Archive for month: August, 2020

An Arthritis Research UK-funded study has cast doubt on the effectiveness of using lateral wedge insoles as a means of relieving pain levels among sufferers of medial knee osteoarthritis.
Medial knee osteoarthritis is the most common type of arthritis affecting the knee joint, affecting the inside of the knee between the femur and the tibia.
The University of Manchester team led by Dr Matthew Parkes assessed the efficacy of lateral wedge treatments – shoes and insoles designed to reduce pressure on the knee – in reducing pain, evaluating data from 12 trials involving almost 900 patients.
According to results published in the Journal of the American Medical Association, while the data showed some connection between the use of these wedges and a reduction in pain levels, the findings were extremely inconsistent and failed to provide any evidence of a clear link.
Moreover, the studies that compared lateral wedge treatments to neutral insoles showed there were no advantages at all associated with the lateral wedge options.
This type of insole fits underneath the sole of the shoe and are thicker on the outside than the inside, thereby tilting the foot inward and transferring the weight of the body to a different part of the foot.
However, the Arthritis Research UK-backed report would appear to suggest that the specific design of the insole itself did not have an impact, with the only studies showing any benefit being the ones in which their performance was compared against patients who were not using insoles at all.
The researchers said: ‘These results suggest that compared with control interventions, lateral wedges are not efficacious for the treatment of knee pain in persons with medial knee osteoarthritis.’
Arthritis Research UK is now funding a new clinical trial that will see the Manchester team investigating whether targeting specific sub-groups of people with medial osteoarthritis who respond biologically to wearing lateral wedge insoles gain benefit. A number of insoles and orthotics which have been designed to potentially lower the loads in the knee joint will be tested.

‘The current way that insoles are prescribed don’t appear to work, but this new trial gives us an opportunity to modify them for particular patients whom we think will respond,’ added the spokesman. Arthritis Research UK

New research suggests that restricting calories for a defined period of time may improve the success of cancer treatment, offering valuable new data on how caloric intake may play a role in programmed cancer cell death and efficacy of targeted cancer therapies.
While previous studies suggest a connection between caloric intake and the development of cancer, scientific evidence about the effect of caloric intake on the efficacy of cancer treatment has been rather limited to date. When humans and animals consume calories, the body metabolises food to produce energy and assist in the building of proteins. When fewer calories are consumed, the amount of nutrients available to the body

When a beating heart slips into an irregular, life-threatening rhythm, the treatment is well known: deliver a burst of electric current from a pacemaker or defibrillator. But because the electricity itself can cause pain, tissue damage and other serious side-effects, a Johns Hopkins-led research team wants to replace these jolts with a kinder, gentler remedy: light.

Five biomedical engineers from Johns Hopkins and Stony Brook universities described their plan to use biological lab data and an intricate computer model to devise a better way to heal ailing hearts. Other scientists are already using light-sensitive cells to control certain activities in the brain. The Johns Hopkins-Stony Brook researchers say they plan to give this technique a cardiac twist so that doctors in the near future will be able to use low-energy light to solve serious heart problems such as arrhythmia.

‘Applying electricity to the heart has its drawbacks,’ said the project

The patient-relevant benefit of positron emission tomography (PET) in oesophageal cancer, alone or in combination with computed tomography (CT), is not proven due to a lack of comparative studies. In terms of their diagnostic and prognostic accuracy, it also remains unclear whether these diagnostic techniques can detect the spreading of tumours better than conventional diagnostics. This is the conclusion of the final report of the German Institute for Quality and Efficiency in Health Care (IQWiG).
About 4800 men and 1400 women are newly diagnosed with oesophageal cancer in Germany each year. The average age of disease onset is 65 years. The 5-year survival rate in Germany is at most 20%; this means that 5 years after diagnosis, at best 20 of 100 affected patients are still alive.
Many experts assume that an examination using PET or PET/CT, alone or in combination with other methods, is better able to evaluate how far a tumour has spread (staging) and whether it has responded to treatment (restaging). In addition, better detection of tumour recurrence ought to be possible. The desired goal: the more exactly it is known how advanced the tumour is, the more precisely and successfully patients can be treated.
IQWiG therefore searched the international literature for studies that had examined the consequences of diagnostic interventions using PET or PET/CT with regard to whether they were accompanied by perceptible improvements for patients, for example, whether they increased their chances of survival or improved their quality of life, or spared them unnecessary operations or further diagnostic interventions.
However, the search for such direct comparative intervention studies was unsuccessful, so that the question regarding the patient-relevant benefit of PET or PET/CT in oesophageal cancer still remains to be answered.

IQWiG also searched for studies in which the diagnostic accuracy and prognostic power of PET or PET/CT was compared with other examination methods.
19 studies directly compared test accuracy of PET and CT
A total of 48 studies were relevant for diagnostic and prognostic accuracy, of which most examined the accuracy of primary staging, that is, the classification of tumour stages before the start of treatment.

19 studies directly compared PET with CT. However, conclusions in favour of one or the two techniques cannot be drawn, as either no statistically significant difference was shown or the data could not be interpreted with sufficient certainty.
Too few studies are so far available that directly compared PET or PET/CT with other diagnostic techniques and investigated treatment response (restaging) or diagnosis and prognosis of tumour recurrence. A reliable conclusion on the diagnostic and prognostic accuracy of PET or PET/CT in restaging or recurrence diagnostics is therefore not possible.
In particular the potential advantage of PET and PET/CT, which visualise metabolic activity, remains unclear versus morphologic imaging techniques such as CT or magnetic resonance imaging, which display anatomical structures.
IQWiG published the preliminary results in the form of the preliminary report in May 2012 and interested parties were invited to submit comments. At the end of the commenting procedure, which included an oral scientific debate including parties who had submitted comments, the preliminary report was revised and sent as a final report to the contracting agency, the Federal Joint Committee (G-BA), in June 2013. The written comments were published in a separate document at the same time as the final report. The report was produced in collaboration with external experts.
The German-language executive summary provides an overview of the background, procedure and further results of the report.

An English-language executive summary will be available soon. If you would like to be informed when the English document is available, please send an e-mail to