The operation replaces arthritic damaged knee joints, with an artificial joint. An article published in the Lancet stated the implants had “proliferated” without full testing.

The UK regulator said the National Joint Registry was a “key source” of safety and performance data. Fear over other false implants, such as PIP breast implants and metal hip replacement, have been raised recently.

The research states more observation is required on the long term effects of joint replacements, and that there is no immediate health risk. Prof Andrew Carr, part of the research team from the University of Oxford, said: “We’re not sitting on a metal-on-metal situation, but there could be something not being picked up as there are not the processes going on for monitoring [total knee replacements].”

However, he said this was “often with little or no evidence of effectiveness or cost-effectiveness” and that regulations should be made tougher and “more along the lines of introducing new drugs”.

The Medicines and Healthcare products Regulatory Agency (MHRA) said safety data for more than 80,000 knee joint replacements in the UK in 2010 has been collected.

Dr Susanne Ludgate, MHRA’s clinical director said: “The National Joint Registry (NJR) is a key source of information on the long-term safety and performance of knee joint replacements and is the largest such registry in the world. The NJR assists surgeons in making choices and regulators in monitoring performance. Since April 2003 all knee joint replacement operations in England and Wales have been recorded in the NJR.”

Data from the NJR showed up no health concerns, however there is a need to improve measure of patients’ experiences e.g. pain levels and range of movement.

Arthritis Research UK’s medical director, Prof Alan Silman said: “Given the current concerns raised by the metal-on-metal hip replacements – although there is no evidence that there are similar implications for knee replacements – it’s appropriate to take stock of the advantages and costs of knee joint replacement. Undoubtedly it produces major benefits for patients and the need will be become greater as the population ages and becomes more obese. However it’s equally important that we are able to understand and measure the benefits of surgery, and we are currently supporting research to measure the benefits to patients in a more effective way, and also to predict who should have the operation, and when.”

Related topics:
- Osteoarthritis
- Knees
- Obesity & Lower Back Pain

The MHRA said patients who already have received large head metal-on-metal hip replacements need annual blood tests for life, to check for metallic debris, and magnetic resonance imaging (MRI) scans. The British Hip Society believes there is not enough evidence to show any benefits outweigh the risks of such joint implants.

Dr Susanne Ludgate, clinical director of the MHRA, said: “We recognise that there is emerging evidence of increased revision rates associated with large head metal-on-metal hip replacements. But the clinical evidence is mixed and this does not support their removal from the market. Metal-on-metal resurfacing hip implants enable young patients to lead pain-free, independent lives. The percentage of patients implanted with these large head metal-on-metal hip implants dropped to 2% in 2010 and is continuing to decrease. There are alternative hip replacements available that are proven to produce good clinical outcomes for patients. The MHRA, in combination with our expert advisory group, is continuing to monitor closely all the latest evidence about these devices. We will take quick action if we need to and, if patients have any questions, they should speak to their orthopaedic surgeon or doctor.”

Related topics:
- Total Knee Replacement Proof Is ‘Lacking’
- Osteoarthritis

Although a lot of research has been conducted on the effect of Vitamin D and bone health, there is less known of the role of Vitamin E.
Some early studies have shown Vitamin E to be good for bone health. However this latest study has found this no longer to be the case.

The size and density of bones can change in adulthood, depending on a balance between cells known as osteoblasts and osteoclasts. Osteoblasts lay new bone, whereas osteoclasts strip away old bone.

The research has found Vitamin E to improve production of osteoclast cells, which results in more bone loss than growth. But Dr Helen Macdonald stressed due to the lack of enough research, there was no need for people to change their diet to avoid the relatively small amounts of vitamin E contained in it. She said: “However, vitamin E supplements involve doses far higher than those in a normal diet. There is increasing evidence that taking supplements doesn’t do any good, and if anything, may be doing harm.”

The University of Edinburgh studied the effect of a drug on mice, which may increase specific protein levels and reverse muscle damage.
Spinal muscular atrophy causes muscle watages, decreased mobility and muscular function. One in 40 people carry the genetic mutation that causes the disease.

