: A 2015 Cochrane review found rituximab with methotrexate to be effective in improving symptoms compared to methotrexate alone. Rituximab works by decreasing levels of B-cells (immune cell that is involved in inflammation). People taking rituximab had improved pain, function, reduced disease activity and reduced joint damage based on x-ray images. After 6 months, 21% more people had improvement in their symptoms using rituximab and methotrexate.


title: Rheumatoid arthritis

text: Biological agents should generally be used only if methotrexate and other conventional agents are not effective after a trial of three months. They are associated with a higher rate of serious infections as compared to other DMARDs. Biological DMARD agents used to treat rheumatoid arthritis include: tumor necrosis factor alpha inhibitors (TNF inhibitors) such as infliximab; interleukin 1 blockers such as anakinra, monoclonal antibodies against B cells such as rituximab, interleukin 6 blockers such as tocilizumab, and T cell co-stimulation blockers such as abatacept. They are often used in combination with either methotrexate or leflunomide. Biologic monotherapy or tofacitinib with methotrexate may improve ACR50, RA remission rates and function. Abatacept should not be used at the same time as other biologics. In those who are well controlled (low disease activity) on TNF inhibitors, decreasing the dose does not appear to affect overall function. Discontinuation of TNF inhibitors (as opposed to gradually lowering the dose) by people with low disease activity may lead to increased disease activity and may affect remission, damage that is visible on an x-ray, and a person's function. People should be screened for latent tuberculosis before starting any TNF inhibitor therapy to avoid reactivation of tuberculosis.


title: Rheumatoid arthritis

text: TNF inhibitors and methotrexate appear to have similar effectiveness when used alone and better results are obtained when used together. Golimumab is effective when used with methotraxate. TNF inhibitors may have equivalent effectiveness with etanercept appearing to be the safest. Injecting etanercept, in addition to methotrexate twice a week may improve ACR50 and decrease radiographic progression for up to 3 years. Abatacept appears effective for RA with 20% more people improving with treatment than without but long term safety studies are yet unavailable. Adalimumab slows the time for the radiographic progression when used for 52 weeks. However, there is a lack of evidence to distinguish between the biologics available for RA. Issues with the biologics include their high cost and association with infections including tuberculosis. Use of biological agents may reduce fatigue. The mechanism of how biologics reduce fatigue is unclear.


title: Rheumatoid arthritis

text: Sodium aurothiomalate (gold) and cyclosporin are less commonly used due to more common adverse effects. However, cyclosporin was found to be effective in the progressive RA when used up to one year.


title: Rheumatoid arthritis

text: Glucocorticoids can be used in the short term and at the lowest dose possible for flare-ups and while waiting for slow-onset drugs to take effect. Combination of glucocorticoids and conventional therapy has shown a decrease in rate of erosion of bones. Steroids may be injected into affected joints during the initial period of RA, prior to the use of DMARDs or oral steroids.


title: Rheumatoid arthritis

text: Non-NSAID drugs to relieve pain, like paracetamol may be used to help relieve the pain symptoms; they do not change the underlying disease. The use of paracetamol may be associated with the risk of developing ulcers.


title: Rheumatoid arthritis

text: NSAIDs reduce both pain and stiffness in those with RA but do not affect the underlying disease and appear to have no effect on people's long term disease course and thus are no longer first line agents. NSAIDs should be used with caution in those with gastrointestinal, cardiovascular, or kidney problems. Rofecoxib was withdrawn from the global market as its long-term use was associated to an increased risk of heart attacks and strokes. Use of methotrexate together with NSAIDs is safe, if adequate monitoring is done. COX-2 inhibitors, such as celecoxib, and NSAIDs are equally effective. A 2004 Cochrane review found that people preferred NSAIDs over paracetamol. However, it is yet to be clinically determined whether NSAIDs are more effective than paracetamol.


title: Rheumatoid arthritis

text: The neuromodulator agents topical capsaicin may be reasonable to use in an attempt to reduce pain. Nefopam by mouth and cannabis are not recommended as of 2012 as the risks of use appear to be greater than the benefits.


title: Rheumatoid arthritis

text: Limited evidence suggests the use of weak oral opioids but the adverse effects may outweigh the benefits.


title: Rheumatoid arthritis

text: Alternatively, physical therapy has been tested and shown as an effective aid in reducing pain in patients with RA. As most RA is detected early and treated aggressively, physical therapy plays more of a preventative and compensatory role, aiding in pain management alongside regular rheumatic therapy.


title: Rheumatoid arthritis

text: Especially for affected fingers, hands, and wrists, synovectomy may be needed to prevent pain or tendon rupture when drug treatment has failed. Severely affected joints may require joint replacement surgery, such as knee replacement. Postoperatively, physiotherapy is always necessary. There is insufficient evidence to support surgical treatment on arthritic shoulders.


title: Rheumatoid arthritis

text: For people with RA, physiotherapy may be used together with medical management. This may include cold and heat application, electronic stimulation, and hydrotherapy. Although medications improve symptoms of RA, muscle function is not regained when disease activity is controlled.


title: Rheumatoid arthritis

text: Physiotherapy promotes physical activity. In RA, physical activity like exercise in the appropriate dosage (frequency, intensity, time, type, volume, progression) and physical activity promotion is effective in improving cardiovascular fitness, muscle strength, and maintaining a long term active lifestyle. In the short term, resistance exercises, with or without range of motion exercises, improve self-reported hand functions. Physical activity promotion according to the public health recommendations should be an integral part of standard care for people with RA and other arthritic diseases. Additionally, the combination of physical activities and cryotherapy show its efficacy on the disease activity and pain relief. The combination of aerobic activity and cryotherapy may be an innovative therapeutic strategy to improve the aerobic capacity in arthritis patients and consequently reduce their cardiovascular risk while minimizing pain and disease activity.


title: Rheumatoid arthritis

text: Compression gloves are handwear designed to help prevent the occurrence of various medical disorders relating to blood circulation in the wrists and hands. They can be used to treat the symptoms of arthritis, though the medical benefits may be limited.


title: Rheumatoid arthritis

text: In general, there is not enough evidence to support any complementary health approaches for RA, with safety concerns for some of them. Some mind and body practices and dietary supplements may help people with symptoms and therefore may be beneficial additions to conventional treatments, but there is not enough evidence to draw conclusions. A systematic review of CAM modalities (excluding fish oil) found that " The available evidence does not support their current use in the management of RA.". Studies showing beneficial effects in RA on a wide variety of CAM modalities are often affected by publication bias and are generally not high quality evidence such as randomized controlled trials (RCTs).


title: Rheumatoid arthritis

text: A 2005 Cochrane review states that low level laser therapy can be tried to improve pain and morning stiffness due to rheumatoid arthritis as there are few side-effects.


title: Rheumatoid arthritis

text: There is limited evidence that Tai Chi might improve the range of motion of a joint in persons with rheumatoid arthritis. The evidence for acupuncture is inconclusive with it appearing to be equivalent to sham acupuncture.


title: Rheumatoid arthritis

text: A Cochrane review in 2002 showed some benefits of the electrical stimulation as a rehabilitation intervention to improve the power of the hand grip and help to resist fatigue. D‐penicillamine may provide similar benefits as DMARDs but it is also highly toxic. Low-quality evidence suggests the use of therapeutic ultrasound on arthritic hands. Potential benefits include increased grip strength, reduced morning stiffness and number of swollen joints. There is tentative evidence of benefit of transcutaneous electrical nerve stimulation (TENS) in RA. Acupuncture‐like TENS (AL-TENS) may decrease pain intensity and improve muscle power scores.


title: Rheumatoid arthritis

text: Low-quality evidence suggests people with active RA may benefit from assistive technology. This may include less discomfort and difficulty such as when using an eye drop device. Balance training is of unclear benefits.


