StemCell Therapy

In Kitwe, the second largest city in Zambia, young mother Verah is carrying her one-year-old daughter, Racheal, into the consultation room at the eye annexe. The only dedicated paediatric eyecare centre in the country, the Kitwe annexe also attracts patients from neighbouring Angola and Congo. Racheal is here for surgery to remove the bilateral cataracts that prevent her from seeing.

A few months after Racheal was born, Verah noticed that something didnt seem right with her vision. I would move my hands in front of her face but she would not react. I would move things past her eyes but she would not follow them, she explains.

The team of nurses, anaesthetists and paediatric ophthalmologists treating Racheal have been trained and are being continually supported by peers from some of the worlds most respected eye hospitals, who fly in on a specially adapted plane the flying eye hospital thanks to an initiative of Orbis, an international blindness prevention charity.

Orbis volunteers who come to share their knowledge and give technical support are very good most of them have been working for a long time so they have very good experience, says Chineshe Mboni, the paediatric ophthalmologist treating Racheal. So we have some from the US, Britain and Israel etc. Techniques are different around the world, so we get a mix of everything.

Sharing experiences and discussing cases with the visiting Orbis medical volunteers raises your confidence, to see that what you are doing is what everyone else is doing around the world, Mboni concludes.

Globally, 285 million people are blind or visually impaired and yet for 80% of them, this could be prevented with access to the right treatment like the surgery Mboni is able to give Racheal. Orbis focuses its efforts in Africa, Asia and Latin America because 90% of the worlds 39 million blind people live in developing countries. Many of the conditions causing blindness such as cataract and trachoma can be easily treated. The loss of sight these conditions can cause have a huge impact as it will impede a persons ability to gain an education, prevent them from finding employment and can plunge families into a life of poverty.

Ann-Marie Ablett, a nurse from the University Hospital of Wales in Cardiff, has been giving up four weeks of her annual leave to volunteer with Orbis since 2003. You cant change everything overnight but you can start with one patient and help them, she says. If everyone plays their small part together, you can make changes.

Ablett is speaking in a terminal at Stansted Airport and just outside is the flying eye hospital, here for a short promotional visit. The white MD-10 aircraft on the tarmac looks like a typical passenger plane. In fact, this is a 46-seat classroom complete with audio-visual equipment that transmits live surgeries that can be watched in 3D. The lead surgeon, who is just next door in a state-of-the-art operating theatre, can be asked questions throughout the procedure. The aircraft, donated by FedEx, also features pre- and post-op spaces and a laser suite.

Orbiss main aim is to train eyecare teams and strengthen hospitals in the 92 countries where it works. Its for this reason that Ablett first chose to volunteer. She says: Were not in the developing country just for numbers, were there to teach so that means we do less surgeries but when we fly off to the next country, the local doctors have got the skills to treat their own patients because they were trained up.

Dr Jonathan Lord, global medical director for Orbis, went from being a regular volunteer to giving up his position as a consultant at Moorfields eye hospital in London and becoming a staff member for the charity before being promoted to his current role.

I was just hooked after my visit trip, he says. Seeing the flying eye hospital work in real life, in the field with the patients being treated on the plane and that treatment being part of a really comprehensive training package that is upskilling all the groups of staff that are needed for each surgery, is amazing.

The need round the world is huge. You realise the magnitude when you look at some of the statistics. In Ethiopia, there is a population of over 80 million, but [until recently] there was little over 80 ophthalmologists practising in the whole country. When I left Moorfields, it had over 150 covering just the catchment area of London.

Programmes usually last two weeks, and require a lot of pre-planning with a team from Orbis flying in ahead to consult on what would be most helpful to the healthcare professionals in that country. The plane will land at a local airport and the team of local surgeons, nurses and anaesthetists board to join their volunteer counterparts. Meanwhile, another team of volunteers goes to the local hospital to provide training using the equipment in situ. At the end of the week, the teams swap.

Becoming hooked after stepping foot on the plane is a running theme among staff and volunteers, including the pilots, all FedEx employees who volunteer their time. Gary Dyson, who has been involved since 2001, says: On my first trip, which was to China, I saw a child who couldnt see on Monday but could see on Wednesday. Its such a life-changing event for them.

For Racheal, the short surgery will have undoubtedly had that effect. As Mboni removes the patches, she blinks a few times and waves her hands in front of her eyes, before looking up and seeing her mother for the first time.

News is spreading across Zambia of successes like this, Mboni says. [People] know we can act fast, so they are telling patients with eye conditions This problem? Go to Kitwe central hospital.

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The life-changing flying eye hospital treating blindness across the globe - The Guardian

A groundbreaking experiment conducted at Hadassah Hospital in Jerusalem using embryonic stem cells has succeeded in preventing blindness in the elderly. The researchers used stem cells to transplant retinal pigment cells into older patients with vision impairment.

Retinal degeneration in older age is a particularly common disease in the Western world. 30 percent of adults older than 75 suffer from it, and 6 to 8 percent of them suffer from total vision loss.

(Photo: Shutterstock)

Embryonic stem cells are harvested from in vitro fertilized embryos. When the couple decides they do not want to expand the family unit anymore, frozen embryos can be used to isolate the stem cells. These cells are unique because during pregnancy they are the ones that actually form the body of the fetus, and they can serve as a source of transplantation for every cell in the human body.

Prof. Benjamin Reubinoff, director of the Hadassah Center for Embryonic Stem Cell Research and an expert in obstetrics and gynecology, founded a company called Cellcure, which focuses on developing embryonic stem cell transplantation in patients with incurable diseases in the nervous system and the eyes.

Prof. Reubinoff and Prof. Eyal Banin, director of the Center for Retinal Degeneration Diseases at Hadassah's Department of Ophthalmology, began performing transplantations in five patients. Using imaging, they found that the transplanted cells were successfully absorbed into the retina.

"This is a great achievement for us. The vision of the elderly has remained stable and has not deteriorated as it would have without the transplant," explained Prof. Reubinoff. "If the treatment is proven to be effective, we will implant the cells at an early stage of the disease, thereby preventing millions of elderly people around the world from losing their sight."

Despite the success of the trial, the researchers believe it will take more time for the treatment to be available to all patients. "We will also have to prove safety and efficacy before we make it effective for everyone," concluded Prof. Reubinoff.

(Translated and edited by N. Elias)

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The Israeli breakthrough that will prevent blindness in the elderly - Ynetnews

Often the first step in diagnosing arthritis is recognising the signs at home. If you see any of the subtle signs, its a good idea to have your cat examined by your vet. They may be able to detect swelling, pain and inflammation or take a radiograph to confirm any suspicions.

The good news for cats and their owners is that arthritis can be managed successfully with appropriate treatment and simple changes to your cats environment.

Medication for arthritis can help reduce pain and inflammation to improve your cats quality of life, though it will not cure arthritis. In many cases, animals affected by arthritis will need to be on medication for the rest of their lives.

