October 2, 2007, 9:06 PM CT

FDA approves knee-injury device

A new knee-surgery device investigated by University of Missouri-Columbia scientists that will help to repair meniscus tears, which were previously defined as irreparable, has been approved by the FDA for use in humans.

Prior therapy options forced surgeons to completely remove the damaged portion of the meniscus. Typically the removal of the meniscus leads to painful, debilitating arthritis in the knee. Herb Schwartz, president and CEO of Schwartz Biomedical, LLC, and James Cook, MU professor of veterinary medicine and surgery and William C. Allen Endowed Scholar for Orthopedic Research in MUs College of Veterinary Medicine, developed the BioDuct Meniscal Fixation Device. Schwartz and Cook think that patients with meniscus tears will now be able to have their meniscus saved along with long-term knee function.

In the past, when faced with meniscus injuries, surgeons were often forced to completely remove the torn meniscal cartilage, leaving a deficient knee that was doomed to develop arthritis, Cook said. With the BioDuct Meniscal Fixation Device, surgeons will be able to repair torn menisci and induce healing. People with meniscus injuries now have a better future ahead.

The meniscus, a padding tissue that provides shock absorption and joint stability in the knee, is crucial for normal knee function. Surgeries for meniscus tears are common with approximately one million occurring in the United States each year. When meniscus function is deficient, bone rubs on bone and arthritis is likely to develop and progress. Because two-thirds of the meniscus is avascular (lacks a blood supply), a tear in that region will not repair itself. This new device will transport blood and cells from the vascular portion of the knee to the avascular portion of the meniscus. Supplied with blood and cells for healing, the previously untreatable meniscal tear now has the potential for allowing the knee joint to be saved......... Posted by: Mark      Read more         Source

September 25, 2007, 5:01 AM CT

Physiotherapy after knee surgery

Physiotherapy can improve the daily lives of patients who have had knee replacement surgery due to osteoarthritis in the short term, as per a research studypublished on bmj.com today.

Osteoarthritis is the commonest form of disability in older people. Total knee replacement surgery (knee arthroplasty) is a common procedure but even after surgery patients may still experience problems carrying out everyday tasks.

At present, it is not clear whether physiotherapy should be routinely provided after discharge from hospital. So scientists evaluated the evidence to determine the effectiveness of physiotherapy after elective surgery in people with osteoarthritis.

Six trials involving 614 patients were included overall in the review. Effectiveness was measured in terms of improving function, quality of life, walking, range of motion in the knee joint, and muscle strength.

The review showed a small to moderate effect of functional exercise on joint motion and quality of life at three to four months after surgery, but the effect was not sustained at one year.

The evidence is not conclusive but, given these results, it seems reasonable to refer patients for a short course of functional physiotherapy exercise after discharge to provide short term benefit, say the authors. These tentative findings also suggest that further research would be worthwhile to reduce the current level of uncertainty......... Posted by: Mark      Read more         Source

September 24, 2007, 9:58 PM CT

New treatment for shoulder pain

Inflammation of a tendon triggered by calcium deposits, or calcific tendinitis, can effectively be treated with a simple and cost effective percutaneous method as per a recent study conducted by scientists from the Hospital de Basurto in Bilbao, Spain.

We started treating calcific tendinitis as the result of the request of several members of our hospital staff that were suffering with this condition, said Jose Luis del Cura, MD, lead author of the study. The results we obtained in these few cases encouraged us to offer this therapy to our patients. Later, in collaboration with the rheumatology department of our hospital, we conducted a study to evaluate the efficacy of the procedure, said Dr. del Cura.

The study consisted of 67 shoulders that were treated with sonographically guided percutaneous needle lavage i.e. injections of lydocaine or saline. As per the study, one year after therapy, 91% of shoulders had considerably or completely improved. Of the 67 shoulders treated, 64% had perfect motion and the calcifications had resolved completely or nearly completely in 89% of the patients.