At any one time, Spinal Muscular Atrophy affects up to (approximately) 6,000 people in the UK. There are three grades of Spinal Muscular Atrophy:

Type 1 – floppy limbs and “flickering” tongues – the most severe grade
Type 2 – usually picked up in children aged 6-18 months old. Affected children can sit, but not walk.
Type 3 – diagnosed over 2 years old with problems walking and can require a wheelchair – the mildest form.

The mental ability of the child is not affected. Although this disease causes damage to the nerves the Edinburgh research team, led by Tom Gillingwater, professor of neuroanatomy, patients also had unhealthy muscles. They found this destruction can arise even if the nerve connections are healthy. Low levels of a protein called SMN, caused by a genetic mutation resulted in the muscle damage. The muscles’ blood supply is disturbed by the genetic mutation which then leads to further muscle damage.

A second study treated mice who had SMA with a group of drugs called HDAC inhibitors. The treatment targeted the genetic mutation, which resulted in increased protein levels in the muscle.

Prof Gillingwater said: “SMA is the most common genetic cause of infant death in the western world. By showing the important role that muscles play in this disease, we can now focus our efforts on trying to block the disease in all affected tissues of the body.”

Current research is looking at how HDAC or other drugs can be adapted to improve muscle control and blood supply. Lucy Blythe, of the SMA Trust, which funded the research, said: “These findings are significant. This is a tragic condition, because so many babies with type 1 die before the age of two.”

Generally men suffer more heart attacks but women younger than 55 are at higher risk of mortality from one. There is a good chance that women are not receiving the right treatment due to not displaying the characteristic symptoms associated with a heart attack. By and large, 42% of women experienced no chest pain in relation to 30% of men.

About 14% of women died in comparison to 10% of men. The research adds to a growing body of evidence that shows the differences experienced between women and men. The article states: “Optimal recognition and timely management of myocardial infarction (MI), especially for reducing patient delay in seeking acute medical care, is critical. The presence of chest pain/discomfort is the hallmark symptom of MI. Patients without chest pain/discomfort tend to present later, are treated less aggressively, and have almost twice the short-term mortality compared with those presenting with more typical symptoms of MI.”

Cathy Ross, senior cardiac nurse at the British Heart Foundation, said: “Symptoms vary; for some the pain is severe and yet others may feel nothing more than a mild discomfort or heaviness. The most important thing to remember is if you think you’re having a heart attack, call 999. Younger women may need to heed that advice more than most because they appear to be less likely to have chest pains. Their symptoms can be overlooked by inexperienced medical staff because heart attacks in young women are rare. More research will hopefully identify why there are such variations in the way heart disease affects men and women.”

Dr Kevin F Fox, a consultant cardiologist at Imperial College Healthcare NHS Trust and speaking for the Royal College of Physicians, said: “The paper has shown that women, and in particular younger women, under 55 years of age, often do not have the typical presenting symptom of chest pain compared to men when they have a heart attack. Although heart attack survival is improving overall, doctors, health care professionals and the public need to be aware and vigilant that women can have a heart attack without the typical chest pain that we all think of as the main symptom.”

Further study is required, and there is no requirement to change the current public health message that chest pain and discomfort could be life threatening regardless of age and gender.

SYMPTOMS
• A dull pain, ache or ‘heavy’ feeling in the chest
• A mild discomfort in the chest that makes you feel generally unwell
• Pain that spreads to the back, arm or stomach
• Pain that feels like a bad episode of indigestion
• Chest pain accompanied by feeling light-headed or dizzy

Related topics:
Heart damage repaired with stem cells
Cure to broken hearts?
Exercise causing heart failure
Heart risk link to a round abdomen questioned

Health Benefits of Pancakes

The batter used to cook pancakes includes milk, a great source protein and calcium. Eggs can supply additional protein. Pancakes made from whole wheat or buckwheat flourare healthier due to the low GI nature of these ingredients, as well as providing fiber, vitamins, antioxidants and minerals. The additional fiber of whole wheat pancakes and added protein from eggs and milk help keep you feeling fuller longer when compared to white flour pancakes.

