31 May

Medical News Today: Opioids might worsen chronic pain, study finds

A new study has questioned the benefits of opioid painkillers, after finding the drugs might worsen chronic pain rather than ease it.
[White pills on a table]
Researchers have questioned the pain-relieving effects of opioids.

Study co-leader Prof. Peter Grace, of the University of Colorado at Boulder (CU-Boulder), and colleagues recently published their findings in the Proceedings of the National Academy of Sciences.

Opioids are among the most commonly used painkillers in the United States; almost 250 million opioid prescriptions were written in 2013 – the equivalent to one bottle of pills for every American adult.

Previous studies have suggested opioids – such as codeine, oxycodone, morphine, and fentanyl – are effective pain relievers. They bind to proteins in the brain, spinal cord, and gastrointestinal tract called opioid receptors, reducing pain perception.

Increasing use and abuse of opioids, however, has become a major public health concern in the U.S.; opioid overdoses are responsible for 78 deaths in the country every day.

Now, Prof. Grace and colleagues have questioned whether opioids really work for pain relief, after finding the opioid morphine worsened chronic pain in rats.

Just 5 days of morphine treatment increased chronic pain in rats

According to Prof. Grace, previous studies assessing morphine use have focused on how the drug affects pain in the short term.

With this in mind, the researchers set out to investigate the longer-term effects of morphine use for chronic pain.

For their study, the team assessed two groups of rats with chronic nerve pain. One group was treated with morphine, while the other was not.

Compared with the non-treatment group, the team found that the chronic pain of the morphine group worsened with just 5 days of treatment. What is more, this effect persisted for several months.

“We are showing for the first time that even a brief exposure to opioids can have long-term negative effects on pain,” says Prof. Grace. “We found the treatment was contributing to the problem.”

Another ‘ugly side’ to opioids

According to the authors, the combination of morphine and nerve injury triggered a “cascade” of glial cell signaling, which increased chronic pain.

Glial cells are the “immune cells” of the central nervous system, which support and insulate nerve cells and aid nerve injury recovery.

They found that this cascade activated signaling from a protein called interleukin-1beta (IL-1b), which led to overactivity of nerve cells in the brain and spinal cord that respond to pain. This process can increase and prolong pain.

The researchers say their findings have important implications for individuals with chronic pain – a condition that is estimated to affect around 100 million Americans.

“The implications for people taking opioids like morphine, oxycodone and methadone are great, since we show the short-term decision to take such opioids can have devastating consequences of making pain worse and longer lasting. This is a very ugly side to opioids that had not been recognized before.”

Study co-leader Prof. Linda Watkins, CU-Boulder

It is not all bad news, however. The researchers found they were able to reverse morphine’s pain-increasing effect using a technique called “designer receptor exclusively activated by designer drugs” (DREADD), which involves the use of a targeted drug that stops glial cell receptors from recognizing opioids.

“Importantly, we’ve also been able to block the two main receptors involved in this immune response, including Toll-Like receptor 4 (TLR4) and another one called P2X7R, which have both been separately implicated in chronic pain before,” notes Prof. Grace.

“By blocking these receptors, we’re preventing the immune response from kicking in, enabling the painkilling benefits of morphine to be delivered without resulting in further chronic pain.”

He adds that drugs that can block such receptors are currently in development, but it is likely to be at least another 5 years before they are available for clinical use.

Read about the new opioid prescription guidelines recently issued by the CDC.

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31 May

Medical News Today: Alzheimer's disease: Could a leaky blood-brain barrier be involved?

A study found that the blood-brain barrier was leakier in a group of people with Alzheimer’s disease than their healthy counterparts. The researchers suggest this means increased brain-barrier permeability may be a key contributor to the early stages of the disease.
brain and blood vessels to and in head
The researchers believe their findings point to impairments in the blood-brain barrier as a potential key mechanism in the early stages of Alzheimer’s disease.

The team, including Walter H. Backes, a professor in medical physics at Maastricht University Medical Center in the Netherlands, reports the study in the journal Radiology.

Prof. Backes says:

“Blood-brain barrier leakage means that the brain has lost its protective means, the stability of brain cells is disrupted and the environment in which nerve cells interact becomes ill-conditioned. These mechanisms could eventually lead to dysfunction in the brain.”

The blood-brain barrier (BBB) separates the brain from circulating blood to keep brain tissue healthy. It is a collection of specialized cells and cellular components that line the walls of blood vessels in the brain and the rest of the central nervous system.

The BBB controls the delivery of important nutrients, blocks substances that can harm the brain, and removes waste from the brain.

Alzheimer’s disease is the most common form of dementia, an illness that disrupts memory, thinking and behavior. Symptoms usually come on slowly and worsen over time, eventually preventing people from living independently. The disease accounts for 60-80 percent of dementia cases.

Potential key mechanism in early Alzheimer’s

For their study, the team used contrast-enhanced magnetic resonance imaging (MRI) to identify leakages in the BBB of patients with early Alzheimer’s.

