Month: August 2022

Categories : Exercise

A Little Less is More for Muscle Strength Training

On By ModernMedia
Photo by Jonathan Borba on Unsplash

A new study published in the Scandinavian Journal of Medicine and Science in Sports reveals that, when it comes to maintaining muscle strength and size, frequent, limited bouts of exercise are optimal.

This latest research from Edith Cowan University (ECU) is in collaboration with Niigata University and Nishi Kyushu University in Japan. In the study, a the four-week training programme had three groups of participants performing an arm resistance exercise and changes in muscle strength and muscle thickness were measured and compared.

The exercise consisted of ‘maximal voluntary eccentric bicep contractions’ performed on a machine which measures muscle strength in each muscle contraction you would do at the gym.

An eccentric contraction is when the muscle is lengthening; in this case, like lowering a heavy dumbbell in a bicep curl.

Two groups performed 30 contractions per week, with one group doing six contractions a day for five days a week (6×5 group), while the other crammed all 30 into a single day, once a week (30×1 group).

Another group only performed six contractions one day a week.

After four weeks, the group doing 30 contractions in a single day did not show any increase in muscle strength, although muscle thickness increased 5.8%.

The group doing six contractions once a week did not show any changes in muscle strength and muscle thickness.

However, the 6×5 group saw a more than 10% increases in muscle strength, with an increase in muscle thickness similar to the 30×1 group. 

Frequency, not volume

Importantly, the increase in muscle strength of the 6×5 group was similar to the group in a previous study that performed only one three-second maximal eccentric contraction per day for five days a week for four weeks. 

ECU Exercise and Sports Science Professor Ken Nosaka said these studies continue to suggest very manageable amounts of exercise done regularly can have a real effect on people’s strength.

“People think they have to do a lengthy session of resistance training in the gym, but that’s not the case,” he said.

“Just lowering a heavy dumbbell slowly once or six times a day is enough.”

Professor Nosaka said while the study required participants to exert maximum effort, early findings from current, ongoing research indicated similar results could be achieved without needing to push as hard as possible.

“We only used the bicep curl exercise in this study, but we believe this would be the case for other muscles also, at least to some extent,” he said.

“Muscle strength is important to our health. This could help prevent a decrease in muscle mass and strength with ageing.

“A decrease in muscle mass is a cause of many chronic disease such as cardiovascular disease, type 2 diabetes, some cancers, dementia, plus musculoskeletal problems such as osteoporosis.”

Jut why the body responds better to resistance exercises with eccentric contractions in smaller doses rather than bigger, less frequent loads is not known at this stage.

Prof Nosaka said it may relate to how often the brain is asked to make a muscle perform in a particular manner.

However, he stressed it was also important to include rest in an exercise regimen.

“In this study, the 6×5 group had two days off per week,” he said.

“Muscle adaptions occur when we are resting; if someone was able to somehow train 24 hours a day, there would actually be no improvement at all.

“Muscles need rest to improve their strength and their muscle mass, but muscles appear to like to be stimulated more frequently.”

He also highlighted if someone was unable to exercise for a period, there was no value in trying to “make up” for it with a longer session later.

“If someone’s sick and can’t exercise for a week, that’s fine, but it is better to just return to regular exercise routine when you’re feeling better” he said.

Source: Edith Cowan University

Categories : Pain Management

Working to Reduce the Pain that Children Suffer from Chemotherapy

On By ModernMedia
Male doctor with young girl patient
Photo by National Cancer Institute on Unsplash

At the University of Queensland, researchers are seeking ways to educe the pain that children experience when they undergo chemotherapy from feeling pain and other debilitating side-effects. Due to differences in metabolism and their immune responses, children react differently to cancer treatments which are usually designed with adults in mind.

An example of their research was the discovery that anakinra, a drug normally used to treat arthritis in children, could potentially relieve the pain and unpleasant effects of the chemotherapy drug vincristine.

Dr Hana Starobova at UQ has been awarded a Fellowship Grant from the Children’s Hospital Foundation to continue her research to relieve children from the side-effects of cancer treatments.

