Orthopaedic Surgeon Shortage Predicted Due to Soaring Joint Replacement Procedures
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In the near future, there may not be enough orthopaedic surgeons to provide joint replacements to all who need them. According to two new studies presented at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the number of patients requiring hip or knee replacement surgery is likely to soon outpace the number of surgeons who can perform the procedure.
According to a study co-authored by Thomas K. Fehring, M.D., if the number of orthopaedic surgeons able to perform total joint replacements continues at its current rate:
• In 2016, 46 percent of needed hip replacements and 72 percent of needed knee replacements will not be able to be completed.
“I was somewhat shocked at the shortfall that we predicted,” says Dr. Fehring, an orthopaedic surgeon at OrthoCarolina Hip and Knee Center in Charlotte. “This is life-changing surgery, offering patients the chance to be mobile, and a very high percentage of patients may not be able to receive it.”
If the Shoe Fits…or Does It?
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Many young children are wearing shoes that are too small, according to a new study presented today at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). As a result, these children may be at high risk for developing serious foot deformities.
The study, which took place in Switzerland, included nearly 250 boys and girls from age 5 to age 10. Researchers measured the children’s feet as well as their indoor and outdoor footwear to determine whether the children were wearing properly sized shoes. They also compared the footwear measurements to the sizes given on the manufacturers’ labels to see if the shoes were marked properly. Finally, they measured the angles of the children’s toes to learn whether any of the subjects were developing a foot deformity called hallux valgus.
Hallux valgus is a condition that occurs when the big toe begins to angle sideways, toward the second toe, causing a bump on the side of the foot just below the big toe. This bump is called a bunion, and can become swollen and painful. Shoes that are too tight are believed to be one of the leading causes of this condition.
ESC reaffirms advice on cardiovascular risks associated with long-haul flights
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Following a review by The Lancet of the medical issues associated with commercial air travel, the European Society of Cardiology has reaffirmed its advice about the risks of venous thromboembolism (VTE), whose risk, according to The Lancet, is increased “up to four-fold” by long-haul flight.
Dr Steen Kristensen, Vice-president of the ESC, says: “Long distance flying is associated with an increase in deep venous thrombosis, which in some cases may lead to clotting of the lungs. People who are immobile, pregnant, taking contraceptive pills or have had venous thrombosis in the past are particularly at risk. To minimise the risk it is important to drink plenty of non-alcoholic fluid and to walk (exercise) before and during the flight. The use of compression stockings is for some travelers an important way of preventing deep venous thrombosis.”
Studies cited by The Lancet suggest that the risk of VTE increases when flight duration exceeds four hours. This raised risk is related to immobility, dehydration, and reduced oxygen in the cabin, as well as to individual risk factors such as obesity, recent surgery and predispositions to thrombosis (thrombophilias).
New Protein May Reverse Neurodegenerative Diseases
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An investigational protein that transformed normal laboratory mice into super-jocks holds great promise in developing new treatments for neurodegenerative diseases like Parkinson’s, Alzheimer’s and ALS (Lou Gehrig’s Disease), say researchers at the University of Virginia Health System.
A study published in the February 17, 2009 online edition of Mitochondrion reports that the protein, rhTFAM (an abbreviation for recombinant-human mitochondrial transcription factor A), succeeded in entering and energizing the DNA of the mice’s mitochondria, enabling them to run two times longer on their rotating rods than a control group cohort.
Because many neurodegenerative diseases cause mitochondria to malfunction, medical researchers have been focusing on developing methods for repairing and restoring them. The new UVA study represents an important step toward achieving that goal. It shows that a naturally occurring protein, TFAM, can be engineered to rapidly pass through cell membranes and target mitochondria. Study findings show that rhTFAM acts on cultured cells carrying a mitochondrial DNA disease as well as lab mice.
At-risk screening not advised for ovarian cancer
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Women with mutations in the BRCA1 or BRCA2 genes are at increased risk for ovarian cancer, but new research indicates that annual screening exams are not worthwhile as they do not help detect the cancer at an early stage.
BRCA1 and BRCA2 belong to a class of genes called tumor suppressors. Both genes encode proteins that help to repair damaged chromosomes. With a mutation in the genes, the proteins cannot perform this job effectively and, therefore, genetic damage persists that may give way to uncontrolled cell growth, also known as cancer. BRCA1 and BRCA2 mutations are also well known for their association with breast cancer.