Contrast-enhanced MRI allows researchers to identify more clearly the different fluids in the brain. Prof. Backes says it helps to spot tiny changes in blood vessels – even in cases where no directly visible cerebrovascular abnormalities can be seen.

The team compared the MRI scans of 16 patients with early Alzheimer’s disease with those of 17 healthy people of the same age (the controls). They measured BBB leakage rate and made a histogram map that showed how much brain tissue was affected.

The results showed that the BBB leakage rate was higher in the Alzheimer’s disease group than the controls.

From the histogram maps, the researchers say they could see that the leakage was distributed throughout the cerebrum – the largest part of the brain.

The Alzheimer’s disease group had a significantly higher proportion of gray matter brain tissue affected by BBB leakage than the controls. The affected gray matter included the cortex, the outer layer of the brain.

From other research, scientists know that two features of Alzheimer’s disease – the plaques and tangles of faulty protein that clog up the brain – tend to spread through the cortex as the disease progresses.

On closer inspection of the histogram data, the team also found evidence of very subtle BBB impairment in the white matter of the brain.

The researchers also found a link between the extent of BBB impairment and reduction in cognitive performance.

They suggest the findings point to impairments in BBB as a potential key mechanism in the early stages of Alzheimer’s disease.

When they added diabetes and other non-cerebral circulation diseases to their analysis, the researchers found they did not affect the results, strengthening the case for a direct link between BBB impairment and Alzheimer’s disease.

“For Alzheimer’s research, this means that a novel tool has become available to study the contribution of blood-brain barrier impairment in the brain to disease onset and progression in early stages or pre-stages of dementia.”

Prof. Walter H Backes

Discover how Alzheimer’s disease is linked to loss of Y chromosome in men.

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31 May

Medical News Today: Chemicals in food packaging, fungicides might damage children's teeth

Early exposure to two chemicals often found in food packaging and fungicides may cause damage to children’s teeth that can never be reversed, a new study finds.
[Dentist checking a child's teeth]
Exposure to BPA and vinclozolin may weaken a child’s tooth enamel, putting them at greater risk for dental caries.

Lead study author Dr. Katia Jedeon, of the French National Institute of Health and Medical Research (INSERM), and colleagues found exposure to the chemicals bisphenol A (BPA) and vinclozolin may interfere with hormones responsible for the growth of dental enamel.

The researchers recently presented their findings at the 2016 European Congress of Endocrinology in Munich, Germany.

BPA and vinclozolin have been identified as endocrine disruptors (EDs) in numerous studies. This means they can interfere with hormone functioning in mammals, increasing the risk of reproductive problems, cancer, births defects, and various other conditions.

BPA is used in the production of certain plastics and resins, many of which are used for food and drink packaging, while vinclozolin is a fungicide used to protect vineyards, orchards, and golf courses.

Molar incisor hypomineralization

Dr. Jedeon and colleagues note that previous animal studies have indicated that EDs may be related to a condition called molar incisor hypomineralization (MIH), which is estimated to affect up to 18 percent of children aged 6-9 years.

MIH is a developmental condition in which enamel defects occur in the first permanent teeth, most commonly the molars and incisors. Such a defect is irreversible; once tooth enamel is damaged, it cannot grow back.

Children with MIH can experience heightened tooth sensitivity, particularly to cold foods and drinks, and they are at greater risk for dental caries. Their teeth may be creamy, yellow, or brown in appearance, and they may chip away easily.

For their study, Dr. Jedeon and colleagues conducted two experiments to gain a better understanding of how exposure to EDs might be associated with MIH.

BPA, vinclozolin block hormones needed for tooth enamel production

Firstly, the team exposed rats to daily doses of either BPA alone or a combination of BPA and vinclozolin from birth for 30 days. Doses were equivalent to the average daily dose a human would be exposed to.

At the end of the 30 days, the researchers collected cells from the surface of the rats’ teeth.

On analyzing the cells, they found that exposure to BPA and vinclozolin altered the expression of two genes – KLK4 and SLC5A8 – that regulate tooth enamel mineralization.

Next, the researchers cultured ameloblast cells of rats, which are cells that deposit enamel during tooth development. They found that these cells contain sex hormones – including estrogen and testosterone – that increase the expression of genes that produce tooth enamel.

Interestingly, they found that testosterone increases the expression of the KLK4 and SLC5A8 genes.

Because both BPA and vinclozolin are known to inhibit the effect of male sex hormones, the authors say their findings indicate that the chemicals may lead to MIH by blocking hormones needed for development of tooth enamel.

“Tooth enamel starts at the third trimester of pregnancy and ends at the age of 5, so minimizing exposure to endocrine disruptors at this stage in life as a precautionary measure would be one way of reducing the risk of enamel weakening.”

Dr. Katia Jedeon

Learn how sharks could aid human tooth regeneration.

