Category Archives: Other Diseases

‘Miracle’ stem cell therapy reverses multiple sclerosis Read Now

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The treatment, is the first to reverse the symptoms of MS, which has no cure, and affects around 100,000 people in Britain.

A pioneering new stem cell treatment is allowing multiple sclerosis sufferers to walk, run and even dance again, in results branded ‘miraculous’ by doctors.

Patients who have been wheelchair-bound for 10 years have regained the use of their legs in the groundbreaking therapy, while others who were blind can now see again.

The treatment, is the first to reverse the symptoms of MS, which has no cure, and affects around 100,000 people in Britain.

The two dozen patients who are taking part in the trials at the Royal Hallamshire Hospital in Sheffield and Kings College Hospital, London, have effectively had their immune systems ‘rebooted’.

Although it is unclear what causes MS, some doctors believe that it is the immune system itself which attacks the brain and spinal cord, leading to inflammation and pain, disability and in severe cases, death.

In the new treatment, specialists use a high dose of chemotherapy to knock out the immune system before rebuilding it with stem cells taken from the patient’s own blood.

Stem cells are so effective because they can become any cell in the body based on their environment.

“Since we started treating patients three years ago, some of the results we have seen have been miraculous,” Professor Basil Sharrack, a consultant neurologist at Sheffield Teaching Hospitals NHS Foundation Trust, told The Sunday Times.

“This is not a word I would use lightly, but we have seen profound neurological improvements.”

During the treatment, the patient’s stem cells are harvested and stored. Then doctors use aggressive drugs which are usually given to cancer patients to completely destroy the immune system.

The harvested stem cells are then infused back into the body where they start to grow new red and white blood cells within just two weeks.

Within a month the immune system is back up and running fully and that is when patients begin to notice that they are recovering.

Holly Drewry, 25, of Sheffield, was wheelchair bound after the birth of her daughter Isla, now two.

But she claims the new treatment has transformed her life.

“It worked wonders,” she said. “I remember being in the hospital… after three weeks, I called my mum and said: ‘I can stand’. We were all crying.

“I can run a little bit, I can dance. I love dancing, it is silly but I do. I enjoy walking my daughter around the park in her pram. It is a miracle but I can do it all.”

However specialists warn that patients need to be fit to benefit from the new treatment.

“This is not a treatment that is suitable for everybody because it is very aggressive and patients need to be quite fit to withstand the effects of the chemotherapy,” warned Prof Sharrack.

Charities welcomed the research but also urged caution.

Dr Sorrel Bickley, Research Communications Manager at the MS Society said: “This new study reports very encouraging findings, which add to a growing body of research into stem cell transplantation in MS. However, there are limitations to how we can interpret these results because there was no control group used, which means we can’t be sure the results are robust.

“Momentum in this area of research is building rapidly and we’re eagerly awaiting the results of larger, randomised trials and longer term follow up data.

“New treatments for MS are urgently needed, but as yet there are no stem cell therapies licensed for MS anywhere in the world. This means they aren’t yet established as being both safe and effective. This type of stem cell therapy is very aggressive and does carry significant risks, so we would strongly urge caution in seeking this treatment outside of a properly regulated clinical trial.”

Read Now: The Best Way to Shed Weight? Go Vegan.

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There are a lot of different diet plans out there: paleo, Weight Watchers, Atkins, and even a number of government recommendations. Each with its own philosophy on health and wellness. But when choosing a diet, it’s more about deciding what kind of food lifestyle you want to lead.

The thing about starting a diet is that it’s not going to be a temporary solution to lose weight. It should be seen as how you plan on eating for the rest of your life.

As part of a recent study, researchers found that going with a vegan eating regimen may be the way to go if you want the best results. However, this way of life may not be for everyone.

Ru-Yi Huang of E-Da Hospital in Taiwan reviewed the results of 12 diet trials, involving 1,151 dieters over the course of nine and 74 weeks. He found a vegetarian plan was one of the most effective. Participants lost more weight compared to their meat-eating dieters (around four pounds). Vegans lost even more weight, compared to participants who indulged in meats (around 5 pounds).

Huang notes that whole grains, fruits, and vegetables all create a kind of harmonious cycle in the body that allows for slower digestion from fibrous whole grains and fruits, and lower glycemic index values that don’t cause blood sugar levels to spike. These results led Huang to conclude, “Vegetarian diets are more effective than non-vegetarian diets for weight loss.”

Many of us would have trouble giving up meat (myself included). It tastes good and it smells good; so why would we want to? Because most Americans don’t need to eat meat, or at least not in the quantities that we’re currently consuming it.

Nutritionist Marion Nestle explains excluding meat from one’s diet is a double-edged sword. It has been hailed as essential for everything from lowering cholesterol to lowering emissions. But, as Nestle explains, the vegetarian movement is not without its potential dangers and dubious beliefs.

Why the Future of Health May Be Mobile Read Now

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What’s the Latest Development?

Telecommunications companies, like the San Diego-based Qualcomm, are wading into professional healthcare waters thanks to information technology’s ability to create and manage massive amounts of data. “Asthmapolis has a GPS sensor for inhalers that uses a Bluetooth radio so people with asthma can track where and when they needed help breathing. CleverCap attaches to pill bottles, flashes and beeps when it’s time to take medication, and then, using Wi-Fi and cellular networks, reports to the Internet whether the pills were taken. The Garmin heart-rate monitor straps across the chest and digitally communicates beeps and blips with yet another wireless protocol, called ANT-plus.”

What’s the Big Idea?

About half of American adults have some kind of chronic condition, including obesity, arthritis, or diabetes. Experts say that wireless devices could let more of their health care happen at home. “To proponents of mobile health, like Don Jones, Qualcomm Life’s head of global marketing and strategy, this means that unnecessary visits to clinics and emergency rooms will plummet, people will refine their use of medicine, and doctors and nurses will have more time to focus on their neediest patients. A PricewaterhouseCoopers report this year estimated that mobile health technology could help save developed countries $400 billion by 2017.”

Personality Disorders to Be Cut READ NOW

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What’s the Latest Development?

“The American Psychiatric Association announced Thursday that the framework for personality disorders in DSM-5 will be a ‘hybrid’ model that is substantially different from how personality disorders are diagnosed currently. The committee working on the personality disorders chapter of the DSM-5, which is due to be published in 2013, has proposed six types of disorders: antisocial, avoidant, borderline, narcissistic, obsessive/compulsive and schizotypal. They have proposed dropping paranoid, histrionic, schizoid and dependent personality disorders.”

