Connect with us
[adrotate group="1"]

Science & Health

13 adults with complete paralysis benefit from nerve transfer surgery

A new study showcases the benefits of nerve transfer surgery — sometimes in combination with traditional tendon transfer surgery — for restoring upper limb function in people with complete paralysis. A team of Australia-based surgeons has restored the function of upper limbs in 13 young adults who experienced spinal cord injury. Spinal cord injury (SCI)…

Published

on

13 adults with complete paralysis benefit from nerve transfer surgery

A new study showcases the benefits of nerve transfer surgery — sometimes in combination with traditional tendon transfer surgery — for restoring upper limb function in people with complete paralysis.
A team of Australia-based surgeons has restored the function of upper limbs in 13 young adults who experienced spinal cord injury.

Spinal cord injury (SCI) affects close to 290,000 people in the United States, according to recent estimates.

Of these SCI cases, about 12% result in full paralysis, which doctors refer to as complete tetraplegia.

Traditionally, surgical interventions to restore the function of the hands and arms have involved tendon transfer surgery.

To perform this procedure, surgeons take healthy, functional muscles that have a less important role and relocate them, replacing the muscles that sustained damage as a result of the injury.

Nerve transfer is an alternative to tendon transfer. Unlike the latter, nerve transfer involves reanimating, or reinnervating, the damaged muscle.

Theoretically, nerve transfer has several advantages compared with tendon transfer. Nerve transfers allow for the reanimation of several muscles at a time, and the recovery time after surgery is much shorter.

Previous studies and case reports have deemed the practice of nerve transfer to be “relatively safe and technically feasible.”

Now, a prospective study has examined the effects of nerve transfer surgery in 16 young adults, following up on their progress up to 2 years after surgery.

In this new, first-of-its-kind research, Dr. Natasha van Zyl led a team of scientists from Austin Health in Melbourne, Australia, who looked at the potential of combining “traditional tendon-based techniques with nerve transfers” for restoring “upper limb function.”

The results appear in the journal The Lancet.

13 adults can perform daily activities

Dr. Van Zyl and her colleagues recruited 16 adults with an average age of 27 years who had experienced SCI to the neck less than 18 months before the study, mostly as a result of traffic accidents or sports-related injuries.

The researchers performed one or several nerve transfers, sometimes combining nerve transfers with tendon transfers, to restore “elbow extension, grasp, pinch, and hand opening” in the participants.

Dr. Van Zyl and team used standard assessments, such as an “action research arm test […], grasp release test […], and spinal cord independence measure,” to evaluate the outcomes of their interventions.

Overall, the team performed 59 nerve transfers, and they combined nerve transfers with tendon transfers in 10 of the participants.

To evaluate the participants’ level of independence, the researchers asked them to complete tasks relating to everyday self-care activities, such as going to the toilet on their own or brushing their teeth.

The team carried out these assessments before surgery, and both 12 and 24 months after surgery.

Two years after the intervention, most participants scored high enough on the pinch and grasp strength tests to be able to perform most day-to-day activities.

Specifically, 13 of the young adults could feed themselves, brush their teeth and hair, put on makeup, write, and use electronic devices as a result of the interventions and intensive physical therapy.

The nerve transfers failed in three of the participants, but the researchers did not record any serious adverse effects in relation to the surgery.

‘Nerve transfer — an exciting new option’

“For people with tetraplegia, improvement in hand function is the single most important goal,” says Dr. Van Zyl.

“We believe that nerve transfer surgery offers an exciting new option, offering individuals with paralysis the possibility of regaining arm and hand functions to perform everyday tasks and giving them greater independence and the ability to participate more easily in family and work life.”

Dr. Natasha van Zyl

“What’s more, we have shown that nerve transfers can be successfully combined with traditional tendon transfer techniques to maximize benefits,” she continues.

“When grasp and pinch [were] restored using nerve transfers in one hand and tendon transfers in the other, participants consistently [reported] that they liked both hands for different reasons and would not choose to have two hands reconstructed in the same way.”

The researchers caution, however, that nerve transfer surgery has its limitations.

