April 24, 2007, 10:51 PM CT

FDA causes unnecessary scare

The U.S. Food and Drug Administration (FDA) has caused an unnecessary scare about some pain relievers by adding a warning to drugs that are safe, says Curt Furberg, M.D., Ph.D., from Wake Forest University School of Medicine. At the same time, he says the agency has failed to recognize the harm of a pain reliever that should be taken off the market.

"The FDA is adding 'black box' warnings to all prescription and over-the-counter pain relievers even to naproxen which the evidence shows is safe," said Furberg, who serves on the FDA Drug Safety and Risk Management Advisory Committee. "This is based on the false assumption that all nonsteroidal anti-inflammatory drugs increase the risk of heart attacks. In fact, there are major differences between these agents".

In a commentary published by Trials, an online journal of BioMed Central, Furberg says the FDA has failed to recognize current scientific evidence when it made decisions on the safety of nonsteroidal anti-inflammatory drugs (NSAIDs) that are often used to treat the pain or inflammation from arthritis.

The most usually used NSAIDs are ibuprofen (Advil), naproxen (Aleve), and diclofenac (Voltaren). There are more than a dozen others, including drugs such as celecoxib (Celebrex) that are in a special class known as selective COX-2 inhibitors because of the hormone they target. The other NSAIDs are known as "non-selective"......... Posted by: Mark      Read more         Source

April 23, 2007, 5:22 PM CT

Adjustable chairs reduce shoulder and neck pain

Adjustable-height chairs with ergonomically curved seats can significantly reduce neck and shoulder pain in garment workers, as per a new study in the April 20 issue of Spine.

The study shows that chair design affects neck and shoulder pain among garment workers -- and possibly in other laborers engaged in visually intensive manufacturing work, the scientists say.

The study was led by David Rempel, MD, MPH, director of the ergonomics program at San Francisco General Hospital and professor of medicine at the University of California, San Francisco; and Beate Ritz, MD, PhD, associate professor of epidemiology, at University of California, Los Angeles.

As per the authors, garment workers typically work in a seated position for seven to 10 hours per day, using their hands to manipulate cloth or to complete fine-motor tasks while sewing. The work is visually intensive, so workers often lean forward and hold their arms and shoulders up. In 2000, the garment industry employed 11 million workers worldwide. Approximately 350,000 of these workers were in the United States. Los Angeles is the home of the largest garment production center in the country.

"Garment workers have not been the focus of a number of studies, despite the fact that they face important occupational health risks," Rempel explained. "Their work is physically demanding, particularly on the upper extremities and neck."........ Posted by: Mark      Read more         Source

February 28, 2007, 9:35 PM CT

Surgery Improves Outcomes For Baseball Pitchers

In the largest study of its kind, surgeons at Hospital for Special Surgery have determined that by modifying a classic ligament surgery, they can return more athletes, such as baseball players, to their prior level of competition. The modified surgery repairs a torn medial collateral ligament (MCL), which links and stabilizes bones of the lower and upper arm where they meet at the elbow.

Less traumatic than the classic Tommy John surgery, the modified surgery called the docking procedure, with time, is likely to become the gold standard for treating these injuries.

"This paper, in the largest series of patients ever published, shows that this particular operation in throwing athletes demonstrates better results than the classic operation," said David W. Altchek, M.D., senior author of the study and co-chief of the Sports Medicine and Shoulder Service at Hospital for Special Surgery (HSS) in New York. The study was presented at a special session of the American Shoulder and Elbow Surgeons, held during the American Academy of Orthopedic Surgeons annual meeting.

MCL injury is most common in professional and amateur athletes involved in so-called overhead throwing sports, such as baseball, softball, football, lacrosse and tennis. These sports involve a throwing motion at high velocity that exerts an exceptional force at the elbow. Repeated over time, this motion can cause inflammation and microtrauma, which can eventually lead to an MCL tear. When this ligament is torn, an individual has a full range of motion and can go about daily life, but a professional or semi-professional athlete cannot perform at their usual level because they cannot exert a significant force......... Posted by: Mark      Read more         Source

February 26, 2007, 6:27 PM CT

Avoiding Carpal Tunnel Syndrome

In work involving the hands, whether using a computer or a hammer, the wrist is a vulnerable spot. Repeated or sustained bending and flexing can lead to carpal tunnel syndrome (CTS).