What’s the Big Idea?

The new model is less rigid than the existing diagnostic model. It is designed to reflect that behavior can change over time while personality traits tend to remain stable. “In the past, we viewed personality disorders as binary. You either had one or you didn’t,” said Dr. Andrew Skodol, chairman of the DSM work group on personality disorders, in a news release. “But now we understand that personality pathology is a matter of degree.” The American Psychiatric Assn. also announced that a public comment period on DSM-5 proposals has been extended through July 15.

Video Game Therapy Could Soothe Symptoms of Multiple Sclerosis, Brain Injuries

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There’s really no scientific consensus. Whenever you read a headline about video games having been proven to be beneficial or proven to be detrimental, know that what you’re reading is probably bullshit. Science is not always about proving one thing or disproving another. Science is about compiling the best possible evidence via sound research practices, and then doing your darndest to grasp the facts through the static. If you’re lucky, the experts reach consensus about a topic and you can more or less put it to bed.

With that said, I’d like to draw your attention to an interesting piece by Joseph Bennington-Castro of Everyday Health. Bennington-Castro compiles several bits of research to present the case for video games as a potential therapy tool for people with multiple sclerosis:

“So far, studies of video game use by people with MS have focused mainly on balance. But other research has indicated that certain types of video games may help with symptoms that are often associated with MS, such as loss of fine motor skills, depression, and memory loss.”

We’ve seen studies such as this one communicate positive results for therapy using Wii Fitbalance boards. As one of the main symptoms of MS is loss of balance (due to miscommunication between the brain and spinal cord), practicing with a game helps patients adapt. Bennington-Castro notes that the Wii Fit balance board has been used to treat other neurological issues. The photo at the top of this article, for instance, features a demonstration of the U.S. Navy’s adoption of Wii Fit‘s yoga program as a physical therapy tool.

I recommend taking a look at Bennington-Castro’s full piece (linked again below) for his perspective on how video games that prioritize cognition, memory, and motor skills could also be beneficial for MS patients. The main takeaway isn’t that video games are magical, healthy, or innately therapeutic, but rather that they can potentially be used as helpful mental exercise tools.

Read Now: A Good Night’s Sleep? The Truth about Using Marijuana and Alcohol as Sleep Aids

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One in three people are said to suffer from occasional insomnia, and anyone who has experienced a more serious form of this sleep disorder will know just how frustrating and debilitating it can be. While some insomniacs turn to sleeping pills to assure them of a good night’s sleep, in the long run this is neither effective nor advisable, medically speaking. Many others rely on self-medication to help them drop off, with alcohol and marijuana commonly cited as effective sleep aids.

But how successful are these drugs in inducing a good night’s sleep — and what are the drawbacks, over time, to using them as sleep aids?

A Nightcap or Three

“I’ve relied on a nightcap — or three — to send me to sleep for years,” says Nick, a computer engineer who’s struggled with insomnia since he was a teenager. “I know people say you shouldn’t drink before bed, but for me it was the only thing that worked. My insomnia peaked during my last year of college, and I was prescribed sleeping pills by my doctor, but they had terrible side effects — I started suffering from extreme mood swings and they left a nasty, metallic taste in my mouth the next day.”

Nick decided to switch to a classic sleep aid: a nightcap – in his case, a few whiskeys in the hours leading up to bedtime. Though it’s common knowledge that on the whole, alcohol can be detrimental to sleep, around 15 percent of people regularly use alcohol to drop off. Studies suggest that alcohol loses its benefit as a sleep aid after just a few nights, and after several nights of drinking your body builds up a tolerance to its soporific effects.

Further, a study this year by scientists at the University of Melbourne found that students who drank alcohol before going to bed displayed interrupted sleep patterns. While this study did, like many before it, find evidence that alcohol can help to reduce the time it takes to actually fall asleep, it also cemented the idea that alcohol is not conducive to a good night’s sleep.

Alcohol significantly reduces REM sleep, the deepest stage of sleep where dreaming is most likely to occur. It does, conversely, increase slow-wave sleep during the first half of the night, a stage of sleep linked to the body’s healing and restoration. So it seems there is somewhat of a compromise: Alcohol can help you fall asleep and enjoy a restful first half of the night, but the trade-off is disrupted, fragmented sleep for the second half. Naturally, people are affected in different ways and there are many people like Nick who insist that a stiff drink before bed is actually beneficial overall:

“I honestly feel rested the next morning. Perhaps the second half of my sleep isn’t as restful as it could be, but it certainly beats the alternative — a sleepless night, tossing and turning and becoming more and more frustrated. Or, turning to sleeping pills, where the long-term effects still aren’t known, and experiencing adverse side-effects. I know it’s not exactly healthy to drink every night, but it’s not like I’m drinking excessively each night; it’s just a few drinks. I’m prepared to pay that price for a good night’s sleep.”

A Deficiency of Dreams

Being prepared to compromise a degree of health for some restful sleep is not uncommon among insomniacs, as freelance writer Leah can attest. A regular marijuana smoker for over nine years, Leah has noticed negative cognitive effects as a result of the drug, but insists it’s all worth it.

“I first started smoking marijuana when I was at college,” Leah says. “I’d found it difficult to fall asleep since I was a child, but the older I got, the more elusive sleep became. I first tried pot as a college student experimenting, and found that it was the only thing that sent me to sleep. My doctor had given me some pretty heavy-duty sleeping pills, but they didn’t work too well. I had a friend who became addicted to sleeping pills with some really bad consequences, so I was very wary of taking them as it was.”

Aside from an increase in appetite, the best known side-effect of marijuana is probably the relaxed, drowsy feeling it provokes, which is why it’s such a popular sleep aid. But inducing sleep isn’t the only affect marijuana has; like alcohol, it reduces REM sleep and therefore dreaming — but to a more extreme effect. It is specifically the ingredient tetrahydrocannabinol (THC) that affects REM sleep, and it’s common for regular marijuana users to witness a flooding of extreme dreams as soon as they stop smoking.