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31 May

Medical News Today: Coffee might prevent exercise-induced eye fatigue

It’s not only the legs that feel the effects of cycling; a new study suggests it can put a strain on the eyes, too. But don’t get off your bike just yet. The study also found that drinking coffee might prevent such an effect.
[A cup of coffee and beans]
Researchers suggest slowed eye movement due to strenuous exercise might be prevented with coffee consumption.

Study leader Dr. Nicholas Gant, of the University of Auckland in New Zealand, and colleagues recently published their findings in the journal Scientific Reports.

In their study, the researchers explain that vigorous exercise can lower the central nervous system’s ability to drive muscle function, resulting in what is known as central fatigue.

Prolonged cycling, for example, can trigger central fatigue, which normally presents through tiring of the legs.

But while it is well known that central fatigue affects limb movement, Dr. Gant and colleagues note that it is unclear whether it impacts other motor systems, such as those involved in eye movement.

To find out, the team enrolled 11 well-trained cyclists, who cycled using exercise bikes for 3 hours.

Some of the participants consumed caffeine during their 3-hour cycling session – at a dose equivalent to two cups of coffee – while the remaining subjects consumed a decaffeinated placebo solution.

The researchers explain that caffeine can indirectly boost the activity of certain neurotransmitters – chemicals that relay signals between brains cells – and note that previous studies have suggested that impairments in neurotransmitter activity might be responsible for central fatigue.

Once participants had finished cycling, the researchers tested their eye movement using a head-fixed eye-tracking system.

Impaired eye movement was restored with caffeine

The team found that the strenuous exercise the participants engaged in caused a neurotransmitter imbalance, which slowed down the subjects’ rapid eye movements.

“Interestingly, the areas of the brain that process visual information are robust to fatigue. It’s the pathways that control eye movements that seem to be our weakest link,” says Dr. Gant.

“These results are important because our eyes must move quickly to capture new information,” he adds. “But there’s hope for coffee drinkers because this visual impairment can be prevented by consuming caffeine.”

The researchers found that participants who consumed the caffeinated beverages saw their neurotransmitter balance restored, which improved their rapid eye movements. No such effect was found among subjects who drank the decaffeinated solution.

Commenting on their findings, the authors say:

“This is the first study to show impaired control of eye movements following fatiguing exercise. Prolonged use of the skeletal motor system influences the function of the oculomotor system, implicating a possible role of central fatigue.

Caffeine is capable of countering this effect, suggesting that central fatigue may be related to a disruption in the balance of one or more excitatory and inhibitory neurotransmitters.”

The researchers are now in the process of investigating whether psychiatric drugs – which work by restoring neurotransmitter levels – might be effective for treating fatigue caused by strenuous exercise.

Learn how drinking coffee might reduce the risk of multiple sclerosis.

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31 May

Medical News Today: Knee Injections vs. Knee Replacement: What are My Options?

According to the Arthritis Foundation, over 50 million Americans have arthritis. The most common form of arthritis is osteoarthritis, which is a degenerative joint disease. Though it can occur in younger people, it often affects people 50 years of age and older.

Osteoarthritis (OA) is a chronic condition that causes the cartilage between the joints to break down. Cartilage behaves as a cushion for joints and protects the surface of the bones. Without this cushion, bones can rub or grind together, causing pain, stiffness, and swelling.

Doctors may recommend physical therapy, a knee brace or other self-care measures to help with the pain and discomfort of OA. For some individuals, oral medications may also relieve knee pain.

If a patient continues to experience discomfort, swelling, or have extensive joint damage, their doctor may suggest other options. They may require knee injections or even a full knee replacement.

Understanding knee injection therapy

Doctors will typically recommend knee injection therapy before recommending surgery. There is a variety of different injections available. For some people, injections help to alleviate knee pain. The following are knee injection therapy options:

Hyaluronic acid supplements (viscosupplementation)

These are also known as gel injections. During treatment, a substance called hyaluronic acid is injected directly into the knee joint to add to the hyaluronic acid that the body makes naturally.

In healthy joints, this fluid acts as a lubricant or shock absorber, helping the joints to work properly.

People with OA seem to experience a breakdown in hyaluronic acid. Hyaluronic acid injections can help to lessen joint pain as well as inflammation.

A small amount of joint fluid will be removed before the injection to make room for the hyaluronic fluid. Patients receive a weekly injection for 1 to 5 weeks depending on the product used. The supplement is available in solution or gel form.

A doctor examines an older man's knee.
Doctors will usually recommend injections before surgery to treat long-term knee pain.

Hyaluronic acid supplements can be an effective form of treatment but they do carry some side effects. Common side effects include irritation at the injection site, pain, swelling, stiffness, and fluid buildup around the knee.

Less common side effects include:

  • Bleeding
  • Blistering
  • Burning
  • Rash
  • Itching
  • Skin irritation around the knee
  • Headache
  • Nausea
  • Muscle pain

Patients should be aware of the possible side effects and report these or any other problems to a doctor immediately. It may be necessary to discontinue use or try a different supplement.