title: Rheumatoid arthritis

text: There has been a growing interest in the role of long-chain omega-3 polyunsaturated fatty acids to reduce inflammation and alleviate the symptoms of RA. Metabolism of omega-3 polyunsaturated fatty acids produces docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which inhibits pro-inflammatory eicosanoids and cytokines (TNF-a, IL-1b and IL-6), decreasing both lymphocyte proliferation and reactive oxygen species. These studies showed evidence for significant clinical improvements on RA in inflammatory status and articular index. Gamma-linolenic acid, an omega-6 fatty acid, may reduce pain, tender joint count and stiffness, and is generally safe. For omega-3 polyunsaturated fatty acids (found in fish oil, flax oil and hemp oil), a meta-analysis reported a favorable effect on pain, although confidence in the effect was considered moderate. The same review reported less inflammation but no difference in joint function. A review examined the effect of marine oil omega-3 fatty acids on pro-inflammatory eicosanoid concentrations; leukotriene (LTB) was lowered in people with rheumatoid arthritis but not in those with non-autoimmune chronic diseases. (LTB) increases vascular permeabiltity and stimulates other inflammatory substances. A third meta-analysis looked at fish consumption. The result was a weak, non-statistically significant inverse association between fish consumption and RA. A fourth review limited inclusion to trials in which people eat ≥2.7 g/day for more than three months. Use of pain relief medication was decreased, but improvements in tender or swollen joints, morning stiffness and physical function were not changed. Collectively, the current evidence is not strong enough to determine that supplementation with omega-3 fatty acids or regular consumption of fish are effective treatments for rheumatoid arthritis.


title: Rheumatoid arthritis

text: Patients with RA often claim that their symptoms are alleviated by special diets or by simple elimination of certain foods. In contrast, some foods might provoke hypersensitivity responses, which may increase symptoms of RA.


title: Rheumatoid arthritis

text: The Dong diet has been suggested for a benefit in RA. This diet is rich in oils, seafood, vegetables, and rice which improve symptoms of RA. It eliminates citrus fruits, chocolate, dairy produce, flour products, alcohol, additives, spices, fizzy drinks, and red meat which are implicated in the aggravation of symptoms.


title: Rheumatoid arthritis

text: The Mediterranean diet is a well‐balanced, nutritionally adequate diet that encompasses all the food groups. This diet is rich in fresh fruits and vegetables, whole grains, seafood, nuts and legumes, and olive oil. In contrast, it limits red meat, sugary foods, and dairy, in small portions of yogurt and cheese. The foods in this category parallel the Dong Diet closely and show evidence of overlap. There is beneficial effect in using a Mediterranean diet and Dong diet for a reduction in the number of tender joints, stiffness, and pain.


title: Rheumatoid arthritis

text: Adequate Vitamin concentrations may provide an important defence against the increased oxidant stress in patients with RA. Here we look at the effects of vitamins E, C and B on the management of RA.


title: Rheumatoid arthritis

text: In general vitamin E deficiency enhances components of the inflammatory response and suppresses components of the immune response. Molecular studies have demonstrated that the formation of the pro-inflammatory prostaglandin E2 is inhibited 95% by aspirin when combined with vitamin E compared to control. This suggests that vitamin E supplementation reduces the need for high dosage of aspirin needed by patients with RA to relieve joint symptoms. This can offer double benefits because lowering the dose of aspirin can also reduce the gastric irritation side effect for patients. Even though there is no evidence of only taking vitamin E supplementation alone, I believe patients with RA should be encouraged to increase their consumption of vitamin E rich cereals, fruit, and vegetables.


title: Rheumatoid arthritis

text: Vitamin C is necessary for the growth and development of all body tissues and plays an important role in antioxidant defences. In animal studies biochemical markers of antioxidant defence mechanisms were increased with vitamin C supplementation and infiltration of inflammatory cells into synovial fluid were decreased. From these studies I can conclude that vitamin C supplementation may be more effective for the pain associated with RA however long-term use might aggravate onset of osteoarthritis.


title: Rheumatoid arthritis

text: Vitamin B6 and B9 play a role in RA management as well. Studies have shown that low plasma levels of pyridoxal-5-phosphate, the metabolically active form of vitamin B6, have been reported in RA patients, which may be associated with the elevated TNF-a production. Folate supplies are also decreased in RA patients who are taking Methotrexate, an anti-rheumatic drug. We see that folate supplementation can reduce the mucosal and gastrointestinal side effects of low dose Methotrexate in patients with RA. This works in a similar pattern to aspirin and vitamin E supplementation. Therefore, RA patients should be advised to consume dietary sources of vitamin B6 and B9 up to the dietary reference value, until further research is undertaken into the toxicity and effectiveness of large dose supplementation.


title: Rheumatoid arthritis

text: Food containing high source of vitamin E to help treat Rheumatoid Arthritis include almonds, avocados, spinach, sunflower seeds and peanut butter. Vitamin C foods include oranges, orange juice, strawberry, broccoli, brussel sprouts and potatoes. Brown rice, barley, and fish contain sources of vitamin B6 and B9. Lastly, Vitamin D can be included in the diet by incorporating tuna, salmon, orange juice and almond Milk into diet.


title: Rheumatoid arthritis

text: Minerals including fluoride, iron, calcium, and zinc have been studied in the role of RA management. The effects of fluoride supplementation in preventing RA-induced bone loss were examined in a randomized control trial. Results suggest that fluoride therapy may increase vertebral bone mass in RA patients.


title: Rheumatoid arthritis

text: Approximately, one-third of cases of anaemia in RA patients may be caused by depletion of iron stores. A major cause for iron deficiency anaemia is the poor dietary intake. Deferioxamine, an iron-chelating agent, which has possible anti-inflammatory properties, causes haemoglobin and serum iron levels to increases. This shows that iron stores are needed within the body and an adequate dietary intake to meet the recommended intakes should be encouraged, even though there is no evidence for additional routine supplementation for patients with RA.


title: Rheumatoid arthritis

text: Studies have examined the effect of calcium supplementation on bone mineral density among subjects taking corticosteroids. A study of calcium combined with vitamin D3 in RA patients taking low-dose corticosteroids demonstrated a reduction in bone mineral density loss in both the spine and trochanter, but not the femoral neck. However, no change was seen in BMD with calcium and vitamin D3 supplementation in RA patients not receiving corticosteroids. Therefore, there is little evidence to support calcium and vitamin D supplementation in corticosteroid receiving RA patients.


title: Rheumatoid arthritis

text: Lastly, low levels of serum zinc have been reported in patients with RA which may be caused by elevated IL-1b levels. However, Zinc supplementations yield contradictory results and at present do not support a therapeutic use of zinc.


title: Rheumatoid arthritis

text: Food containing high source of fluoride to help treat Rheumatoid Arthritis include tomatoes, oranges, bell peppers and grapefruit, which you should eat in moderation. Iron can be incorporated into the diet by eating seafood, spinach, and peas. Moderate amounts of calcium should be included into the diet by having milk, cheese, dairy products, curly kale, okra, bread and fortified flour products such as cereals.


title: Rheumatoid arthritis

text: The American College of Rheumatology states that no herbal medicines have health claims supported by high-quality evidence and thus they do not recommend their use. There is no scientific basis to suggest that herbal supplements advertised as "natural" are safer for use than conventional medications as both are chemicals. Herbal medications, although labelled "natural", may be toxic or fatal if consumed.


title: Rheumatoid arthritis

text: Due to the false belief that herbal supplements are always safe, there is sometimes a hesitancy to report their use which may increase the risk of adverse reaction.