“I’ve definitely noticed that I don’t dream anymore,” acknowledges Leah. “But for me, that was a pretty welcome side-effect. I used to have very vivid, messed-up dreams that would leave me feeling unsettled for hours in the morning. I can’t say I miss that.”

While Leah may not miss her dreams, they are nonetheless important. Dreaming is the brain’s way of sifting through the numerous images and thoughts that one experiences each day, and quashing this function is not at all ideal, as Dr. Hans Hamburger explains:

“By smoking weed, you suppress the REM sleep, and with that you also suppress a lot of important functions of that REM sleep. One of those functions is reliving the things you have experienced and coming to terms with them, as it were. Processing all kinds of psychological influences is something you do in REM sleep. You also anticipate the things that will happen the next day or the days after that. While you’re sleeping, you already consider those and make decisions in advance.”

Science’s Greatest Unsolved Mystery

It has even been suggested that marijuana can actually exacerbate insomnia; a study last year by the University of Pennsylvania found that people who began using marijuana early on in life were more prone to sleep problems later. However, it must be noted that this notion is still inconclusive. While around 42 percent of daily marijuana users experienced sleep disturbances when they quit (just as nearly 75 percent of alcoholics experienced insomnia for a period after quitting), for regular users like Leah this is inconsequential:

“I suffered from chronic insomnia way before I started smoking pot. I do wish I didn’t have to rely on it though, because while it means I can guarantee a long, deep sleep, it does affect me negatively in some ways. I’m usually quite groggy in the mornings — although, far less groggy than I would be if I hadn’t slept at all! But I have started to notice the effect on my memory, which is quite alarming considering that I’m not even 30 yet. But realistically, what else can I do if I want to sleep and refuse heavy medication? There’s no cure for insomnia; I can’t afford to go to a sleep clinic and even if I could, I don’t have the time for it.”

Unfortunately for Leah, the causes and cures of insomnia still remain, to a large part, a mystery to scientists. Though we spend around a third of our lives sleeping — and all animals sleep in various forms — the fact remains that scientists still don’t fully understand why: Sleep has even been called “one of the greatest unsolved mysteries of science.” Despite the risks associated with self-medicating with alcohol or marijuana, it seems that the threat of not sleeping at all counteracts that — to insomniacs, at least.

Read Now: Top 10 Myths About Multiple Sclerosis

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Myths and facts about MS

by Denise Mann

Most of us know or know of someone with multiple sclerosis (MS), but how much do we really know about this illness? MS is an autoimmune disease that occurs when the body’s immune system misfires against myelin, a fatty substance that insulates the nerve fibers of the brain, spinal cord, and optic nerves.

Approximately 400,000 people in the U.S. are living with MS, yet there are many misconceptions about the illness (and its prognosis).

Here we debunk the top 10 myths, and tell you what you can really expect if you, or someone you love, has been diagnosed with MS.

MS is a death sentence

The facts: MS is not a death sentence. Life expectancy is normal or close to normal for most people with MS.

It is a life sentence, however, meaning that there is no cure—although there are plenty oftreatments to slow MS down and reduce symptoms.

“Many people with MS live full, active lives,” says Nancy L. Sicotte, M.D., director of the Multiple Sclerosis Program at Cedars-Sinai Medical Center in Los Angeles. “We think of it as a chronic disease that can be managed, but there are a small percentage of people with severe MS who will die from complications.”

You’ll need a wheelchair

The facts: Most people with MS will never need a wheelchair or other assistive device to get around. “When patients come in after their diagnosis, they are usually devastated because they think it means they will be in a wheelchair in five years, but this is simply not true,” Dr. Sicotte says.

Thanks to earlier detection and better treatments, you can’t assume that you’d know someone has MS just by looking at them.

Everyone’s MS follows the same path

The facts:  This is not your neighbor’s MS or your mother’s or that celebrity you follow on TV. The truth is that no two cases of MS are ever alike. Some people have mild numbness in the limbs once in their lifetime, while others may develop severe paralysis or loss of vision. The course of MS is often unpredictable.

“You can’t even look at family members who have MS to say that ‘this is how my MS will behave,’”says Carrie Lyn Sammarco, of the Multiple Sclerosis Comprehensive Care Center at New York University Langone Medical Center in New York City.”MS varies from person to person, and even within the person.”

Only old people get MS

The facts: MS is not a disease of aging. Most people with MS are diagnosed between the ages of 20 and 50. That said, young children, teens, and even seniors can also develop MS.

According to the National Multiple Sclerosis Society, approximately 400,000 people in the U.S. have MS—and 200 more people are diagnosed every week.

MS is on the rise

The facts: Researchers can’t say for sure that MS is on the rise. “We may be getting better at diagnosing it and there may be cases that we would not have diagnosed in the past due to the advent of MRI scans,” says Dr. Sicotte.

We can say that the gap between women and men with MS is expanding. “We know women are diagnosed with MS  more frequently than men, but the ratio is increasing,” she says. “It used to be two women for every one man and now it is approaching four women to every one man!”

Women with MS can’t get pregnant

The facts: Like with some other autoimmune diseases, pregnancy may actually be a good thing for women with MS. “The majority of women with MS will go into remission during their third trimester of pregnancy,” Dr. Sicotte says. There is even a growing body of evidence that pregnancy can lower a women’s risk for ever developing MS in the first place.

One study of more than 700 Australian women showed that women with at least one child were about 50% less likely to develop MS than women without kids. The reduction was even greater for women with three or more children. Researchers don’t know why this is, but they suspect that hormonal milieu of pregnancy may play a role.

Women with MS can’t breast-feed

The facts: While MS often goes into a period of remission during pregnancy, many women will relapse after delivery. “If the disease was active before pregnancy, there is a higher risk for a relapse afterward,” Dr. Sicotte says.

Some of the medications used to treat MS flares can’t be taken while breast-feeding. It’s best to discuss your risks and medication with your doctor, but some women can safely breast-feed with MS. Don’t despair, adds NYU’s Sammarco. “We can help develop a plan that allows most women with MS to breast-feed.”

MS risk is all in your genes

The facts: “It is clearly an autoimmune disease,” Dr. Sicotte says. Genes do play a role, but they are not the be all and end all.  “If you do a detailed family history, there will likely be other cases of MS or autoimmunity in the family, but this is just part of the equation.”

Risk for MS is about 10 times higher if you have a family member with MS, but environmental factors and possibly infectious agents may play a role in determining who develops MS and who doesn’t.