“Although children have a higher survival rate than adults following cancer treatments, they can still be suffering side-effects well into their adulthood,” Dr Starobova said.

“A five-year-old cancer patient could be suffering severe pain, gastrointestinal problems, or difficulty walking 20 years on from treatment.

“There has been a lack of studies on children, which is an issue because they are not just small adults – they suffer from different cancers, their immune systems work differently and they have a faster metabolism, all of which affect how treatments work.

“Our aim is to treat children before the damage happens, so the side-effects are dramatically reduced or don’t occur in the first place.”

In her previous research, Dr Starobova found an anti-inflammatory drug substantially reduced nerve pain associated with a chemotherapy drug, and did not reduce the effectiveness of the cancer treatment.

Dr Starobova is currently analysing how specific drugs could prevent a cascade of inflammation caused by chemotherapy drugs, which lead to tingling and numbness in hands and feet, and muscle pain and weakness that makes everyday tasks, like walking and doing up buttons, a challenge.

Her focus is on acute lymphoblastic leukaemia, one of the most frequently diagnosed cancers in children.

A woman in a white lab coat, goggles and gloves holds a piece of equipment in a laboratory, she is smiling at the camera
Dr Hana Starobova

In collaboration with Brisbane’s Queensland Children’s Hospital and Mater Children’s Hospital, and Perth’s Telethon Kids Institute, Dr Starobova and her team share a strong motivation to improve quality of life for children.

“We are studying the most commonly used chemotherapy treatment for children, which is a mix of drugs that are very toxic, but have to be used to treat the cancer fast and stop it becoming resistant to the drugs,” Dr Starobova said.

“It’s a fine balance – too little chemotherapy and the cancer won’t be killed but sometimes the side-effects are so bad, patients have to stop the therapy.

“I hope that by having a treatment to reduce side-effects, it will be one less thing for these kids and their families to worry about.”

Source: University of Queensland

Categories : COVIDTags :

Long COVID Resulted in Long-term Increase in Health Service Use

On By ModernMedia
Image by Quicknews

A US study published in JAMA Network Open found that COVID was associated with a 4% increase in use of health care services across that country over the six months after initial infection.

Long COVID is known to affect some COVID patients long after symptoms of the acute infection had subsided. The typical clinical symptoms in long COVID are tiredness, dyspnoea, fatigue, brain fogginess, autonomic dysfunction, headache, persistent loss of smell or taste, cough, depression, low-grade fevers, palpitations, dizziness, muscle pain, and joint pains. This study showed that the greatest increase in encounters for these patients was in virtual visits, followed by emergency department visits.

“This study showed us that, in terms of the number of follow-up visits, a substantial amount of health care utilisation occurs in the six months following the acute stage of SARS-CoV-2 infection, which highlights the potential for COVID to exert an ongoing demand  on health care organisations,” said epidemiologist Sara Y. Tartof, PhD, one of the study’s lead authors. “A 4% increase in encounters applied across a large population is a large number of visits associated with substantial cost. The absolute number is big. In this case, it was over 27 000 extra encounters among the eight health care organisations included in this study.”

Dr Tartof added: “On a broader scale, this study will help health care organisations develop their long-term strategic plans to meet patients’ needs following COVID infection.”

This study included patients of all ages from eight large integrated health care organizations across the US who completed a COVID diagnostic test between March 1 and November 1, 2020. Patients were matched on age, sex, race, ethnicity, site, and date of COVID test, and were followed for 6 months. The final matched study group consisted of 127 859 patients who tested positive for COVID-19 with an equal number testing negative.

  • Overall coronavirus infection was associated with a 4% increase in health care use over six months, predominantly for virtual encounters, followed by emergency department visits.
  • COVID-associated health care encounters for 18 conditions remained elevated 6 months from the acute stage of illness, with the largest increase in COVID-related utilisation including:
    • lingering COVID
    • alopecia, also known as hair loss
    • bronchitis
    • pulmonary embolism or deep vein thrombosis
    • difficulty breathing
  • In total, extra health care use associated with the effects of COVID infection consisted of 212.9 additional encounters per 1000 patients with COVID.
  • The study is one of the largest and most comprehensive studies of post-COVID utilisation among children under age 17.
  • COVID-positive children experienced increased health care use over six months for pulmonary embolism or deep vein thrombosis; irregular heartbeat; difficulty breathing; and ear, nose, and throat disorders.