Adding flaxseed you can make your pancake even more healthy. Flaxseed adds to the fiber content of the pancake. A typical 6 inch pancake should contain 175 calories.

What about the Extras?

Adding extras such as syrup, butter, whipped cream, sauces, powder sugar and fruit can all add to additional unnecessary calories. Fruit is the healthiest extra from this list. Using whole fruits are better than those covered in a sugary fruit syrup. To further reduce unwanted calories which not try a light syrup instead of the regular syrup. A low sugar or sugar-free jam can also help.

Enjoy

Now you can sit back and enjoy your pancake with zero guilt.

Click here to read more about the ingredients that can help your body’s skin health.

Over a third of 14- and 15-year-old boys in 1987 said they ate sugary cereals on most mornings. This reduced to 16% by 2010. More than 25% of 12- and 13-year-old girls in 2000 said they ate deep fried or roast potatoes on most days. This decreased to 11% by 2010. This suggests that today’s youngsters are eating more vegetables. Almost 50% of 12- and 13-year-old boys said they ate vegetables on most days in 2010, compared with around 33% of the same group in 1999.

“When I go to the supermarket I see a wall of crisps and sweets. So we asked ourselves do we believe these results? And I think we do,” said Dr Regis. “Schools are serving better school dinners and they are also taking more of an interest in the contents of pupils’ lunchboxes. The packed lunch and tuck-shop police have been in action. Tuck shops are no longer the sea of fizzy drinks and crisps they once were.”

However the study also shows some teenagers are missing meals to reduce weight. In 2010 almost a third of Year 10 girls (14- and 15-year-olds) had no breakfast. The day before, 25% of this group also missed lunch.

A general increasing trend in numbers of students skipping lunch has been shown. The study also showed that most of the pupils missing meals were older girls, who were reported to saying they were doing so in an attempt to lose weight. Between 1991 and 2010 the number of girls on a diet went up by 60%.

Dr Regis said: “As a secondary analysis, we also recorded the pupils’ weight and height and we did not find that this number of pupils were overweight. There is some genuine cause for concern here. Do 60% of Year 10 females need to lose weight? Probably not. The good news is that teenagers are eating better. The bad news is that some are skipping meals, which is not healthy. There has been a tendency for the government and schools to promote the healthy eating message loudly, by megaphone. You can’t do the same about skipping meals being a bad idea. A bit of listening to what teenagers are really thinking wouldn’t go amiss.”

Further studies need to be carried out to show the reason why teenagers diet. Some say celebrities are to blame for our perception of what is a normal body image. This may be celebrities on extreme diets, or severely edited photos on billboards and magazine covers. Ironically, eating fewer calories than our body requires, pushes it into “starvation mode”. In this mode the body will try to convert as much food as possible into fat. This is because the body’s natural mechanisms strive for survival, and as it is not receiving enough energy, it will try to save as much as it can for later use. It is far better to calculate your Base Metabolic Rate (BMR), consume at least this amount in a day, and ensure you burn off more through activity. This method, combined with eating meals regularly, means that you will always be in a calorie deficit, and that fresh energy is in constant supply to the body.

For more advice on how you can benefit from a healthier lifestyle, book in to see Principal Osteopath Mr Trishul Vadi, and start using your body the way it was supposed to be.

Related topics:
Body Mass Index (BMI) – ‘misses obesity risks’

It is important to note that the trials are still only at the early stages and carried out in just a handful of patients. Similar techniques with cells extracted from bone marrow (prime source of stem cells), has been shown to have a much longer pedigree.
The report by Cochrane concluded that bone marrow therapy “may lead to a moderate long-term improvement” in heart function which “might be clinically very important”.

Proof is still needed of “any significant effect on mortality” when compared with standard treatment. However, this could be due to the small size and short time of the studies. Lead author Dr Enca Martin-Rendon, from NHS Blood and Transplant at the John Radcliffe Hospital in Oxford, said: “This new treatment may lead to moderate improvement in heart function over standard treatments. Stem cell therapy may also reduce the number of patients who later die or suffer from heart failure, but currently there is a lack of statistically significant evidence based on the small number of patients treated so far.”