The most commonly used drugs for managing arthritic pain are called non-steroidal anti-inflammatory drugs (NSAIDs). These drugs can be very effective at controlling the pain and inflammation associated with arthritis, but pet owners must take proper care when administering them and they should always be used under direct veterinary supervision to avoid the risk of side effects.

Usually, a combination of medication and complementary approaches, including diet and weight management and physiotherapy is used to treat arthritis.

Every cat requires a specific treatment plan. Your veterinarian will be in the best position to discuss a tailored treatment plan for your cat.

Omega-3 fatty acids

Disease ModifyingAgents, Nutraceuticals

Weight reduction, diet management

Physiotherapy, gentle exercise, massage, Hydrotherapy, Heat and cold therapy

Non-steroidal anti-inflammatory drugs, the cornerstone of arthritic pain management

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Cats with Arthritis -Cats with Arthritis

On "Fox & Friends" today, we heard the story of a mother who went beyond modern medicine to help cure her young son of a painful arthritic condition.

Susannah Meadows lays out the details of her son's case, and others, in her book, "The Other Side of Impossible." She told Ainsley Earhardt and Janice Dean, who lives with multiple-sclerosis, how her son was diagnosed with juvenile idiopathic arthritis at age three.

The condition causes painful swelling in the joints and can lead to disability. The medication he was prescribed did little to help the arthritis and made him feel sick.

"As I watched him lie on the couch, I could not accept that that was going to be his life," she said.

Meadows then pursued a non-traditional course of treatment, approved by her son's doctor. The idea came from another mother who said her son's arthritis improved with doses of probiotics and fish oil and by removing gluten and dairy from his diet.

Meadows said her son, now 9, is totally healthy and does not need medication anymore.

Watch the interview above and learn more about the book, here.

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Author-Mom Goes Beyond Modern Medicine to Cure Son's Arthritis - Fox News Insider

(Reuters Health) - Osteoarthritis, a painful condition in which the tissue between bones wears down, frequently affects people in old age and a new study finds that as many as 4 in 10 people may develop the condition in their hands.

Among women, researchers found the lifetime risk was 47 percent while for men it was about 25 percent. Obese people also had 11 percent higher lifetime risk than those who were not obese.

Hand osteoarthritis can cause disability and problems with daily living, but is not often a subject of research, the study team writes in the journal Arthritis and Rheumatology.

Past research shows the lifetime risk for arthritis of the knee to be 45 percent and 25 percent for the hip, they write.

These findings indicate that symptomatic hand osteoarthritis is very common, and affects a substantial proportion of the population in their lifetimes, lead author Jin Qin told Reuters Health by email.

Given the aging population and increasing life expectancy in the United States, it is reasonable to expect that more Americans will be affected by this painful and debilitating condition in the years to come, said Qin, an epidemiologist at the Centers for Disease Control and Prevention in Atlanta.

The researchers analyzed data from a North Carolina-based study of more than 2,000 people over age 45. The study collected data between 1999 and 2010, using self-reports of arthritis symptoms and X-ray images of the participants hands.

Based on this group, researchers estimated the proportion of people who will develop osteoarthritis in at least one hand by age 85 to be 39.8 percent.

Whites were at greater risk, at 41 percent, for hand osteoarthritis than blacks, with 29 percent. Obese people had a lifetime risk of 47 percent, compared to 36 percent among the non-obese.

Some people with hand osteoarthritis have minimal or no symptoms. But for many, symptomatic hand osteoarthritis greatly affects their everyday lives, with few options for improving their symptoms, Dr. Fiona Watt, a research lecturer and honorary consultant rheumatologist at the University of Oxford in the UK, said by email.

The pain can vary and tends to be worse the more people use their hands, flaring up during daily activity like carrying heavy shopping bags or typing on keyboards or phones, said Watt, who was not involved in the study.

Our hands are so important, and we need to look after them, Watt said, adding that doing aerobic exercise and watching our weight can help protect against all types of osteoarthritis.

We know that injury can increase the risk of osteoarthritis, Watt said. Although we cant always prevent hand injuries, wearing supporting and protective gloves in occupations with heavy use of the hand is important.

Preventing injuries and maintaining a healthy weight may lower the risk of osteoarthritis, Qin said. Earlier diagnosis allows earlier use of interventions (e.g. physical/occupational therapy), that may help manage symptoms, maintain better function, and improve quality of life, she said.

SOURCE: bit.ly/2qVwAsy Arthritis and Rheumatology, online May 8, 2017.

LONDON A trial of AstraZeneca's key immunotherapy drug durvalumab showed it reduced disease progression in lung cancer patients, sending the company's shares higher and giving it a lead over rivals as it seeks to transform its oncology business.

KINSHASA At least one person has died from the Ebola virus in Democratic Republic of Congo, the Health Ministry and the World Health Organization (WHO) said on Friday, signaling a new outbreak of the disease which killed thousands in West Africa.

(Reuters Health) - Surgery wont cure chronic knee pain, locking, clicking, a torn meniscus, or other problems related to knee arthritis, according to a panel of international experts.

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Lifetime risk of hand arthritis may be over 40 percent | Reuters - Reuters

Japanese drugmaker Seikagaku has taken a step towards lining up a big pharma partner for its phase 3 osteoarthritis drug SI-613, with Ono taking an option on the drug.

SI-613 draws on Seikagaku's long-standing experience with hyaluronic acid, which is widely used in preparations used to treat osteoarthritis and is thought to improve the functioning of joints. The company's scientists have bound hyaluronic acid to a nonsteroidal anti-inflammatory drug (NSAID) using a proprietary linker technology to add long-lasting pain relief and anti-inflammatory properties to the molecule.

Importantly, the drug keeps the NSAID localized within the joint, with little escaping into the circulation to cause systemic side effects such as gastric irritation, according to its developer.

Seikagaku has already completed phase 2 trials of the drug in patients with osteoarthritis of the knee, showing a significant improvement in symptoms following direct injection into the affected joint. The phase 3 trial is enrolling patients with arthritis of the hip, ankle, elbowand shoulder as well.

Describing the current deal as a "basic agreement", the two companies saidthey are now in discussions about firming up the terms into a definitive licensing deal.

The prospect of signing up larger pharma group Ono is a boost for Seikagaku, which started pivotal trials of the drug in Japan earlier this year but has made no secret of its ambition to bring it forward onto the global stage. That would prove tough for the small drugmaker without the help of a larger partner.

If the phase 3 trial proves the worth of SI-613, the drug could emerge as a new treatment option in the osteoarthritis market, which is valued at around $3.5 billion a year in the seven countries with the largest pharma markets, according to GlobalData.

Why so little? Despite millions of sufferers around the worldaround 9 million in Japan aloneosteoarthritis treatment still largely relies on cheap generic drugs that have been around for decades. SI-613 could provide a shakeup in the market, although the need for injections into the joints may reduce its use in patients with less severe symptoms who may prefer to take tablets.

In the meantime, after years of stagnation there are some emerging biologic drugs for osteoarthritis that for the first time promise to affect the underlying disease process, rather than simply alleviating symptoms.