“With complete data from all care settings across large integrated health care organisations, this study represents one of the largest and most comprehensive studies of post-COVID conditions to date,” said epidemiologist Debbie Malden, DPhil, another lead author.

Source: Kaiser Permanente

Categories : Surgeries & ProceduresTags :

Regenerating Muscles for Better Rotator Cuff Repair

On By ModernMedia
Photo by Harlie Raethel on Unsplash

Researchers have pioneered a technique way to regenerate muscle that could help encourage muscle growth in damaged rotator cuff muscles and aid in their repair. Their findings are available to read online in the Proceedings of the National Academy of Sciences.

Tears of the major tendons in the shoulder joint, commonly called the rotator cuff, are common injuries in adults. Improved rotator cuff repairs are now possible with surgical advances, though failure rates with surgery can still be high.  Now, a team of researchers from the UConn School of Medicine led by surgeon, engineer and scientist Dr Cato T. Laurencin reported that a graphene/polymer matrix embedded into shoulder muscle can prevent re-tear injuries.

“Most repairs focus on the tendon,” and how to reattach it to the bone most effectively, Laurencin says. “But the real problem is that the muscle degenerates and accumulates fat. With a tear, the muscle shrinks, and the body grows fat in that area instead. When the tendon and muscle are finally reattached surgically to the shoulder bone, the weakened muscle can’t handle normal stresses and the area can be re-injured again.

The researchers developed a polymer mesh infused with nanoplatelets of graphene. When they used it to repair the shoulders of rats who had chronic rotator cuff tears with muscle atrophy, the muscle grew back. When they tried growing muscle on the mesh in a petri dish in the lab, they found the material seemed to encourage the growth of myotubes, precursors of muscle, and discourage the formation of fat.

“This is really a potential breakthrough treatment for tears of the rotator cuff. It addresses the real problem: muscle degeneration and fat accumulation,” Dr Laurencin said.

The next step in their work is studying the matrix in a large animal. The team looks forward to developing the technology in humans.

Source: University of Connecticut

Categories : Pain ManagementTags :

Intraosseous Morphine Reduces Pain after Knee Replacement Surgery

On By ModernMedia
Knee pain
Source: CC0

In knee replacement patients, injecting a combination of morphine and the antibiotic vancomycin into the tibia of their knee joint resulted in less pain post-surgery compared to those who received the infusion without morphine during surgery. The findings were published in The Journal of Arthroplasty.

“Despite many technological advances, controlling pain after total knee arthroplasty can be challenging; most patients experience considerable pain and discomfort, especially in the first couple of weeks into their recovery,” explained Kwan “Kevin” Park, MD, orthopaedic surgeon at Houston Methodist. “Intraosseous infusion, which involves injecting medication directly into the bone marrow, allows us to control pain pre-emptively so that patients don’t have to take as much pain medicine later on.”

Total knee replacement is the recommended treatment to alleviate chronic pain caused by damage to the knee joint from arthritis or injury.

Despite the high frequency and favourable outcomes of the surgical procedure, the manipulation of soft tissue and resurfacing damaged bones during knee replacement cause pain in the early postoperative periods.

“Twenty years ago, patients would remain in the hospital for several days after their surgery and receive extremely high-dose narcotics to help with their postoperative pain,” Dr Park said. “But there has been a paradigm shift; patients are often discharged the same day after knee replacement surgery, and we use multimodal pain management techniques that work much better for pain control and require fewer narcotics.”

