|
|
|
|
| HEALTH & FITNESS |
|
|
|
New life with
‘technology knees’ Cancer of the
food-pipe — a silent killer Health
Notes
|
|
New life with ‘technology knees’ When
you think of arthritis, you think it affects only the elderly. Contrary to this misconception, arthritis these days is found increasingly among the younger population. However, age is not a factor for arthritis; it can affect the young and the old alike. Higher levels of stress coupled with modern lifestyle are increasing the incidence of arthritis. Today in Punjab alone there would be close to 25 lakh arthritis patients and these numbers are increasing rapidly. There are more than 5 lakh patients with advanced arthritis of which 50,000 would require immediate surgery. Rheumatoid arthritis is also significantly increasing every year. Obesity coupled with increasing sedentary lifestyle has made north Indians vulnerable to arthritis. Joint replacement has alleviated the suffering of millions of patients who would otherwise be crippled by arthritis. Whatever the uncertainties about the effects of the procedure, the benefits are very real. Total joint replacement is one of the most successful contemporary surgical procedures. Refined surgical techniques, improved implant characteristics, aggressive physical rehabilitation and a focus on pain management have all contributed to this achievement. The long-term success rates for total hip and total knee surgery currently exceed 98 per cent. Increasingly, young people are beginning to suffer knee joint injuries just as much as older individuals, and these injuries may sideline potential sports careers, diminish the range of motion, and ultimately lead to a more sedentary lifestyle. Young men and women are starting to experience joint pain, lack of mobility and frozen knees caused by arthritis, osteoporosis, and other medical conditions, earlier more common in older individuals. Once the damage is done, replacement is often the only solution for a young person’s knees. The number of knee replacement surgeries in people younger than 60 jumped 150-fold between 1980 and 2012, according to a Finnish study published online in Arthritis & Rheumatism. While orthopaedic surgeons operate on patients aged between 12 and 95 years for various replacements, it is people in the age group above 65 years who are mostly affected by various forms of arthritis. Sometimes a replacement surgeon operates on as many as 15 patients in a day. But, thankfully, latest technology has now come to the aid of those suffering from various forms of arthritis. Orthopaedic surgeons have historically been reluctant to offer young patients knee joint replacement surgical options because they have higher activity levels than older patients, and most standard knee implants usually last between 10 and 15 years. New knee implant technologies approved by the FDA have changed that, as such implants are available now as are designed to last 30 to 35 years. Oxinium, a new oxidized zirconium material, has been used successfully for both hip and knee implants since approval by the FDA. Oxinium knee joints are made of metal composites coated with ceramic, infused and then coated with oxygen to create an extremely durable joint replacement that lasts nearly 90 times longer than the more common knee joints. Because of the strong compounds used in this implant and the fact that they offer excellent wear resistance, the new joint is ideal for younger individuals who suffer from limited range of motion, on-going pain, stiffness and lack of mobility from knee injuries or other medical conditions. Because they are made of bio-compatible elements, these new prosthetic joints are also easy for the body to tolerate and won’t as readily irritate the immune system. Oxinium also is used in the place of nickel, enabling people who are allergic to nickel to receive the implant. The key benefit of the new oxinium implant is that it is an ideal joint implant for younger patients who require knee surgery because of its effectiveness when dealing with patients who typically provide more stress on the implant through their activities. Minimally invasive painless surgery Now thanks to a combination of technology and modified surgical techniques, a patient can walk next day after getting implants in both knees in one go. New “Quad sparing” technique where the main thigh muscles quadriceps are almost completely spared helps in quick recovery and almost no pain. There is a small incision on the skin and the patient can bend and straighten his/her leg the same day and walk next day. It has been confirmed that pain during and after joint replacement surgery is the biggest hindering factor for physical and emotional recovery of patients undergoing joint replacement surgery. If pain can be controlled, then not only can it be very comfortable for the patient but will also lead to a much faster and quicker recovery. After surgery the recovery time is less than one-third of that with conventional TKR technique. Now the ultimate concept is based on reduced tissue trauma surgery and pain control. High flexion, low wear fourth generation implants are now available. Over the last few years, the designs of implants have also evolved with high performance implants being the new