New robotic device to help patients with spinal cord injury

Researchers from Columbia University in the US have invented a robotic device that can be used to assist and train people with Spinal Cord Injuries (SCIs). The team consisting of an Indian, said the device delivers forces on the torso when the user performs upper body movements beyond the postural stability limits while sitting.The device can help the patient to sit more stably, an advance which may aid the recovery of patients with SCI.

The robotic device— the Trunk-Support Trainer, or TruST—is a motorised-cable driven belt placed on the torso of people with SCI to determine their control limits of posture, and workspace area while sitting.

The study, published on Monday in the journal Spinal Cord Series and Cases, is the first to measure and define the sitting workspace of patients with SCI based on their active trunk control.

"We designed TruST for people with SCIs who are typically wheelchair users," said study co-author Sunil Agrawal from Columbia University.

"We found that TruST not only prevents patients from falling, but also maximizes trunk movements beyond patients' postural control, or balance limits," he added.

Five subjects participated in a pilot study examining TruST with the Postural Star-Sitting Test.

In this customised postural test, the participants were required to follow a ball with their head and move their trunk as far as possible, without using their hands.

The users repeated the test in eight directions, following which the researchers used the results to compute the sitting workspace of each individual.

TruST was customised for each subject, the researchers said, so that they could apply personalised assistive force fields on the torso while the participants performed the same movements again.

With the new robotic device, the subjects could reach further during the trunk excursions in all eight directions.

According to the study, TruST significantly expanded the sitting workspace around their bodies, on an average of about 25 per cent more.

"The capacity of TruST to deliver continuous force-feedback personalised for the user's postural limits opens new frontiers to implement motor learning-based paradigms to retrain functional sitting in people with SCI. We think TruST is a very promising SCI rehab tool," said study co-author Victor Santamaria, a physical therapist at Columbia University.

Agrawal and his team are now exploring the use of TruST to improve the trunk control of adults and children with SCI.

"The robotic platform will be used to train participants with SCI by challenging them to move their trunk over a larger workspace, with TruST providing assist-as-needed force fields to safely bring the subjects back to their neutral sitting posture. This force field will be adjusted to the needs of the participants over time as they improve their workspace and posture control," Agrawal said. 

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A common indicator of cardiovascular disease may also detect cancer

One of the most common signs of cardiovascular diseasee can also detect cancer, found a new study. Microvascular endothelial dysfunction, a common early sign of cardiovascular disease, maybe a useful marker for predicting risk of solid-tumour cancer, the finding was published in the European Journal of Preventive Cardiology.

Researchers in the study involved 488 cardiac patients whose cases were followed for up to 12 years.

"The study demonstrated that noninvasive vascular function assessment may predict the future development of cancer," said senior author, a cardiologist and director of cardiovascular research at Mayo Clinic.

Microvascular endothelial dysfunction involves damage to the walls of small arteries in the heart, which affects their ability to expand and limits the flow of oxygen-rich blood.

Hypertension, high cholesterol, obesity, and diabetes are among the causes, and symptoms of dysfunction include chest pain. The condition is treatable but difficult to detect.

The study reviewed the cases of 488 patients who underwent microvascular endothelial function assessment at Mayo Clinic between 2006 and 2014.

The noninvasive procedure, called reactive hyperemia peripheral arterial tonometry, measures blood flow to the fingers during blood pressure inflation and release.

Dysfunction was defined as a tonometry index at or below 2, and the median follow-up period was six years. Of 221 patients identified as having dysfunction, 9.5 per cent were diagnosed with solid-tumour cancer during the follow-up period.

The findings were consistent after adjusting for age, gender, coronary artery disease and other factors.

Moreover, the association between the sign and cancer was independent but more prominent among men and in patients with factors such as hypertension, significant coronary artery disease, smoking and obesity.

"This risk prediction appears to precede the development of the disease by more than five years," the Dr. said.

Patients with microvascular endothelial dysfunction tend to have other health issues, as well, and that may have drawn more medical attention to these patients, resulting in higher levels of incidental detection of cancer, according to the study.

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Are cooling caps the solution to prevent hair loss during chemotherapy?

Hair loss—one of the most-feared side effects of cancer treatment—may have met its match. Scientists have known since the 80s that cooling a person's scalp can prevent significant hair loss during chemotherapy. A cooling device called DigniCap was approved for women with breast cancer by the U.S. Food and Drug Administration in 2015. This cap was tested in a clinical trial at UCLA led by Dr. Sara Hurvitz, director of hematology and oncology breast cancer program at UCLA's Jonsson Comprehensive Cancer Center. 

