September 28, 2006, 10:01 PM CT
High-resolution CT For Shin Splints
Shin splints may develop in the muscles in the front and outer parts of the shin.
Image courtesy of Merck
High resolution CT can accurately show medial tibial stress syndrome, better known as shin splints, in distance runners according, to a study conducted at the University of Messina in Messina, Italy.
According to the study, medial tibial stress syndrome is one of many overuse lower leg injuries that may be found in athletes and accounts for between 13.2% and 17.3% of all running injuries.
For the study, high-resolution CT of both tibiae (shin bones) was performed on 41 subjects: 20 distance runners with no symptoms of shin splints, 11 distance runners with pain due to shin splints and 10 volunteers not involved in a sport. A total of 82 shin bones, 14 painful and 68 painless, were evaluated. Among the distance runners, CT abnormalities were found in 14 of 14 (100%) painful tibiae in patients with shin splints.
"The study demonstrates that CT is capable of revealing cortical abnormalities in medial tibial stress syndrome, thus representing a reliable diagnostic tool in patients with leg pain," said Fabio Minutoli, MD, lead author of the study.
"The results are useful for the management of athletes, particularly long distance runners. Moreover, we think that CT can be used in research studies, to evaluate other subtle bone abnormalities; for example it can be useful in studies concerning osteoporosis," said Dr. Minutoli.........
Posted by: Mark Permalink Source
September 20, 2006, 9:54 PM CT
Skeletal Microdamage Stable After First Year
Skeletal microdamage resulting from bisphosphonate therapy may be maximal during the first year of therapy, and not continue to accumulate with longer periods of therapy, as per new research being presented today at the 28th Annual Meeting of the American Society for Bone and Mineral Research (ASBMR).
Bisphosphonates are the most common class of drugs used for the therapy of osteoporosis because of their demonstrated effect on fracture reduction but the occurence rate of microcracks - small cracks in the skeleton - has been shown to increase with bisphosphonate therapy. This has led to some concerns regarding the potential long-term adverse effects of these agents. This study shows that the continued use of alendronate (a bisphosphonate) is not linked to continued accumulation of microdamage.
Matt R. Allen, Ph.D., assistant research professor, and David B. Burr, Ph.D., chairman, both from the Indiana University School of Medicine Department of Anatomy and Cell Biology, Indianapolis, IN, reviewed the effects of alendronate in one-year-old female beagles. The beagles were given oral doses of alendronate at levels comparable to that employed in humans (.2 mg/kg/day) or at five times the clinical dose (1 mg/kg/day) for either 1 year or 3 years.
Scientists found there was no increase in vertebral microcracks after 3 years of alendronate therapy compared to the beagles treated for 1 year. These results suggest that microcrack accumulation is greatest during the early course of alendronate therapy. This is an encouraging sign for long-term safety of these drugs.........
Posted by: Mark Permalink Source
September 13, 2006, 9:01 PM CT
Dieting Female Athletes More Likely to Get Stress Fractures
Female college athletes on low-calorie diets could be putting themselves at risk for stress fractures, as per new Saint Louis University research published in this month's The American Journal of Sports Medicine.
Scientists studied risk factors for exercise-related leg pain, including stress fractures in women participating in four popular fall sports - cross-country running, field hockey, soccer and volleyball.
Women with "disordered eating," which includes eating disorders such as bulimia and anorexia but more generally refers to insufficient caloric intake, were more likely to develop stress fractures as a result of decreased estrogen production, says researcher Mark Reinking, PT, Ph.D., chairman of the department of physical treatment at Saint Louis University's Doisy College of Health Sciences.
"When people expend more calories than they consume, they release fewer hormones, which slows down menstrual cycles. This decreases estrogen in the body, which is responsible for bone development," says Reinking, also chairman of the American Board of Physical Therapy Specialties.
Leg pain is one of the most common problems afflicting athletes, Reinking says.
"It causes people to miss practices and competitions, and I wanted to understand if two people were undergoing the same exercise regime, why only one of them would have leg pain," he says. "It's not as simple as 'Run less' or 'Change your shoes every 300 miles.' It's a complex problem, and you can't prevent something if you don't know what causes it."........
Posted by: JoAnn Permalink Source
September 5, 2006, 10:21 PM CT
Hormone-replacement therapy hurts hearing
The largest study ever to analyze the hearing of women on hormone-replacement treatment has observed that women who take the most common form of HRT have a hearing loss of 10 to 30 percent more in comparison to similar women who have not had the treatment. The results are being published on-line this week by the Proceedings of the National Academy of Sciences.
It's as if the usual age-related hearing loss in women whose HRT included progestin, a synthetic form of the hormone progesterone, was accelerated in comparison to women taking estrogen alone or women not taking HRT. On average, women who received progestin had the hearing of women five to 10 years older.