title: Rheumatoid arthritis

text: The following are under investigation for treatments for RA, based on preliminary promising results (not recommended for clinical use yet): boswellic acid, curcumin, devil's claw, Euonymus alatus, and thunder god vine ("Tripterygium wilfordii"). NCCIH has noted that, "In particular, the herb thunder god vine (Tripterygium wilfordii) can have serious side effects."


title: Rheumatoid arthritis

text: There is conflicting evidence on the role of erythropoiesis-stimulating agents for treatment of anemia in persons with rheumatoid arthritis.


title: Rheumatoid arthritis

text: More than 75% of women with rheumatoid arthritis have symptoms improve during pregnancy but might have symptoms worsen after delivery. Methotrexate and leflunomide are teratogenic (harmful to foetus) and not used in pregnancy. It is recommended women of childbearing age should use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned. Low dose of prednisolone, hydroxychloroquine and sulfasalazine are considered safe in pregnant women with rheumatoid arthritis. Prednisolone should be used with caution as the side effects include infections and fractures.


title: Rheumatoid arthritis

text: People with RA have an increased risk of infections and mortality and recommended vaccinations can reduce these risks. The inactivated influenza vaccine should be received annually. The pneumococcal vaccine should be administered twice for people under the age 65 and once for those over 65. Lastly, the live-attenuated zoster vaccine should be administered once after the age 60, but is not recommended in people on a tumor necrosis factor alpha blocker.


title: Rheumatoid arthritis

text: The course of the disease varies greatly. Some people have mild short-term symptoms, but in most the disease is progressive for life. Around 25% will have subcutaneous nodules (known as rheumatoid nodules); this is associated with a poor prognosis.


title: Rheumatoid arthritis

text: RA reduces lifespan on average from three to twelve years. Young age at onset, long disease duration, the presence of other health problems, and characteristics of severe RAsuch as poor functional ability or overall health status, a lot of joint damage on x-rays, the need for hospitalisation or involvement of organs other than the jointshave been shown to associate with higher mortality. Positive responses to treatment may indicate a better prognosis. A 2005 study by the Mayo Clinic noted that individuals with RA have a doubled risk of heart disease, independent of other risk factors such as diabetes, excessive alcohol use, and elevated cholesterol, blood pressure and body mass index. The mechanism by which RA causes this increased risk remains unknown; the presence of chronic inflammation has been proposed as a contributing factor. It is possible that the use of new biologic drug therapies extend the lifespan of people with RA and reduce the risk and progression of atherosclerosis. This is based on cohort and registry studies, and still remains hypothetical. It is still uncertain whether biologics improve vascular function in RA or not. There was an increase in total cholesterol and HDLc levels and no improvement of the atherogenic index.<ref name="biologics cv effects/ cancer"></ref>


title: Rheumatoid arthritis

text: RA affects between 0.5 and 1% of adults in the developed world with between 5 and 50 per 100,000 people newly developing the condition each year. In 2010 it resulted in about 49,000 deaths globally.


title: Rheumatoid arthritis

text: Onset is uncommon under the age of 15 and from then on the incidence rises with age until the age of 80. Women are affected three to five times as often as men.


title: Rheumatoid arthritis

text: The age at which the disease most commonly starts is in women between 40 and 50 years of age, and for men somewhat later. RA is a chronic disease, and although rarely, a spontaneous remission may occur, the natural course is almost invariably one of the persistent symptoms, waxing and waning in intensity, and a progressive deterioration of joint structures leading to deformations and disability.


title: Rheumatoid arthritis

text: There is an association between periodontitis and rheumatoid arthritis (RA), hypothesised to lead to enhanced generation of RA-related autoantibodies. Oral bacteria that invade the blood may also contribute to chronic inflammatory responses and generation of autoantibodies.


title: Rheumatoid arthritis

text: The first recognized description of RA in modern medicine was in 1800 by the French physician Dr Augustin Jacob Landré-Beauvais (1772–1840) who was based in the famed Salpêtrière Hospital in Paris. The name "rheumatoid arthritis" itself was coined in 1859 by British rheumatologist Dr Alfred Baring Garrod.


title: Rheumatoid arthritis

text: The art of Peter Paul Rubens may possibly depict the effects of RA. In his later paintings, his rendered hands show, in the opinion of some physicians, increasing deformity consistent with the symptoms of the disease. RA appears to some to have been depicted in 16th-century paintings. However, it is generally recognized in art historical circles that the painting of hands in the 16th and 17th century followed certain stylized conventions, most clearly seen in the Mannerist movement. It was conventional, for instance, to show the upheld right hand of Christ in what now appears a deformed posture. These conventions are easily misinterpreted as portrayals of disease.


title: Rheumatoid arthritis

text: Historic (though not necessarily effective) treatments for RA have also included: rest, ice, compression and elevation, apple diet, nutmeg, some light exercise every now and then, nettles, bee venom, copper bracelets, rhubarb diet, extractions of teeth, fasting, honey, vitamins, insulin, magnets, and electroconvulsive therapy (ECT).


title: Rheumatoid arthritis

text: Rheumatoid arthritis is derived from the Greek word "ῥεύμα-rheuma (nom.), ῥεύματος-rheumatos (gen.)" ("flow, current"). The suffix -"oid" ("resembling") gives the translation as "joint inflammation that resembles rheumatic fever". Rhuma which means watery discharge might refer to the fact that the joints are swollen or that the disease may be made worse by wet weather.


title: Rheumatoid arthritis

text: Meta-analysis found an association between periodontal disease and RA, but the mechanism of this association remains unclear. Two bacterial species associated with periodontitis are implicated as mediators of protein citrullination in the gums of people with RA.


title: Rheumatoid arthritis

text: Vitamin D deficiency is more common in people with rheumatoid arthritis than in the general population. However, whether vitamin D deficiency is a cause or a consequence of the disease remains unclear. One meta-analysis found that vitamin D levels are low in people with rheumatoid arthritis and that vitamin D status correlates inversely with prevalence of rheumatoid arthritis, suggesting that vitamin D deficiency is associated with susceptibility to rheumatoid arthritis.


title: Rheumatoid arthritis

text: The fibroblast-like synoviocytes have a prominent role in the pathogenic processes of the rheumatic joints, and therapies that target these cells are emerging as promising therapeutic tools, raising hope for future applications in rheumatoid arthritis.


title: Muggsy Bogues

text: Tyrone Curtis "Muggsy" Bogues (born January 9, 1965) is a former American basketball player. The shortest player ever to play in the National Basketball Association (NBA), the Bogues played point guard for four teams during his 14-season career in the NBA. Although best known for his ten seasons with the Charlotte Hornets, he also played for the Washington Bullets, Golden State Warriors, and Toronto Raptors. Bogues finished in the top seven in assists in six consecutive seasons (1989–1995), and in the top ten in steals in three of those seasons. He had 146 career NBA double-doubles. After his NBA career, he served as head coach of the now-defunct Charlotte Sting of the WNBA.


title: Muggsy Bogues

text: Bogues was born in Baltimore, Maryland, and grew up in the Lafayette Court housing projects. His mother was and his father was . He had three older siblings.


title: Muggsy Bogues

text: Bogues's childhood was troubled. At five years old, he was hit by stray buckshot in his neighborhood and had to be hospitalized. As a child, he witnessed a man get beaten to death with a baseball bat, a sight that haunted him into adulthood. When Bogues was 12 years old, his father was sentenced to twenty years in prison for armed robbery. Around the same time, his brother Chuckie began using hard drugs.


title: Muggsy Bogues

text: In addition to basketball, Bogues was a standout wrestler and baseball player growing up. As a child playing basketball on playgrounds, he was nicknamed "Muggsy" after a diminutive character from The Bowery Boys.