mantra. High flex implants also have the added advantage of low wear. The increased life expectancy of Indians coupled with their more active lifestyles, patients today demand more than pain-free mobile joints. They want their unhindered lifestyle to continue and they continue to engage in activities of their choice like sports, travel, driving, trekking, sitting on the floor and socialising. Patients expect a painless, functional stable knee as their first priority, but deep knee flexion is unquestionably next in line! The fourth generation high flex implant is an advanced design available today to meet the needs of the demanding population. High flex implant offers bone preservation retaining most of the vital natural bone, tissue and ligaments. Changing expectations have significantly altered the patient demographics in total joint replacement. Younger patients who want to continue their active lifestyle are now requesting for surgery. Likewise, overweight patients and those with comorbidities, who would have been rejected in the past because of high risk, are now expecting relief of their symptoms. Remedying mantra A few preventive measures young people can take to avoid arthritis: Watch your weight. Extra weight puts pressure on your joints and, when trying to hide from arthritis, you certainly don’t want to stress out your joints. Just add arthritis to the list of diseases and ailments that can be discouraged by maintaining a healthy weight. Prevent and treat injuries: Too many ankle sprains or insufficient treatment following sprains can put you on the road to arthritis in your ankles. Stay active: Inactivity is a dangerous thing — for the body as well as the mind. Brisk daily walks, strength-training, swimming, tennis, or yoga are excellent ways to keep your body active. Stretching exercises and swimming are two of the best ways to keep your joints happy and stress-free and your muscles in top working condition. Try to get at least 30 minutes of activity daily. Exercise builds your muscles and your muscles support your joints. The writer, a Ranawat joint replacement fellow (USA), is Director & Head, Deptt of Orthopaedics & Joint Replacement, Fortis Hospital, Mohali.manuj.wadhwa @gmail.com |
|
Cancer of the food-pipe — a silent killer Cancer
of the esophagus (food-pipe cancer) is common in India. According to a report from cancer registries in India, esophageal cancer is the second most common disease among males and fourth most common cancer among females. High incidence rates are reported from Kashmir, north-eastern parts of India and southern states of the country. The high-risk areas of esophageal cancer are Iran, North-Central China, North Afghanistan, India and countries in the southern parts of Africa. Esophageal cancer is an aggressive cancer and a major cause for cancer-related deaths worldwide. Survival rates are low. Most esophageal cancers do not cause symptoms until they have reached an advanced stage. Pain or difficulty in swallowing is one of the most common symptoms of esophageal cancer, and the feeling that food is stuck in the throat or chest. Other possible symptoms are constant cough, hoarseness, chest infections, bleeding and unintentional weight loss. The exact cause is not known. Important risk factors are increasing addiction to tobacco, alcohol and a combination of tobacco smoking and excessive alcohol consumption, drinking hot beverages, gastroesophageal reflux disease (chronic heartburn), corrosive damage to the esophagus, and achalasia (a condition where there is ineffective peristalsis). Stomach acid damaging the lower part of the esophagus is a major risk factor for esophageal cancer. This occurs when people experience acid reflux or gastroesophageal reflux disease over a long period. Those having frequent heartburn shluld take steps to get this reflux under control. The causal relationship between gastroesophageal reflux disease and esophageal cancer is established fairly well. No screening test has been shown to lower the risk of cancer in people who are at risk. There are no guidelines for screening cancer of the esophagus. Conventional endoscopy with biopsy remains the standard procedure for the identification of pre-cancerous and early-cancerous changes. The most efficient and cost-effective tool for targeting biopsies is lugol dye chromoendoscopy and is an easy, accurate, inexpensive and world-wide available diagnostic technique. In China, screening is performed using transnasal balloon cytology. Identifying risk factors is the first step towards preventing the disease. Smoking cessation and decreasing alcohol intake are by far the best methods of decreasing the risk. Allow hot beverages to cool for a few minutes before drinking. Treating people with reflux disease may help prevent esophageal cancer. Studies from India and the United States have shown that people who suffer from acid reflux should undergo endoscopy on a regular basis to detect the problem in time.Chronic heartburn should not be considered as a mere annoyance and needs to be treated and followed closely. Diagnostic evaluation of the patient with esophageal cancer confirms the diagnosis and methods employed are radiological imaging studies and endoscopy with biopsy and cytology. Diagnostic evaluation