New therapy to treat ‘tennis elbow’ without surgery

Tennis elbow, painful chronic condition that affect job performance and quality of life, can be effectively treated without surgery, scientists say.

The condition, also known as lateral epicondylitis, stems from repetitive stress injuries that occur in activities such as sports, typing and knitting, and the injury is common in carpenters, cooks and assembly line workers.

Researchers found that through transcatheter arterial embolisation (TAE), an image-guided, non-surgical treatment that decreases abnormal blood flow to the injured area to reduce inflammation and pain, the condition may be treated.

“Tennis elbow can be difficult to treat, leaving many patients unable to perform the simplest tasks, such as picking up their children, cooking dinner, or even working on a computer,” said a researcher.

“With this frustration, many patients turn to invasive major surgery after years of failed physical therapy and medication use,” said  lead author of the study.

“We were interested to see if this technique, already in use in other areas of the body, would be effective for this common, debilitating condition and help people immediately regain a range of motion that many of us take for granted in our everyday tasks,” he said.

The team conducted a prospective study in 52 patients with tennis elbow who did not find relief from other forms of treatment. The patients received TAE between March 2013 and October 2017 and were followed for up to four years after the treatment. The researchers said they found statistically significant reductions in pain-rating scores, and pain-free grip strength. Images taken in 32 patients two years after undergoing TAE showed an improvement in tendinosis and tear scores.

The treatment can be completed in approximately one hour and requires only a needle hole to access the radial artery in the wrist under local anesthesia. A catheter is moved through the wrist to the elbow where the inflamed blood vessels are embolised, preventing excessive blood flow to the affected part of the elbow. The treatment is safe and effective and does not require physical therapy, researchers said. No adverse events were observed and no patients experienced negative effects to the surrounding bones, cartilage or muscles.

Tennis elbow is caused by overuse and repetitive stress to the tendons and muscles around the elbow. It typically affects people who play sports with repetitive swinging motions, such as tennis or golf, but it can also affect job performance of carpenters, cooks, assembly-line workers and others. While pain is a hallmark symptom, chronic tennis elbow can cause loss of grip and arm strength, limited use of the arm, and burning sensations on the outer portion of the arm. 

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Blood, urine tests can detect autism in kids

Scientists have developed new blood and urine tests that can diagnose autism in children, allowing patients to get appropriate treatment much earlier in their lives. Autism spectrum disorders (ASD) are defined as developmental disorders mainly affecting social interaction and they can include a wide spectrum of behavioural problems. These include speech disturbances, repetitive and/or compulsive behaviour, hyperactivity, anxiety, and difficulty to adapt to new environments, some with or without cognitive impairment. Since there is a wide range of ASD symptoms diagnosis can be difficult and uncertain, particularly at the early stages of development. "Our discovery could lead to earlier diagnosis and intervention," said a researcher. "We hope the tests will also reveal new causative factors. With further testing we may reveal specific plasma and urinary profiles or "fingerprints" of compounds with damaging modifications," said the researcher. "This may help us improve the diagnosis of ASD and point the way to new causes of ASD," she said. The study found a link between ASD and damage to proteins in blood plasma by oxidation and glycation - processes where reactive oxygen species (ROS) and sugar molecules spontaneously modify proteins. They found the most reliable of the tests they developed was examining protein in blood plasma where, when tested, children with ASD were found to have higher levels of the oxidation marker dityrosine (DT) and certain sugar-modified compounds called "advanced glycation endproducts" (AGEs). Genetic causes have been found in 30-35 per cent of cases of ASD and the remaining 65-70 per cent of cases are thought to be caused by a combination of environmental factors, multiple mutations, and rare genetic variants. However the research team also believe that the new tests could reveal yet to be identified causes of ASD. The research also confirmed the previously held belief that mutations of amino acid transporters are a genetic variant associated with ASD. Researchers, recruited 38 children who were diagnosed with ASD (29 boys and nine girls) and a control group of 31 healthy children (23 boys and eight girls) between the ages of five and 12. Blood and urine samples were taken from the children for analysis. The team discovered that there were chemical differences between the two groups. The changes in multiple compounds were combined together using artificial intelligence algorithms techniques to develop a mathematical equation or "algorithm" to distinguish between ASD and healthy controls. The outcome was a diagnostic test better than any method currently available.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.    