One of these is TissueGene's Invossa, a cell-based disease-modifying osteoarthritis drug that requires a single injection into the affected joint and has been filed for approval in South Korea by licensee Kolon Life Sciences. It is currently in phase 3 trials in the U.S., and was recently licensed in Japan to Mitsubishi Tanabe in a $434 million deal last November.

GlobalData also tips Nordic Bioscience/Merck KGaA's sprifermin as another candidate to watch. The drug, a recombinant form of fibroblast growth factor 18 (FGF18), is in phase 2 testing for osteoarthritis and is thought to stimulate joint repair.

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Ono takes a long look at Seikagaku arthritis candidate | FierceBiotech - FierceBiotech

May 12, 2017

Researchers have pinpointed a key enzyme that is vital for the production of fresh blood cells in the body. The enzyme is essential for the survival of specialised stem cells that give rise to new blood cells, the study found. Experts say the findings could help to improve the success of stem cell therapies that are being developed to treat some blood cancers and disorders of the immune system.

Enzyme

Scientists focused on an enzyme called fumarase, which is known to play a key role in the generation of energy inside cells. Children with gene mutations that affect fumarase have blood defects, which prompted researchers to investigate its function.

The mouse study found that deletion of fumarase from blood cells causes major defects in new blood cell production. These defects could be traced back to defects in the specialised stem cells that give rise to new blood cells. Blocking the enzyme causes a molecule called fumarate to build up inside the cells, which has wide-ranging toxic effects.

Stem cells

The study sheds new light on the conditions that blood stem cells need to survive, which could help to boost the success of stem cell therapies, the researchers say. Stem cell metabolism is an emerging field of research with an immense therapeutic potential. In future, we hope to identify the biochemical pathways affected by fumarate in stem cells and, by manipulating these pathways, improve the success of stem cell transplant therapies.

Professor Kamil Kranc says, "The research was prompted when researchers noticed that children with genetic mutations in the fumarase gene have blood defects."

The research was prompted when researchers noticed that children with genetic mutations in the fumarase gene have blood defects.

Scientists from the Medical Research Council Centre for Regenerative Medicine at the University of Edinburgh led the study.

The research is published in the Journal of Experimental Medicine and was funded by The Kay Kendall Leukaemia Fund, Cancer Research UK, Bloodwise, Tenovus Scotland and Wellcome.

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Blood study insight could improve stem cell therapy success - Medical Xpress

It is the "shock absorber" between the vertebrae of the spine, cushioning every step, bend and jump: the intervertebral disc. If the fibrocartilage tissue in the spine degenerates over time, an intervertebral disc can "slip" -- pinching the medulla or nerves. The consequences include intense pain or even paralysis. Not only people, but also dogs are often susceptible to this disease. Since intervertebral discs themselves cannot regenerate, the affected disc material is removed in an operation that can be performed on both people and animals. The pressure on the nerves and medulla disappears, but the degeneration of the disc remains.

Great hope has thus been placed on stem cell therapy as practiced by Frank Steffen, neurologist at the Clinic for Small Animal Surgery at the Vetsuisse Faculty of the University of Zurich. Stem cells are multipotent cells that can be differentiated into various cell types. Steffen hopes that the stem cells will possibly form new disc cartilage once injected into a damaged disc. His study on three sick German shepherds demonstrate that a treatment with the body's own stem cells are well tolerated -- an important first step.

Gaining knowledge directly from the afflicted animal

Research on intervertebral disc regeneration is frequently performed using animal testing. At the Clinic for Small Animal Surgery in Zurich, researchers have taken another path: "Since we treat numerous dogs who spontaneously sustain a slipped disc every year, we have been able to gain important knowledge directly from animals that are actually afflicted with this disease," Frank Steffen explains. "Due to the similarity in pathology and the course of the illness, conclusions can presumably be drawn for the treatment of affected persons as well." The project for the development of stem cell therapy in dogs is being conducted in cooperation with Swiss Paraplegic Research (SPR) in Nottwil, Switzerland.

The study on the sick German shepherds was organized as follows: With the permission of the dog owners, neurologist Frank Steffen and his team removed stem cells from the marrow of the pelvic bone of the affected animals. After the cleaning and preparation of the cell material in the laboratory, the stem cells were injected into the degenerated intervertebral disc during a disc operation that had become necessary for the animal in question. "Our objective is for the stem cells to trigger cellular and molecular repair processes and, ideally, to form new intervertebral disc cells in order to contribute to the regeneration of the tissue," Steffen says.

After tolerability, check effectiveness

The results are pleasing: The three dogs well tolerated the injections of their own stem cells and the researchers have determined no negative effects. However, later X-rays and magnetic resonance tomographies did not show clear indications that the damaged discs have already regenerated in comparison with the control group.

Not yet -- of that, Steffen is confident. "Proving the tolerability of the therapy was our first important step." Now he is working on the effectiveness of the stem cell injections, for example, with the targeted addition of growth factors. "If our method proves successful one day, it would be a pioneering step -- for human medicine as well," the neurologist says.

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Materials provided by University of Zurich. Note: Content may be edited for style and length.

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New intervertebral discs from stem cells - Science Daily

Scientists report a step forward in the plan to create a truly artificial pancreas, offering new hope to people withtype 1 diabetes.

A 43-year-old single mother with dangerously difficult-to-control diabetes had insulin-producing islet cells transplanted into her omentum -- a fatty membrane in the belly.

The cells began producing insulin faster than expected, and after one year she is doing well and doesn't need insulin injections, the University of Miami researchers said.

"We're exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach," said the study's lead author, Dr. David Baidal. He's an assistant professor in the university's Diabetes Research Institute.

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Some diabetes patients are begging doctors for free samples of life-saving insulin because of costs. Between 2002 and 2013, the price of insulin ...

Others voiced optimism as well. "This study was a good start at evaluating a novel site for transplant," said Julia Greenstein, vice president of discovery research for JDRF (formerly the Juvenile Diabetes Research Foundation).

Type 1 diabetes is an autoimmune disease. That means the body's immune system mistakenly damages healthy cells -- in this case, the islet cells found in the pancreas. This leaves people with type 1 diabetes without enough insulin to convert sugars from foods into energy for the body.

As a result, they must take multiple daily insulin injections, or use a pump that delivers insulin via a tube inserted under the skin that must be changed every few days.

Currently, islet cells from deceased donors are transplanted into the liver, but that's not an ideal option.

This new research was a proof-of-concept study expected to be the first step on a path toward developing a mini-organ called the BioHub.

In its final stages, the BioHub would mimic a pancreas and act as a home for transplanted islet cells, providing them with oxygen until they could establish their own blood supply.

The hope is that the BioHub also would attempt to tackle the autoimmune attack that causes type 1 diabetes.

But, the first step in developing the BioHub was to find a suitable location in the body. When the liver is used for islet cell transplants, only a limited amount of islet cells can be transplanted. There's also a risk of bleeding when the transplant is done and the possibility of other complications, the researchers said.