title: Muggsy Bogues

text: Bogues initially attended and played basketball at Southern High School in Baltimore. Because Bogues aspired to be a dental technician, he transferred to Baltimore's Dunbar High School which offered healthcare classes. At Dunbar, he was coached by Bob Wade, later the head coach at the University of Maryland. He was a teammate of future NBA players David Wingate, Reggie Williams and Reggie Lewis (the latter two of whom were in his graduating class). The Dunbar Poets finished the 1981–82 season at 29–0 during Bogues's junior year and finished 31–0 during his senior year in 1982–83, and were ranked first in the nation by "USA Today".


title: Muggsy Bogues

text: Bogues received scholarship offers to play college basketball for several schools including Virginia, Penn State and Seton Hall.


title: Muggsy Bogues

text: He played four years at Wake Forest University, averaging 11.3 points, 8.4 assists and 3.1 steals per game in his junior year. He followed with a senior campaign in which he averaged 14.8 points, 9.5 assists, 3.8 rebounds and 2.4 steals per game. In 1986–87, he led the Atlantic Coast Conference in steals and assists and received the Frances Pomeroy Naismith Award. As a senior, he received the Arnold Palmer Award as Wake Forest's most valuable athlete. When his collegiate career ended, he was the ACC career leader in steals and assists.


title: Muggsy Bogues

text: Wake Forest retired his number within a few years of his leaving the program. In 2001, he was inducted into the Wake Forest Sports Hall of Fame. , he remains Wake Forest's all-time leader in both steals and assists.


title: Muggsy Bogues

text: Bogues played for the USA national team in the 1986 FIBA World Championship and won the gold medal. Under head coach Lute Olson, Bogues played in all ten of the team's games and led them in assists and steals.


title: Muggsy Bogues

text: Bogues was selected second overall in the 1987 United States Basketball League draft by the Rhode Island Gulls. Bogues was a fan favorite in the USBL and the Gulls led the league in attendance. In his only season in the league, he averaged 22.2 points and 8.4 assists per game and led the league in minutes per game before an ankle injury ended his season.


title: Muggsy Bogues

text: Bogues was drafted twelfth overall in the 1987 NBA draft by the Washington Bullets, and was part of a talent-laden draft class that also included David Robinson, Reggie Miller, Scottie Pippen, and Kevin Johnson. Bogues made his NBA debut on November 6, 1987 against the Atlanta Hawks at Omni Coliseum; he started and led the team in assists. At the time of his debut, he was shorter than the average NBA player. In his rookie year, Bogues was a teammate of Manute Bol who stood tall. They were the tallest and shortest players in NBA history at the time, with difference between them. Bol and Bogues appeared on three magazine covers together. Bogues's playing time dropped dramatically when coach Kevin Loughery was fired and replaced with Wes Unseld. Despite starting only fourteen games as a rookie, Bogues led the Bullets in both steals and assists.


title: Muggsy Bogues

text: The following season, the Bullets left Bogues and Jay Murphy unprotected in the 1988 NBA expansion draft and he was selected by the Charlotte Hornets. Bogues told the "Washington Post" that he had "no quarrel" with the Bullets for leaving him unprotected and his agents reported that he was excited to start anew in Charlotte.


title: Muggsy Bogues

text: In Charlotte's first season, head coach Dick Harter confined Bogues to the bench, preferring to use him to provide short bursts of energy as a substitute. Harter was fired during the following season and Bogues began to flourish in the up-tempo offenses run by his successors, Gene Littles and Allan Bristow. Bogues would go on to play parts of ten seasons with the Hornets, spending the vast majority of his time as a starter and becoming one of the faces of the Hornets alongside Alonzo Mourning and Larry Johnson.


title: Muggsy Bogues

text: During his time in Charlotte, the Hornets rose from mediocrity to a serious contender; Bogues three times led the team to the playoffs. During this time, Bogues was wildly popular among basketball fans, as were the Hornets. In all six seasons between 1989 and 1995, he finished in the top ten in the league in assists, only once finishing worse than fourth. In 1992–93, Bogues had the NBA's best assist-to-turnover ratio. One of his best seasons came in 1993–94 when he averaged a double-double, including a second place finish in assists per game. In the 1994–95 season, he set


title: Muggsy Bogues

text: a career high with 10.8 points per game. However, in August 1995, after six consecutive seasons of an increasing scoring average, he underwent arthroscopic surgery on his left knee. The recovery and repeated setbacks saw him placed on the injured list at least three separate times in the 1995–96 season. He finished the season with only fourteen points in six games. Bogues returned to action in earnest the following season but missed 17 games and his production had dropped off slightly across the board.


title: Muggsy Bogues

text: Bogues's relationship with the team soured considerably in 1997. In June, coach Dave Cowens suggested that Bogues should consider retiring due to his nagging knee injury. Only a week later, the Hornets signed point guard David Wesley, his presumptive replacement. In August, owner George Shinn assured Bogues that he would be able to finish his playing career with the team. However, the team later requested that he undergo a preseason MRI on his injured knee. On November 7, Bogues was traded, along with Tony Delk, to the Golden State Warriors in exchange for B. J. Armstrong. At the time, he was the NBA's all-time leader in assist-to-turnover ratio and the franchise leader in steals and assists. After the trade, he severed ties with the organization. After the trade, Dell Curry, Bogues's closest friend on the team, was the last remaining original member of the Hornets.


title: Muggsy Bogues

text: Bogues led the Warriors in assists in the 1997–98 season despite starting in less than half of the team's games. He appeared in 36 games in the lockout-shortened following season, missing time due to hamstring and knee injuries as well as chickenpox.


title: Muggsy Bogues

text: Prior to the 1999–2000 season, Bogues signed with the Toronto Raptors for the veterans' minimum, reuniting him with longtime teammate Dell Curry. With the Raptors in 1999–2000, he played 80 games in a season for the first time since 1992–93, though he started in only five of those games. At 35 years old on March 3, 2000, he tied a career high with 24 points in a victory over the Boston Celtics.


title: Muggsy Bogues

text: Due to his chronic knee injury, Bogues appeared in only three games in the 2000–01 season, which would be his final. His last game came on January 27, 2001 against the Chicago Bulls, a scoreless outing. On February 22, 2001, he was traded with Mark Jackson to the New York Knicks for Chris Childs and a 2002 first round draft pick. He was included in the trade for salary cap reasons and never reported to New York during his stint with them. At the end of the last season in which he played, Bogues ranked twelfth all-time in assists and thirteenth all-time in assists per game in NBA history.


title: Muggsy Bogues

text: On August 10, 2001, Bogues was traded to the Dallas Mavericks in a three-team deal involving Shandon Anderson, Howard Eisley and Glen Rice. The Mavericks waived Bogues on October 29, after he told the team that he intended to step away from basketball to care for his mother who was fighting cancer. On October 31, he became a free agent.


title: Muggsy Bogues

text: In July 2002, Bogues told "The Baltimore Sun" that he had not retired and was still hoping to play again.


title: Muggsy Bogues

text: His autobiography, "In the Land of Giants", was released in 1994 and recounts the struggles of growing up in inner-city Baltimore and achieving success in the NBA.


title: Muggsy Bogues

text: After leaving the NBA, Bogues worked in the real estate business until August 3, 2005, when he was named head coach of the Charlotte Sting in the Women's National Basketball Association, despite a lack of coaching experience. He was shorter than all of his players—at , Helen Darling was the shortest Sting player. Bogues led the Sting to a 14–30 record before the team folded in January 2007.


title: Muggsy Bogues

text: In 2011, he became the head coach of United Faith Christian Academy boys' high school basketball team in Charlotte, North Carolina after serving as an assistant to former head coach Shaun Wiseman. The school produced six all-state players during his three seasons as head coach. Despite being offered a new contract, he stepped down in 2014 to pursue other opportunities.


title: Muggsy Bogues

text: On March 18, 2014, Bogues was named the Charlotte Hornets' Ambassador, participating in the team's rebranding.