For instance, it may take months for movement to arise and years before the person achieves full strength in their muscles. Also, nerve transfers need to occur up to 12 months after the injury to produce the best results.

Finally, given that four nerve transfers failed in three participants, the scientists say that more research is necessary to minimize failure and evaluate which participants are best suited to nerve transfer surgery.
Read More

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

*

code

Science & Health

Vitamin D sufficiency may reduce complications of COVID-19

A recent small-scale study has concluded that hospitalized patients with COVID-19 are less likely to have life threatening complications if they have sufficient vitamin D levels.A new study demonstrates that people with sufficient levels of vitamin D are less likely to develop life threatening COVID-19 complications when hospitalized with the disease.The research, published in the…

Published

on

By

Vitamin D sufficiency may reduce complications of COVID-19

A recent small-scale study has concluded that hospitalized patients with COVID-19 are less likely to have life threatening complications if they have sufficient vitamin D levels.A new study demonstrates that people with sufficient levels of vitamin D are less likely to develop life threatening COVID-19 complications when hospitalized with the disease.The research, published in the journal PLOS ONE, could be valuable for doctors attempting to reduce the mortality rates of COVID-19 in the absence of an effective vaccine.If further studies back up these findings, vitamin D supplements might offer a cost-effective way to limit the risk of severe COVID-19. It is important to note that this recent study has several limitations, which we address below.Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.Since the sudden emergence of the virus SARS-CoV-2 and the disease that it causes, COVID-19, scientists have paid a great deal of attention to the development of a vaccine. Experts consider a vaccine to be crucial in reducing the effects of the virus, even if it is not yet clear to what extent an initial vaccine would moderate rates of transmission and infection.Alongside the endeavor to develop a vaccine, researchers are also focusing on developing effective COVID-19 treatments. Even if none can make a person immune to the virus, treatments may be able to reduce the disease’s severity.The Food and Drug Administration (FDA) have approved two drugs as treatments for COVID-19: remdesivir and dexamethasone.Another candidate is vitamin D. Research has suggested that it might, in theory, be effective, but corroborating this requires further efforts.Rather than analyzing the effects of vitamin D as COVID-19 treatment, the researchers behind the present study looked at the effects of a person’s vitamin D levels on the severity of the disease.To do so, they analyzed data from patients with confirmed COVID-19 who had been admitted to the Sina Hospital, in Tehran, Iran.Of the 611 people admitted with confirmed COVID-19 before May 1, 2020, there were records of the 25-hydroxyvitamin D levels, an indication of overall vitamin D levels, for 235 patients. Their mean age was 58.7 years, ranging from 20–90 years, and 37.4% were older than 65.The researchers classified the patients into two groups: those with vitamin D levels of at least 30 nanograms per milliliter (ng/ml) — an amount considered sufficient by the Endocrine Society — and those with lower values.They then analyzed the severity of the patients’ COVID-19 signs and symptoms using guidelines from the Centers for Disease Control and Prevention (CDC). Severe or critical disease might involve a range of issues, including shortness of breath, respiratory failure, or a significantly reduced blood oxygen level.After cross-checking the patients’ vitamin D levels with the severity of their COVID-19 symptoms and accounting for confounding factors, the researchers found that having a vitamin D level of above 30 ng/ml was significantly associated with having less severe COVID-19.Among the 235 patients with confirmed COVID-19, only 32.8% had sufficient levels of the vitamin.The researchers also found that the patients with sufficient vitamin D had higher blood lymphocyte counts and lower levels of C-reactive protein in their blood — both of which indicate a positive immune response.The researchers speculate that this may have reduced the likelihood of developing cytokine storm, which can cause acute respiratory distress syndrome in COVID-19 patients, sometimes resulting in death.The findings highlight, the researchers say, that vitamin D sufficiency may be important in the eventuality that people develop COVID-19 alongside another respiratory disease, such as influenza.According to the study’s corresponding author, Dr. Michael F. Holick, director of the General Clinical Research Unit at the medical campus of Boston University, in Massachusetts, “There is great concern that the combination of an influenza infection and a coronal viral infection could substantially increase hospitalizations and death due to complications from these viral infections.”For the researchers, their findings suggest that vitamin D supplementation would be valuable. As Dr. Holick notes: “Because vitamin D deficiency and insufficiency is so widespread in children and adults in the United States and worldwide, especially in the winter months, it is prudent for everyone to take a vitamin D supplement to reduce [the] risk of being infected and having complications from COVID-19.”It is worthing noting the present study’s limitations. First, the researchers only had access to a relatively small number of patients. Before drawing solid conclusions, scientists need to carry out much larger studies.Also, various issues can influence both vitamin D status and COVID-19 severity, such as socioeconomic factors and smoking status. The scientists accounted for neither of these in their analysis.Also, because the study was cross-sectional, the researchers could not prove that vitamin D insufficiency caused an increase in disease severity. To address these limitations, the researchers call for “large-scale studies and randomized clinical trials.”For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.
Read More