"For most people, the liver isn't a problem. It's a great source of blood. It's a good place for insulin to be made. But, there are rare complications that can occur and we want to be able to explant [take the cells out] in case something does happen," said Greenstein, adding that you can't take the cells out of the liver.

Also, with islet cell transplants in the liver, the underlying autoimmune condition is still there. And, if people didn't take immune-suppressing medication, the new islet cells would likely be destroyed.

Because of these and other issues, islet cell transplantation is generally reserved for people whose diabetes is very difficult to control or who no longer have an awareness of potentially dangerous low blood-sugar levels (hypoglycemia unawareness).

The woman in the current study had a 25-year history of type 1 diabetes. She also had severe hypoglycemia unawareness.

"Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father" in case her blood sugar levels dropped dangerously low, Baidal explained.

The surgery was minimally invasive, and the islet cells were placed on a "scaffold" that eventually dissolved. There were no complications, the researchers said.

"We were happily surprised when her glucose [blood sugar] profile improved quite dramatically," Baidal said.

Normally, after a transplant, doctors wait a while before stopping insulin to give the new islet cells a chance to rest. But the new islet cells worked so well that the injected insulin was causing low blood sugar levels.

"We were able to discontinue insulin sooner than we thought we would. And, the glucose control was very stable," Baidal said.

Baidal said the study results need to be replicated in other patients, and the researchers want to see what happens post-treatment over a longer time. The researchers plan to test the omentum as a site in five more patients.

Greenstein said a big clinical trial isn't necessary because "either the transplant works or it doesn't work," so only a small number of people is needed.

The study's findings were published online May 10 in theNew England Journal of Medicine.

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Woman with type 1 diabetes still off insulin one year after cell transplant - CBS News

Despite declining rates of diagnosis, the number of diabetes cases in America is still high.

In 2016, the Centers for Disease Control and Prevention reported more than 29 million citizens are living with diabetes and 86 million are living with pre-diabetes, which increases the risk of being diagnosed with type 2 diabetes and other chronic diseases.

Diabetes was the seventh leading cause of death in the United States in 2013 (and may be underreported), the Centers for Disease Control and Prevention states on its website. It is the leading cause of kidney failure, lower-limb amputations and adult-onset blindness.

Twin Towns Area residents can learn if theyre at risk for diabetes by taking the Centers for Disease Control and Preventions screening test. The test, available at https://www.cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf, consists of seven yes or no questions with point values ranging from 1-9, as well as a chart to compare when your weight is potentially too high for your height.

Residents with high scores are invited to join Weight 2 Change, a free, weekly one-hour class held by Essentia Health and the NDSU Extension office, Richland County. Starting Thursday, June 15, Weight 2 Change classes will be held at 1 p.m. at ComDel Innovation/Heartland Precision building 10, 2200 15th St. N. in Wahpeton.

This free 16-week series is a community-based wellness program that offers education and support to maintain a healthy lifestyle. (It meets) once a week with a lifestyle coach to learn about maintaining a healthy weight, choosing and preparing healthy meals and ways to increase activity levels, states materials for the class.

Requirements for taking Weight 2 Change classes are:

One of the following: a history of gestational diabetes, a doctors diagnosis of pre-diabetes within the last year or a score of nine or more on the screening test

Your healthcare provider can refer you to the program, but a referral is not required, said Deb Evenson, an administrative assistant with NDSU Extension.

Following the 16 weekly sessions, an additional eight sessions will be held each month.

According to the NDSU Extension, Weight 2 Change was developed by the Centers for Disease Control and Prevention and has a proven track record of preventing diabetes in people who are at risk.

Results showed participants who made lifestyle changes reduced their risk of type 2 diabetes by 58 percent, stated information Evenson shared. Participants age 60 or older reduced their risk by 71 percent.

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'Weight 2 Change' class offers support on lowering diabetes - Wahpeton Daily News

With a stack of small, brown envelopes in hand, Li Jianyue trudges through a rice field in southern China to gather grain specimens she hopes might one day fight diabetes.

The obesity-linked disease is on a tear in China, and rice -- the countrys favorite staple -- is showing up in studies as an important contributor. The black kernels Li pinches off mature stalks with her fingers and drops into paper sachets have been bred to avoid causing the high spikes in blood-sugar when eaten that can eventually lead to type-2 diabetes.

China tops the world in the number of adults living with diabetes: 109.6 million as of 2015. Another 40 million could join the ranks by 2040 unless preventative steps are taken. Refined white rice is seen as an obvious target because the majority of the nations 1.4 billion people consume it at least once a day, and eating it has a similar effect on blood-sugar levels as gorging on white bread.

Photographer: Qilai Shen/Bloomberg

The number of people with diabetes is surging, said Li, a professor of life and environment sciences at Shanghai Normal University, treading between muddy rows of rice in green rubber boots. Still, healthier rice alone wont tackle the problem -- it has to taste good too, she said. So, were also trying to improve the texture.

The rice experiments Li is working on -- under a giant bird net at a plant-breeding site about 20 kilometers (12 miles) from Sanya city, on the southern tip of Hainan island -- are part of an international effort to improve the nutritional value of rice.

The Bill & Melinda Gates Foundation, for example, is working with rice researchers in the Philippines and Bangladesh on rice enriched with vitamin A to tackle blindness.

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Australias Commonwealth Scientific and Industrial Research Organisation, or CSIRO, is developing rice with more fiber so that its broken down in the lower digestive tract, where it can aid gut health and avoid the glucose-surge that can weaken the bodys response to insulin and eventually lead to type-2 diabetes. A separate program underway with the Chinese Academy of Sciences is seeking to pack rice with more vitamin B and E, iron, and zinc.

Middle-class Chinese are now very focused on nutrition, said Phil Larkin, a chief research scientist with the CSIRO in Canberra. The rate of increase in type-2 diabetes in China is very frightening.

A study released in 2013 estimated that China had 114 million people living with diabetes, or 21.6 million million more than a study three years earlier.

Lis experimental rice has a larger germ -- the embryonic part of the kernel -- than normal rice, she explains. That feature gives it more protein and less carbohydrate, which is converted into glucose during digestion. Her current work involves creating hybrids that combine that property with the taste and texture of the rice varieties popular on Chinas populous eastern seaboard.

A rice sample developed by Li.

Photographer: Qilai Shen/Bloomberg

Black rice from her lab grown on a 1-hectare (2.5-acre) plot last year was sold to two local companies. Shanghai Microwells Biotechnology Co. removed the hull and blended it unpolished with white rice in a 20 percent blend. General Manager He Jianhui said it was a potentially risky move since most Chinese prefer eating white rice and believe that unpolished rough rice is inferior.

But, now that more Chinese are seeking a healthy diet, we hope the unpolished rice can help people with the potential to develop diabetes, and that by improving their diet, they can avoid turning to doctors for medicine, He said.