One option for women with a proven BRCA1 or BRCA2 mutation is to choose screening “with the main objective to identify ovarian cancer in an early stage to improve prognosis and reduce morbidity and mortality,” write Dr. Geertruida H. de Bock and colleagues at the University of Groningen, the Netherlands.
Childhood abuse damages genes, study finds
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Researchers who looked at the brains of suicide victims said on Sunday their findings have helped support theories that childhood abuse can alter the genes and cause lifelong damage.
They found clear changes in the brains of people who were abused as children and who committed suicide in comparison to the brains of people who were not abused and who died in accidents or suicide.
This helps explain why childhood abuse, such as sexual abuse or neglect, can cause depression, other mental health effects and suicide, and could some day lead to treatments to help victims overcome their abusive childhoods.
Calcium use may cut cancer risk in women
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Calcium consumption may reduce the risk of all cancers in women and the risk of cancers of the digestive tract in women and men, according to a report in the Archives of Internal Medicine.
“Our study is one of the first cohort studies to examine dairy food and calcium intakes in relation to total cancer as well as (uncommon) cancers,” Dr. Yikyung Park, from the National Cancer Institute, Bethesda, Maryland, and colleagues note.
Using data from the National Institutes of Health-American Association of Retired Persons Diet and Health Study, the researchers assessed the impact of dairy food and calcium intake on the risk of cancer in 293,907 men and 198,903 women.
Mouse study sheds light on obesity gene
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German scientists said on Sunday they have shown how a gene long associated with obesity might make people fat, a finding that could lead to new drugs to help control weight.
Mice without the FTO gene did not become obese and had less fat tissue overall because they burned off more calories even though they moved less and ate more, according to the study published in the journal Nature.
FTO has been long linked to obesity. Studies have shown people with two copies of the “obese” version of the gene on average weigh nearly 7 lbs (3 kg) more and are about 70 percent more likely to be obese than those with other versions.
Antibodies protect against bird flu and more
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Researchers have discovered human antibodies that neutralize not only H5N1 bird flu but other strains of influenza as well and say they hope to develop them into lifesaving treatments.
The antibodies—immune system proteins that attach to invaders such as viruses—also might be used to protect front-line workers and others at high risk in case a pandemic of flu broke out, the researchers said.
In tests on mice the viruses neutralized several types of influenza A viruses, including the H5N1 avian influenza virus, the researchers reported in Sunday’s issue of the journal Nature Structural & Molecular Biology.
More patient information may not lead to best care
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Colon cancer patients who seek out more information about their care are more likely to be prescribed cutting-edge, expensive medications that aren’t necessarily the best drugs for them, new research shows.
Bevacizumab, sold as Avastin, and cetuximab, brand name Erbitux, are U.S. Food and Drug Administration-approved for treating advanced colon cancer. They are known as targeted therapies; Avastin prevents the development of new blood vessels to tumors, while Erbitux shuts down a protein that regulates cell growth. While both drugs are the standard of care for patients with disease that has spread beyond the colon, or metastasized, they are not approved for use in patients with earlier-stage cancer.
Dr. Stacy W. Gray from the Dana-Farber Cancer Institute in Boston and associates surveyed 633 colon cancer patients to see if information-seeking behavior was related to whether the patients had heard of these drugs and whether they were taking them.
B vitamins may ward off age-related vision loss
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Taking folic acid and vitamin B6 and B12 may help women preserve their eyesight as they age, a new study out in the Archives of Internal Medicine shows.
Among 5,205 women 40 and older, those who had been randomly assigned to take the vitamin combo were about 35 percent less likely to develop age-related macular degeneration (AMD), a deterioration of the retina that is the leading cause of vision loss among older US adults.
“There’s no way other than avoiding cigarette smoking to reduce the risk of the onset of age-related macular degeneration, and this is the first suggestion that maybe there’s something else we can do,” Dr. William G. Christen of Brigham and Women’s Hospital and Harvard Medical School in Boston, a researcher on the study, told Reuters Health. But the findings must be confirmed before the vitamins can be recommended for AMD prevention, he added.
Post Traumatic Stress Disorder and the Female Soldier
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As of September 30, 2008 over 200,000 women were serving on active duty in the U.S. military. While women are technically barred from serving in combat they are serving in support positions in combat areas in greater numbers. This new role for women in the military brings with it new physical and mental health concerns, namely post traumatic stress disorder (PTSD) for those exposed to combat-related trauma.
