Some potentially good news for aging Baby Boomers: researchers believe that they have developed a hip replacement that will last longer and create fewer problems for the people who receive them than those currently in use. The secret? An implant that "tricks" the host bone into remaining alive by mimicking the varying porosity of real bones.

Interestingly, the key factor that distinguishes the new implant is that is LESS rather than more solid than those in current use, while still being just as strong.

Damiano Pasini, the man behind the design of the new hip replacement, points at the pyramid-like shapes visible on its surface. The implant is known as a femoral stem and connects the living femur with the artificial hip joint. "What we’ve done throughout the femoral stem is to replicate the gradations of density found in a real femur by using hollowed-out tetrahedra," he explains. "Despite the fact that there are spaces within the tetrahedra, these forms are incredibly strong and rigid so they’re a very efficient way of carrying a load. Just think of the lattice-work in the legs of the Tour Eiffel."

Pasini teaches mechanical engineering at McGill University and first started working on the concept for the implant more than 6 years ago. He smiles ruefully as he pulls earlier versions of the implant down from the shelves in his office to show how far he has come since then. He elaborates:

"So because the implant loosely mimics the cellular structure of the porous part of the surrounding femur, it can "trick" the living bone into keeping on working and staying alive. This means that our implant avoids many of the problems associated with those in current use."

Indeed, the main problem with most implants is that because they are solid, or only porous on the surface, they are much harder and more rigid than natural bone. As a result, the implants absorb much of the stress along with the weight-bearing role that is normally borne by the living femur. Without sufficient stress to stimulate cell formation, the bone material in the living femur then becomes reabsorbed by the body and the bone itself begins to deteriorate and become less dense. This is one of the reasons that many implants become painful and need to be replaced after a time. It also explains why people often have difficulty if they have to have the same hip replaced a second time, because there simply isn’t enough normal, healthy bone to hold the implant in place.

It is a problem that orthopaedic surgeons are seeing more and more frequently.

McGill University www.mcgill.ca/newsroom/channels/news/towards-better-hip-replacements-263893

For the first time, researchers have shown that using Magnetic Resonance Imaging (MRI) can effectively identify bone marrow cancer (myelofibrosis) in an experimental model. The findings may change the way this disease is diagnosed which is now through invasive bone marrow biopsies.

Myelofibrosis is a slow evolving condition hallmarked by increased myeloid cells and in the case of primary myelofibrosis, with an excessive number of large bone marrow cells called megakaryocytes. The pathology also is characterized by structural abnormality of the bone marrow matrix, which at end-stage manifests in excessive deposition of reticulin fibres and cross-linked collagen in the bone marrow, suppression of normal blood cell development and bone marrow failure. Currently the diagnosis is made via an invasive bone marrow biopsy and histophatology to assess cellularity and reticulin deposition in the marrow.

Researchers at Boston University School of Medicine (BUSM) led by Katya Ravid, PhD, designed and tested whether a T2-weighted MRI could detect bone marrow fibrosis in an experimental model. The group was able to show that an MRI could detect a pre-fibrotic state of the disease with a clear bright signal, as well as progressive myelofibrosis. The investigators proposed that the abundance of large megakaryocytes contribute to the signal, since in T2-weighted MR-images, increased water/proton content, as in increased cellularity, yield high (bright) MR-signal intensity.

This is the first study to evaluate a T2-weighted MRI in an experimental model of myelofibrosis with examination of potential sources of the MRI signal, researchers said. ‘Our study provides proof-of-concept that this non-invasive modality can detect pre-fibrotic stages of the disease,’ said Ravid, professor of medicine and biochemistry at BUSM. ‘It is intriguing to speculate that future pre-biopsy MRI of the human pathology might guide in some cases decisions on if and where to biopsy,’ she added.

Boston University School of Medicine www.bumc.bu.edu/busm/2016/11/14/researchers-propose-non-invasive-method-to-detect-bone-marrow-cancer/

A new study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has found that lower levels of vitamin D in the blood increase the risk of clinical relapse in patients with Ulcerative Colitis (UC), an inflammatory bowel disease that causes long-lasting inflammation and ulcers in the colon.

Lower vitamin D levels have been associated with active disease in patients with UC, but it has been unknown whether they increase disease relapses. ‘Prior studies in patients with Crohn’s disease and Ulcerative Colitis had linked low vitamin D levels to disease flare-ups,’ said senior author Alan Moss, MD, a gastroenterologist at the Digestive Disease Center at BIDMC and Associate Professor of Medicine at Harvard Medical School. ‘However, it has been unclear if the flare-up was lowering vitamin D levels, or if low vitamin D levels were causing the flare-up. We thought that if we looked at vitamin D levels when the disease was inactive and then followed patients moving forward, the impact of baseline vitamin D levels on future events may be clearer.’

Moss and colleagues collected vitamin D serum levels through a physician-blinded prospective study of 70 patients with UC in clinical remission who were followed up after a surveillance colonoscopy at BIDMC. The study measured vitamin D levels in blood samples and levels of inflammation through blood tests and biopsies. The researchers then followed the patients for 12 months and compared the data from participating patients who remained well and the others who experienced relapses. The investigators found the mean baseline vitamin D level to be lower in patients who later relapsed than those who did not.

‘Patients who had higher vitamin D levels when their disease was in remission were less likely to experience a relapse in the future,’ said John Gubatan, MD, a physician at BIDMC and first author of the study. ‘This suggests that higher vitamin D levels may play some role in preventing the UC relapse.’ The threshold level of blood vitamin D that was protective was greater than 35ng/ml, which is within the range recommended by the National Institutes of Health for a healthy individual.