Refined white rice -- even varieties bred to have less of a detrimental effect on blood-sugar -- is still a nutrient-poor food, said Sun Qi, an assistant professor at Harvard Universitys T.H. Chan School of Public Health in Boston. Whereas whole grains, including brown rice, are rich in cereal fiber, minerals, vitamins, and beneficial phytochemicals.

Hybrid varieties with increased vigor and disease-resistance have helped China achieve some of the worlds highest rice yields among major producers and remain largely self-sufficient in the cereal, even as consumption advanced 13 percent over the past decade driven by population growth.

Until recently, nutritional and processing quality had been overlooked in striving for yield improvement, said Zhongyi Li, a plant molecular biologist with the CSIROs in Canberra.

Annual per-capita consumption slipped to 104.8 kilograms in China last year, from a peak of 109.7 kilograms in 1997, as diets changed and improved food transportation gave consumers more choice. The nations wheat-based bakery industry expanded about 10 percent last year.

Making rice more nutritious and less likely to accumulate heavy metals, like cadmium, may help reverse the decline in per-capita consumption, and boost prices.

In the Philippines, the International Rice Research Institute, or IRRI, has identified the genetic basis of a component of starch that may be used to counter the cereals glycemic impact -- or propensity to spike blood-sugar, said Nese Sreenivasulu, head of the institutes grain quality and nutrition center.

IRRI found in 2012 that the glycemic index, or GI, of riceranges from 48 to 92 across more than 200 varieties from around the world. The sugars of low-GI food are absorbed more slowly, resulting in a gradual and sustained release of glucose in the blood, reducing the need for a surge of insulin that can eventually lead to insulin-resistance and diabetes.

As of today, more than 430 million cases of type-2 diabetes occur worldwide and the problem is severe in developing countries like China and India, Sreenivasulu said. Many modern varieties have a high to intermediate glycemic index, hence breeding for low-GI is an important trait.

With assistance by Shuping Niu

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New Strains of Rice May Help Fight China's Diabetes Scourge - Bloomberg

PELHAM The father-and-son duo display good humor with their bicycle team's name the Mustache Guys and serious dedication to beating a formidable disease that a family member has had for 46 years.

Paul Dadak and his son, Zachary, will push off from the Topsfield Fairgrounds on May 21 and bike 62 miles for Ann Dadak, Paul's wife and Zachary's step-mother.

Ann, a Type 1 diabetic, is touched by their dedication.

"I feel incredible loved and supported that they are willing to do this year after year, and that they are committed as I am to finding a cure," she said.

Paul, 69, and Zachary, 34, will ride in the North Shore Tour de Cure, the largest fundraising event for American Diabetes Association in New England.

Paul, a Pelham resident since 1981, has biked the ride at least 18 years, raising more than $10,000 in total.

The father and son want everyone to know the hardship and health hazards that diabetes poses, especially the Type 1 variety, which affects about 5 percent, or 1.25 million, of the more than 29 million Americans with diabetes.

Diabetes can be deadly, or lead to blindness, circulation problems, amputations or heart disease.

Paul Dadak is no stranger to heart disease.

Ten days after the Tour de Cure he rode in spring 2015, Dadak felt a slight pressure in his chest, like a bite from a peanut butter sandwich was lodged in his chest.

He had it checked and learned he had significant blockage and a weakened coronary artery.

He underwent double by-pass heart surgery.

He slowly got back on his feet and resumed biking.

"I will ride until I can't ride anymore or until it is cured," he said.

It irks Paul to hear people talk on television about how diabetes is a lifestyle disease, implying that it is people's fault that they got the disease.

The immune system in people with Type 1 diabetes destroys pancreatic beta cells that make insulin.

"When you have Type 1 your pancreas doesn't work," he says.

Money raised in the Tour de Cure will primarily go to research to find a cure for disease, says Tara Greeley, who manages the Tour de Cure New England.

It also funds programming and advocacy including summer camps for children with diabetes.

The Tour de Cure, which includes live music and lunch and education tents, celebrates everyone's efforts, not the least of which are the riders wearing red jerseys, known as Red Riders. They are people with diabetes.

Red Riders lead each race and speak before the group pedals off. There will be about 120 of them in this year's ride.

"If you see a Red Rider you should yell 'Go, Red Rider,'" Greeley said.

Dadak, who grew up on a chicken farm in Dracut, and became an engineer working for companies including Hewlett-Packard, now works at the Lowell National Historical Park for the Tsongas Industrial History Center.

Ann Dadak works for Road Scholar, which organizes educational tours throughout the country and world.

Paul Dadak and his son enjoy biking together, riding side-by-side, and chatting over the miles, talking politics or wherever the conversation leads.

When it came time to brainstorm a name for their bike team, Paul thought of mustaches.

He has had one ever since his son was born, and Paul wears it in the style of his hero, Mark Twain.

Meanwhile, his son, Zachary, does not have mustache but will wear a party store variety glued under his nose.

Their goals remains the same. Inform more people about the disease, and, most importantly, find a cure.

To donate to Paul's ride: main.diabetes.org/goto/pdadak

For more information: diabetes.org/northshoretour

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Mustache Guys ride to leave diabetes behind - Eagle-Tribune

Tawnya Galland can hold a ruler perpendicular from her hip to demonstrate how much her waistline has shrunk.

"There's a ruler less of me," she quipped.

The process began almost four years ago when a co-worker invited her to come along to a nutrition class at the YMCA. Galland figured she had nothing to lose, so she tagged along.

It was fortuitous. The nutrition class they attended was the Diabetes Prevention Program, a joint project between St. Vincent Healthcare and the YMCA.

Heavy and not very active, Galland was pre-diabetic, and she likely would have ended up with type 2 diabetes had she not followed her friend to the class and begun to change her life.

"We give people some broad guidelines," said Bev McHugh, the YMCA's registered dietitian and lifestyle coach for the diabetes prevention program.

In the class, she teaches participants about the importance of diet and exercise, helps them to create food journals where they track everything they eat and talks to them about the importance of finding balance in their lives. And then a relatively intensive exercise portion kicks in after the first month.

In other words, she said, she gives them some tools and teaches participants how to use them. But it's those in the class who have to make it work.

"To sustain a healthy lifestyle, people have to take ownership," McHugh said.

Galland was on board from the start, although she admits when she learned there was an exercise component she got a little nervous. She was all too aware of what it would look like for someone her size to saunter into a fitness center.

"Walking into a gym can be overwhelming," she said. "But you're all starting pretty much at the same level. So that was the benefit to doing it in a group."

And rather than starting straight out on exercise equipment, Galland was able to use the pool and work out in a water aerobics class.

"When you weigh as much as a linebacker, your joints don't like the land classes," she said with a laugh.

The biggest surprise was that she enjoyed it. She meticulously kept up her food diary, exercised multiple times a week and eventually lost 44 inches from her waistline.

These days, she's doing a spin class three times a week, a two-hour swim class twice a week and one group aerobics class on Saturdays. She finds genuine pleasure from the workouts, saying they're as good for her head as they are for her heart.

"I'm not happy when I haven't made it to the gym," she said.

