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By John Schieszer
Medical Minutes 

Improving knee implants and brain function

Medical Minutes

 

March 1, 2019



Self-powered knee implants

Researchers at State University of New York are now developing self-powered knee implants that could reduce the number of knee replacement surgeries. They are working on implants that can provide physicians with regular activity updates and are powered by the patient’s movement.

Knee replacement surgery is the most common joint replacement procedure, with the number of surgeries increasing every year. Many of these surgeries are done to replace an older implant or one that has worn out. Often, doctors don’t know if patients are overexerting themselves until they begin to develop symptoms. By that point, the damage to the implant has already been done. For patients going through knee replacement surgery every five or 10 years, it is a daunting task.

Researchers decided it was time to create smarter knee implants that could monitor changes in activity as they happened.

“We are working on a knee implant that has built-in sensors that can monitor how much pressure is being put on the implant so doctors can have a clearer understanding of how much activity is negatively affecting the implant,” said Sherry Towfighian, who is an assistant professor at Binghamton University in New York.

The sensors allow doctors to tell patients when a certain movement has become too much for the implant so patients can quickly adjust and avoid further damage to the implant. It helps them find the sweet spot of activity for each particular patient.

The researchers are using triboelectric energy, a type of energy that is collected from friction. Once someone walks, the friction of the micro-surfaces coming into contact with each other can be used to power the load sensors. These smart implants will not only give feedback to doctors but will help researchers in the development of future implants. “The sensors will tell us more about the demands that are placed on implants, and with that knowledge researchers can start to improve the implants even more,” said Towfighian.

Lowering blood pressure may have important brain benefits

Intensive control of blood pressure in older adults may significantly reduce the risk of developing mild cognitive impairment (MCI), a precursor of early dementia, according to researchers at Wake Forest School of Medicine. They have found that better control of blood pressure may help protect the brain in very important ways.

MCI is defined as a decline in memory and thinking skills that is greater than expected with normal aging and is a risk factor for dementia. Dementia is defined as a group of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.

“We are encouraged to finally have a proven intervention to lower someone’s risk for MCI,” said the study’s principal investigator, Dr. Jeff Williamson, who is a professor of gerontology and geriatric medicine at Wake Forest School of Medicine. “In the study, we found that just three years of lowering blood pressure not only dramatically helped the heart but also helped the brain.”

The researchers conducted a trial with 9,361 volunteers who were age 50 and older with hypertension but without diabetes or history of stroke. The participating group was 35 percent female, 30 percent black and 10 percent Hispanic and thus representative of the broader U.S. population. Participants were randomly assigned to a systolic blood pressure goal of either less than 120 mm HG (intensive treatment) or less than 140 mm HG (standard treatment). They were then classified after five years as having no cognitive impairment, MCI or probable dementia.

Will hyperbaric oxygen therapy help with Alzheimer’s disease?

Researchers have the first PET scan-documented case of improvement in brain metabolism in Alzheimer’s disease in a patient treated with hyperbaric oxygen therapy (HBOT). There has been controversy about whether this approach really works or is a waste of money.

Dr. Paul Harch, Clinical Professor and Director of Hyperbaric Medicine at LSU Health New Orleans School of Medicine, and Dr. Edward Fogarty, Chairman of Radiology at the University of North Dakota School of Medicine, report the first PET scan-documented case of improvement in brain metabolism in Alzheimer’s disease in a patient treated with HBOT.

The authors report the case of a 58-year-old woman who had experienced five years of cognitive decline, which began accelerating rapidly. Single photon emission computed tomography (SPECT) suggested Alzheimer’s disease. The diagnosis was confirmed by 18Fluorodeoxyglucose (18FDG) positron emission tomography (PET) brain imaging, which revealed global and typical metabolic deficits in Alzheimer’s.

The patient underwent a total of 40 HBOT treatments — five days a week over 66 days. Each treatment consisted of 1.15 atmosphere absolute/50 minutes total treatment time. After 21 treatments, the patient reported increased energy and level of activity, better mood and ability to perform daily living activities as well as work crossword puzzles. After 40 treatments, she reported increased memory and concentration, sleep, conversation, appetite, ability to use the computer, more good days (5/7) than bad days, resolved anxiety, and decreased disorientation and frustration.

“We demonstrated the largest improvement in brain metabolism of any therapy for Alzheimer’s disease,” notes Dr. Harch. “HBOT in this patient may be the first treatment not only to halt, but temporarily reverse disease progression in Alzheimer’s disease.”

The physicians report that two months post-HBOT, the patient felt a recurrence in her symptoms. She was retreated over the next 20 months with 56 HBOTs (total 96) at the same dose, supplemental oxygen, and medications.

The first successful HBOT-treated case of Alzheimer’s disease was published in 2001. The present case report is the first patient in a series of 11 HBOT-treated patients with Alzheimer’s disease.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

Author Bio

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

Email: medicalminutes@gmail.com

 
 

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