According the National Institute of Mental Health, PTSD is a condition that develops after a distressing ordeal that involved physical harm or the threat of physical harm. This harm may have happened to the person who develops PTSD or to a friend or loved one, or may have simply been witnessed by the person who develops PTSD. People with PTSD may suffer flashbacks to the traumatic event, become aggressive or withdrawn, have nightmares, or become emotionally numb or even violent. Symptoms of PTSD usually appear about three months after the traumatic event.
PTSD affects approximately 2.6% of the U.S. population. Among military personnel serving in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), that percentage climbs as high as 17%. In the general population, women suffer from PTSD at almost twice the rate as do men. Why are women more susceptible to PTSD? Animal models have shown that male and female rats react to stress differently. For example male rats are more prone to develop memory impairments in response to stressors. In addition, women have been shown to ruminate over non-traumatic negative events more than men, who tend to use more distraction-based coping techniques. While these behaviors may pose evolutionary advantages for each sex, they also may contribute to the increased incidence of PTSD in women. Surprisingly, female soldiers suffer from PTSD at about the same rate as do male soldiers. More study is needed to determine whether the degree of trauma experienced by female soldiers is less severe, due to the differences in job assignments.
Aching Back? Cholesterol Medication Might Help
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Back pain, a hallmark of degenerative disc disease, sends millions of people to their doctor. In fact, more than 80 percent of patients who undergo spine surgery do so because of disc degeneration. And part of the answer may be as close as a patient’s medicine cabinet.
In their quest to discover ways to stop or reverse degenerative disc disease, orthopaedic researchers have been removing disc tissue from patients who are having spine surgery and extracting cells from that tissue for cultivation in vitro (a controlled environment outside of a living organism). They then transfer the cells back into the patient. Shu-Hua Yang, MD, PhD, is part of a Taiwanese research team that has discovered that Lovastatin, a cholesterol-lowering medication, helps the differentiation of disc cells in vitro.
Dr. Yang, who is chief of the department of orthopedics at National Taiwan University Hospital, Yun-Lin-Branch, is presenting the group’s findings in the poster “Lovastatin Helps Re-Differentiation of Human Nucleus Pulposus Cells During Monolayer Expansion” during the 55th Annual Meeting of the Orthopaedic Research Society, Feb. 22–25, 2009, in Las Vegas. Dr. Yang is also presenting the results of a related study, “Influences of Age-Related Degeneration on Regenerative Potential of Human Nucleus Pulposus Cells,” at the same meeting. The two studies reveal the findings of a team of researchers from National Taiwan University Hospital.
Specialized Cognitive Behavioral Treatment Available for People with PTSD and Serious Mental Illness
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Sufferers of post traumatic stress disorder (PTSD) are receiving specialized treatment from UMDNJ-University Behavioral HealthCare as a part of a National Institute of Mental Health study in collaboration with Dartmouth Medical School whose researchers adapted the treatment for people with serious mental illness.
Steven Silverstein, Ph.D., director and Stephanie Marcello, Ph.D., both of the Division of Schizophrenia Research, are implementing the new therapy, which is based on principles of cognitive behavior therapy. The treatment process includes relaxation training, helpful information about how stress causes the symptoms, and “cognitive restructuring” or techniques that people learn to help replace anxiety-arousing thoughts with more realistic appraisals about themselves and the level of danger in their environments. Treatment is closely coordinated with clients’ clinicians.
UMDNJ is the first institution outside of Dartmouth Medical School to offer this new treatment to mentally ill patients in a culturally diverse urban environment. All the patients in the study come from UMDNJ community mental health centers in New Brunswick, South Brunswick, Piscataway, and Newark.
Young teens who smoke may boost MS risk
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Smokers who pick up the habit in their early teens may nearly triple their risk of developing multiple sclerosis (MS) later on, according to the first study to look at the relationship between early smoking and MS.
In MS, the immune system attacks the protective myelin sheath that surrounds nerve cells, causing fatigue, movement problems, loss of coordination, and many other symptoms, which typically first appear in a person’s 20s, 30s or 40s.
Scientists first proposed in the early 1980s that the autoimmune disease could be triggered by some sort of early-life exposure, although this “mysterious factor” has not yet been identified, explained Dr. Joseph Finkelstein of Johns Hopkins University School of Medicine in Baltimore, the lead researcher on the study.