Continue Reading

Science & Health

Video gaming as a child related to improvements in memory

A new study exploring the link between video games and cognition finds that playing video games as a child can improve a person’s working memory years later on specific tasks.Video games can be a contentious topic, particularly among parents or caregivers who may be concerned about the effects of spending hours in front of the…

Published

on

By

Video gaming as a child related to improvements in memory

A new study exploring the link between video games and cognition finds that playing video games as a child can improve a person’s working memory years later on specific tasks.Video games can be a contentious topic, particularly among parents or caregivers who may be concerned about the effects of spending hours in front of the console.Yet, it seems that some video gaming could actually be beneficial. Recent studies have shown that playing video games could improve learning and may even protect against dementia in older adults.The authors of a recent review of the evidence on video games concluded that gaming could have benefits for both cognitive and emotional skills.In a new study, which features in the journal Frontiers in Human Neuroscience, researchers from the Universitat Oberta de Catalunya in Barcelona trained volunteers to play “Super Mario 64” — a game that researchers have previously shown to induce structural changes in parts of the brain associated with executive function and spatial memory.The new study found that people who played video games as children showed greater improvements in their working memory than those who did not, suggesting that video games can have long lasting benefits for cognition.This study combined video game playing with transcranial magnetic stimulation (TMS), a noninvasive form of brain stimulation that scientists have studied as a treatment for mood disorders. In 2008, the Food and Drug Administration (FDA) approved its use for the treatment of major depression when other approaches have failed.Studies have also shown TMS to boost cognitive performance under some conditions, with more than 60 studies reporting that the treatment led to significant improvements in cognition, including in working memory (holding and manipulating information over a short period).The researchers behind the new study wanted to find out whether combining video game training and TMS could enhance cognitive function more than either element alone.They asked 27 healthy volunteers, with an average age of 29 years, to take part in 10 video game training sessions, during each of which they played “Super Mario 64” for an hour and a half.At the end of each session, the researchers applied TMS to part of the prefrontal cortex, which is at the front of the brain and is important for complex cognitive functions, such as working memory and reasoning. The researchers assessed the cognitive function of the participants before the study started, at the end of the 10 sessions, and 15 days after this.They assessed a range of cognitive functions, including reaction time, working memory, attention span, visuospatial skills, and problem-solving.Although the results overall showed very limited changes in cognitive ability, which seemed to result only from the video game training and not the TMS, the researchers did find that participants with early experience of video gaming had improved working memory.“People who were avid gamers before adolescence, despite no longer playing, performed better with the working memory tasks, which require mentally holding and manipulating information to get a result,” explains lead author of the study Dr. Marc Palaus, Ph.D.People with prior experience of playing video games (but not the actual game in the study) also showed improvements in processing and were better able to focus on relevant stimuli during the tasks.“People who played regularly as children performed better from the outset in processing 3D objects, although these differences were mitigated after the period of training in video gaming, when both groups showed similar levels,” adds Dr. Palaus.The results suggest that video games may induce cognitive changes that last for years after people have stopped playing.Dr. Palaus says that video games that provide motivation — making the player want to keep on playing — and also get more difficult to stay challenging require intensive use of brain resources, which makes them ideal for boosting cognitive ability.“Video games are a perfect recipe for strengthening our cognitive skills, almost without our noticing.”– Dr. Marc Palaus, Ph.D. It is important to note that this study included a small number of participants who were all healthy, young, and highly educated, meaning that the findings might not be more widely applicable.Talking about the findings of their study, Dr. Palaus stressed that these improvements only have a limited effect on the performance of other activities not linked to video gaming, as is the case with most cognitive training.
Read More