People with MS should avoid the gym

The facts:  “In the olden days, people were told that they should not exercise if they have MS,” says Dr. Sicotte. But now we know that the benefits of exercise outweigh the risks for people with MS—unless they are experiencing a relapse. The tide changed in 1996 when researchers at the University of Utah showed that aerobic exercise improved many of the symptoms of MS including bladder and bowel function, fatigue, and depression.

Many other studies support these findings. Exercise can cause someone with MS to become overheated, which can trigger symptoms, but staying hydrated and balancing activities with rest can help people stay cool.”Weight loss can help too if you are overweight” says Dr. Sicotte. “The less you have to move around, the easier it is to move.”

MS is curable

The facts: Unfortunately, there is no cure for MS yet. That said, long-term remission is possible for many people. Some may never experience any further symptoms after they are diagnosed with MS, but evidence of progression can still pop up on new magnetic resonance imaging (MRI) scans of the brain.

“MRI changes occur 7-10 times more frequently than clinical activity,” Dr. Sicotte says. The good news is that there are more MS treatments available today than ever before and advances with stem cell transplants and other cutting-edge technologies may one day represent a true cure for MS.

Attention: Worst Things to Say to a Person With Bipolar Disorder

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Helping someone with Bipolar – For circle of relatives and buddies
some humans trivialize melancholy (often by accident) by using losing a platitude on a depressed person as if that is the one thing they needed to listen. While some of these thoughts have been helpful to a few humans (as an example, a few humans discover that praying could be very helpful), the context in which they’re frequently stated mitigates any supposed gain to the hearer. Platitudes do not treatment despair.

“what’s your trouble?”
Will you forestall that constant whining?”
What makes you observed that everybody cares?”
“have you gotten worn-out yet of all this me-me-me stuff?”
“You simply need to present your self a kick within the rear”
“but it is all on your mind”
“I idea you have been stronger than that”
“no one ever stated existence become truthful”
“Pull your self up by means of your bootstraps”
“Why don’t you simply grow up?”
“forestall feeling sorry for yourself”
“There are quite a few humans worse off than you”
“you have got it so desirable – why are not you happy?”
“What do you need to be depressed approximately?”
“you suspect you have got issues…”
“nicely as a minimum it’s no longer that awful”
“lighten up”
“You ought to get off all those capsules”
“you’re what you think”
“Cheer up”
“you are continually feeling sorry for yourself”
“Why can’t you just be regular?”
“You need to get out extra”
“Get a grip”
“most oldsters are approximately as happy as they make up their minds to be”
“Get a task”
“You don’t ‘appearance’ depressed”
“you’re just looking for interest”
“every person has a bad day now and then”
“Why do not you smile more?”
“someone your age must be having the time of their life”
“The only one you are hurting is your self”
“you could do some thing you want if you just set your mind to it”
“despair is a symptom of your sin against God”
“You brought this on yourself”
“Get off your rear and do some thing”
“Snap out of it”
“you are always concerned approximately your issues”
“simply don’t reflect onconsideration on it”
“go out and have a few fun”
“simply strive a touch tougher”
“i know how you feel – i used to be depressed once for numerous days”
“you’d experience higher if you went to church”
“Shit or get off the pot”
“What you want is a few actual tragedy to your life to offer you perspective”
“This too shall pass”
“go out and get some sparkling air”
“all of us have our cross to endure”
“You do not like feeling that way? So alternate it”
“you are a actual downer to be round”
“you’re embarrassing me”
“you’d feel better if you lost some weight”
“you are too tough on your self. Stop being the sort of perfectionist”
“do not take it out on each person else round you”
“you’re going to lose lots of pals in case you don’t snap out of this”
“you’re dragging me down with you”
“you are simply being immature”
“you’re your personal worst enemy”
“this is life – get used to it”
“My lifestyles is not a laugh either”
“You do not care about the rest of us – you are so self-absorbed”

Good News: New Approaches to the Psychological Treatment of Obsessive- Compulsive Disorder in Adults

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1. Introduction

the key features of Obsessive-Compulsive disease (OCD) are the experience of recurrent, undesirable and intrusive thoughts (obsessions) and/or the of completion of repetitive ritualistic behaviours (compulsions). Compulsions are frequently completed to lessen the distress related to the obsessional thoughts [1]. The lifetime prevalence of OCD is predicted to be 2-3% inside the wellknown population, with epidemiological research indicating consistency in quotes throughout specific countries and cultures [2,3].

OCD is a intense anxiety ailment this is associated with considerable disability. In reality, the arena fitness organisation has rated OCD because the 10th leading motive of incapacity inside the international. If left untreated, OCD generally will become a chronic trouble with a sample of frequent re-occurrence and relapse [2]. Unluckily, many people will extensively postpone help-searching for, due to motives including a worry of embarrassment, and as a result go through for years with enormous symptoms and distress [4,5].

OCD is usually identified in line with Diagnostic and Statistical guide of mental problems criteria [1]. Those stipulate that the man or woman must experience both obsessions, compulsions, or each, and that those ought to intervene with the individual’s existence due to the time they devour (i.E., more than one hour in keeping with day) or with the aid of inflicting marked distress or huge impairment. To achieve an accurate prognosis, clinicians will often use established diagnostic interviews including the Mini worldwide Neuropsychiatric Interview (MINI) [6], anxiety problems Interview agenda (ADIS-IV) [7], or structured scientific Interview for the Diagnostic and Statistical manual of mental problems (SCID) [8]. Moreover, clinicians and researchers will frequently utilize a variety of measures to check symptom severity and to assess for scientific outcomes. The most commonplace of those consist of the Yale-Brown Obsessive Compulsive Symptom tick list (YBOCS) [9], and the Obsessive Compulsive stock – Revised (OCI-R) [10].

2. Why new processes to remedy are wished

For some time now, the dominant technique to treating this disease is a behavioural remedy referred to as exposure and response Prevention (ERP). ERP is taken into consideration the gold-trendy treatment as it currently has the most convincing proof of efficacy from numerous controlled trials [11] and metaanalytic studies [12] spanning a number of years. In a take a look at analyzing the change rankings due to remedy effects, Fisher and Wells [13] observed that fifty-60% of contributors were likely to be categorised as recovered following ERP remedy. ERP is usually added on an character basis and may be carried out as a stand by myself remedy, or mixed with cognitive techniques below the label of Cognitive Behaviour therapy (CBT). Notwithstanding the fulfillment of ERP in alleviating the signs and symptoms of OCD for plenty individuals, there remains tons scope for further improving the fulfillment of mental remedies for the sickness. Issues including treatment refusal, non-of completion of ERP, non-reaction in a few cases and limited accessibility are just a few problems effecting effects.