Prof Anthony Mathur, from Barts and the London School of Medicine and Dentistry, is leading the largest ever trial of stem cells in heart attack patients, expected to start this year. Three thousand participants will be injected with stem cells five days after a heart attack. Their response will be then monitored for the next two years.

Prof Peter Weissberg, medical director at the British Heart Foundation, said: “This review reflects the consensus of opinion about these trials – cell therapy has a modestly beneficial effect. Despite that, no-one knows why, or even if, cell therapies will translate into better survival or sustained improvement in damaged hearts. It’s much too early to judge the likely long-term benefits.”

Related topics:
Cure to broken hearts?

Cryotherapy, the technique of submerging muscles in cold water, reduces swelling, stiffness and soreness resulting from a hard workout on the muscles.
It was first introduced for elite level sports people, however it is rapidly becoming more popular amongst the general public and regular gym goers.

The participants who took part in the research carried out by the Cochrane team were submerged in cold water post-exercise, e.g. running, cycling or weight lifting. Participants in most of the studies stayed in the water (10-15C) for 5 -24 minutes.

The study was lead by Dr Chris Bleakley, of the University of Ulster, Northern Ireland, who said: “We found some evidence that immersing yourself in cold water after exercise can reduce muscle soreness, but only compared to resting or doing nothing. It is important to consider that cold water immersion induces a degree of shock on the body. We need to be sure that people aren’t doing anything harmful, especially if they are exposing themselves to very cold water for long periods.”

Leonie Dawson, professional adviser to the Chartered Society of Physiotherapy, said: “This isn’t advisable for everyone. If someone had an underlying heart condition then the shock could be damaging. And for anybody with Raynaud’s – a problem of the circulation – it would have a devastating effect on them.”

Generally, applying something cold to the skin to decrease pain and swelling was safe. It makes up part of the PRICE guidelines – Protect, Rest, Ice, Compression and Elevation – for managing soft tissue injury. But it is worth remembering that some of those gel ice packs you can get go down to temperatures of minus 20 and if you go to sleep with them on you can get a rather nasty ice burn.

Mr Trishul Vadi, Principal Osteopath at The Osteocare Clinic said: “As a general rule of thumb, ice should be used in the first 24 hours for 5 minutes every 15-30 minutes. Heat can be introduced between the ice after the initial 24 hours period. However, advice must be tailored to each patient to get the best and safest results.”

A heart attack occurs as a result of the organ being deprived of oxygen, e.g. a clot blocking blood to the heart. As the heart mends, the dead muscle tissue is replaced with scar tissue, but because this does not contract like heart muscle the efficiency to pump blood around the body is decreased. The larger the scar tissue the greater the deficiency of the heart. Stem cells, which can transform into any other type of specialised cell, figure prominently plans to “regenerating” the heart to replace the scar tissue with functioning muscle.

The trial consisted of twenty five patients. Scar tissue accounted for an average of 24% of their left ventricle, a major chamber of the heart, before the trial. This figure decreased to 16% after just six months and 12% after a year. Healthy heart muscle appeared to replace the scarring. The study concluded the cells, “have an unprecedented ability to reduce scar and simultaneously stimulate the regrowth of healthy [heart] tissue”.

Researcher Dr Eduardo Marban said: “While the primary goal of our study was to verify safety, we also looked for evidence that the treatment might dissolve scar and regrow lost heart muscle.This has never been accomplished before, despite a decade of cell therapy trials for patients with heart attacks. Now we have done it. The effects are substantial, and surprisingly larger in humans than they were in animal tests.”
However, a significant increase of the heart’s ability to pump was not found. Prof Anthony Mathur said: “The findings would be very interesting, but obviously they need further clarification and evidence.”

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, said: “It’s the first time these scientists’ potentially exciting work has been carried out in humans, and the results are very encouraging. These cells have been proven to form heart muscle in a petri dish but now they seem to be doing the same thing when injected back into the heart as part of an apparently safe procedure. It’s early days, and this research will certainly need following up, but it could be great news for heart attack patients who face the debilitating symptoms of heart failure.”