title: Muggsy Bogues

text: In 2018, Bogues invested in Ash & Erie, a clothing company for short men, after watching an episode of "Shark Tank" and reaching out to "Shark Tank" panelist Mark Cuban who had also invested in the company.


title: Muggsy Bogues

text: Bogues founded the Muggsy Bogues Family Foundation, a 501(c)(3) organization "organized to assist vocationally bound students with scholarships and develop community outreach programs for at-risk families that address the most basic necessities" and "encourage youth and families by providing resources that emphasize stability and empower youth and families to reach their full potential, becoming well rounded students and productive adult citizens."


title: Muggsy Bogues

text: Bogues met his wife, Kim, in 1984 at a Dunbar High School alumni game. They had a daughter, Brittney, in 1987, were married in 1989 and had a son, Ty, in 1991. Bogues also had a daughter named Tyisha from an earlier relationship when he was 17 years old. Bogues and his wife separated in 1995 and divorced in 1997 with Kim retaining physical custody of their children. The couple remarried in 2015.


title: Muggsy Bogues

text: On June 21, 1991, Bogues and Hornets teammate Dell Curry appeared in a Minor League Baseball game for the Gastonia Rangers of the South Atlantic League. George Shinn, as owner of both teams, arranged the publicity stunt. Bogues and Curry were scheduled to play the entire nine-inning game but it was shortened by rain. Bogues played second base and was hitless in both of his at bats.


title: Muggsy Bogues

text: In August 1993, Bogues's father died in Baltimore of pneumonia. He had been released early from prison but had resumed using drugs, often with Bogues's brother, Chuckie.


title: Muggsy Bogues

text: In 1995, Bogues moved his oldest brother, Chuckie, into his home to help him battle drug addiction while Bogues himself rehabbed from knee surgery. , Chuckie was still living with Bogues and had not used hard drugs in 23 years.


title: Muggsy Bogues

text: When Bogues left Wake Forest in 1987, he was 19 credits short of a degree. In 1996, he returned to Wake Forest to take summer courses to complete his degree. He finished his classes by correspondence and received a Bachelor of Arts in Speech Communications in May 1998.


title: Muggsy Bogues

text: Bogues's sister, Sherron, worked for the Baltimore Department of Recreation and Parks for 32 years until her death from cancer at age 55 in 2015. Baltimore Mayor Stephanie Rawlings-Blake named June 27 "Sherron Bogues Day" in her honor.


title: Muggsy Bogues

text: Bogues's grandson, Samartine, is a youth basketball player who received media attention for his play while still in elementary school and received his first college basketball scholarship offer in 2020 while still a high school freshman.


title: Muggsy Bogues

text: Bogues appeared in the movie "Space Jam", as one of five NBA players (along with Charles Barkley, Shawn Bradley, Larry Johnson, and Patrick Ewing) whose playing ability is stolen by the villainous Monstars.


title: Muggsy Bogues

text: Bogues made a cameo appearance in TV series "Curb Your Enthusiasm" as himself, sharing a restroom with Larry David and Richard Lewis and nearly having an altercation with David after catching them looking at his penis while urinating.


title: Muggsy Bogues

text: In 1996, Bogues had a cameo at the end of "Eddie" in which Whoopi Goldberg's character flirts with him. He then walks out onto the court to support her character preventing Wild Bill from moving the Knicks.


title: Muggsy Bogues

text: He made a cameo appearance on an episode of "Saturday Night Live" with Charles Barkley hosting and Nirvana the musical guest.


title: Muggsy Bogues

text: Bogues appeared in "Rebound", the first episode of season 7 of "Royal Pains", in which he attended a welcoming party hosted by Ms. "New Parts" Newberg.


title: Muggsy Bogues

text: Bogues was interviewed for "Baltimore Boys", an "ESPN 30 for 30" documentary that highlighted the Dunbar Poets high school basketball team.


title: Muggsy Bogues

text: Although Bogues has appeared in several television advertisements, he avoided advertisements which focused on his small stature, at least during his career. During his career, Bogues appeared in commercials for Sprite, AT&T, First Union National Bank, Bojangles and Hyundai among others. In 1995, both he and his mother appeared in commercials for Reebok in a campaign featuring NBA players and their mothers. In 2002, he appeared in IBM commercials. In 2014, he appeared as a Christmas elf in a commercial for "NBA 2K15". In 2016, he appeared in an ad for Axe. In 2019, Bogues appeared in a series of commercials for the web hosting company GoDaddy. In 2022, he appeared in a commercial for Caesars Entertainment.


title: Lorenzo de' Medici

text: Lorenzo di Piero de' Medici (; 1 January 1449 – 8 April 1492) was an Italian statesman, banker, "de facto" ruler of the Florentine Republic and the most powerful and enthusiastic patron of Renaissance culture in Italy. Also known as Lorenzo the Magnificent ("Lorenzo il Magnifico" ) by contemporary Florentines, he was a magnate, diplomat, politician and patron of scholars, artists, and poets. As a patron, he is best known for his sponsorship of artists such as Botticelli and Michelangelo. He held the balance of power within the Italic League, an alliance of states that stabilized political conditions on the Italian peninsula for decades, and his life coincided with the mature phase of the Italian Renaissance and the Golden Age of Florence. On the foreign policy front, Lorenzo manifested a clear plan to stem the territorial ambitions of Pope Sixtus IV, in the name of the balance of the Italian League of 1454. For these reasons, Lorenzo was the subject of the Pazzi conspiracy (1478), in which his brother Giuliano was assassinated. The Peace of Lodi of 1454 that he supported among the various Italian states collapsed with his death. He is buried in the Medici Chapel in Florence.


title: Lorenzo de' Medici

text: Lorenzo's grandfather, Cosimo de' Medici, was the first member of the Medici family to lead the Republic of Florence and run the Medici Bank simultaneously. As one of the wealthiest men in Europe, Cosimo spent a very large portion of his fortune on government and philanthropy, for example as a patron of the arts and financier of public works. Lorenzo's father, Piero di Cosimo de' Medici, was equally at the centre of Florentine civic life, chiefly as an art patron and collector, while Lorenzo's uncle, Giovanni di Cosimo de' Medici, took care of the family's business interests. Lorenzo's mother, Lucrezia Tornabuoni, was a writer of sonnets and a friend to poets and philosophers of the Medici Academy. She became her son's advisor after the deaths of his father and uncle.


title: Lorenzo de' Medici

text: Lorenzo, considered the most promising of the five children of Piero and Lucrezia, was tutored by a diplomat and bishop, Gentile de' Becchi, and the humanist philosopher Marsilio Ficino, and he was trained in Greek by John Argyropoulos. With his brother Giuliano, he participated in jousting, hawking, hunting, and horse breeding for the Palio, a horse race in Siena. In 1469, aged 20, he won first prize in a jousting tournament sponsored by the Medici. The joust was the subject of a poem written by Luigi Pulci. Niccolò Machiavelli also wrote of the occasion, perhaps sarcastically, that he won "not by way of favour, but by his own valour and skill in arms". He carried a banner painted by Verrocchio, and his horse was named Morello di Vento.


title: Lorenzo de' Medici

text: Piero sent Lorenzo on many important diplomatic missions when he was still a youth, including trips to Rome to meet the pope and other important religious and political figures.


title: Lorenzo de' Medici

text: Lorenzo was described as rather plain of appearance and of average height, having a broad frame and short legs, dark hair and eyes, a squashed nose, short-sighted eyes and a harsh voice. Giuliano, on the other hand, was regarded as handsome and a "golden boy", and was used as a model by Botticelli in his painting of "Mars and Venus". Even Lorenzo's close friend Niccolo Valori described him as homely, saying, "nature had been a stepmother to him in regards to his personal appearance, although she had acted as a loving mother in all things concocted with the mind. His complexion was dark, and although his face was not handsome it was so full of dignity as to compel respect."


