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Health and wellness

Lap band surgery for extreme obesity also reduces knee pain as patients lose weight, doctors say

The younger patients have the surgery and the more weight they lose, the more they will reduce arthritic knee pain, US researchers say. Also in health news: stem cell treatment counters age-related eye condition, restoring some sight

PUBLISHED : Thursday, 22 March, 2018, 6:16am
UPDATED : Thursday, 22 March, 2018, 6:16am

Extremely obese people who have a band surgically strapped around their stomachs to restrict food intake not only lose weight but also suffer less from arthritic knee pain, a new report has found.

The extra weight they bear causes deterioration and inflammation in the knee joints, say the study leaders at New York University School of Medicine. The pain relief seen with lap-band surgery applied to all patients with osteoarthritic knees, but was most helpful in the youngest men and women who lost the most weight.

“Our study shows that extremely obese people seeking relief from their knee pain should consider lap-band surgery earlier because the benefits from it being successful – although significant for all ages – decrease with age,” says study senior investigator and rheumatologist Jonathan Samuels.

He adds it is likely that knee joints and cartilage become so damaged after a certain point that there is little cushion left for weight loss to preserve. The research team found that people in their 40s reported nearly twice as much pain relief after lap-band as those who had the surgery in their 50s.

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More than 130,000 Americans have had the procedure done since 2011, national statistics show. Although the operation is considered relatively safe, complications may include nausea, stomach ulcers, and infection.

The study authors say their findings are especially important because one in three American adults is now overweight. (In Hong Kong, the Department of Health estimates nearly 39 per cent of the population aged 18 to 64 are overweight or obese.) Studies also show that the number of Americans with osteoarthritis has more than doubled since the second world war.

Published online in the journal Seminars in Arthritis and Rheumatism in February, the new analysis was based on the experiences of 120 patients at NYU Langone Health who had lap-band surgery between 2002 and 2015. All were surveyed about what they remembered about their knee pain immediately before surgery, a year after their procedure, and for as long as 14 years later.

The survey’s main purpose, researchers say, was to find out why some extremely obese people showed more knee-pain relief from lap-band surgery than others. Study participants had an average body mass index, or BMI, of 40, which equates to a 1.78 metre (5 ft 10 in) man weighing 127kg (280 pounds) or a 1.68 metre (5 ft 6 in) tall woman who weighs 113kg (250 pounds).

Survey results found men and women in their 40s experienced post-surgical knee pain reductions after one year of between 50 per cent and 60 per cent; those in their 50s had pain reductions one year later between 30 per cent and 40 per cent; and those in their 60s, had reductions between 20 per cent and 30 per cent. Pain relief persisted for a decade in all patients monitored.

Half of Hongkongers over 15 now overweight or obese, damning government health study reveals

Study participants who lost the most weight had the steepest reductions in knee pain. Dropping more than 13 points on the BMI scale halved their pain scores. EurekAlert

Stem cell eye treatment for age-related condition safe, and restores some vision, study finds

Two people with severe vision loss due to a degenerative eye disease can read after embryonic stem cell treatment, say researchers.

The pair suffer from “wet” age-related macular degeneration, which can blur vision or cause a blind spot when abnormal blood vessels leak fluids into the eye, damaging a layer of cells called the retinal pigment epithelium (RPE). This damage to the retina kills light-sensing cells.

A British-American research team used human embryonic stem cells (hESC) to grow RPE cells on a thin plastic scaffold. They then transplanted this “engineered tissue” into the two volunteers’ eyes.

Before surgery, neither was able to read any more, the team reported this week in the journal Nature Biotechnology. A year later, both could read “with normal reading glasses, though slowly,” said a Nature press summary.

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The team said further research is needed before the procedure can be approved as a treatment.

Embryonic stem cells can become any tissue of the body, raising hope of using them to replace limbs or organs lost to disease, accident, or war. But donated stem cells can provoke an immune response, be rejected by the body, or even cause cancer.

Stem cell expert Dusko Ilic, of King’s College London, describes the study findings as “encouraging”, and says they reduce safety concerns around stem-cell-based therapies.

“They represent another step forward in materialising our hopes of clinical implementation of hESC-based treatment of age-related macular degeneration in the not-so-distant future,” he said.

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The eye is thought to be a promising site for stem cell transplants, as it is behind a shield called the blood-ocular barrier where there is a weaker immune response.

Four years ago, researchers used embryonic stem cells to restore some vision in patients with a more common and less severe form of macular degeneration – the “dry” type.

Other teams are testing so-called induced pluripotent stem cells – adult human cells that have been reprogrammed to a youthful, versatile state.

These can be derived from the patient, making them less likely to be rejected, while also sidestepping ethical qualms about taking cells from embryos.

Pin-prick blood test detects deadly sepsis, research shows

Scientists have unveiled a quick, cheap way to detect sepsis, a life-threatening condition in which the body is attacked by its own immune system.

In clinical trials at Massachusetts General Hospital in Boston, the researchers – by analysing a single drop of blood with a thumb-size filtering device – singled out sepsis patients in a matter of hours with 95 per cent accuracy.

Currently, nearly a third of sepsis patients are misdiagnosed with devices that can take days to yield results. For every hour that a sepsis diagnosis is delayed, the risk of death increases by nearly eight per cent, previous research has shown.

“This approach may allow us to identify patients at risk of developing sepsis earlier than any other method,” said Jarone Lee, director of an intensive care unit at Massachusetts General and co-author of a study in Nature Biomedical Engineering.

Sepsis occurs when the body’s immune system runs amok in reaction to a major infection, leading to low temperature, vomiting and – in extreme cases – tissue damage, organ failure and death.

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The condition affects at least 30 million people worldwide every year, and leaves five million dead, according to a recent study in the American Journal of Respiratory and Critical Care Medicine.

Up to half of people who survive severe sepsis suffer from post-traumatic stress disorder, chronic pain, organ dysfunction or amputations, according to the Sepsis Alliance, a US charitable advocacy organisation.

The researchers’ test isolates a white blood cell type, called a neutrophil.

In earlier research, senior author Daniel Irimia, a surgeon at the hospital and assistant professor at Harvard Medical School, noticed that spontaneous movements of these white blood cells corresponded to the likelihood that patients would develop sepsis. Irimia and colleagues developed the hand-held device that coaxes neutrophils through a microscopic maze.

Follow-up tests with a larger, more diverse group of volunteers are under way.