These multimodal regimens, he added, often include a combination of medications, such as nonsteroidal anti-inflammatory drugs, opioids and neurogenic agents that act on the nervous system, administered both pre-emptively and after the surgery. However, opioid medications, although very effective in managing pain, have known side effects, like constipation and nausea, and some individuals are allergic to opiates. Opioid medication can be highly addictive, as well. Furthermore, a consensus on the optimal preoperative protocol to mitigate pain is lacking.

Previously, the researchers demonstrated that injecting the antibiotic vancomycin directly into the tibia before surgery helped in reducing infection by reaching a higher concentration of the drug in the knee. Motivated by this success, they investigated whether adding morphine into the tibial bone with a standard antibiotic solution could improve postoperative pain management.

For the study, the team included 48 patients needing total knee replacement surgery. Of these patients, half were randomised to receive vancomycin and morphine injected directly into the bone marrow, using an infusion device that was inserted into the tibial tubercle region, and the remainder were only administered vancomycin as controls. Post-surgery, the researchers monitored patient-reported pain, nausea and opioid use for up to 14 days after surgery. Serum levels of morphine and interleukin-6 were measured in all study participants for 10 hours after the operation.

Analysis showed that the vancomycin and morphine group had lower pain scores after their knee replacements compared to the controls. This was effective up to two weeks after surgery. Further, these patients also reported having less pain for several days even though they had similar interleukin-6 inflammatory marker levels as the control group. Taken together, although the patients who received pain medication infused directly into the tibia during surgery had comparable inflammation, these patients were taking less pain medication post-surgery.

Dr Park noted that this infusion of opiates directly into the bone marrow during surgery could potentially even facilitate a swifter recovery of the knee joint.

“By infusing pain medication intraosseously we’re able to reduce postoperative pain for up to two weeks, reduce the number of pain pills patients need and even possibly improve the function of the knee over time,” he said. “Our technique also can improve the multimodal pain management protocol we have been using for knee replacement over the years.” 

Source: Houston Methodist

Categories : Diseases, Syndromes and ConditionsTags :

A Breakthrough Tinnitus Therapy – on a Smartphone

On By ModernMedia
Photo by Dylann Hendricks | 딜란 on Unsplash

After 20 years searching for a cure for tinnitus, for which there is no pharmacological treatment, there are ‘encouraging results’ from a clinical trial of a smartphone app therapy, the results of which have been published in Frontiers in Neurology.

The study randomised 61 patients to one of two treatments, the prototype of the new ‘digital polytherapeutic’ or a popular self-help app producing white noise. On average, the group with the polytherapeutic (31 people) showed clinically significant improvements at 12 weeks, while the other group (30 people) did not.

“This is more significant than some of our earlier work and is likely to have a direct impact on future treatment of tinnitus,” said Associate Professor in Audiology at the Universirt of Auckland, Dr Grant Searchfield.

Key to the new treatment is an initial assessment by an audiologist who develops the personalised treatment plan, combining a range of digital tools, based on the individual’s experience of tinnitus.

“Earlier trials have found white noise, goal-based counselling, goal-oriented games and other technology-based therapies are effective for some people some of the time,” says Dr Searchfield.

“This is quicker and more effective, taking 12 weeks rather than 12 months for more individuals to gain some control.”

“What this therapy does is essentially rewire the brain in a way that de-emphasises the sound of the tinnitus to a background noise that has no meaning or relevance to the listener,” Dr Searchfield says.

Audiology research fellow Dr Phil Sanders says the results are exciting and he found running the trial personally rewarding.

“Sixty-five percent of participants reported an improvement. For some people, it was life-changing – where tinnitus was taking over their lives and attention.”

Some people didn’t notice an improvement and their feedback will inform further personalisation, Dr Sanders noted.

Tinnitus is a phantom noise and its causes are complex. It has so far defied successful treatment.

While most people experience tinnitus, or ringing in the ears at least on occasions, around five percent experience it to a distressing degree. Impacts can include trouble sleeping, difficulty carrying out daily tasks and depression.

Dr Searchfield says seeing his patients’ distress and having no effective treatment to offer inspired his research. “I wanted to make a difference.”

The next step will be to refine the prototype and proceed to larger local and international trials with a view to FDA approval.