title: Lorenzo de' Medici

text: Lorenzo, groomed for power, assumed a leading role in the state upon the death of his father in 1469, when he was 20. Already drained by his grandfather's building projects and constantly stressed by mismanagement, wars, and political expenses, the assets of the Medici Bank reduced seriously during the course of Lorenzo's lifetime.


title: Lorenzo de' Medici

text: Lorenzo, like his grandfather, father, and son, ruled Florence indirectly through surrogates in the city councils by means of payoffs and strategic marriages until 1490. Rival Florentine families inevitably harboured resentments over the Medicis' dominance, and enemies of the Medici remained a factor in Florentine life long after Lorenzo's passing. The most notable of the rival families was the Pazzi, who nearly brought Lorenzo's reign to an end.


title: Lorenzo de' Medici

text: On Sunday, 26 April 1478, in an incident known as the Pazzi conspiracy, a group headed by Girolamo Riario, Francesco de' Pazzi, and Francesco Salviati (the archbishop of Pisa), attacked Lorenzo and his brother and co-ruler Giuliano in the Cathedral of Santa Maria del Fiore in an attempt to seize control of the Florentine government. Shockingly, Salviati acted with the blessing of his patron Pope Sixtus IV. Giuliano was killed, brutally stabbed to death, but Lorenzo escaped with only a minor wound to the neck, having been defended by the poet Poliziano. News of the conspiracy spread throughout Florence, and it was brutally put down by the populace through such measures as the lynching of the archbishop of Pisa and members of the Pazzi family who were involved in the conspiracy.


title: Lorenzo de' Medici

text: In the aftermath of the Pazzi conspiracy and the punishment of supporters of Pope Sixtus IV, the Medici and Florence earned the wrath of the Holy See, which seized all the Medici assets that Sixtus could find, excommunicated Lorenzo and the entire government of Florence, and ultimately put the entire Florentine city-state under interdict. When these moves had little effect, Sixtus formed a military alliance with King Ferdinand I of Naples, whose son, Alfonso, Duke of Calabria, led an invasion of the Florentine Republic, still ruled by Lorenzo.


title: Lorenzo de' Medici

text: Lorenzo rallied the citizens. However, with little support from the traditional Medici allies in Bologna and Milan, the war dragged on, and only diplomacy by Lorenzo, who personally traveled to Naples and became a prisoner of the king for several months, ultimately resolved the crisis. That success enabled Lorenzo to secure constitutional changes within the government of the Florentine Republic that further enhanced his own power.


title: Lorenzo de' Medici

text: Thereafter, Lorenzo, like his grandfather Cosimo de' Medici, pursued a policy of maintaining peace, balancing power between the northern Italian states and keeping major European states such as France and the Holy Roman Empire out of Italy. Lorenzo maintained good relations with Sultan Mehmed II of the Ottoman Empire, as the Florentine maritime trade with the Ottomans was a major source of wealth for the Medici.


title: Lorenzo de' Medici

text: Efforts to acquire revenue from the mining of alum in Tuscany unfortunately marred Lorenzo's reputation. Alum had been discovered by local citizens of Volterra, who turned to Florence to get backing to exploit this important natural resource. A key commodity in the glassmaking, tanning and textile industries, alum was available from only a few sources under the control of the Ottomans and monopolized by Genoa before the discovery of alum sources in Italy at Tolfa. First the Roman Curia in 1462, and then Lorenzo and the Medici Bank less than a year later, got involved in backing the mining operation, with the pope taking a two-ducat commission for each cantar quintal of alum retrieved and ensuring a monopoly against the Turkish-derived goods by prohibiting trade in alum with infidels. When they realized the value of the alum mine, the people of Volterra wanted its revenues for their municipal funds rather than having it enter the pockets of their Florentine backers. Thus began an insurrection and secession from Florence, which involved putting to death several opposing citizens. Lorenzo sent mercenaries to suppress the revolt by force, and the mercenaries ultimately sacked the city. Lorenzo hurried to Volterra to make amends, but the incident would remain a dark stain on his record.


title: Lorenzo de' Medici

text: Lorenzo's court included artists such as Piero and Antonio del Pollaiuolo, Andrea del Verrocchio, Leonardo da Vinci, Sandro Botticelli, Domenico Ghirlandaio and Michelangelo Buonarroti, who were instrumental in achieving the 15th-century Renaissance. Although Lorenzo did not commission many works himself, he helped these artists to secure commissions from other patrons. Michelangelo lived with Lorenzo and his family for three years, dining at the family table and participating in discussions led by Marsilio Ficino.


title: Lorenzo de' Medici

text: Lorenzo was an artist and wrote poetry in his native Tuscan. In his poetry, he celebrates life while acknowledging with melancholy the fragility and instability of the human condition, particularly in his later works. Love, feasts and light dominate his verse.


title: Lorenzo de' Medici

text: Cosimo had started the collection of books that became the Medici Library (also called the Laurentian Library), and Lorenzo expanded it. Lorenzo's agents retrieved from the East large numbers of classical works, and he employed a large workshop to copy his books and disseminate their content across Europe. He supported the development of humanism through his circle of scholarly friends, including the philosophers Marsilio Ficino, Poliziano and Giovanni Pico della Mirandola. They studied Greek philosophers and attempted to merge the ideas of Plato with Christianity.


title: Lorenzo de' Medici

text: Apart from a personal interest, Lorenzo also used the Florentine milieu of fine arts for his diplomatic efforts. An example includes the commission of Ghirlandaio, Botticelli, Pietro Perugino and Cosimo Rosselli from Rome to paint murals in the Sistine Chapel, a move that has been interpreted as sealing the alliance between Lorenzo and Pope Sixtus IV.


title: Lorenzo de' Medici

text: In 1471, Lorenzo calculated that his family had spent some 663,000 florins (about US$460 million today) on charity, buildings and taxes since 1434. He wrote, "I do not regret this for though many would consider it better to have a part of that sum in their purse, I consider it to have been a great honour to our state, and I think the money was well-expended and I am well-pleased."


title: Lorenzo de' Medici

text: From 1479 Lorenzo became a permanent member of the committee supervising the rebuild of the "signoria" in Florence. He created a court of artists in his sculpture garden at San Marco which allowed him to exert ‘enormous influence on the selection of artists on public projects’.


title: Lorenzo de' Medici

text: Lorenzo married Clarice Orsini on 7 February 1469. The marriage in person took place in Florence on 4 June 1469. She was a daughter of Giacomo Orsini, Lord of Monterotondo and Bracciano by his wife and cousin Maddalena Orsini.


title: Lorenzo de' Medici

text: Lorenzo adopted his nephew Giulio di Giuliano de' Medici (1478–1534), the illegitimate son of his slain brother Giuliano. In 1523, after serving four years as ruler of Florence, Giulio ascended to the papacy as Pope Clement VII.


title: Lorenzo de' Medici

text: During Lorenzo's tenure, several branches of the family bank collapsed because of bad loans, and in later years he got into financial difficulties and resorted to misappropriating trust and state funds.


title: Lorenzo de' Medici

text: Toward the end of Lorenzo's life, Florence came under the influence of Savonarola, who believed Christians had strayed too far into Greco-Roman culture. Lorenzo played a role in bringing Savonarola to Florence.


title: Lorenzo de' Medici

text: Lorenzo died during the late night of 8 April 1492, at the longtime family villa of Careggi. Savonarola visited Lorenzo on his deathbed. The rumour that Savonarola damned Lorenzo on his deathbed has been refuted in Roberto Ridolfi's book "Vita di Girolamo Savonarola". Letters written by witnesses to Lorenzo's death report that he died peacefully after listening to the Gospel of the day. Many signs and portents were claimed to have taken place at the moment of his death, including the dome of Florence Cathedral being struck by lightning, ghosts appearing, and the lions kept at Via Leone fighting one another.