A significant amount of the patients (about half of them) experienced a transitory limited recurrence about two months after the therapy, which we found surprising, said Dr. del Cura. When the recurrence did occur, the symptoms were different; milder and predominately at night, lasted several weeks and finally disappeared, commonly without sequels. We hypothesized that this may have been the result of reparative changes inside the tendon, he said......... Posted by: Mark      Read more         Source

September 18, 2007, 5:24 AM CT

Rating your pain from 0 to 10 might not help your doctor

The most commonly used measure for pain screening may only be modestly accurate, according to researchers from the Indiana University School of Medicine and the University of North Carolina. In a study that appears in the October issue of the Journal of General Internal Medicine, they evaluate the usefulness of a scale that asks patients in primary care to rate their current pain from 0 (no pain) to 10 (worst pain).

Universal pain screening is an increasingly common practice, largely because of the Joint Commission on Accreditation of Healthcare Organizations requirement that accredited hospitals and clinics routinely assess all patients for pain. JCAHO is the nations predominant standards-setting and accrediting body in health care.

Our study is the first to evaluate the accuracy of the widely-used numeric rating scale [NRS] as a screening test to identify primary care patients with clinically important pain. Accurate screening is important because pain symptoms, both serious and not so serious, are among the most common complaints in primary care, said Erin E. Krebs, M.D., M.P.H., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute research scientist. To be helpful, a screening test needs to provide accurate information that doctors can use to improve care. If a test isnt very accurate or useful, doctors learn to tune out the numbers......... Posted by: Mark      Read more         Source

September 12, 2007, 7:02 PM CT

Best solution for managing chronic pain

Approximately 30% of Canadians suffer daily from chronic pain. Patients may be affected differently depending on the intensity, but all chronic pain is debilitating and difficult to treat. A study carried out by Louise Lamb, a physician nurse at the Pain Centre of the Montreal University Health Centre (MUHC), and Dr. Yoram Shir, the Director of the Centre, shows that methadone in combination with innovative and high-quality case management can provide relief for a number of patients. The study results are reported in the recent issue of Pain Management Nursing.

Methadone is most often linked to drug addiction therapy, yet this opioid is regularly used in hospital settings to relieve acute pain from cancer or arthritis or following an accident.

Because the body metabolizes methadone slowly, intense monitoring is mandatory to avoid toxicity. As an ambulatory centre, we needed a way to monitor patients effectively after they go home with their prescriptions, explained Ms. Lamb. The centre implemented an innovative program and then measured its precise impact by following 75 patients over 9 months. Patients, with their family members, began with an education session. They received medicine information and therapy guidelines, as well as a diary so they could note any related changes of the pain intensity, and its associated impact on mood and activities. The pain diary is a very important tool as it allows us to track symptoms. Also, paying attention to bodily changes helps patients become more aware of their physical state, stated Ms. Lamb......... Posted by: Mark      Read more         Source

September 6, 2007, 9:59 PM CT

Genetic Risk Factor for Rheumatoid Arthritis, Lupus

A genetic variation has been identified that increases the risk of two chronic, autoimmune inflammatory diseases: rheumatoid arthritis (RA) and systemic lupus erythematosus (lupus). These research findings result from a long-time collaboration between the Intramural Research Program (IRP) of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other organizations. NIAMS is part of the National Institutes of Health.

These results appear in the Sept. 6 issue of the New England Journal (NEJM).

"Eventhough both diseases are believed to have a strong genetic component, identifying the relevant genes has been extremely difficult," says study coauthor Elaine Remmers, Ph.D., of the Genetics and Genomics Branch of the Intramural Research Program at the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Remmers and her colleagues tested variants within 13 candidate genes located in a region of chromosome 2, which they had previously linked with RA, for association with disease in large collections of RA and lupus patients and controls. Among the variants were several disease-associated single nucleotide polymorphisms (SNPs) - small differences in DNA sequence that represent the most common genetic variations between individuals - in a large segment of the STAT4 gene. The STAT4 gene encodes a protein that plays an important role in the regulation and activation of certain cells of the immune system......... Posted by: Mark      Read more         Source

August 16, 2007, 8:59 PM CT

Whiplash may produce delayed jaw pain

One in three people exposed to whiplash trauma is at risk of developing delayed TMJ symptoms that may require therapy, as per research reported in the recent issue of The Journal of the American Dental Association.

Scientists at Ume University, Sweden, studied short- and long-term temporomandibular joint (TMJ) pain and dysfunction in 60 patients in hospital emergency rooms directly after they were involved in a rear-end car collision and reviewed them again one year later.