Ongoing work by Gubatan and Moss is now examining the link between vitamin D and a protein called cathelicidin in the cells lining the colon. The link may have beneficial effects on microbial composition, an important component of a healthy colon. Building on this research, investigators are trying to unravel how vitamin D may protect cells in the colon and the microbial composition of the bacteria, fungi, protozoa and viruses that live on and inside the human body, Moss noted.

Beth Israel Deaconess Medical Center www.bidmc.org/News/PRLandingPage/2017/February/Moss-Ulcerative-Colitis-Vitamin-D.aspx

A portable power-free test for the rapid detection of bacterial resistance to antibiotics has been developed by academics at Loughborough University and the University of Reading.
The new test termed Lab-on-a-Stick is an inexpensive microfluidic strip – comprising of tiny test tubes about the size of a human hair – capable of identifying bacteria found in urine samples and checking if they are resistant to common antibiotics.
Simple to use and cheap to manufacture, the Lab-on-a-Stick is a dip and read’ method using a transparent micro-capillary film suitable for naked eye detection or measurement with portable, inexpensive equipment such as a smartphone camera.
The test, which is at least 12 times faster than current microbiological tests, is the result of research by Dr Nuno Reis, Lecturer in Chemical Engineering at Loughborough University, and Dr Al Edwards, Associate Professor in Biomedical Technology at the University of Reading.
The study showed that dipstick tests routinely used for testing in a variety of scenarios from soil pH strips for the garden to pregnancy tests, could be updated using the latest approach in miniaturized testing technology to help form the basis of a new generation of advanced, yet affordable, point-of-care tests for global diagnostics.
As part of the study, different cellular tests were carried out to demonstrate the full potential of Lab-on-a-Stick devices for a range of clinical situations:
Anti-microbial resistance – this was measured with E. coli samples typical of common urinary tract infection (UTIs). UTIs can be hard to treat with antibiotics because antibiotic resistance is so common and lab testing takes at least two days. The assay detects antibiotic resistance – in other words, can the cells grow in the presence of the antibiotic, and how much antibiotic is needed to stop cell growth? This demonstrated the advantage of using the microcapillary film which enables 10 different concentrations of antibiotic per sample to be tested with a single test strip. The research team are currently optimizing this so that the test, which currently requires overnight incubation in a multi-well plate, could in the future be completed in less than two hours in a single test strip.
Bacteria identification – classical analytical microbiology tests used for the identification of bacteria were miniaturized and performed in parallel microcapillaries, resulting in simple and rapid identification of bacteria. To identify bacteria, many different tests must be performed on every sample, illustrating again the benefits of microcapillary film which performs 10 tests per test strip. This study demonstrated a four-hour test to distinguish two very closely related bacteria – a harmless laboratory strain of E. coli from a type of Salmonella that causes food poisoning.
ABO blood typing – a simple blood test that takes only two minutes was miniaturized and the results were recorded using an everyday digital camera.
Dr Reis said: ‘This is a major step towards miniaturizing complex, routine microbiological and clinical tests that cannot at the moment be performed outside of the laboratory setting.
‘Our secret is simplicity. We have shown how micro-engineered film material made from a very transparent plastic with special optical properties, makes it easy to perform laboratory tests without lab equipment. Previously, we showed how a portable Lab-in-a-briefcase made it possible to record blood test results with the assistance of a simple smartphone.’

Loughborough University http://tinyurl.com/hb4mrph

Preliminary computerized imaging reveals the shape of the prostate and a compartment within the gland-called the transitional zone-consistently differ in men with prostate cancer than those without the disease, according to new research led by Case Western Reserve University.
The finding may provide a new avenue to diagnose the disease-perhaps even the cancer’s aggressiveness.
The differences held up in comparisons of magnetic resonance imaging (MRI) scans of 70 patients. The scans came from three different medical institutions in Ohio and two in Sydney, Australia, on different makes and models of MRI’s.
‘Looking at shape is a fundamental shift from looking at the intensity of pixels in an image to predict if a patient has prostate cancer,’ said Anant Madabhushi, professor of biomedical engineering and leader of the research. ‘Pixel intensities vary, but shape is resilient.’
Variability in MRI scans can result in disagreement as to whether prostate cancer is present, in turn potentially resulting in unnecessary biopsies and treatments. The American College of Radiology and others are working to develop standards to eliminate inconsistencies in imaging.
To find the differences in shapes, the researchers took images of 35 cancerous prostates, aligned them into a single frame and created a statistical shape atlas. They then took images of 35 healthy prostates, aligned them in one frame and created a second statistical shape atlas.
The researchers then aligned the two frames and controlled for size-tumours and a noncancerous condition, called benign prostatic hyperplasia (which some images in this study showed), increase the gland’s volume.
Comparing cancerous and cancer-free prostates showed clear, statistically significant differences in both the shape of the transitional zone-which is in the central part of the gland-and the gland itself.
The researchers analysed and compared the images from each of the five medical institutions and found that, no matter where the images were from, differences in shapes between cancerous and cancer-free prostates were consistent.
Madabhushi said that if shape proves to be a reliable marker of cancer, it could be combined with radiomics, which employs computer algorithms to extract differentiating features in cancerous and non-cancerous tissues.

Case Western Reserve University http://tinyurl.com/zonynty