title: Lorenzo de' Medici

text: Lorenzo was buried with his brother Giuliano in the Church of San Lorenzo in the red porphyry sarcophagus designed for Piero and Giovanni de' Medici, not, as might be expected, in the New Sacristy, designed by Michelangelo. The latter holds the two monumental tombs of Lorenzo and Giuliano's less known namesakes: Lorenzo, Duke of Urbino, and Giuliano, Duke of Nemours. According to Williamson and others, the statues of the lesser Lorenzo and Giuliano were carved by Michelangelo to incorporate the essence of the famous men. In 1559, the bodies of Lorenzo de' Medici ("the Magnificent") and his brother Giuliano were interred in the New Sacristy in an unmarked tomb beneath Michelangelo's statue of the Madonna.


title: Lorenzo de' Medici

text: Lorenzo's heir was his eldest son, Piero di Lorenzo de' Medici, known as "Piero the Unfortunate". In 1494, he squandered his father's patrimony and brought down the Medici dynasty in Florence. His second son, Giovanni, who became Pope Leo X, retook the city in 1512 with the aid of a Spanish army. In 1531, Lorenzo's nephew Giulio di Giuliano – whom Lorenzo had raised as his own son, and who in 1523 became Pope Clement VII – formalized Medici rule of Florence by installing Alessandro de' Medici the city's first hereditary duke.


title: Bob Geldof

text: Robert Frederick Zenon Geldof (; born 5 October 1951) is an Irish singer-songwriter, and political activist. He rose to prominence in the late 1970s as lead singer of the Irish rock band the Boomtown Rats, who achieved popularity as part of the punk rock movement. The band had UK number one hits with his compositions "Rat Trap" and "I Don't Like Mondays". Geldof starred as "Pink" in Pink Floyd's 1982 film "Pink Floyd – The Wall". As a fundraiser, Geldof organised the charity supergroup Band Aid and the concerts Live Aid and Live 8, and co-wrote "Do They Know It's Christmas?", one of the best-selling singles of all time.


title: Bob Geldof

text: Geldof is widely recognised for his activism, especially anti-poverty efforts concerning Africa. In 1984, he and Midge Ure founded the charity supergroup Band Aid to raise money for famine relief in Ethiopia. They went on to organise the charity super-concert Live Aid the following year and the Live 8 concerts in 2005. Geldof currently serves as an adviser to the ONE Campaign, co-founded by fellow Irish rock singer and activist Bono, and is a member of the Africa Progress Panel (APP), a group of ten distinguished individuals who advocate at the highest levels for equitable and sustainable development in Africa. A single father, Geldof has also been outspoken for the fathers' rights movement.


title: Bob Geldof

text: Geldof was granted an honorary knighthood (KBE) by Elizabeth II in 1986 for his charity work in Africa; although it is an honorary award as Geldof is an Irish citizen, he is often referred to as 'Sir Bob'. He is a recipient of the Man of Peace title which recognises individuals who have made "an outstanding contribution to international social justice and peace", among numerous other awards and nominations. In 2005, he received the Brit Award for Outstanding Contribution to Music.


title: Bob Geldof

text: Geldof was born and brought up in Dún Laoghaire, Ireland, a son of Robert and Evelyn Geldof. His paternal grandfather, Zenon Geldof, was a Belgian immigrant and a hotel chef. His paternal grandmother, Amelia Falk, was a British Jew from London of German-Jewish descent. When Geldof was six years old, his mother Evelyn died at age 41 of a cerebral haemorrhage.


title: Bob Geldof

text: Geldof attended Blackrock College, where he was bullied for being a poor rugby player and for his middle name, Zenon. After work as a slaughterman, a road navvy and pea canner in Wisbech, England, he was hired as a music journalist in Vancouver, British Columbia, Canada, for "The Georgia Straight". He briefly guest hosted the Canadian Broadcasting Corporation children's program "Switchback".


title: Bob Geldof

text: Returning to Ireland in 1975, he became lead singer of the Boomtown Rats, a rock group closely linked with the punk movement. In 1978, The Boomtown Rats had their first No. 1 single in the UK with "Rat Trap", the first new wave chart-topper in Britain. In 1979, they gained international attention with their second UK No. 1, "I Don't Like Mondays". This was both successful and controversial. Geldof had written it in the aftermath of Brenda Ann Spencer's attempted massacre at an elementary school in San Diego, California in 1979. In 1980, The Boomtown Rats released the album "Mondo Bongo".


title: Bob Geldof

text: Geldof became known as a colourful interview subject. The Boomtown Rats' first appearance on Ireland's "The Late Late Show" saw Geldof as deliberately brusque to host Gay Byrne and during his interview he attacked Irish politicians and the Catholic Church, which he blamed for many of the country's problems. He responded to nuns in the audience who tried to shout him down by saying they had "an easy life with no material worries in return for which they gave themselves body and soul to the church". He also criticised Blackrock College. The interview caused uproar, making it impossible for The Boomtown Rats to play in Ireland again.


title: Bob Geldof

text: In January 2013, Geldof announced The Boomtown Rats would be reforming to play together for the first time since 1986 at that year's Isle of Wight Festival in June. They have subsequently announced further tour dates and released a new CD "".


title: Bob Geldof

text: Geldof left the Boomtown Rats in 1986 to launch a solo career and publish his autobiography, "Is That It?", which was a UK best-seller.


title: Bob Geldof

text: His first solo records sold reasonably well and spawned the hit singles "This Is The World Calling" (co-written with Dave Stewart of the Eurythmics) and "The Great Song of Indifference". He also occasionally performed with other artists, such as David Gilmour and Thin Lizzy; a performance of "Comfortably Numb" with Gilmour is documented in the DVD release "David Gilmour in Concert" (2002). In 1992, he performed at the Freddie Mercury Tribute Concert with the surviving members of Queen at the old Wembley Stadium, singing a song he jokingly claimed to have co-written with Mercury, called "Too Late God". (The song was actually co-written by Karl Hyde.)


title: Bob Geldof

text: Geldof has also worked as a DJ for XFM radio. In 1998, he erroneously announced Ian Dury's death from cancer, possibly due to hoax information from a listener who was disgruntled at the station's change of ownership. The event caused music paper "NME" (who had been involved in a running feud with Geldof since his Boomtown Rats days—primarily due to his disparagement of The Clash) to call Geldof 'the world's worst DJ'.


title: Bob Geldof

text: Along with U2's Bono, he has devoted much time since 2000 to campaigning for debt relief for developing countries. His commitments in this field, including the organisation of the Live 8 concerts, kept Geldof from producing any more musical output since 2001's album "Sex, Age & Death".


title: Bob Geldof

text: In 2002, he was listed as one of the 100 Greatest Britons in a poll conducted among the general public, despite not being British.


title: Bob Geldof

text: After Live 8, Geldof returned to his career as a musician by releasing a box set containing all of his solo albums entitled "Great Songs of Indifference – The Anthology 1986–2001" in late 2005. Following that release, Geldof toured, albeit with mixed success.


title: Bob Geldof

text: In July 2006, Geldof arrived at Milan's Arena Civica, a venue capable of holding 12,000 people, to play a scheduled concert to find that the organisers had not put the tickets on general sale and that only 45 people had shown up. Geldof refused to go on stage once he found out how small the attendance was. To offer some compensation for fans, Geldof stopped to sign autographs to those who had shown up. He then played a well-attended free "Storytellers" concert for MTV Italy in Naples, in October 2006.