As per the study, the occurence rate of new symptoms of TMJ pain, dysfunction or both between the initial examination and follow-up was five times higher in subjects than in uninjured control subjects. In the year between the two examinations, 7 percent of control subjects developed symptoms in the TMJ versus 34 percent of study subjects.

As per the American Dental Association, the TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make a number of different movements, including a combination of rotating and translocational (gliding) action, used when chewing and speaking. Any problem that prevents this system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder......... Posted by: Janet      Read more         Source

August 16, 2007, 8:55 PM CT

More Successful Bone Implants

Scientists from the American Dental Association Foundation (ADAF) and the National Institute of Standards and Technology (NIST) have developed a new method for layering two kinds of biomaterials into one strong, yet porous unit that may lead to improved reconstruction or repair of bones.

Currently, calcium phosphate cements (CPCs)-water-based pastes of powdered calcium and a phosphate compound that form hydroxyapatite, a material found in natural bone-are used for reconstructing or repairing skeletal defects, but only in bones that are not load-bearing (such as those in the face and skull). Macropores built into the CPCs make it easier for new bone cells to infuse and, eventually, solidify the implant. Until this happens, however, the macropores leave the implant brittle and susceptible to failure.

In the September 2007 issue of Biomaterials,* Hockin Xu and his colleagues describe a unique approach for providing the strength needed to help an implant better survive its early stages. First, a macroporous CPC paste is placed into the area needing reconstruction or repair. Then, a strong, fiber-reinforced CPC paste is layered onto the first CPC to support the new implant. Once new bone has grown into the macroporous layer and increased its strength, the absorbable fibers in the strong layer dissolve and create additional macroporous channels that promote even more bone tissue ingrowth. This method mimics the natural bone structure in which a strong layer, called cortical bone, covers and strengthens a weaker, macroporous layer (spongy bone)......... Posted by: Mark      Read more         Source

August 6, 2007, 5:05 PM CT

Backache Sufferers Who Fear Pain Change

People who fear aggravating a backache will change the way they move to prevent more pain, a new study finds. But doing so may set the stage for further injury, scientists warn.

As per a research findings reported in the journal Spine, Ohio University scientists Jim Thomas and Christopher France examined 36 adults who recently had experienced lower back pain. They split them into two groups: one that confessed a high fear of aggravating the backache and another that was less afraid of reinjury.

The scientists next asked the participants to perform a series of three reaching tasks designed to simulate everyday activities, such as bending to open a mailbox or leaning to ring a doorbell. Sensors attached to the study subjects recorded their muscle movements.

The study confirmed what scientists have long suspected: People with a high fear of back pain will twist, bend and make other unusual moves to try to avoid more aches. It might be okay to baby sore muscles for a while, but protecting them for too long can cause them to weaken. When those muscles are called into play unexpectedly -- such as lurching forward to grab a bag of falling groceries -- more injury can occur, said Thomas, an associate professor of physical treatment whose study is funded by a four-year, $1.5 million grant from the National Institutes of Health......... Posted by: Mark      Read more         Source

August 3, 2007, 5:30 AM CT

Controlling stress helps fight chronic diseases such as Lupus

Lupus is an autoimmune disease affecting more than 5 million people around the world, and makes the immune system attack the body's cells and tissue as if they were enemies.

- It especially affects women of fertile age between 15 and 44 years old.

- A study conducted at the University of Granada (Universidad de Granada) shows that reducing stress in people suffering from lupus also decreases some symptoms of this disease such as inexplicable loss of weight, feeling of fatigue, continuous fever or pain and inflammation in joints.

- Patients who received psychological treatment significantly reduced their levels of stress, anxiety and depression, achieving even lower levels than those of the general population.

C@MPUS DIGITAL Lupus is an autoimmune disease which produces antibodies causing injuries to the body's cells and tissue. It makes the immune system go out of control and the organism attack healthy cells instead of the germs on them. This pathology, which affects more than 5 million people around the world, is more developed in women of fertile age between 15 and 44 years old.

A study conducted in the Department of Medicine at the University of Granada determined that daily stress (which occurs in circumstances of little importance but of high frequency) could exacerbate the symptoms of patients suffering from lupus. In other words, controlling the stress level of those suffering from this disease allows the determination of its negative effects, such as inexplicable loss of weight, feeling of fatigue, continuous fever or pain and inflammation in joints......... Posted by: Janet      Read more         Source