McHugh talks to her class about the myriad ways there are to mark success. It's not just about pounds lost or physical endurance gained.

"There's many measures of progress," she said.

Most important, she said, is giving class participants tools that will help them keep in place the lifestyle changes they make when they finish the course.

McHugh likes to tell her class that she can't motivate them but that she can help them find their motivation.

ForGalland, that motivation comes from a desire not to lose the progress she's made and from the positive changes she's experienced in her life. Her mood has improved along with her health. She's more energetic throughout the day, and she has more confidence.

"I don't want to go backwards," she said. "It scares me to go backwards."

The diabetes prevention program lasts a year. It starts with 16 weekly classes, then moves to classes every other week. Then, for the last six months of the class, participants meet once a month. Through it all, there's the exercise regimen.

The best way to prevent diabetes is to improve diet and get active, McHugh said. Those improvements can be charted through weight loss.

"The goal of the program is moderate weight loss," she said, which is defined as a 5 percent to 10 percent loss from a person's starting weight.

Galland has dropped 103 pounds over the last three years, and she's happy with the balance she's struck in her life. Had she tried to do this 10 years ago, she wouldn't have been able to pull it off. Her life simply wasn't in the right place at the time.

"You have to find that place in your life when it'll work," she said. "I'm content with where I'm at."

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'I don't want to go backwards': Woman beats diabetes before she gets it with help of YMCA class - Billings Gazette

As per a new study, a new gene-delivery system can help deal with cases of an inherited form of blindness.

According to a new study, a new gene-delivery system for an inherited form of blindness shows promise. Researchers at Case Western Reserve University have developed gene-carrying nanoparticles that home in on target cells and prevent vision loss in mice with a human form of Leber congenital amaurosis.

The condition is one of the most common causes of blindness in children, according to the National Institutes of Health, affecting two to three of every 100,000 newborns.

Though this research focused on the form of the disease called Leber congenital amaurosis 2, or LCA2, the scientists and engineers involved in the study believe the technology holds promise for other forms of LCA as well as other inherited diseases that lead to severe vision loss or blindness.

Leader Zheng-Rong Lu said that they believe this technology can deliver almost any type of gene to tackle inherited visual disorders.

Those with LAC2 carry a mutated RPE65 gene and suffer from profound vision loss from birth. The mutated gene fails to produce RPE65 protein in the retinal pigment epithelium (RPE), a cell layer critical for protecting photoreceptors (rods and cones). The protein is an essential constituent of the visual cycle that converts light to electrical signals to the brain.

Lu and colleagues designed a lipid-based nanoparticle called ECO to deliver healthy RPE65 genes to RPE cells.

The promise of this technology is it localizes the drug to the photoreceptor cells, sparing the liver and kidney from exposure, said researcher Krzysztof Palczewski.

While other researchers focus on using modified viruses to deliver genes for therapy, sometimes the genes are too large for viruses to carry, Lu said. The ECO can be tailored to fit the cargo.

The exterior of the nanoparticle is coated with nucleic acids that act as targeting agents, drawing the delivery system to the retina and facilitating uptake by RPE cells. To track activity, Lus team included a fluorescent marker

Following injection into the retina of mice, the researchers could see fluorescent green concentrating in RPE cells. Testing showed a significant increase in light-induced electrical activity from the eyes to the brain, indicating the rods and cones were operating as they should in the visual cycle.

The therapeutic effect lasted 120 days in treated mice. No improvements were observed in untreated mice.

The researchers are now investigating whether the ECO system is effective against other visual disorders, including Stargardt disease, which is a form of inherited juvenile macular degeneration, primarily affecting the central portion of the visual field. They are also studying whether the nanoparticles can be used with the CRISPR/Cas9 gene-editing technique to treat genetic lesions related to retinal degenerative diseases.

The study appears in the journal Molecular Therapy Nucleic Acids.

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Originally posted here:
New gene-delivery system can stop hereditary blindness, says study - Hindustan Times

Increasing laser pointer attacks have Havasus ferry captains concerned.

The ferry between Lake Havasu City and Havasu Landing has been struck three times by green laser pointers in the past month, from locations including Windsor Beach, Crazy Horse Campground and from further within mainland Havasu. When directed into the pilots cabin, these lasers can cause temporary blindness or difficulty seeing, according to ferry Captain Greg Erkes. Laser pointers can put the crew, the ship and its passengers in jeopardy.

It can blind someone if its intense enough, Erkes said. We run our ships at night with the lights off so we can see other lights on the water. If (laser pointer owners) are doing it intentionally, then its malicious.

In Arizona, deliberately shining a laser-pointer at another person in such a way that requires medical treatment qualifies as an act of misdemeanor assault, punishable by up to one year in prison and a $2,500 fine.

Ferries arent the only recent targets of laser pointers, and the devices have proven a constant hazard for aircraft pilots as well.

Havasu-based Air Methods operates emergency medical helicopters throughout the state, and serves Havasu Regional Medical Center. While laser flashes are more common in major cities like Phoenix and Las Vegas, they are still a threat.

Pilots have been warned, dont look at them, said Air Methods spokeswoman Karey Madsen. One past crew member got hit in the eye with a lasershe was out for a while. It can cause eye damage, and it can be a distraction for the pilot. It could definitely put crews and patients in jeopardy. If a pilot cant see, they cant land or maneuver the aircraft.

Deliberately aiming a laser pointer at an aircraft is a felony in Arizona, punishable by a prison sentence up to 18 months. Federal penalties for doing so include a $250,000 fine and up to five years in prison.

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Laser pointer 'attacks' are putting boaters, pilots at risk of temporary blindness - Today's News-Herald

CHANGLANG, May 11: Dapkhu, Namleng, Galenja Ponthai, Podumoni and Mohong Christian under Bordumsa were declared Avoidable Blindness Free. With the declaration, Arunachal Pradesh, and Bordumsa in particular has created a niche in the national arena in regards to Avoidable Blindness Free villages. Speaking at an event to mark the day at Bordumsa CHC on Thursday, Deputy Director General of Health Services (NPCB), New Delhi Dr Promila Gupta informed about the centres modified schemes under the national programme for Control of Blindness and committed to help the state. She later handed over certificates of avoidable blindness free to the goan burahs and Certificate of Appreciations to five ASHA workers for their tireless efforts in making their villages Avoidable Blindness Free. Global Director, Programmes, Operation Eye Sight Universal, Hyderabad Kashinath Bhoosnurmath appreciated the effort made by the NPCB team and ASHA workers in achieving the milestone. He pledged continuous support to the ongoing project and assured to come back in September with more packages for the Community Eye Care development in the state. State Programme Officer, NPCB Dr Taba Khanna outlined the road map for developing more eye-based hospitals in the state in the next two years, for which he sought liberal funding from the Government of India and help of more philanthropic non-governmental organizations. He also highlighted the challenges faced by health care workers and eye care team in Arunachal Pradesh. Franklin Daniel gave a presentation on the Avoidable Blindness Free Arunachal (ABFAR) project. He described in detail about the beginning of project implementation to declaration of avoidable blindness free. He thanked the government of Arunachal Pradesh, District Health Authority, staff of Bordumsa CHC and ASHA workers for continuous support. Chairman RDO Trust, Nilgiris Dr N K Perumal, ADC Bordumsa, Mika Nyori, DMOs Dr Dondu Wange and Dr Nani Rika, ZPM Tongroi Singpho, Head Gaon Burah Sikhet Tang Singpho and Anchal Chairperson Sindu Nong Singpho also spoke on the occasion. Earlier in the day, the Eye Department was established and the renovated Eye OT was inaugurated. With the establishment of the eye department with state of the art OT and sophisticated equipment, the Bordumsa CHC is one of the best eye care centres in the state, said Dr Khanna.