Continue Reading

Science & Health

Lax gun laws in neighboring states may increase firearm deaths

A US study suggests strong gun control regulations reduce a state’s firearm deaths, but having neighbors with more lenient laws undermines their effect.Share on PinterestNew research suggests that one state’s lax gun laws could undo the effects of its neighbor’s stricter firearm regulations.In 2017, 39,773 people died from gun-related injuries in the United States, according…

Published

on

By

Lax gun laws in neighboring states may increase firearm deaths

A US study suggests strong gun control regulations reduce a state’s firearm deaths, but having neighbors with more lenient laws undermines their effect.Share on PinterestNew research suggests that one state’s lax gun laws could undo the effects of its neighbor’s stricter firearm regulations.In 2017, 39,773 people died from gun-related injuries in the United States, according to the National Center for Injury Prevention and Control.Overall, research indicates that stronger state laws governing the sale and ownership of firearms reduce firearm-related deaths. However, some states have relatively high rates of gun deaths despite strict regulations. To investigate why this might be the case, scientists at the University of Alabama at Birmingham, and the Boston University School of Public Health at Boston, MA, looked into the effects of firearm laws in neighboring states.They used the Web-based Injury Statistics Query and Reporting System to obtain figures for firearm-related deaths in the 48 adjacent U.S. states from 2000 to 2017. There were 578,022 firearm deaths in total, including homicides and suicides, but excluding deaths due to shootings by police or other law enforcement agents. The scientists also searched the State Firearm Laws Database for laws in each state regarding:background checksgun dealer regulationsbuyer regulationsgun-trafficking lawsThe team used the number of these laws as a proxy for gun control strength in each state.If you would like to check your registration status or register to vote, we have added some useful links at the bottom of this article.Overall, stronger state gun laws were associated with reduced firearm deaths, but having a neighboring state with more permissive laws undermined this protective effect.Larger policy differences across state borders were associated with increased gun-related deaths, suicides, and homicides, though the results were statistically stronger for suicide than homicide.The authors conclude:“This study adds to the growing literature emphasizing the role played by neighboring states’ firearm regulations in addition to own-state firearm regulations in firearm deaths. Failing to account for neighboring states with weaker laws, in some instances, can make a state’s own regulations appear less effective in reducing firearm deaths.”The scientists calculate that, on average, failure to account for weaker firearm laws in neighboring states make it appear as though a state’s laws were about 20% less effective at reducing deaths than they really were.They report their findings in the American Journal of Preventive Medicine.The researchers write that higher prices and strong marketing regulations can lead consumers to purchase firearms in adjacent, relatively unregulated markets. They say these are a frequent source of the guns used in crimes.They believe their work supports the case for more cooperative legislation between neighboring states and at the federal level.“I think the main message of this study is that to solve a nationwide problem we need to think of a nationwide or at least a regional-level (i.e. multistate) approach, like we may also need for the COVID-19 pandemic,” says Dr. Ye Liu, who is a doctoral student in the Department of Health Care Organization and Policy at the University of Alabama and the first author of the study. “An ‘each state on its own’ approach is ultimately inadequate to address one of the biggest public health challenges in this country,” Dr. Liu adds.The authors acknowledge the number of gun-control laws may not perfectly reflect the strictness of a state’s regulations. In addition, they note states may vary in how diligently they enforce these laws.They call for further studies that might use alternative measures of regulatory strength, focus on specific categories of law, or explore the effects of regulations in more distant states. To check your voter registration status, click here to visit VoteAmerica, a nonprofit, nonpartisan organization dedicated to increasing voter turnout. They can also help you register to vote, vote by mail, request an absentee ballot, or find your polling place.
Read More

Continue Reading
error: Content is protected !!