A group of human factors/ergonomics (HF/E) scientists from the University of California at San Francisco and McMaster University in Ontario, Canada, have conducted the first study that systematically identifies how one contributor to CTS carpal tunnel pressure can be examined in detail to establish limits on how much a wrist can be flexed before nerve damage sets in. The scientists believe their findings could be used to create simple guidelines to help workers avoid wrist postures that are likely to cause nerve trauma. The findings from their study appear in a paper in the recent issue of Human Factors: The Journal of the Human Factors and Ergonomics Society.

The research team studied the pressure that is placed on the nerve in the carpal tunnel in various wrist postures in 37 healthy men and women between the ages of 22 and 50. Wrist postures that are not neutral (that is, bent or flexed) cause increased pressure on the nerve. The scientists concluded that when sustained pressure on the carpal tunnel reaches 30 mmHG, injury is likely to occur.

In order to keep pressure below 30 mmHG, it is recommended that sustained wrist extension (bending the hand back) should not exceed 32.7 degrees, wrist flexion (bending the wrist toward the palm) should not exceed 48.6 degrees, ulnar deviation (sideways toward the small finger) should not exceed 14.5 degrees, and radial deviation (sideways toward the thumb) should not exceed 21.8 degrees......... Posted by: Mark      Read more         Source

February 7, 2007, 9:02 PM CT

Take More Breaks To Avoid Back Injury

Workers who lift for a living need to take longer or more frequent breaks than they now do to avoid back injury, as per a new study at Ohio State University.

The study also suggests that people who are new on the job need to take breaks even more often than experienced workers, and that the risk of injury is higher at the end of a work shift.

People who took part in the study lifted boxes onto conveyor belts for eight hours, while scientists measured the amount of oxygen that was reaching the muscles in their lower back.

The oxygen level indicated how hard the muscles were working, and whether they were becoming fatigued, explained William Marras, professor of industrial welding and systems engineering at Ohio State. His research and others' has shown that muscle fatigue is associated with back injury.

The study, which appeared in a recent issue of the journal Clinical Biomechanics, is the first to examine what happens to muscle oxygenation over a full workday.

Despite the fact that the study participants were performing the same job at the same pace all day, their back muscles needed more oxygen as the day went on. Taking a half-hour lunch break helped their muscles recover from the morning's exertion, but once they started working again, their oxygen needs rose steeply and kept climbing throughout the afternoon.........

Posted by: Mark      Read more         Source

January 30, 2007, 7:04 PM CT

Osteoporosis Isn't Just A Woman's Problem

A McMaster University researcher is alerting men and their doctors that osteoporosis isn't just a woman's problem but that the bone-wasting disease can severely afflict them, too.

To overcome this common perception, Dr. Aliya A. Khan, a professor of clinical medicine, led a group of five Canadian experts in the development of guidelines for the diagnosis, therapy and management of osteoporosis in men. Their paper appears in the January 30 issue of the Canadian Medical Association Journal (CMAJ).

Dr. Khan said the CMAJ paper is intended to make physicians aware of the fact that they can no longer overlook diagnosing osteoporosis in their male patients. "That's the bottom line. We want to bring all the research we have to the forefront and we want to bring it to the desk of Canadian physicians".

The CMAJ paper supplements clinical practice guidelines for the diagnosis and management of osteoporosis published by Osteoporosis Canada in 2002. It provides a review and synthesis of the current literature on the diagnosis and management of osteoporosis in men.

Up until now, Dr. Khan said, doctors have underestimated even how common the condition is in men. One in eight men over 50 years of age has osteoporosis, in comparison to one in four women after menopause.........

Posted by: Janet      Read more         Source

January 9, 2007, 8:53 PM CT

Caffeine Cuts Post-workout Pain

Eventhough it's too soon to recommend dropping by Starbucks before hitting the gym, a new study suggests that caffeine can help reduce the post-workout soreness that discourages some people from exercising.

In a study would be reported in the recent issue of The Journal of Pain, a team of University of Georgia scientists finds that moderate doses of caffeine, roughly equivalent to two cups of coffee, cut post-workout muscle pain by up to 48 percent in a small sample of volunteers.

Lead author Victor Maridakis, a researcher in the department of kinesiology at the UGA College of Education, said the findings may be especially relevant to people new to exercise, since they tend to experience the most soreness.

"If you can use caffeine to reduce the pain, it may make it easier to transition from that first week into a much longer exercise program," he said.