The researchers hope the app will be clinically available in around six months.

Source: University of Auckland

Categories : Neurodegenerative DiseasesTags :

Researchers Uncover Major Contributor to Alzheimer’s Disease

On By ModernMedia
Gut microbiome. Credit: Darryl Leja, NIH

Research reports for the first time a pathway that begins in the gut and ends with a potent pro-inflammatory toxin in brain cells contributing to the development of Alzheimer’s disease (AD). Results are published in Frontiers in Neurology, where the researchers also report a simple way to counter the process.

The researchers, led by Drs Yuhai Zhao and Walter J Lukiw, found evidence that a molecule containing a very potent microbial-generated neurotoxin (lipopolysaccharide or LPS) derived from the Gram-negative bacteria Bacteroides fragilis in the human gastrointestinal (GI) tract generates a neurotoxin known as BF-LPS.

“LPSs in general are probably the most potent microbial-derived pro-inflammatory neurotoxic glycolipids known,” explained Dr Lukiw. “Many laboratories, including our own, have detected different forms of LPS within neurons of the Alzheimer’s disease-affected human brain.”

The researchers detailed the pathway of BF-LPS from the gut to the brain and its mechanisms of action once there. BF-LPS leaks out of the GI tract, crosses the blood brain barrier via the circulatory system, and accesses brain compartments. Then it increases inflammation in brain cells and inhibits neuron-specific neurofilament light (NF-L,) a protein that supports cell integrity. A deficit of this protein leads to progressive neuronal cell atrophy, and ultimately cell death, as is observed in AD-affected neurons. They also report that adequate intake of dietary fibber can head off the process.

The novel features of this newly described pathological pathway are threefold. The AD-stimulating pathway begins in the gut microbiome and therefore is very “locally sourced” and active throughout our lives. The highly potent neurotoxin BF-LPS is a natural by-product of gut-based microbial metabolism. Bacteroides fragilis abundance in the microbiome, which is the source of the neurotoxin BF-LPS, can be regulated by dietary fiber intake.

“Put another way, dietary-based approaches to balance the microorganisms in the microbiome may be an attractive means to modify the abundance, speciation, and complexity of enterotoxigenic forms of AD-relevant microbes and their potential for the pathological discharge of highly neurotoxic microbial-derived secretions that include BF-LPS and other forms of LPS,” Dr Lukiw explained.

The researchers conclude that an improved understanding of the interaction between the Gut–Brain axis and the gut microbiome and Alzheimer’s disease has considerable potential to lead to new diagnostic and therapeutic strategies in the clinical management of Alzheimer’s disease and other lethal, progressive, and age-related neurodegenerative disorders.

Source: Louisiana State University Health Sciences Center

Categories : Pain ManagementTags :

Clinical Trial Finds Dry Cupping Relieves Chronic Back Pain

On By ModernMedia
Photo by RODNAE Productions

In the Journal of Acupuncture and Meridian Studies, researchers report that combining ear acupuncture with dry cupping to treat chronic back pain, and showed that it can provide effective relief over acupuncture alone.

Dating back to ancient times, cupping therapy is a technique that uses cups placed over the skin to create negative pressure through suction. In 400 BC, Herodotus listed wet and dry cupping as a treatment for many ailments, including maldigestion, lack of appetite, and headaches. Ear acupuncture, also known as ‘battlefield acupuncture’ has also been modernised by the US military as a simple treatment method in challenging environments.

The open-label, randomised, parallel-group controlled clinical trial recruited 198 adults with chronic back pain. The people were randomised to receive only ear acupuncture as the control group or receive ear acupuncture along with dry cupping as the experimental group.

Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life.

Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group.

Source: Keck School of Medicine USC

Categories : Ageing General InterestTags :

The 100 Year Old Doctor Who Won’t Hang Up His Stethoscope

On By ModernMedia
Credit: “What’s Next” Documentary

At 100, Dr Howard Tucker holds the Guinness world record for being the world’s oldest practising doctor. Though he has only just stopped seeing patients, he still teaches medical residents at St. Vincent Charity Medical Center in Ohio, USA.