title: Bob Geldof

text: Geldof's first major charity involvement took place in September 1981 when he performed as a solo artist for Amnesty International's benefit show "The Secret Policeman's Other Ball", held at Drury Lane theatre in London's West End. At the invitation of Amnesty show producer Martin Lewis, Geldof performed a solo version of "I Don't Like Mondays". Other rock artists had 'planted a seed' and appeared to have affected Geldof in a similar manner. Monty Python alumnus John Cleese conceived (and directed) the show, and on its impact on Geldof, Sting states "he took the 'Ball' and ran with it."


title: Bob Geldof

text: In 1984, Geldof responded to a BBC News report from Michael Buerk about the famine in Ethiopia by mobilising the pop world to do something about the images he had seen. With Midge Ure of Ultravox he wrote "Do They Know It's Christmas?" in order to raise funds. The song was recorded in a single day at Sarm West Studios in Notting Hill, London on 25 November 1984 by various artists performing under the name of Band Aid.


title: Bob Geldof

text: In its first week of release, the single became the UK's fastest-seller of all time, entering the UK Singles Chart at number one and staying there for five weeks, becoming the Christmas number one of 1984. It went on to sell over 3 million copies, making it the biggest-selling single in UK history up to that point, a title it held for almost 13 years. The single was also a major US hit, peaking at number 13 on the "Billboard" Hot 100 and selling an estimated 2.5 million copies in the US by January 1985. Worldwide the single would eventually sell 11.7 million copies. Following this massive success, preparations were started for the biggest rock concerts the world had ever seen, the following summer.


title: Bob Geldof

text: New versions of "Do They Know It's Christmas?" were recorded in 1989 and 2004. In November 2014, Geldof announced that he would be forming a further incarnation of Band Aid, to be known as Band Aid 30, to record an updated version of the charity single, with the proceeds going to treat victims of the Ebola virus in West Africa.


title: Bob Geldof

text: As Geldof began to learn more about the situation, he discovered that one of the main reasons why African nations were in such dire peril was the obligation to make repayments on loans that their countries had taken from Western banks. For every pound donated in aid, ten times as much would have to leave the country in loan repayments. It became obvious that one song was not enough.


title: Bob Geldof

text: On 13 July 1985, Geldof and Ure organised Live Aid, a huge event staged simultaneously at the Wembley Stadium in London and John F. Kennedy Stadium in Philadelphia. Thanks to an unprecedented decision by the BBC to clear its schedules for 16 hours of rock music, the event was also broadcast live in the UK on television and radio.


title: Bob Geldof

text: It was one of the most monumental stage shows in history, with Phil Collins flying on Concorde so that he could play at both Wembley and Philadelphia on the same day.


title: Bob Geldof

text: During the broadcast of Live Aid, Geldof shocked viewers into giving cash by not only twice mouthing profanities but also by slamming his fist on the table and ordering them not to go out to the pub but to stay in and watch the show.Nearly seven hours into the concert in London, Geldof gave an infamous interview in which he used the word "fuck". The BBC presenter David Hepworth, conducting the interview, had attempted to provide a list of addresses to which potential donations should be sent; Geldof interrupted him in mid-flow and shouted: "Fuck the address, let's get the [phone] numbers!" It has passed into folklore that he yelled at the audience, "Give us your fucking money!" although Geldof has stated that this phrase was never uttered. Due to his Irish accent, the profanity was stated to be misheard as "fock" and "focking" respectively. After the outburst, donations increased to £300 per second.


title: Bob Geldof

text: The harrowing video of dying, skeletal children—introduced by David Bowie following the end of his set—that had been made by CBC photo-journalists setting their films to the tune of "Drive" by The Cars, contributed to the concert's success.


title: Bob Geldof

text: In total, Live Aid raised over £150 million for famine relief. Geldof subsequently received an honorary knighthood, at age 34, for his efforts. His autobiography, written soon after with Paul Vallely, was entitled "Is That It?". The book achieved further fame for being featured on the General Certificate of Secondary Education examination syllabus in a following year.


title: Bob Geldof

text: Much of the money raised by Live Aid went to NGOs in Ethiopia, some of which were under the influence or control of the Derg military junta. Some journalists have suggested that the Derg was able to use Live Aid and Oxfam money to fund its enforced resettlement and "villagification" programmes, under which at least 3 million people are said to have been displaced and between 50,000 and 100,000 killed. However, in November 2010 the BBC formally apologised to Geldof for misleading implications in its stories on the subject of Band Aid, saying it had 'no evidence' that Band Aid money specifically went to buy weapons.


title: Bob Geldof

text: In January 2004, on a visit to friends in Africa, Geldof came to believe that more people were at risk of starvation there than had died in the famine of 1984/85 which had prompted Live Aid. He telephoned the British Prime Minister Tony Blair from Addis Ababa. According to the Live 8 programme notes by Geldof's biographer and friend, Paul Vallely, the Prime Minister responded: "Calm down Bob. ... And come and see me as soon as you get back."


title: Bob Geldof

text: The result was the Commission for Africa. Blair invited Geldof and 16 other Commissioners, the majority from Africa and many of them politicians in power, to undertake a year-long study of Africa's problems. They came up with two conclusions: that Africa needed to change, to improve its governance and combat corruption, and that the rich world needed to support that change in new ways. That meant doubling aid, delivering debt cancellation, and reforming trade rules. The Commission drew up a detailed plan of how that could be done. It reported in March 2005. To force the issue Geldof decided to create a new international lobby for Africa with eight simultaneous concerts around the world to put pressure on the G8. He called it Live 8. The commission's recommendations later became the blueprint for the G8 Gleneagles African debt and aid package.


title: Bob Geldof

text: Geldof is a member of the Africa Progress Panel (APP), a group of ten distinguished individuals who advocate at the highest levels for equitable and sustainable development in Africa. Every year, the Panel releases a report, the Africa Progress Report, that outlines an issue of immediate importance to the continent and suggests a set of associated policies. In 2012, the Africa Progress Report highlighted issues of Jobs, Justice and Equity. The 2013 report outlined issues relating to oil, gas and mining in Africa.


title: Bob Geldof

text: Bob Geldof worked closely with DATA (Debt, AIDS, Trade, Africa), an organisation founded by U2's Bono in 2002 to promote debt-relief, third world trade and AIDS relief in Africa. It merged with One Campaign in 2008, where Geldof also is very active. In June 2009, on behalf of One Campaign, he co-edited a special edition of the Italian newspaper "La Stampa" with a view on 35th G8 summit.


title: Bob Geldof

text: On 31 March 2005, Geldof and Ure announced the Live 8 project, to raise awareness of issues that burden Africa, including government debt, trade barriers, hunger, and AIDS issues. Geldof organised ten concerts on 2 July 2005 in large cities throughout the industrialised world. They featured musicians from different genres and locations around the world. The cities where Live 8 concerts were played were in industrialised countries, and drew huge crowds. The locations were London, Paris, Berlin, Rome, Philadelphia, Barrie, Chiba, Johannesburg, Moscow, Cornwall and Edinburgh.


title: Bob Geldof

text: The concerts were free, and were scheduled just days before world leaders gathered in Gleneagles, for the G8 economic summit, on 6 July. Ure organised the 'final push' Live 8 concert at Edinburgh. 'The boys and girls with guitars will finally get to turn the world on its axis,' Geldof said in a statement. Pink Floyd's performance in London was their first since 1981 to include original vocalist/bassist, Roger Waters.


title: Bob Geldof

text: Geldof performed his rendition of Nick Lowe's "(What's So Funny 'Bout) Peace, Love, and Understanding" at Night for Ukraine, a fundraising benefit held at the Roundhouse in north London on the evening of March 9, 2022, with the funds raised being donated to the Disasters Emergency Committee appeal, to provide aid to people fleeing Ukraine following the Russian invasion. The event was organized by Fabien Riggall in collaboration with the Ukrainian pop duo Bloom Twins.