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Too much physical workload can increase rheumatoid arthritis risk

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Prolonged repetitive physical workload increases the risk of developing rheumatoid arthritis, new research has found.

The findings suggest that building workers are particularly vulnerable to developing the condition.

For example, exposure to repeated vibration, carrying or lifting weights greater than 10 kg, bending/turning, and working with hands either below knee level, or above shoulder level may put people at higher risk of developing the inflammatory disorder affecting many joints, including those in the hands and feet, the findings showed.

For the study, the researchers analysed information from a population of 3,680 rheumatoid arthritis patients and 5,935 matched controls included in the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA).

To investigate whether some people are more susceptible than others, the risk was compared in participants with and without a specific genotype (HLA-DRB1), and an analysis was performed in relation to the presence/absence of ACPA (anti-citrullinated protein antibodies) among rheumatoid arthritis patients.

“We found that some types of physical workload increased the odds of developing RA (rheumatoid arthritis) more than others,” said Pingling Zeng from Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.

“There also appeared to be a significant interaction between genetic makeup, in terms of HLA-DRB1 genes, and the risk of ACPA-positive RA from specific types of physical workload,” she noted.

The estimated odds ratio of developing rheumatoid arthritis in exposed versus unexposed participants was greater than or equal to 1.5, the study said.

The findings were presented at the European League Against Rheumatism Annual Congress (EULAR 2016) in London.

“These new insights into the cause of RA may hopefully lead to effective strategies to prevent the development of RA, particularly in those RA patients with a susceptible genotype,” Zeng concluded.

Oxytocin may help treat psychiatric disorders

Love hormone – oxytocin – could help treat psychiatric disorders such as autism and schizophrenia, according to new research.

Scientists have found encouraging evidence that oxytocin could be a useful treatment for certain mental health diagnoses – particularly those involving impaired social functioning.

Oxytocin is a neuropeptide hormone, most familiar for its role in initiating labour and breast milk flow in pregnant women.

Among other biological effects, oxytocin is “an important regulator of human social behaviours,” according to the research.

Researchers found evidence of oxytocin’s involvement in “social decision making, evaluating and responding to social stimuli, mediating social interactions, and forming social memories” in humans.

Based on these effects, researchers believe that oxytocin may be a common factor in certain psychiatric disorders.

Oxytocin may one day “be a useful treatment agent for improving some aspects of social cognition and for reducing repetitive behaviours” in patients with autism spectrum disorders, although studies are only in the early stages to fully evaluate clinical effectiveness, researchers found.

The authors also discussed a case report of significant reductions in autism severity with oxytocin, and the only controlled trial of long-term oxytocin treatment showed improvement in identifying emotions and quality of life measures.

Studies of oxytocin’s relationship to schizophrenia have yielded conflicting results – associations with oxytocin-related genes don’t appear as strong as for autism.

Nevertheless, some studies have suggested that oxytocin might be a helpful treatment for patients with schizophrenia, with trials reporting encouraging effects on schizophrenia severity and on social cognition.

Because oxytocin is involved in responses to stress, studies have also looked at its potential role in mood disorders and anxiety disorders.

“The evidence suggests a role of oxytocin in the pathophysiology of some psychiatric disorders, particularly those characterised by impairments in social functioning,” authors wrote.

“However, the preliminary nature of the currently available data precludes a clear understanding of the exact nature of this role,” they said.

Thus, despite some promising results, it’s much too early to conclude that oxytocin is a helpful treatment for autism, schizophrenia, or any other psychiatric disorder.

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