Presently, there are main troubles with fees and restrained psychological therapy resources inside the public healthcare device [14]. There are very constrained therapeutic services to be had to the public inside the place of OCD, and most people of individuals do not have get entry to to top treatments. In step with Shafran and colleagues [15], proof indicates that even though a number of proof-based totally psychological remedies have been advanced, clients are not receiving them inside scientific settings. Furthermore, when evidence-based totally mental remedies are delivered, they’re frequently now not delivered to an ultimate trendy [15]. Shafran and associates [15] provided some of guidelines to approach this gap in nicely-added evidence-primarily based mental remedies, however, it may take time to growth awareness and information approximately proof-primarily based psychological treatments, as well as the implementation of them. Given the shortage of to be had healing offerings being supplied to the general public in addition to the transport of evidence-based psychological remedies, a stepped care technique ought to offer every other solution in the intervening time to this hassle [14].

A stepped care approach simply refers to remedies at differing intensities [14]. Inside a stepped care technique, the remedy ought to be the least restrictive, but still provide big upgrades to fitness. With this in mind, if a remedy is furnished at a lower degree or step, and the consumer isn’t enhancing publish-remedy, the client’s wishes have to be evaluated, and the best step to remedy supplied. The restrictiveness of a remedy normally refers to the fee and personal inconvenience. While regarding the therapist, it can additionally discuss with the provision of the therapists time and the quantity of time required by way of a consultant therapist [14]. Given the confined variety of therapists educated within the location of OCD, a stepped care technique seems to be mainly warranted inside the remedy of OCD.

The national Institute for fitness and clinical Excellence (excellent) guidelines for Obsessive-compulsive disorder [16], a international-famend document outlining proof-based tactics to treating the sickness, endorses using a stepped-care version within the prevention and provision of treatment services to individuals with OCD. The first-rate recommendations outline six tiers of intervention as follows. It need to be mentioned that all references to CBT within this stepped care version emphasize the need to include an ERP aspect in therapy.

Step 1: consciousness and reputation

Step 2: reputation and evaluation (inclusive of referral to suitable offerings)

Step 3: preliminary remedy via guided self-assist and CBT via organization or person format

Step 4: For OCD with comorbidity or a terrible response to initial remedy – treatment through CBT within a multidisciplinary team, viable medicinal drug

Step five: For OCD with huge comorbidity, extreme impairment or restrained treatment response – professional treatment offerings with expertise in CBT, feasible medicinal drug

Step 6: Inpatient or in depth remedy applications such as medication and CBT to lessen the danger to existence, intense self-forget or intense distress or incapacity.

As may be seen, at the same time as the better degree steps inside this care model indicate the want for ERP based totally psychotherapy, that’s supplied on an person foundation, there is lots scope for exploring much less intensive, less expensive, and greater extensively on hand formats for the transport of ERP based totally treatment programs.

Furthermore, it’s far essential to check rising and change methods to the conceptualization and treatment of this disorder. The capacity for ERP based remedies to result in large and clinically big exchange for plenty customers is properly documented. However, previous studies have referred to that up to 25% of sufferers refuse ERP remedy due to the time commitments needed to complete the treatment, a worry that the exposure physical games will bring about overwhelming tension, or a fear that a dreaded outcome will occur need to the individual fail to complete their rituals [17]. Inside this stepped care model there are confined proof-based totally options for remedy apart from remedy-based totally remedy, which people might also refuse or be not able to tolerate. It’s far consequently critical that we hold to discover new psychological treatment strategies for this ailment and therefore offer wish to folks who refuse or do no longer respond to the contemporary gold-preferred remedy techniques.

3. New treatment techniques

the subsequent segment will offer a evaluate of quite a number of latest processes to the treatment of OCD. First, the usage of treatment modalities that range from general individual primarily based CBT or ERP might be discussed. This will explore the use of the institution therapy layout, and using present day technology inside the transport of cognitive and behavioural treatment options. Next, rising conceptualizations and treatment tactics can be discussed. This will review the proof for Metacognitive and popularity and dedication based tactics to the control of OCD. Each technique will first be described, the proposed mechanisms of exchange mentioned and then a crucial assessment of the proof for efficacy may be presented.

Organization therapy for OCD

The principal agencies that have been evaluated for OCD are both cognitive, behavioural or a aggregate of both. Provision of remedy in agencies for OCD makes intuitive feel due to the recognized issues referring to disgrace, isolation and embarrassment that have been diagnosed among sufferers. Being able to meet others with a comparable set of issues can allow for signs and symptoms to be normalized and destigmatised. Participating in a group can allow the person to increase a aid network for sharing techniques, statistics and resources, and the manner of supporting others can also decorate ones vanity, and sense of social competence and connectedness. From a medical angle, peer modeling of ERP physical games might also offer additional possibilities for exposure and enhance compliance with homework. Further to those potential blessings, as already stated, stepped-care fashions emphasize the significance of offering remedy alternatives which might be much less costly and in depth. Group therapy formats have the ability to increase get right of entry to to well-trained clinicians, and decrease capability ready instances.

Empirical proof for group CBT for OCD

A meta-analysis by using Jónsson and Hougaard [18] tested the effectiveness of organization CBT and ERP as reported in 13 prior remedy trials. This covered randomized managed trials, non-randomized controlled trials, and naturalistic trials. The meta-analysis indicated that group CBT and ERP yields a large ordinary pre-put up effect length of one.18. Importantly, institution dropout quotes of 13.Five% had been in comparison with stated individual treatment dropout prices of 12.1%. This changed into considered an illustration that the group format regarded an appropriate approach of treatment delivery to most patients. When this records is mixed with the sooner findings that direct comparisons between organization and person primarily based remedies have no longer demonstrated a sizeable difference in submit treatment outcomes [19,20], group CBT and ERP honestly seem like viable and efficacious remedy alternatives inside the management on this ailment. Moreover, the meta-evaluation indicated that compared to pharmacological treatment, the between corporations effect size of zero.Eighty favoured organization CBT/ERP.