The results of the study involving 124 women confirm results from a smaller study that the same group reported in 2004 at the annual meeting of the Association for Research in Otolaryngology. The new results also identify progestin as the component of HRT doing possible damage.
"Whether a woman goes on HRT is certainly her decision, and she should discuss the options with her doctor," says senior author Robert D. Frisina, Ph.D. "In light of these findings, we feel that hearing loss should be added to the list of negative things to keep in mind when talking about HRT. Women particularly who already have a hearing problem should weigh this decision carefully. Women on HRT should consider having a thorough hearing check-up done every six months".........
Posted by: Emily Permalink Source
August 9, 2006, 7:10 AM CT
Transcendental Meditation And Pain
Twelve healthy long-term meditators who had been practicing Transcendental Meditation for 30 years showed a 40-50% lower brain response to pain in comparison to 12 healthy controls, reported by a latest NeuroReport journal article, published by Lippincott Williams & Wilkins (Vol.17 No.12; 21 August 2006:1359-1363). Further, when the 12 controls then learned and practiced Transcendental Meditation for 5 months, their brain responses to pain also decreased by a comparable 40-50%. www.neuroreport.com Current issue (Aug 9).
Transcendental Meditation could reduce the brain's response to pain because neuroimaging and autonomic studies indicate that it produces a physiological state capable of modifying various kinds of pain. In time it reduces trait anxiety, improves stress reactivity and decreases distress from acute pain.
As per Orme-Johnson, lead author of this research, "Previous research indicates that Transcendental Meditation creates a more balanced outlook on life and greater equanimity in reacting to stress. This study suggests that this is not just an attitudinal change, but a fundamental change in how the brain functions".
Pain is part of everyone's experience and 50 million people worldwide suffer from chronic pain. Transcendental Meditation would have a long term effect in reducing responses in the affective component of the pain matrix. Future research could focus on other areas of the pain matrix and the possible effects of other meditation techniques to relieve pain.........
Posted by: Daniel Permalink Source
August 1, 2006, 6:48 AM CT
Higher Blood Pressure Associated with Decline in Walking Ability
Decline in lower limb function is common in older people, and worsening gait is linked to increased risk of dementia and death. However, factors contributing to gait difficulties in older persons are not well understood. A study by scientists at Rush University Medical Center suggests that higher blood pressure may be one factor linked to a decline in walking ability in later life. The research, by Dr. Raj Shah and his colleagues at the Rush Alzheimer's Disease Center, is reported in the August 2006 issue of the Journal of Gerontology: Medical Sciences, the scientific journal of The Gerontological Society of America.
Scientists recruited 888 older Catholic clergy without dementia or Parkinson's disease who are participating in the Religious Orders Study. At baseline, blood pressure was measured, the presence of vascular diseases and diabetes was recorded, cognitive function was assessed, and medications were inspected.
At baseline and subsequent annual visits, gait and balance were assessed using performance-based tasks, such as the time and number of steps taken to walk 8 feet, the time to sit up and down five times, the number of steps off the line during an 8-foot heel-to-toe walk, and a comparison of ability to stand with eyes open and eyes closed.
Participants completed a mean of nearly eight annual evaluations with a high rate of follow-up. Controlling for age, education, and gender, the study found a 10mmHg increment in systolic blood pressure was linked to greater decline in lower limb function. On average, lower limb function declined 28.7% faster in persons with a systolic blood pressure of 160 mmHg than in persons with a normal systolic blood pressure of 120 mmHg.........
Posted by: Daniel Permalink Source
July 28, 2006, 9:26 PM CT
Steroid Osteoporosis Connection
Scientists are closing in on the solution to a persistent medical puzzle: why do high doses of cortisone, widely prescribed for asthma, rheumatoid arthritis and other inflammatory and autoimmune conditions, weaken bones?
Through studies of mice, researchers at Washington University School of Medicine in St. Louis have now identified osteoclasts, cells that dismantle old bone, as the essential link between osteoporosis and cortisone. As scientists flesh out the molecular-level details of this connection, they may be able to identify targets for therapy to prevent cortisone's damaging side effects on bone.
"High-dose cortisone is the second most common cause of osteoporosis, and we currently have no real treatment for this serious side effect," says senior author Steven L. Teitelbaum, M.D., Messing Professor of Pathology and Immunology. "Given how frequently these drugs are used to treat many different conditions, that's a major clinical problem".
Teitelbaum and colleagues including lead author Hyun-Ju Kim, Ph.D., a postdoctoral fellow, publish their results in the recent issue of the Journal of Clinical Investigation.
Cortisone is a steroid produced naturally by the adrenal gland and synthesized by a number of pharmaceutical companies for clinical use. The drug is also used to treat lupus, multiple sclerosis and chronic obstructive pulmonary disease, and it is prescribed to transplant patients to prevent rejection of transplanted organs.........