Two studies  found that the cap was effective; results showed that women lost less than 50 percent of their hair. The trial Hurvitz participated in paved the way for physicians to help people with cancer overcome one of the most visible signs of treatment.

How did scientists come up with the idea of cooling the scalp to help save the hair of a woman who has cancer, and how long did the development process take?
The idea to cool the scalp during chemotherapy infusion to reduce hair loss is not a new one. It has been in place for over three decades and evaluated by several other companies. There are other devices in use clinically. This is the first one to be FDA approved.

How did your research play a role in the FDA approval of this cooling cap?
We participated in the clinical trial that led to the FDA approval of this device. We enrolled and treated multiple patients on this study who were undergoing standard chemotherapy for early stage breast cancer.

How does the cooling cap actually work?
Cooling the scalp slows down blood flow to the hair follicles during the infusion of chemotherapy, which in turn limits the delivery of chemotherapy to the scalp. This lessens the toxic effects of chemotherapy on the hair follicle, thus limiting hair loss. Several devices utilize ice caps that are cumbersome to store and to manage. The device we evaluated is a tight-fitting cap, much like a bathing cap, that is attached to a cooling machine and worn during chemotherapy and for an hour or two after chemotherapy. This machine avoids the need to use a freezer or change caps during treatment.


Why do you think this cooling cap is beneficial for women going through treatment?
Hair loss from chemotherapy causes a major impact on quality of life for many women with early stage breast cancer. The hope is that reduction in or prevention of hair loss will reduce the emotional stress associated with a cancer diagnosis.

Why is it that some women still lose their hair after using the cooling cap?
Hair loss is not completely prevented in the majority of patients with scalp cooling, but half of patients are able to keep more than 50 percent of their hair with cooling (whereas nearly all patients who take curative chemotherapy without cooling cap use will lose over 50 percent of their hair). This allows a woman to look more like herself during chemotherapy. Hair also tends to fill in and look normal more quickly after chemotherapy has completed, compared to women who did not use scalp cooling.

What is the future of the cooling cap and could it prevent hair loss in people with other cancer types as well as men who have cancer?
Different devices are being evaluated in clinical trials in a variety of cancer types. This could certainly be utilized by male cancer patients as well. 

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Many Causes of Chronic Back Pain and How to Treat Them

Back pain can be a real… well, pain. It limits mobility and often shoots up to the shoulders, spine and can cause neck pain so intense that it can seem like a migraine. Roughly eight out of ten Americans will experience severe back pain at some point in their life, and it is the leading musculoskeletal reason for sick leaves in the U.S. There can be a wide array of reasons for recurring back pain, which makes identifying the cause rather difficult. Here are several possible explanations for the back pain that’s hounding you:

 

1. Underdeveloped Lats

The latissimus dorsi (or lats, as it's commonly referred to) is the single largest muscle in the human torso, and also one that’s rather hard to build up, as it is impossible to isolate in training. Strong lats provide support to the spine and a stable posture. Conversely, underdeveloped lats combined with overdeveloped frontal muscles or excess fatty tissue in the chest or abdomen can strain the back, causing pain. The best exercises for the lats are rowing and pull-ups.

2. Bloating and Other Digestive Problems

While not connected directly to the back muscles, gastrointestinal conditions which cause bloating or inflammation of the stomach and intestines (such as IBS, ulcerative colitis and celiac disease) may cause pain to radiate to the back, due to the proximity of the digestive tract to spinal nerves.

3. Strains and sprains

Injuries to the back muscles and ligaments can be a major reason for back pain, which can be the result of careless physical activity (such as lifting heavy weights) and poorly-developed back muscles. Though sprains and strains are often simple enough to address, we should nevertheless treat them as a wake-up call, as an unconditioned back can lead to all sorts of misfortunes, such as:

4. A herniated disc

The spinal discs are rubbery rings of cartilage surrounding a nucleus of gel. A tear in the outer ring causes the gel to surge forth, pressing against the nerves, causing acute pain. One way to recognize a herniated disc is if the pain shoots down to the legs.

5. Pregnancy

Though usually a cause for celebration, pregnancy can cause serious back pain as weight starts shifting to the front and hormones do their number on the body. By exercising and practicing better posture, some of these pains can be alleviated.

6. Endometriosis

This cruel malady affecting women causes uterus lining tissue to grow outside of the uterus, causing intense pelvic and lower back pain, and ultimately sterilization. If the pain is especially acute during menstrual periods, this may be a sign of endometriosis. Though endometriosis is currently incurable, there are treatments that inhibit pain and delay tissue growth. Due to potential loss of fertility, it may be crucial to catch endometriosis in time and seek treatment.