Having practised medicine for 75 years, the secret is to keep going, he said. “I look upon retirement as the enemy of longevity,” Dr Tucker told TODAY over a video call. He has a computer and smartphone, and is determined to keep up with technology.

“I think that to retire, one can face potential shrivelling up and ending in a nursing home. It’s fun staying alive and working…  It’s delightful work. Every day I learn something new.”

Born on July 10, 1922 and graduating from medical school in 1947, Dr Tucker got the “gift of COVID” from one of his relatives at his 100th birthday last month, but recovered quickly and felt fine. He even broke is neck while skiing in the late 1980s, though he “came out of it totally intact”.

At age 67 he passed the Ohio Bar Exam because he was interested in law.

Tucker shared some of his longevity advice with TODAY:

“Heredity and family history of longevity is a healthy start. However, it must be supported by moderation of nutrition, alcohol, and happiness,” Dr Tucker explained in his Guinness World Records entry.

Longevity runs in his family: his mother lived to 84 and his father to 96, and he has avoided the diseases of ageing such as heart disease and dementia. In addition, Dr Tucker never smokes but drinks alcohol occasionally, and eats in moderation. He has exercised his entire life – though he is now banned from skiing. The day after his 100th birthday, he threw the opening pitch for a baseball game.

His advice is to not retire , and stay active. Though there are jobs which people can’t or don’t wat to do anymore as they age, people should at least take up a hobby or do communal work to provide a daily stimulus for the brain.

The other challenge is to keep learning. As well as earning his law degree, he stayed current with technology, for which he credits his grandson, Austin, who is also making a documentary about the centenarian’s life. He also keeps up with his field of neurology, which he follows with excitement.

Finally, Dr Tucker said that you have to cultivate happiness. “You have to be happy in your job and in your domestic life,” he said.

Source: Today

Categories : Uncategorized

Small Trial Suggests that Dupilumab is Effective in Severe COVID

On By ModernMedia
Photo by Mufid Majnun on Unsplash

Dupilumab, a monoclonal antibody that suppresses interleukin-13 can improve survival rates for patients with moderate to severe COVID, according to the results of a small clinical trial published in the Open Forum of Infectious Diseases.

Dupilumab is most often prescribed for skin conditions such as atopic dermatitis, asthma, and sinus congestion and swelling. The treatment also proved safe in the small study, as expected, because dupilumab is already a safe and effective allergy medicine.

The small trial, designed and led by Dr Jennifer Sasson, found that dupilumab improved patient survival at 60 days and reduced the number of patients who needed intensive care. Almost 90% of patients who received dupilumab in the randomised trial were alive at 60 days, compared with 76% of patients who did not.

“Our clinical trial suggests that treatment with the anti-allergy medicine dupilumab may decrease deaths due to COVID,” said Dr Sasson, of the University of Virginia School of Medicine. “A large multi-institution study to validate these preliminary results is being designed. If successful, this multi-site trial will open a new window to treatment of COVID and potentially other viral pneumonias.”

Cytokine levels inspire trial

The researchers were inspired to launch the trial after discovering that COVID patients were at significantly greater risk of needing a ventilator if their blood contained high levels of the cytokine interleukin-13. Dupilumab, which received FDA approval in 2017, works by blocking the effects of IL-13 and reducing inflammation.

To see if dupilumab could improve the body’s immune response to COVID, Sasson and her collaborators enrolled 40 patients with moderate to severe cases in a clinical trial. The trial was double-blinded, meaning neither the patients nor the doctors knew whether the patient was receiving the antibody or a placebo. Both groups of trial participants otherwise received standard care.

After 28 days, no difference was seen between the two groups in ventilator-free survival or in adverse events. But by 60 days, there were only two deaths among the patients receiving dupilumab and five deaths among those receiving placebo. 

Among the patients who were not already in the intensive care unit when they joined the trial, three receiving dupilumab were ultimately admitted to the ICU, compared to six receiving placebo.

Source: University of Virginia