Posted by: Scott Permalink Source
July 26, 2006, 5:47 PM CT
Treating Severe Psoriasis
NICE's announcement comes as welcome relief to the thousands of UK patients who have exhausted current available therapy options and failed to sustain a long-term benefit. It is a positive sign for patients throughout Europe, whose healthcare systems are influenced by NICE decisions. Leeroy Blake in England was fortunate enough to be offered therapy with a biological treatment, after years of trying every other available psoriasis therapy: "For a number of years, I tried every suitable therapy but nothing seemed to relieve the painful itching. As the itching got worse, I would get more stressed and this only made my condition worse. Following a therapy review with my doctor, I was prescribed a biological treatment and for the first time since developing psoriasis, my skin started to clear and my confidence came back. This therapy might not be suitable for everyone with severe psoriasis, but I believe that it's important that patients at least discuss this option with their doctor".
Latest research has dismissed the preconception that psoriasis is merely a skin complaint, with recent data showing that severe psoriasis can affect a patient's quality of life to a similar extent as other prevalent chronic diseases such as diabetes and even heart diseases.
In addition to the impact on a patient's appearance, up to 30% of patients with psoriasis have been reported to have psoriatic arthritis, which causes pain, stiffness and swelling in and around the joints. Coinciding with its decision on the use of biological therapies in moderate to severe psoriasis, NICE has also given its backing for the NHS to use Enbrel and Remicade (infliximab) to treat patients with severe, active psoriatic arthritis. Professor Robert Moots, Professor of Rheumatology at the University of Liverpool, UK welcomes this guidance commenting, "the NICE guidance is a positive step forward for those patients whose condition is severe enough to warrant therapy with biologic therapies" adding that "the onus is now on NHS trusts to take note of this recent recommendation and ensure that the necessary funding is in place to allow patients access to these much-needed therapies".........
Posted by: George Permalink Source
July 26, 2006, 4:58 PM CT
New MRI Technique And 3-d Images Of Knees
A faster magnetic resonance imaging (MRI) data-acquisition technique will cut the time a number of patients spend in a cramped magnetic resonance scanner, yet deliver more precise 3-D images of their bodies.
Developed at the University of Wisconsin-Madison, the faster technique will enable clinics to image more patients - especially the burgeoning group of elderly adults with osteoarthritis-related knee problems - and can help scientists more rapidly assess new therapys for such conditions.
Magnetic resonance has long been touted as the ideal method for capturing 3-D images of the human body. "But unfortunately, it is kind of a slow technique," says Walter Block, an associate professor of biomedical engineering and medical physics. "You can only sample a few pieces of information needed to build the image at a time".
Consequently, most magnetic resonance technicians acquire images as a series of 2-D slices, which yield high resolution in a single plane and poor resolution in the remaining direction, he says.
To capture an image, a magnetic resonance scanner usually conducts hundreds to thousands of little "experiments," or encodings, that help to make up the big picture. Block's data-acquisition technique capitalizes on recent magnetic resonance hardware advances that, coupled with a novel way of maintaining a high-level magnetic resonance signal throughout the scan, will speed an MRI session. "But to maintain the high-level signal," he says," you need to be able to complete each of these smaller encodings within a couple of milliseconds."........
Posted by: Mark Permalink Source
July 23, 2006, 10:56 PM CT
Prescription pain killer overdose
Trends analysis of drug poisoning deaths has helped explain a national epidemic of overdose deaths in the USA that began in the 1990s, concludes Leonard Paulozzi and his colleagues at the Centers for Disease Control and Prevention in Atlanta, USA. The contribution of prescription pain killers to the epidemic has only become clear recently. This research is published this week in the journal, Pharmacoepidemiology and Drug Safety.
Drugs called "opioids" are frequently prescribed to relieve pain, but if abused they can kill. Over the past 15 years, sales of opioid pain killers, including oxycodone, hydrocodone, methadone and fentanyl, have increased, and deaths from these drugs have increased in parallel.
In 2002, over 16,000 people died in the USA as a result of drug overdoses, with most deaths correlation to opioids, heroin, and cocaine. Opioids surpassed both cocaine and heroin in extent of involvement in these drug overdoses between 1999 and 2002.
The situation appears to be accelerating. Between 1979 and 1990 the rate of deaths attributed to unintentional drug poisoning increased by an average of 5.3% each year. Between 1990 and 2002, the rate increased by 18.1% per year. The contribution played by opioids is also increasing. Between 1999 and 2002 the number of overdose death certificates that mention poisoning by opioid pain killers went up by 91.2%. While the pain killer category showed the greatest increase, death certificates pointing a finger of blame at heroin and cocaine also increased by 12.4% and 22.8% respectively.........
Posted by: Janet Permalink Source