Considering that this meta-evaluation, Belotto-Silva and associates [21] compared group CBT (GCBT) with Fluoxetine, a Selective Serotonin Reuptake Inhibitor, in a controlled trial inclusive of 158 individuals (GCBT N=70; Fluoxetine N=88). A complete of 12 organization therapy sessions of two hours length were supplied every week. The Fluoxetine organization acquired 80mg/day for the equal length (12 weeks). Suggest YBOCS rankings reduced by 23% (GCBT) and 21% (Fluoxetine). The authors word that this degree of symptom discount, despite the fact that vast, is much less than has been discovered in a few other CBT studies. They finish that this is maximum probable because of the high fee of comorbidity present inside the sample. In reality the effects are towards different similar studies which have utilised much less stringent exclusion standards and consequently arguably extra consultant samples [19,22]. In another examine since the meta-analysis [23], the effectiveness of GCBT for OCD changed into further evaluated in a representative, clinic sample in Norway. In this open trial, fifty four sufferers diagnosed with OCD were provided with 12 classes of GCBT. At publish treatment and again at 3 and 12 month comply with-up substantial upgrades in OCD signs as well as despair and tension have been determined.

It can be argued that those outcomes are definitely because of the non-specific results of collaborating in a collection, together with the elevated social support that participants experience. A observe via Fineberg and colleagues [24] therefore tried to account for the function of non-precise organization outcomes within their research design by using which include a rest placebo manage institution. The outcomes indicated that each those inside the CBT and relaxation placebo group improved, and that there has been no large difference between the effects for the two groups. But, there was a substantial bias toward non-uptake of the relaxation therapy situation. With more potential members dropping out previous to the trial even beginning, this can mean that the very last relaxation group members represented people predisposed to believe that rest became a reputable form of remedy for OCD and that they therefore had more desirable expectations of remedy. There has been additionally a sizeable difference in drop-out rates across conditions with 35% of individuals dropping out of the rest organization compared to four% in the CBT organization. Due to the determined difficulties with finding a credible institution placebo, we aren’t but able to verify whether or not these outcomes are virtually due to the non-particular organization factors. However, this examine yielded a massive treatment impact size of 1.45 for GCBT, imparting similarly guide for the in addition use of group CBT.

Ordinary, the large impact sizes cited in previous studies show that group CBT and ERP are viable remedy options for provider provision, with comparable findings to individual therapy and pharmacological remedies for OCD. Despite the fact that further group placebo managed trials may work some manner to keeping apart out the consequences of non-particular group elements, the constant reports of clinically and statistically vast improvements for contributors, and the capacity advanced get entry to to professional offerings for clients and price savings for clinicians suggest that group remedy is a worthy choice inside the remedy of this sickness.

Telemental health processes

Telemental health is a term used to capture the vast application of telecommunication and records technology inside the provision of various intellectual fitness services. There are a number of special packages which have been evolved and trialed for the treatment of OCD in adults. A precis of the evidence base and key benefits and drawbacks of these packages is furnished in table 1.
BT-Steps [25] is a well-evaluated behaviour therapy self-help application that is administered thru the phone. It does now not contain direct therapist touch as clients surely get entry to an automated device wherein they input details in their development and acquire automated hints and activates from an digital recording. Discounts in YBOCS signs of up to 30% had been pronounced in open research of patients who completed the self-publicity section of BT-Steps [26] however a primary problem of this approach is the unusually high dropout rate that has been found within the research. In try to research this in addition, Kenwright, Marks, Graham, Franses and Mataix-Cols [27] in comparison the self-administered BT-Steps to a BT-Steps with inclusion of 9 sessions of therapist guide. The ones inside the supported condition evidenced both stepped forward compliance and consequences.

3 trials of CBT via telephone with therapist contact were performed with increasingly improved methodological rigor. Lovell and associates [28] first carried out a case series with 4 contributors analyzing the impact of eight weekly smartphone contacts with a cognitive behavioural therapist, starting and finishing with a face-to-face consultation. 3 out of the 4 individuals progressed, with discounts of between 24% to sixty seven% cited at the YBOCS. In a later trial, Taylor and co-workers [29] supplied 12 weekly therapy sessions by phone and with provision of a self-help e book and compared this to a waitlist control. Thirty 3 participants were protected and consequences indicated massive reduction in signs and symptoms for the telephone organization. More currently, Lovell and associates [30] compared phone-based totally remedy with face-to-face CBT in a non-inferiority trial involving seventy two members. In every circumstance contributors received 10 remedy periods but, the smartphone sessions were half of the period of the face-to-face sessions. Equal improvements were observed across both organizations suggesting that the cellphone situation may additionally represent an powerful treatment with enormous reduction in therapist’s time requirements.

Videoconferencing

Videoconferencing is a pc-assisted approach that bears the nearest resemblance to stand-to-face remedy due to the fact each therapist and purchaser have interaction in actual-time. It has essential blessings in phrases of getting rid of the difficulty of distance between therapist and purchaser. It’s miles particularly beneficial for customers who’ve restricted mobility for any purpose or who won’t otherwise be inclined to leave their houses to wait remedy periods. To this point, research have explored the treatment of OCD via videoconference. Himle and colleagues [31] utilised a more than one-base line design to analyse the outcomes of a 12-week manualised CBT intervention. 3 individuals were covered inside the look at and significant upgrades in symptoms were determined for all members as measured by the YBOCS. Individuals also reported high satisfaction with the therapy and high-quality ratings on therapeutic alliance have been additionally acquired.

In a recent case collection design, Vogel and colleagues [32] investigated the effectiveness of videoconferencing remedy with the addition of mobile phones. Fifteen sessions of ERP became brought thru six teleconference and nine mobile cellphone periods. 4 of the six members made big profits and no longer met standards for OCD on the stop of therapy. Importantly, those gains were maintained at a three month comply with-up, and all patients rated the remedy format as ideal and that the running alliance with the therapist was high. The authors did notice that these outcomes must be interpreted with warning because of the small sample size, loss of a manage evaluation and blind rankings, and possible selection bias of members wherein those who are greater comfortable with technologies self-pick into the have a look at. However, it turned into additionally diagnosed that the addition of cell telephones to the trial allowed for a again-up whilst teleconferencing device did not paintings, and allowed the clinician to monitor exposure sporting events conducted faraway from the videoconferencing system. With the increasing wide variety of cell telephones allowing video calls, the ability for this portable generation to enhance the capacity for in-situ exposure physical activities must handiest improve with time.