Corticosteroid injections

Corticosteroid injections are one of the most common injection options. Doctors inject corticosteroids directly into the knee joint to help relieve knee pain and inflammation quickly.

A knee is injected.
Corticosteroid injections can be carried out in a doctor’s office.

Corticosteroids are a class of medications related to the steroid cortisone. They are routinely used to reduce inflammation. Corticosteroids mimic the effects of a substance called cortisol which is naturally produced by the adrenal glands.

In high doses, corticosteroids can lessen inflammation. They are also beneficial in suppressing the immune system. This can be helpful in controlling conditions such as rheumatoid arthritis where the immune system mistakenly attacks its own tissues.

The corticosteroid is quickly absorbed into the bloodstream and travels to the inflammation site. Injection therapy provides much quicker relief to the inflamed area and is more powerful than traditional oral anti-inflammatory medications.

In addition to providing quick relief, the injection does not cause many of the side effects that oral corticosteroid medications do.

Doctors can administer the injection in their office. They may numb the knee area before injecting the corticosteroid drug directly into the joint. Some people feel relief almost immediately while others only feel the effects several days later.

Depending on the condition of the knee, the benefits can last from a few days to more than 6 months. Factors such as the extent of inflammation and overall health play a role in how long the effects of the steroid injection will last. It is important to note that the effects of the shot are temporary. Additional cortisone injections may be necessary.

Many people have no adverse effects with steroid injections besides a little pain or tingling where the injection was made. In some cases, however, corticosteroids can cause dangerous side effects, especially when taken too often.

Side effects include:

  • Death of nearby bone (osteonecrosis)
  • Joint infection
  • Nerve damage
  • Thinning of the skin and soft tissue around the injection site
  • Temporary flare of pain and inflammation in the joint
  • Thinning of nearby bone (osteoporosis)
  • Whitening or lightening of the skin around the injection site
  • Diabetic patients can experience elevated blood sugar
  • Allergic reaction

Exposure to high levels of cortisol over a prolonged period of time increases the risk of developing hypercortisolism or Cushing’s syndrome. Effects include upper body obesity, a round-shaped face, increased bruising, trouble healing, weak bones, excessive hair growth, irregular menstrual periods in women and fertility problems in men.

This side effect is treated by gradually reducing the amount of cortisone used or adjusting dosage.

Is knee replacement my only option?

Though corticosteroid and hyaluronic acid supplements can control pain and inflammation efficiently, they often just provide temporary relief. As OA progresses, mobility and quality of life may get worse, leaving a knee replacement as the only option.

A doctor will likely recommend knee replacement surgery once all other treatment options such as physical therapy and injections have been tried.

A knee replacement is also referred to as knee arthroplasty or knee “resurfacing” because only the surface of the bones is replaced. The surgeon will cut away damaged bone and cartilage from the shinbone and kneecap and replace it with an artificial joint.

During a total knee replacement, the damaged knee joint is removed and replaced with a prosthesis made out of metal, ceramic, or high-grade plastic and polymer components.

There are four basic steps:

  1. Preparing the bone – the cartilage surfaces that are found at the end of the femur and tibia are removed along with a small amount of underlying bone.
  2. Positioning the metal implants – the cartilage and bone that have been removed are then replaced with metal components to recreate the surface of the joint. The metal parts are either cemented or “fit” into the bone.
  3. Resurfacing the patella – the undersurface of the patella or kneecap may be cut and resurfaced with a plastic button.
  4. Inserting a spacer – a medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface, making walking easier and smoother.

Before the procedure, patients will work alongside with their doctors to design their artificial knee. Factors such as age, weight, activity levels, and overall health are taken into account.

Delaying your surgery

There are risks associated with delaying knee replacement surgery. The main risks are deterioration of the joint, increased pain, and lack of mobility.

Theater staff are operating on a patient.
Some cases of OA of the knee can only be treated with replacement surgery.

Other risk factors include:

  • Risk of deformities developing inside and outside the joint
  • Risk of muscles, ligaments, and other structures becoming weak and losing function
  • Increased pain or an inability to manage pain
  • Increased disability or lack of mobility
  • Difficulty with normal daily activities

The doctor will thoroughly explain the procedure and allow the patient to ask questions as needed. They will record a medical history, including any medications or supplements that are being taken. Allergies and previous health problems should also be noted.

Patients are typically put to sleep under general anesthesia before the surgery. Patients often begin physical therapy to get the new joint moving during a short hospital stay. Rehabilitation to help regain strength and range of motion continues after leaving the hospital.

Knee replacement risks

Though knee replacement surgery often goes smoothly, it carries risks just like any other surgery.

These risks include:

If surgery is postponed for too long, other risks may arise. Developed deformities may make the knee replacement procedure much more complicated. Surgery may take longer, and knee replacement options may be limited.

Regaining mobility

Both knee therapy and knee replacement are viable treatment options, depending on the severity of joint degeneration.

Physical therapy and oral medications are usually the first treatments that are offered. If oral medication is unsuccessful, injection therapy is often next. For some, injections in conjunction with lifestyle changes such as exercise help to control OA.