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Five Arunachal villages declared avoidable blindness free - The Arunachal Times

(WXYZ) - The videos have gone viral. People who are red-green colorblind are seen trying on glasses and then, all of a sudden, they're able to see colors they've never seen before.

Jake Gutenberg remembers being in kindergarten, looking at drawings and realizing he didn't see the same as his classmates.

"They were like 'no everything looks dull boring and dead to me'. I was like, 'it looks normal to me..I don't know what's wrong with your guys' eyes, but my eyes are perfect'," says Jake.

He's 17 years old now and about to graduate from Stevenson High School in Sterling Heights. Being red-green color blind is all he's known.

Jake says, "Everything looks similar. Some colors will stand out like blue against red, but if you put green next to it, it's hard to tell the difference between them."

He says he's adapted well since it's all he's known, but when he started seeing those online videos, he wanted to try the glasses.

"I've been wanting to try it ever since. I wanna see what everyone else sees," he says.

We were there as Jake tried the Vino Optics red-green color blindness correction glasses. After 17 years of seeing the world one way, Jake felt like the glasses changed his view. He said the glasses make everything more vivid and bright.

"You can tell the contrast. Everything doesn't look like one straight color. Everything's now spread apart and different," he says.

Dr. Nitin Kumar is an opthalmologist with Henry Ford Health Systems. He says red-green color blindness is the most common form of color blindness - with about 5 percent of the population having the genetic condition.

"People who have trouble with their reds and their greens will see the color, but they don't see the color like somebody who does not have a color vision anomaly will see them," says Dr. Kumar.

Jake really noticed a difference when he went outside.

"The leaves are green, instead of brown and almost dead looking," he says.

For Jake's parents, this has made their world brighter, too.

"It's just an amazing feeling - knowing he can see what we see and see how vibrant colors are," says Jennifer Gutenberg.

Jake's dad, WIlliam, says "His wow moment was a wow moment for us, too. It was overly exciting to see what happened. It was awesome".

There are a variety of these kinds of glasses on the market, but they don't work for every kind of color deficiency.

To learn more about the Vino Optics glasses and prices, go to http://www.vino.vi/colorblindglasses.

If you'd like to see what it's like to be color blind, you can check out this simulator http://www.color-blindness.com/coblis-color-blindness-simulator/

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Amazing technology allows the color blind to see a whole new world - WXYZ

Arthritis of the knee is very common, and isn't helped by arthroscopic surgery, a study finds. BSIP/UIG via Getty Images hide caption

An international panel of surgeons and patients has challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems.

The guidelines, published Wednesday in the journal BMJ, reviewed 13 studies involving nearly 1,700 patients and found the surgery did not provide lasting pain relief or improve function for most of them. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery.

Fewer than 15 percent of patients felt an improvement in pain and function three months after the procedure, and that those effects disappeared after one year, the review found. In addition, the surgery exposed patients to "rare but important harms," such as infection.

Casey Quinlan, 64, who had the surgery in 2003 and was on the panel issuing the guidelines, said her orthopedist told her the procedure would not only help restore mobility in her knee after a nasty ski accident but also improve her arthritis.

Quinlan, of Richmond, Va., said the procedure did not deliver, since her arthritis remained unchanged. "It was not what I was told to expect," she says.

In an arthroscopic knee surgery, physicians make several small incisions around the joint and insert a tiny camera that allows them to see inside the knee as well as insert small instruments to correct problems they identify. Often the surgery is performed to remove part of a damaged meniscus, a disc of cartilage that helps cushion the knee.

The panel said meniscal tears "are common, usually incidental findings, and unlikely to be the cause of knee pain, aching or stiffness."

The panel said the surgery is performed more than 2 million times a year across the globe, and in the United States alone costs more than $3 billion annually.

The panel's recommendations are counter to guidelines from a number of medical groups. Most of those organizations have recommendations against arthroscopy for patients solely with arthritis that can be seen through an X-ray. But many still promote the procedure for people with ailments such as meniscal tears, which are frequently present in arthritic patients.

The American Academy of Orthopaedic Surgeons does not recommend the treatment for patients with arthritis, said David Jevsevar, chairman of orthopedics at the Dartmouth Geisel School of Medicine and chair of the AAOS Council on Research and Quality. He said the BMJ assessment is in line with current evidence, but he also cautioned that generalizing a variety of randomized trials does not necessarily take into account the circumstances of individual patients.

"Guidelines don't apply to every patient," Jevsevar says. "There's always going to be an exception."

Reed Siemieniuk, a physician in Ontario, Canada, and the lead author of the panel's statement, said he understands the frustration some people may have about the guideline especially those who have seen an improvement with surgery.

The strongest evidence of a procedure's benefit is a randomized controlled trial, Siemieniuk notes, "Despite those personal experiences that say it might be doing good, the evidence suggests that it might not be doing any good."

Siemieniuk said that the panel's reading of the studies suggests that "on average, the pain relief that you're getting is not going to be important to you at all."

The BMJ assessment is the latest in a string of studies that have raised concerns about the surgery. The journal also published a study in 2015 by researchers in Denmark showing that arthroscopic repair of the meniscus for middle-aged people was not much better than exercise in relieving pain and carried a risk of rare but debilitating side effects.

The surgery was questioned in 2002 after researchers reported in The New England Journal of Medicine that in a randomized trial of older veterans with osteoarthritis in their knees, arthroscopic surgery was no more effective in treating pain than a placebo surgery in which patients had incisions made but no instruments were inserted into the knee. At least three other studies in that journal since then have also found arthroscopy is not better than sham surgery or physical therapy in relieving arthritis pain in the knees of older adults.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization.

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Arthroscopic Surgery Doesn't Help With Arthritis Knee Pain - NPR

Grating, cracking or popping sounds around joints may predict future arthritis, especially in the knees, according to a recent U.S. study.

Among thousands of people with no knee pain who were followed for three years, one quarter had noisy knees yet they made up three quarters of the cases of symptomatic knee arthritis that emerged by the end of the study period, researchers found.

"Many people who have signs of osteoarthritis on X-rays do not necessarily complain about pain. Presently, there are no known strategies for preventing the development of pain in this group," said lead study author Grace Lo of Baylor College of Medicine in Houston, Texas.