Internet-primarily based CBT

treatments which can be brought through computers allow a customer to advantage help from faraway places or from the ease of their personal houses. For a while now, less costly and excessive varieties of intervention consisting of bibliotherapy and self-directed publicity have been identified as an effective choice for provision of psychological remedy [33]. More these days, bibliotherapy has been introduced into the technological age with the development of automated variations that as in step with their authentic counterparts, do no longer include any therapist contact. But, at the whole, the evidence has counseled that better outcomes are completed with the addition of minimum therapist guide [34].

A recent open trial of an 8-week CBT remedy (‘The OCD application’) delivered thru the internet has been completed [35]. Twenty-two people with a number one diagnosis of OCD participated within the trial receiving eight on line CBT lessons further to twice-weekly phone contact from a medical Psychologist. It ought to be stated that the average amount of therapist touch time was simplest 86 minutes throughout the eight weeks. Sizable enhancements in YBOCS overall rankings had been observed with a reported within-agencies impact length of one.28 at post-remedy. This suggests that good sized upgrades in signs may be possible with simplest very confined therapist enter.

In another recent open trial [36], 23 patients identified with OCD were provided with a 15-week internet-primarily based CBT program with therapist assist. Regular with the Wootton have a look at, therapist contact time become minimal (common of 92 mins per patient across the whole 15 weeks) and the within-agencies effect length on the YBOCS became large (1.Fifty six). Taken collectively, the results of those trials advise that CBT supplied over the net with most effective minimum therapist time can bring about extensive symptom reduction of a similar importance to that seen in face-to-face research. However, as these are most effective open trials randomized controlled trials with large samples and comparisons in opposition to face-to-face CBT are required to bolster the conclusions.

Virtual truth

Riva and Gamberini [37] assert that “digital reality is an software that we could users navigate and interact with a 3-dimensional laptop-generated environment in actual time” (p.327). Virtual fact may be conducted on a variety of different structures ranging from 3-size software program set up on a private pc to immersive headsets related to a hand manage [38]. Digital fact treatments are based on the idea that human beings feel “gift” in the virtual environment, wherein at a few degree their perception fails to recognize the position of era of their revel in [39]. A specific gain of digital fact structures is that they have the ability to provide correct standardization and replication of a prescribed environment [40].

Virtual reality treatment plans have been confirmed to be extra powerful than no remedy for several precise phobias, inclusive of spider phobia, acrophobia, and a worry of flying [39]. However, head-to-head trials with gold-trendy in-vivo ERP remedies are limited, and the fee of this form of remedy over the present day main technique is therefore uncertain at this level. The ability value effectiveness of publicity thru a virtual fact system is maximum obvious for troubles in which stimuli for the publicity exercise can be hard or high priced to come back by means of (e.G., flights for exposure exercises to deal with a worry of flying, or spiders to address a spider phobia). Digital reality therapies therefore remain a promising vicinity for future instructions in tension ailment treatment, but require similarly assessment at this stage.

In the most effective take a look at comparing digital truth for OCD thus far, Clark, Kirkby, Daniels, and Marks [41] used an interactive digital surroundings to provide vicarious exposure to dust for thirteen individuals with OCD. Contributors completed three forty five-minute computer primarily based treatment sessions at weekly intervals. During the consultation, the participants had been instructed to direct a parent at the display to engage in exposure, which includes by way of touching dirt in a digital lawn, and encouraged to chorus from selecting that the figure wash their hands in the virtual sink. Participants had been presented factors for exposing their figure to dirt, after which for refraining from washing their palms no matter the figure rating their tension as excessive. Following treatment, individuals confirmed a great lower on their depression ratings and on one measure of OCD symptoms, the Padua stock. But, no sizable alternate became stated on their YBOCS ratings.

In a comply with-up record at the identical study, it turned into cited that throughout the three digital reality classes members have become quicker at accomplishing hand dirtying, and have been much less probably to engage in hand-washing in the digital surroundings [42], indicating that participants had been capable of study the concepts of ERP via this layout. Given the low dose of therapy carried out on this trial (i.E., three classes handiest), and potential to offer this remedy with out ongoing therapist input, this remedy format virtually warrants in addition investigation to examine whether or not mastering from the virtual environment can generalize to actual-world reports. The principle obstacle to future development of virtual truth packages for OCD can be the want to create a enough variety of digital environments and activities to cater for the expansive form of OCD symptom presentations past contamination fears and associated hand-washing.

Precis of Empirical evidence for Telemental fitness treatment of OCD

Taken together, the field of telemental health treatment for OCD is very promising with some of controlled trials now showing that treatments administered thru laptop with minimum or no therapist assistance can result in extensive reductions in obsessive-compulsive symptoms. Specially promising effects are being visible in net-based treatments wherein as little as ten mins of smartphone contact in line with week from a therapist is related to huge impact sizes on obsessive-compulsive signs and symptoms. While a few strategies may also permit discounts in therapist contact hours, procedures inclusive of video-conferencing won’t reduce contact hours but as a substitute enable individuals with OCD to acquire professional remedy regardless of geographical vicinity. It is consequently envisaged that future treatments within a stepped care version should utilize computer and net primarily based remedies at a lower step, with technology consisting of video-conferencing being used to provide information for people with high levels of comorbidity or who have not responded to less excessive treatment codecs who could otherwise have issue having access to such offerings. Whilst using virtual reality based packages requires further investigation, it’s miles possible that should it’s proven as an effective treatment layout, it can be built into modern-day laptop or internet based self-help packages as a stand-on my own treatment, or as a issue in an usual treatment which additionally consists of psychoeducation and the development of a personalized ERP hierarchy.