determines the stage of the disease and planning of appropriate therapeutic modalities. New endoscopic imaging techniques may enable the detection of relevant pre-cancerous lesions and early cancer. Surgical resection is currently the treatment of choice for patients with resectable cancer, if they are well enough to undergo resection. Long-term survival after surgery, however, remains suboptimal and recurrence rates are high. Trimodality therapy — neoadjuvant chemoradiotherapy followed by surgery—appears to increase resectability, improve local control, and overall survival compared to surgery alone. Esophageal cancer is one of the most difficult cancers to cure despite improved surgical techniques and the introduction of multimodality therapy. The recurrence rate following radical therapy is high. Therefore, a close follow-up is required. Endoscopic mucosal resection is established as an effective and safe treatment for early esophageal cancer, and good treatment results have been reported using this technique. This endoscopic procedure is well tolerated by elderly patients. Palliative treatment strategies should primarily aim at the improvement of tumour-related symptoms and maintenance of nutrition. Esophageal stent placement provides immediate palliation. Stent placement with radiotherapy is a safe approach in these patients with advanced disease. Recanalisation of the tumour-compressed esophageal lumen by argon plasma coagulation or chemical tumour necrolysis with consequent radiotherapy results in relief of dysphagia. People with esophageal cancer present with problems in swallowing leading to significant weight loss. Smoking cessation and decreasing alcohol intake are by far the best methods of decreasing the risk of developing cancer of the esophagus. Current research recognises that chronic heartburn is a major risk factor for esophageal cancer. Decreasing the risk of acid reflux is the best method of prevention.Becoming aware of the risk factors and early cancer signs can lead to early diagnosis and treatment, thereby increasing the chances of survival. Treatment options have changed considerably with the introduction of multimodal treatment concepts. The writer is a former Professor and Head, Department of General Surgery, PGI, Chandigarh. |
|
Too much or too little activity harmful for knees
Washington: Both high and low levels of physical activity can accelerate the degeneration of knee cartilage in middle-aged adults, according to a new study. For the new study, the UCSF researchers looked at changes in knee cartilage among a group of middle-aged adults over a four-year period. They used magnetic resonance imaging (MRI)-based T2 relaxation times to track the evolution of early degenerative cartilage changes in the knee. “T2 relaxation times generated from MR images allow for analysis of the biochemical and molecular composition of cartilage,” said Wilson Lin, research fellow and medical student at UCSF. “There is increased water mobility in damaged cartilage, and increased water mobility results in increased T2 relaxation time.” — ANI Pedalling gives health boost to Parkinson’s patients
Washington: A new study has revealed that people with Parkinson’s disease benefit from exercise programmes on stationary bicycles, with the greatest effect for those who pedal faster. Functional connectivity magnetic resonance imaging (fcMRI) data showed that faster pedaling led to greater connectivity in brain areas associated with motor ability. Exercise is thought to have beneficial effects on Parkinson’s disease. Jay L. Alberts, neuroscientist at the Cleveland Clinic Lerner Research Institute in Cleveland, saw this firsthand in 2003 when he rode a tandem bicycle across Iowa with a Parkinson’s disease patient to raise awareness of the disease. The patient experienced improvements in her symptoms after the ride. — ANI
Psoriasis drugs may help ‘slow dementia’
London: A study on mice has suggested that the drugs which are used to calm inflammation in psoriasis may also help to combat the effects of Alzheimer’s disease. Tests showed the short-term memory of the animals improved when given similar drugs and the build-up of proteins thought to destroy brain cells was also reduced, the BBC reported. Psoriasis is an inflammatory disorder caused when the immune system attacks healthy skin cells, stimulating the production of new skin. The immune system, which controls levels of inflammation, has been implicated in both Alzheimer’s disease and psoriasis. — ANI
Smoking can ‘rot’ your brain
London: Smoking can be hazardous not only for the health of your body, but of your mind too. Smoking “rots” the brain by damaging memory, learning and reasoning, researchers at King’s College London have warned. A study of 8,800 people over 50 showed high blood pressure and being overweight also seemed to affect the brain, but to a lesser extent. The researchers were investigating links between the likelihood of a heart attack or stroke and the state of the brain. Data about the health and lifestyle of a group of over-50s was collected and brain tests, such as making participants learn new words or name as many animals as they could in a minute, were also performed. — ANI |
Pedalling
gives health boost to Parkinson’s patients