Maridakis and colleagues studied nine female college students who were not regular caffeine users and did not engage in regular resistance training. One and two days after an exercise session that caused moderate muscle soreness, the volunteers took either caffeine or a placebo and performed two different quadriceps (thigh) exercises, one designed to produce a maximal force, the other designed to generate a sub-maximal force. Those that consumed caffeine one-hour before the maximum force test had a 48 percent reduction in pain in comparison to the placebo group, while those that took caffeine before the sub-maximal test reported a 26 percent reduction in pain.........

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January 7, 2007, 8:31 AM CT

MRI Of The Ankle Changes Patient Treatment

MR imaging can make a dramatic difference in the management of patients with ankle pain, changing therapy in about one-third of the patients, a new study finds.

The study, of 91 patients, observed that MR changed the management plans of 35% of patients, said Philip W.P. Bearcroft, MD, of Cambridge University Hospitals in England. "This is itself is significant, but more significant is the fact that before an MRI was done, 65 of the 91 patients were scheduled to undergo surgery. After an MRI was done, nine of those patients were treated nonsurgically," Dr. Bearcroft said.

Dr. Bearcroft and colleagues conducted the study in conjunction with an orthopedic foot and ankle surgeon at a regional teaching hospital. The surgeon noted his proposed therapy plan for each patient before and after an MR examination. The surgeon also noted the potential diagnoses for each injury. Before an MR examination was done, the surgeon indicated an average 2.3 possible diagnoses per patient. "After MRI waccording toformed, the number of diagnoses per patient was reduced to 1.2," said Dr. Bearcroft. MRI increased the referring physician's confidence in his diagnoses, Dr. Bearcroft said. "In 66% of the MRI examinations performed, the referring surgeon felt that his understanding of the patient's disease had either depended upon or had been substantially improved by MRI," he added.........

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December 26, 2006, 7:50 PM CT

Acid Suppression Medications And Hip Fracture

Use of the drugs proton pump inhibitors (PPIs) for the therapy of acid-related diseases such as gastro esophageal reflux disease (GERD) is linked to a greater risk of hip fracture, as per a research studyin the December 27 issue of JAMA.

Potent acid suppressive medications such as PPIs have revolutionized the management of acid-related diseases. Millions of individuals have been using these medications on a continuous or long-term basis, as per background information in the article. Some research has shown that PPI treatment may decrease insoluble calcium absorption or bone density in certain patients. These factors could increase the risk for hip fracture, which has a death rate during the first year after the fracture of 20 percent. Among those who survive this period, 1 in 5 require nursing home care and often an emergency department visit, hospitalization, surgery, and rehabilitation, with huge health care costs.

Yu-Xiao Yang, M.D., M.S.C.E., of the University of Pennsylvania School of Medicine, Philadelphia, conducted a study to determine what effects PPI treatment has on bone metabolism and hip fracture risk in a large group representative of the general population. The scientists analyzed data from the General Practice Research Database (1987-2003), which contains information on patients in the United Kingdom. The study group consisted of users of PPI treatment and nonusers of acid suppression drugs who were older than 50 years.........

Posted by: Mark      Read more         Source

December 5, 2006, 4:48 AM CT

How Movement Lubricates Bone Joints

Taking a cue from machines that gently flex patients knees to help them recover faster from joint surgery, bioengineering scientists at UC San Diego have shown that sliding forces applied to cartilage surfaces prompt cells in that tissue to produce molecules that lubricate and protect joints.

The results reported in Osteoarthritis and Cartilage are important in the ongoing efforts of the group led by Robert Sah, a Howard Hughes Medical Institute (HHMI) professor at UCSDs Jacobs School of Engineering, to grow cartilage in the laboratory that can be used to replace patients injured or diseased joint surfaces.

We have shown that shear forces on cartilage prompt chondrocyte cells in it to produce proteoglycan 4, said Sah. This is an important step toward our goal of eventually growing joint tissue for transplantation.

Proteoglycan, a name that reflects its protein and polysaccharide components, is a basic building block of connective tissue throughout the body. The chondrocyte cells of cartilage make several forms of proteoglycans, including several that build up in cartilage and contribute to its stiffness. However, proteoglycan-4 is primarily secreted into the joint fluid where it coats and lubricates cartilage surfaces.

Researchers have known for years that defects in a gene for proteoglycan 4 result in a type of childhood joint failure that resembles osteoarthritis in the elderly. Sahs goal is to stimulate healthy chondrocytes in cartilage tissue grown in the laboratory to form robust tissue that makes proteoglycan 4 and has a smooth, well-lubricated surface.........

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