Though it may not last forever, a knee replacement is generally the final option when pain and a lack of mobility get too much. Surgery is generally recommended when people have severe knee pain or stiffness that limits their ability to move.

Whether a patient is undergoing injection therapy or a full knee replacement, their doctor can discuss the pros and cons to ensure they make the best decision.

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31 May

Medical News Today: Control of immune response relies on a key protein, study finds

Scientists have identified a protein that appears to play a key role in controlling immune response. By testing how the protein works in mice, they found possible explanations for why immune T cells sometimes fail to eliminate tumors and chronic infections. They suggest the discovery may lead to new treatments for many diseases, including cancer, autoimmune diseases, and infections.
t cells attacking cancer
The researchers suggest targeting a protein that controls T-cell activity could boost immune response to cancer and other diseases.

The study, led by Sanford Burnham Prebys Medical Discovery Institute (SBP) in La Jolla, CA, is published in the journal Immunity.

Senior author Linda Bradley, a professor in SBP’s Immunity and Pathogenesis Program, says:

“We discovered that a protein on the surface of T cells, P-selectin glycoprotein ligand-1 (PSGL-1), acts as a negative regulator of T cell function. PSGL-1 has the broad capacity to dampen T cell signals and promote the exhaustion of T cells in viral and tumor mouse models.”

The researchers were interested in studying T cells because there is evidence many diseases – including infections and cancer – may arise because of problems with T-cell response.

T cells recognize and destroy specific invaders, including infectious bacteria and viruses from outside the body and rogue cells from inside the body that can trigger tumors.

T-cell activity is highly sensitive to control signals from other immune cells. These adjust T-cell response according to the nature of the “invasion.” However, sometimes the response fails – for example, chronic viruses and cancers are able to escape attack by the immune system by disrupting T-cell response.

‘Crucial for limiting immune responses’

One reason the T-cell response fails is because the cancer cells or viruses are able to use “checkpoints” on the T cells that turn down their activity – effectively exploiting a natural brake on the T cells. The checkpoints are normally controlled by patrolling immune cells and ensure T cells do not overreact and attack healthy tissue.

New drugs called “checkpoint inhibitors” – because they remove the brakes on the T cells – are beginning to show promise in treating some cancers. These drugs could potentially extend survival by years in the case of lung cancer and melanoma, note the authors.

From tests on mice, Prof. Bradley and colleagues found PSGL-1 plays a key role in inhibiting T-cell activity. It is needed to increase levels of checkpoints.

In mice bred to lack the protein, T cells remained active for longer than normal and completely eradicated lymphocytic choriomeningitis virus (LCMV) infections, which normally last months.

“Total clearance of LCMV is rare,” Prof. Bradley notes. “When we saw that, we knew PSGL-1 was crucial for limiting immune responses.”

When they injected the same mice with melanoma cells, the researchers found the resulting tumors grew more slowly than normal, suggesting PSGL-1 regulates T-cell responses in general.

Prof. Bradley suggests blocking the protein could boost the immune response to cancer and chronic viral infections like hepatitis. Alternatively, increasing the protein could inhibit immune response, an approach that could be useful for treating autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, psoriasis, and lupus.

“PSGL-1 inhibitors could provide another tool in the arsenal against cancer, and benefit the many patients who don’t respond to the currently available checkpoint inhibitors.”

Prof. Linda Bradley

The team at SBP is now looking at how the protein target might work with other anti-cancer drugs. T-cells do not reach all tumor cells, so an immunotherapy based on PSGL-1 could be more effective when combined with drugs that kill cancer more directly – and vice versa.

Learn how another cancer immunotherapy ‘takes the brakes off natural killer cells’.

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30 May

Medical News Today: Diabetes risk 'surprisingly lower' in older men who are unhappily married

A new study suggests that the link between a person’s health and the quality of their marriage may be less straightforward than we might assume. It finds that – compared with happily married peers – men in unhappy marriages are less likely to develop diabetes, and if they do, it arises later and is better managed.
husband and wife arguing
One explanation the researchers suggest is having a wife that nags him about his diabetes monitoring may benefit a man’s health, even if it puts a strain on his marriage.

The study, led by Hui Liu, an associate professor in sociology at Michigan State University in East Lansing, is published in the Journals of Gerontology: Social Sciences.

In 2012 there were 29.1 million Americans – or 9.3 percent of the population – living with diabetes. This figure includes 8.1 million undiagnosed people.

However, among older Americans, the prevalence of diabetes is much higher: 25.9 percent of adults aged 65 and over – 11.8 million seniors – are thought to have the disease.

In this context, the goal of the study was to examine the link between marital quality and both the risk of developing diabetes and how well it is managed after it develops in later life.

The study uses data from the first two waves of the National Social Life, Health and Aging Project (NSHAP).

The NSHAP data – which includes biomeasures and survey responses collected in interviews and in self-reports – covers many facets of social life, health, aging, and relationships in older, community-dwelling Americans.