Especially when people have joint space loss or other arthritis-related changes visible on X-rays, their also having noisy knees can be considered a sign of higher risk for developing pain within the next year, she said.

HOSPITAL HEROES: KNITTERS MAKE THOUSANDS OF HATS FOR CHEMO PATIENTS

Osteoarthritis is the most common form of arthritis, affecting more than 30 million adults in the United States, Lo and colleagues write in Arthritis Care and Research. Symptomatic knee osteoarthritis, which means X-ray evidence of arthritis plus pain or stiffness, affects about 16 percent of adults older than 60, they note.

Lo and colleagues analyzed data from 3,495 participants ranging in age from about 50 to 70 in a long-term study conducted in hospitals in Rhode Island, Ohio, Pennsylvania and Maryland. None had symptomatic knee arthritis at the start.

The researchers looked at how often people experienced knee pain, stiffness and "crepitus," or noises and scraping feelings in their knees.

During clinic visits, people were asked questions like, "Do you feel grinding, hear clicking or any other type of noise when your right knee moves?" and "During the past 12 months, have you had pain, aching or stiffness in or around your right knee on most days for at least one month?" The patients were evaluated at the beginning of the study and again at 12, 24 and 36 months. X-rays were also taken once a year.

At the start, 65 percent of participants said they had no crepitus, 11 percent experienced it "rarely," 15 percent had it "sometimes" and 9 percent had it "often" or "always."

Overall, 635 participants, 18 percent, developed symptomatic arthritis of the knee during the study period.

LOOKING FOR A SPERM DONOR? SWIPE RIGHT

Even after adjusting for weight and other factors, researchers found that odds of developing symptomatic arthritis rose along with the frequency of crepitus. Those who reported it "rarely" had 50 percent higher risk than those who never had it, and those with crepitus "sometimes" or "often" had about double the odds.

People with crepitus "always" were three times more likely to develop arthritis over four years than those who never had it.

Older age and having crepitus also increased the likelihood of developing arthritis, and men with crepitus were more likely than women with noisy knees to go on to develop arthritis.

"Differences across genders is interesting and unexplained. This may tell us about differences in symptom reporting or the biology of osteoarthritis," said Daniel Solomon, the chair of arthritis and population health at Harvard Medical School in Boston.

"Knowing how to predict who will develop symptomatic osteoarthritis may give patients and providers clues to who should receive earlier treatment or even prevention," Solomon, who wasn't involved in the study, told Reuters Health by email.

"It would be helpful to look at the MRIs of the people who had X-ray evidence, no pain and always had crepitus to understand what is happening in their knees," Lo said. "This could help identify ways to decrease the risk for developing knee pain."

Since MRI scans are more sensitive than X-rays, Lo added, researchers for future studies may be able to see osteophyte formations or other symptoms around the knee that they can't usually see.

"Not all noises coming from a knee are a bad sign," she said. "It might be helpful to ask your doctor for an X-ray to see if you have evidence of osteoarthritis and then take precautions from there."

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Cracking, popping joints may foretell arthritis - Fox News

"Keyhole" arthroscopic surgery should rarely be used to repair arthritic knee joints, a panel of international experts says in new clinical guidelines.

Clinical trials have shown that keyhole surgery doesn't help people suffering from arthritis of the knees any more than mild painkillers, physical therapy or weight loss, said lead author Dr. Reed Siemieniuk. He is a health researcher with McMaster University in Toronto, Canada.

"You can make a pretty strong statement saying that from a long-term perspective, it really doesn't help at all," Siemieniuk said. "If they knew all the evidence, almost nobody would choose to have this surgery."

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Keyhole surgery is one of the most common surgical procedures in the world, with more than 2 million performed each year, Siemieniuk said. The United States alone spends about $3 billion a year on the procedure.

The new guidelines -- published online May 10 in theBMJ-- were issued as part of the journal's initiative to provide up-to-date recommendations based on the latest evidence. The guidelines make a strong recommendation against arthroscopy for nearly all cases of degenerative knee disease.

This includes osteoarthritis as well as tears of the meniscus, the padding between the two leg bones in the knee, Siemieniuk said.

"With age and with use, the grinding of the two bones together can break down that padding," he said. "It's very common to see little rips and tears in that padding in patients with arthritis."

Siemieniuk and his colleagues noted that a trial published in 2016 showed that surgery was no better than exercise therapy in patients with a meniscus tear.

Despite this and other medical evidence, most guidelines still recommend keyhole surgery for people with meniscus tears, sudden onset of symptoms like pain or swelling, or mild to moderate difficulties with knee movement.

Arthroscopic surgery relies on small incisions through which a tiny camera and miniature instruments are inserted. Doctors can remove or repair damaged tissue without having to cut the knee open.

The American Academy of Orthopaedic Surgeons currently advises against performing arthroscopic surgery in patients with full-fledged knee osteoarthritis, said Dr. Kevin Shea, an academy spokesman.

"Most orthopedic surgeons have dramatically reduced arthroscopic surgery in patients with degenerative arthritis," Shea said. "Most I know have abandoned it over the last 10 to 15 years."

However, arthroscopic surgery still can help people with joint movement problems caused by meniscus tears who have not developed moderate or severe knee osteoarthritis, said Shea.

Those patients should be treated first with mild painkillers and exercise therapy, but keyhole surgery should remain an option for them, he added. Shea is an orthopedic surgeon based in Boise, Idaho.

"Not that long ago, I operated on a 67-year-old retired schoolteacher who's an avid skier," Shea said. "She had no arthritis in her knee but a huge meniscus tear that kept locking, catching and popping. Not offering treatment to her would not have been fair."

Under theBMJguidelines, patients with meniscus tears should be treated with painkillers and physical therapy, as well as weight loss if they are overweight, Siemieniuk said. Knee replacement surgery is the last treatment option, done once degeneration has progressed to the point where all other therapies don't work.

There is a financial incentive for doctors and hospitals to perform unnecessary keyhole surgeries, but Siemieniuk said these surgeries also might be prompted by the desire to treat a painful medical condition.

"It's hard to take away one of the options from people when chronic knee pain and arthritis can be very debilitating," he said. "And there's an expectation from patients that by the time they see a surgeon, the surgeon is going to have something to be able to offer them."

Inertia might also play a role. "It's a lot easier to introduce a new treatment into clinical care than to de-implement one that we later find out doesn't work," Siemieniuk said. "That's what we're seeing here."

Keyhole surgery has its downsides. Recovery can last anywhere from 3 days to 6 weeks, Siemieniuk said, and there is a risk of blood clots or infection in the knee.

Patients should go through a shared decision-making process with their surgeon, questioning whether this surgery would truly help them, he said.

The surgery still can be useful to fix torn ligaments or repair damage caused by severe trauma, Siemieniuk said. But in most cases, he said, given the evidence, insurers "may choose not to fund it, which I think would be appropriate."

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"Keyhole" surgery not helpful for knee arthritis, experts say - CBS News