Metacognitive therapy

Metacognition refers to beliefs approximately wondering and strategies used to alter and control questioning and become at first elaborated upon with the aid of Flavell [43]. Due to the fact that then a number of theorists have incorporated components of metacognition into various psychological models of OCD [44-47]. Maximum great among those theorists is Adrian Wells who, in conjunction with colleagues, has evolved a complete metacognitive account of OCD based on the Self Regulatory govt (S-REF) version [48,49]. In step with this model, a fashion of thinking called the cognitive attentional syndrome (CAS) is the primary causal component in prolonging all emotional disorders. However, Wells has long past on to specify which particular factors of this version are most relevant to expertise OCD. Wells and Mathews [48] and Wells [46] endorse that three forms of metacognitive knowledge are essential within the etiology and upkeep of signs and symptoms: concept fusion ideals, ideals approximately the need to perform rituals, and criteria that signal rituals may be stopped. On this model, notion fusion ideals are prolonged past thought action fusion (notion that having a thought will increase the threat of appearing on it) however also concept-event fusion (the notion that having a idea can reason an event or way that an occasion has took place) and thought object fusion (the perception that mind or emotions may be transferred into gadgets). Consistent with the model the 3 overall forms of metacognitive expertise function in a causal chain to provide an explanation for obsessive-compulsive signs.

The principle method used in MCT for OCD is to help the client to emerge as aware of their metacognitive processing and to learn how to modify these better order metacognitions which include beliefs approximately the significance of thoughts. MCT differs from wellknown CBT in that no tries are made to modify lower order value determinations which includes ‘i am accountable to ensure not anything takes place to my own family’. Additionally, MCT does not encompass exposure sports aimed at habituation however as a substitute includes using behavioural experiments to help inside the interruption of unhelpful metacognitive approaches which include attempts to suppress mind.

Empirical proof for MCT for OCD

two small trials of MCT for adults with OCD had been conducted to date. The primary case collection trial protected four individuals diagnosed with OCD who received 12 classes of person MCT [50]. Vast reduction in obsessive-compulsive signs turned into located with all members meeting medical importance standards for recovery at publish-remedy and three-month follow-up. A second open trial covered 8 people diagnosed with OCD who received 12 sessions of group-based MCT [51]. Comparable effects were determined on this study with seven out of eight participants attaining healing according to the YBOCS clinical importance standards. This end result became maintained at 3-month observe-up.

Steffen Moritz and colleagues [52] advanced and tested a self-assist remedy referred to as ‘My Metacognitive education for OCD’ (myMCT) which includes a combination of trendy cognitive-behavioural factors plus the addition of metacognitive remedy elements. They recruited 86 individuals with OCD over the internet and randomly assigned them to both the self-assist or wait-list situation. Those within the myMCT circumstance were emailed an digital version of the self-help e-book. Members who obtained the intervention confirmed drastically extra discounts in obsessive-compulsive signs and symptoms as compared to the wait-list institution. It ought to be cited that this treatment did incorporate traditional cognitive restructuring factors and is thus much less of a ‘pure’ test of metacognitive treatment for OCD.

Given that every one bar one participant in the earlier MCT trials finished healing fame and had maintained this at 3-month comply with-up, MCT can also represent a promising manner forward for clinicians and sufferers alike. As this therapeutic method does no longer immediately rely upon publicity physical activities, it may offer a less aversive shape of therapy for individuals who inside the beyond have refused to begin or have initiated however then dropped out of ERP applications. The small samples sizes, lack of manage situations, and possible non-specific results of taking part in a group software do restrict the conclusions of these trials. Furthermore, there has been no comparison between MCT and gold-general ERP thus far. Similarly research ought to move a few way toward figuring out whether MCT fits within the stepped care model of remedy as an efficacious stand on my own individual based totally treatment, an alternative to group ERP or CBT, or as a self-assist based application.

GOOD NEWS: Injection to end pain of arthritis: New treatment will stop agony without side-effects

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Scientists have developed a pioneering way to deliver drugs immediately into cartilage – tissue formerly believed to be impenetrable.

The remedy makes use of tiny debris of a affected person’s personal cells to hold the “payload” into affected joints.

It’d require only in the future in health center every three months and might not reason the facet-outcomes associated with other cures.

Saying the step forward, Professor Mauro Perretti, of Queen Mary university of London, said: “Cartilage has long been idea to be impenetrable to cells and other small systems main to robust limitations in our talents to supply treatments for arthritis.
“To our marvel we’ve got now discovered vesicles [tiny fluid-filled sacs] launched from white blood cells can ‘journey’ into the cartilage and supply their cargo. They also have a shielding impact on cartilage affected by arthritis.”

the brand new technique has labored in experiments on mice and human cells.

Similarly evaluation is now wanted before clinical trials can begin but the remedy will be available in clinics in five years.

At the least eight.Five million Britons be afflicted by osteoarthritis, the maximum not unusual form, that is as a result of put on and tear on joints where the cartilage that cushions movement is worn away.
Bones then come into touch with each different and the friction makes joints swollen and extremely painful.

Dr Lucy Norling, additionally of Queen Mary college of London, said the injections could be simple to administer, no longer too pricey, and the impact of every one would closing about three months.

Professor Perretti introduced: “Our have a look at indicates that those vesicles will be a singular form of therapeutic method for patients affected by cartilage harm because of a number sicknesses, including osteoarthritis, rheumatoid arthritis and trauma.

“Treating sufferers with their own vesicles may additionally most effective require a day in sanatorium and the vesicles could also be ‘fortified’ with other healing dealers, as an instance, omega-3 fatty acids or different small molecules.”
A study published inside the magazine science Translational medicinal drug suggests genetically engineered mice with inflammatory arthritis had reduced cartilage harm whilst treated with vesicles.

The particles additionally included cartilage when injected in human cells grown within the laboratory.

Dr. Stephen Simpson, director of studies and programmes at Arthritis studies uk, which component-funded the take a look at, said the day prior to this: “the use of the body’s own shipping gadget to get new and modern-day healing sellers at once into the cartilage holds the promise we will be capable of lessen joint harm more effectively than ever.

“A wholesome and intact joint effects in less ache and incapacity, improving the excellent of lifestyles for thousands and thousands of people residing with arthritis.
“This examine doubtlessly bridges the distance among current studies and powerful, correct medical interventions that might have tangible results on human beings’s lives.”

each yr extra than one hundred forty,000 hip and knee replacements are achieved at a fee of extra than £1billion.

It manner a new remedy for osteoarthritis ought to potentially shop the NHS a fortune.

Some patients even should undergo two joint substitute operations due to the fact artificial hips or knee joints can put on out after best 15 years.