The data set that Prof. Liu and colleagues analyzed covered 1,228 married men and women who were aged 57-85 at the time of the first wave survey (conducted 2005-2006). At the time of the second wave survey (2010-2011), 389 of the participants had diabetes.

‘Sometimes nagging is caring’

The survey data collected were not specifically designed to assess marital quality, so the researchers used a statistical approach called “factor analysis” to construct positive and negative marital quality scales from relevant survey items.

For example, the survey includes items on satisfaction with current relationship, behavior with partner, intimacy, attitude to partner, and sexual contact.

When the team compared the survey data with the diabetes information collected from the participants, they made some surprising discoveries.

The most surprising finding was that for men, negative marital quality was linked to lower risk of developing diabetes and better management of the disease once diagnosed.

One explanation might be that, because diabetes is a condition that needs careful and constant monitoring, persistent nagging from a wife might boost a husband’s health just through effect on health behavior, although it may also appear to increase marital strain over time.

For women, it was positive marital quality that was linked to a lower risk of developing diabetes over the course of the study.

Prof. Liu suggests this could be that women are more sensitive to marital quality and thus more likely to experience this as a positive effect on health.

These results also prompt questions about how to define negative and positive marital quality, and to what extent they may differ between the sexes.

“The study challenges the traditional assumption that negative marital quality is always detrimental to health. It also encourages family scholars to distinguish different sources and types of marital quality. Sometimes, nagging is caring.”

Prof. Hui Liu

Learn how researchers found cancer patients may live longer than unmarried ones.

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30 May

Medical News Today: The Best Walking and Running Shoes for Osteoarthritis of the Knee

Osteoarthritis is a degenerative joint disease and is the most common chronic condition of the joints.

According to the Arthritis Foundation, osteoarthritis affects about 27 million Americans.

Osteoarthritis (OA) is most common in the knees, hips, lower back, neck, small joints of the fingers, and the bases of the thumb and big toe.

Cartilage covers the end of each bone. It provides a smooth gliding surface for easy joint motion and acts as a cushion between the bones. In people with OA, the cartilage breaks down, resulting in pain, swelling, and problems moving the joint.

Though arthritis can occur just about anywhere there is a joint, according to the American College of Rheumatology, the lifetime risk of developing OA in the knee is about 46 percent. As a result, the knee one of the most common areas affected.

There is no cure for OA, but there are things that can be done to reduce pain and improve knee function.

Physical exercise is useful in treating OA. Exercise can help to improve muscle strength, decrease joint pain and stiffness, and also lower the chance of disability due to OA.

Why is it important to wear the right athletic shoes?

The type of athletic shoes that people with OA of the knee wear are very important. As a result, people should take care to find the right type of shoe to wear.

The right type of shoe is important whether performing normal daily activities or walking or running to get in some exercise.

Wearing the wrong type of shoe only makes existing problems worse, and can cause damage and complication to the many joints in the feet.

The kind of shoes that people wear impacts directly on the load put on the knee joints. Elevated joint loads during walking can cause OA to progress more rapidly.

If someone has OA of the knee, the right shoe can help to reduce or even eliminate foot pain which plays a huge role in mobility.

Fast facts on athletic shoes

Here are some key points about athletic shoes. More detail and supporting information is in the main article.

  • Stability shoes help control how the foot rolls when walking and running
  • Neutral shoes are easy to combine with inserts or specially designed insoles
  • Shoes with good cushioning reduce shock to the knees
  • Arch supports help with weight distribution
  • Laces can reduce pressure on the outside of the foot

Types of athletic shoes

Athletic shoes fall into two main categories: stability and neutral shoes.

Two older adults are stretching.
Stability and neutral are the two main types of athletic shoe.

Stability shoes are composed of a dense, cushioned midsole and a heel that is designed to help control motion and overpronation. Overpronation refers to the tendency of the foot to roll inward more than it needs to for weight distribution and shock absorption.

Stability shoes help to take the weight off of the ball of the foot which is very important for people with OA of the knee. For those whose feet roll unevenly, stability shoes also provide good cushioning and motion control.

Neutral shoes do not correct for uneven foot rolling but offer good shock absorption and cushioning. The neutral design also makes it easy to add an insert or custom-molded orthotic, which are commonly prescribed for people with arthritis.

People who are not sure whether their feet roll normally, a podiatrist, orthopedic surgeon or a store specializing in athletic shoes can help. They can look at the distinctive wear patterns of running or walking shoes and determine if they were caused by abnormal pronation.

Neutral sneakers are usually better for walkers and runners with normal pronation and no physical problems. People whose feet do not roll inwardly enough or have issues due to injury or age should look for a shoe that addresses their specific problems.

Tips for choosing the right shoe

Finding the right footwear involves more than choosing a favorite color or getting the right size. Certain things should be kept in mind when shopping for athletic shoes to help minimize knee pain.