7. Fibromyalgia

Another vicious medical condition that affects women at a disproportionate rate, fibromyalgia causes widespread chronic pain (including the back), fatigue and depression. Like endometriosis, there is no known cure, but symptoms can be managed through medication, therapy and exercise. Treatment aimed at addressing the mental state of those suffering from fibromyalgia has been shown to be effective in curbing its physical manifestations, as well.

8. Depression

Though not a cause for chronic pain in and of itself, people who complain about chronic pain suffer from depression at an inordinate rate, which is easy enough to understand, considering how disheartening chronic pain can be. And while depression may not be the source of your ailment, it certainly exacerbates it. As mentioned before, by treating the depression aspect of chronic pain, many people have reported an improvement in physical symptoms.

9. Cancer

While not the most common cause for back pain by any stretch of the imagination, several strains of cancer can cause back pain. Obviously, spinal bone cancer will cause pain in the back, but any cancer affecting organs in the vicinity of the spine (such as colon, breast, testicular and lung cancer) can be the catalyst for back pain. About 25% of people diagnosed with lung cancer have reported experiencing back pain as a symptom.

10. Arthritis

Osteoarthritis, a condition characterized by degeneration of joint or spinal cartilage, may be the offender in cases of back pain. Patients suffering from osteoarthritis of the spine often report weakness and numbness in their limbs. As a degenerative disease, it’s unfortunately incurable, but can be managed by weight loss, physical therapy and painkillers.

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Human brain cells develop throughout life

Human beings keep making new brain cells throughout their lives, even into the 90s, a finding that may pave the way to treatments for Alzheimer’s disease –linked to loss in brain cells, according to a study. Scientists had earlier thought that most of our neurons – brain cells that send electrical signals – are indeed in place by the time we are born.

The team looked at the brains of 58 deceased people who were aged between 43 and 97 and focused on the hippocampus – a part of the brain involved in memory and emotion – lost in Alzheimer’s patients. They were able to spot immature or “new” neurons in the brains that they examined, the BBC reported.

In healthy brains there was a “slight decrease” in the amount of this neurogenesis with age. “I believe we would be generating new neurons as long as we need to learn new things,” researcher was quoted .  “And that occurs during every single second of our life,” she added.

However, the study says in people at the beginning of Alzheimer’s, the number of new neurons forming fell from 30,000 per millimetre to 20,000 per millimetre. “That’s a 30 per cent reduction in the very first stage of the disease,”she said.

“It’s very surprising for us, it’s even before the accumulation of amyloid beta (a hallmark of Alzheimer’s) and probably before symptoms, it’s very early.”

Understanding why there is a decrease in neurogenesis could lead to new treatments in both Alzheimer’s and normal ageing, she said.

“While we start losing nerve cells in early adulthood, this research shows that we can continue to produce new ones even into our 90s,” said a researcher.

Alzheimer’s radically accelerates the rate at which we lose nerve cells and this research provides convincing evidence that it also limits the creation of new nerve cells.”

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Drug that limits brain damage in stroke identified

Scientists have identified a drug that limits the death of brain cells due to stroke and helps repair the damage by promoting the birth of neurons.
A reduction in blood flow to the brain caused by stroke is a major cause of death and disability, and there are few effective treatments.
Scientists at The University of Manchester in the UK found that a potential new stroke drug not only works in rodents by limiting the death of existing brain cells but also by promoting the birth of new neurons (so-called neurogenesis).
This finding provides further support for the development of this anti-inflammatory drug, interleukin-1 receptor antagonist (IL-1Ra in short), as a new treatment for stroke.
The drug is already licensed for use in humans for some conditions, including rheumatoid arthritis.
Several early stage clinical trials in stroke with IL-1Ra have already been completed in Manchester, though it is not yet licensed for this condition.
The researchers showed that in rodents with a stroke there is not only reduced brain damage early on after the stroke, but several days later increased numbers of new neurons, when treated with the anti-inflammatory drug IL-1Ra.
Previous attempts to find a drug to prevent brain damage after stroke have proved unsuccessful and this new research offers the possibility of a new treatment.
Importantly, the use of IL-1Ra might be better than other failed drugs in stroke as it not only limits the initial damage to brain cells, but also helps the brain repair itself long-term through the generation of new brain cells. 

 These new cells are thought to help restore function to areas of the brain damaged by the stroke.

Earlier work by the same group showed that treatment with IL-1Ra does indeed help rodents regain motor skills that were initially lost after a stroke. Early stage clinical trials in stroke patients also suggest that IL-1Ra could be beneficial. 

 "The results lend further strong support to the use of IL-1Ra in the treatment of stroke, however further large trials are necessary," said Stuart Allan, professor at University of Manchester.

The study was published in the journal Brain, Behaviour and Immunity. 

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