Choose well-cushioned shoes

Shoes with plenty of cushion help to prevent shock to the knees while walking or running. Shoes that have a lot of cushion absorb the impact when the foot hits the ground, putting less stress on the knees. Much of the shock never even reaches the knees.

Well-cushioned shoes also help to lessen the impact of walking on hard surfaces such as concrete sidewalks and even standing on concrete floors.

Close up on a walkers trainers.
Firm midsoles are very important for stopping feet from rolling inwardly too much.

Pay attention to the soles

Firm midsoles can help prevent feet from rolling inwardly too much. This is of particular importance for people with low arches. When feet roll too far inward, the lower leg and knee rotate inward each time the foot hits the ground. This inward motion can lead to knee strain and pain.

Make sure they have arch support

Arch supports help to “build up” the arches which helps to lessen pain and make walking or running more comfortable. Arch supports are critical for people with extremely flat feet.

A lack of support can cause discomfort when walking, but arch supports can help to alleviate this problem. They also distribute weight evenly, helping with balance. More importantly, they provide additional shock absorption and take the pressure off of areas that may be sore such as the ball of the foot.

Make sure to get the right size

Many people fail to get the right size shoe. People with wider feet should make sure to look for shoes that come in wide widths. There should be plenty of room in the toe area in addition to the shoe being long enough. Shoes that don’t provide adequate space can lead to blisters and other foot discomfort.

Lace them up

Athletic shoes should have shoe laces. Lacing up shoes helps minimize pain and risk of injury. Shoes that are tightly laced up cut down on uneven foot rolling and reduce impact loading rates.

Lacing shoes up tightly also reduces the pressure on the outside of the foot.

When the foot is firmly anchored in the shoe, friction is reduced which helps to prevent blisters. Make sure that the heel does not come out of the shoe when walking or running.

These steps help to make sure that the foot is properly supported, cutting down on foot or ankle injuries.

Buying a pair of athletic shoes

Orthopedic insoles.
Special inserts can sometimes be added to shoes to help improve the mobility of the wearer.

It is a good idea to visit a shoe store where staffers are trained to help customers choose the right athletic shoe. They can make sure that the best shoe for foot type and activity is chosen.

Some shoes are better geared toward running, and others are designed for people who prefer walking.

Visit a podiatrist or another specialist for information about special inserts or orthotics that may help to improve mobility.

Unfortunately, OA of the knee cannot be reversed, but lifestyle changes such as incorporating exercise can help.

These are just a few things to look for when finding the best walking or running shoes for knee OA. It is important to invest in the right athletic shoes to avoid further aggravating the condition.

Shoppers should be prepared to ask questions and try on dozens of shoes if needed before finding the right one. All feet are different so shoes that are recommended for low arches or unevenness may not necessarily work for everyone.

Shoes should not have to be “broken in” and if they are too tight in the store, there is nothing that says that they will loosen up. Wearers should consult a doctor if pain and discomfort continue to be experienced.

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30 May

Medical News Today: Wearable, tricorder-like device elevates health and fitness monitoring

Star Trek fans will be familiar with the tricorder – a device used in the fictional TV series to scan and gather detailed information about places and living things. Now, researchers have brought the technology to the real world, creating a wearable, tricorder-like device that can measure biochemical and electrical signals in the human body simultaneously.
[The Chem-Phys patch]
The Chem-Phys patch is the first wearable device to measure biochemical and electrical body signals simultaneously.
Image credit: Jacobs School of Engineering/UC-San Diego

The device – called the “Chem-Phys patch” – measures real-time levels of lactate, a biochemical that serves as an indicator of physical activity, as well as the heart’s electrical activity.

Put simply, the novel technology monitors a person’s fitness levels and heart function at the same time, and it is the first device that can do so.

“One of the overarching goals of our research is to build a wearable tricorder-like device that can measure simultaneously a whole suite of chemical, physical and electrophysiological signals continuously throughout the day,” says co-project leader Patrick Mercier, of the Jacobs School of Engineering at the University of California-San Diego.

“This research represents an important first step to show this may be possible.”

Mercier and colleagues reveal how the device was created and how it works in a study published in Nature Communications.

According to the team, the majority of wearable fitness trackers currently on the market only have the ability to measure one body signal at a time, such as the number of steps taken or heart rate.

Furthermore, almost none of them have the ability to measure chemical signals, such as lactate.

Mercier and colleagues set out to address this gap in the field by creating a wearable sensor that can simultaneously measure electrical and biochemical body signals.

How was the Chem-Phys patch created?

The Chem-Phys patch is made of a thin, adhesive, flexible sheet of polyester, which the researchers manufactured using screen printing.

A lactate-sensing electrode is situated in the center of the patch, and two electrocardiogram (EKG) electrodes – which sense the heart’s electrical signals – are situated either side.

The main challenge the team faced was ensuring that the signals from each electrode did not interfere with each other, which could skew the results.

The researchers placed the electrodes at various distances from each other and tested which distance best avoided interference. They found that a distance of 4 centimeters – around 1.5 inches – between the EKG electrodes provided the best quality signal.

Additionally, the researchers needed to ensure the EKG sensors were entirely separate from the lactate sensor; because the lactate sensor works with the help of a small voltage, which can pass through sweat, it has the potential to disrupt EKG readings.

To make sure sweat only comes into contact with the lactate sensor, avoiding the EKG electrodes, a soft, water-repellent silicone rubber was added to the device.

Next, the researchers connected each sensor to a small, custom-printed circuit board. This consists of a microcontroller and a Bluetooth low energy chip, which send the information gathered by the device to a smartphone, smartwatch, or laptop.

Device could benefit elite athletes, heart disease patients

For their study, Mercier and colleagues tested the Chem-Phys patch on three men as they engaged in 15-30 minutes of intense cycling.

All three men wore the patch on their chest, near the base of their sternum, and two of the men also wore a commercial heart rate monitor on their wrist.

The researchers found that the data collected by the EKG electrodes closely matched the data collected by the commercial heart rate monitor.

Furthermore, they found that the information gathered by the lactate sensor closely matched lactate data collected during increasing physical activity in previous studies.

Based on their results, the researchers believe their Chem-Phys patch brings closer the possibility of a wearable fitness device that simultaneously measures a variety of body signals.

The researchers say their device could prove useful in a number of areas.

“There would certainly be interest in the sports medicine community about how this type of sensing could help optimize training regimens for elite athletes.

The ability to concurrently assess EKG and lactate could also open up some interesting possibilities in preventing and/or managing individuals with cardiovascular disease.”

Dr. Kevin Patrick, University of California-San Diego

The team now plans to make a number of improvements to the device, including the addition of sensors that can measure other vital signs and chemical markers, such as magnesium and potassium.

Read about a wearable sweat sensor that could monitor dehydration and fatigue.

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Source: medicalnewstoday

29 May

Medical News Today: Wire-bristle brushes: A barbecue health hazard

As we dust off our barbecues in preparation for Memorial Day weekend, researchers offer a word of caution: check your food before eating – it may be tainted with wire bristles from grill-cleaning brushes. If swallowed, they can cause severe injury.
[A man cleaning a barbecue]
Wire-bristle brushes used to clean barbecues can lead to serious injuries if ingested.

A new study published in the journal Otolaryngology-Head and Neck Surgery estimates that between 2002-2014, more than 1,600 emergency department visits occurred as a result of wire-bristle brush injuries.

While wire grill brushes may be an effective cleaning tool prior to or following a cookout, the bristles can easily fall off and make their way into people’s food.

If ingested, these little strands of metal can cause some serious injuries to the mouth, throat, and gastrointestinal region.

“One little bristle unrecognized could get lodged in various areas of the body, whether in the throat, tonsil, or neck region,” explains study co-author Dr. David Chang, of the University of Missouri School of Medicine.

He notes that if the bristle passes through these regions without getting stuck, it may become embedded in the esophagus, stomach, or intestine.

“The biggest worry is that it will lodge into those areas and get stuck in the wall of the intestine. The bristles could migrate out of the intestine and cause further internal damage.”

Wire-bristle brush injuries ‘a potential consumer safety issue’

For their study, Dr. Chang and colleagues wanted to get an idea of the scale of wire-bristle brush injuries in the United States.

To do so, they analyzed data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS).

From this information, the researchers were able to estimate the number of emergency department visits that occurred due to wire-bristle brush injuries between 2002-2014.

The team found that 1,698 visits occurred as a result of such injuries during that time. Most of these injuries involved the mouth, throat, and tonsils, with some requiring surgery.

Dr. Chang notes that the incidence of wire-bristle brush injuries between 2002-2014 is likely to be even bigger, since the researchers did not account for injuries reported by urgent care facilities and other outpatient settings.

The researchers hope their findings will promote greater awareness among manufacturers, consumers, and healthcare providers of the potential health hazards associated with wire-bristle brushes.

“Wire-bristle brush injuries are a potential consumer safety issue, so it is important that people, manufacturers, and health providers be aware of the problem.

If doctors are unaware that this problem exists, they may not order the appropriate tests or capture the correct patient history to reach the right diagnosis.”

Dr. David Chang

How to avoid wire-bristle brush injuries

With the barbecue season upon us – a period when wire-bristle brush injuries are most likely – Dr. Chang offers a number of tips to help avoid a visit to the emergency department.

  • Before cleaning your grill with a wire brush, check the utensil is in a good condition; throw it away if there are any loose bristles
  • Use alternative cleaning methods, such as nylon-bristle brushes
  • Check the grates of your grill before cooking food
  • Check your grilled food after cooking to make sure there are no loose bristles stuck to it

“If cautionary measures fail and individuals do experience problems with swallowing or pain after eating something that has been barbecued or grilled, they should seek advice from a physician or an emergency department and let the physician know that they were just at a barbecue event or they just grilled food,” adds Dr. Chang.

Learn how laundry detergent pods are becoming an increasing health hazard for children.

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