An end to needle phobia: Device could make painless injections possible

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study. Credit: © uwimages / Fotolia

Imagine no tears during infant vaccines and no fear of the needle for those old enough to know what's coming. Such painless injections could be possible with a device that applies pressure and vibration while the needle is inserted in the skin, according to a study presented at the ANESTHESIOLOGY™ 2014 annual meeting.

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study and a professor of anesthesiology in perioperative medicine and pain management at the University of Saskatchewan, Saskatoon, Canada. 

"Our early research suggests that using a device that applies pressure and vibration before the needle stick could help significantly decrease painful sensations by closing the 'gate' that sends pain signals to the brain."

Researchers studied the use of pressure, vibration, and cooling or warming in 21 adults poked in the shoulder by a plastic needle that doesn't break the skin but produces needle-like pain. They tested different levels of pressure, vibration and temperature to determine the amount that provided the most benefit. The perception of pain was significantly decreased when a specific amount of pressure and vibration was applied to the site for 20 seconds prior to using the plastic needle. The addition of heat added a small benefit, but it wasn't significant. The study should be repeated in children, who may experience pain differently, said Dr. McKay. The addition of heat or cold might be more beneficial, he said.

While commercial devices that include some of these features are available, they could be improved by incorporating the additional features tested in this and other studies, he said. They could be used to prevent pain prior to providing intravenous (I.V.) treatment, the drawing or donating of blood, or administering vaccinations.

The concept likely works by distraction as well as employing the gate-control theory of pain, in which these sensations (pressure, vibration and potentially temperature) close the gate that allows the brain to register pain.

Source: American Society of Anesthesiologists (ASA)

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Back pain killing your sex life? Study reveals best positions to save your spine

Contrary to popular belief, spooning is not always the best sex position for those with a bad back, according to new research from the University of Waterloo. For the first time ever, scientists have successfully documented the way the spine moves during sex and discovered exactly why certain positions are better than others when it comes to avoiding back pain. The pioneering study combined infrared and electromagnetic motion capture systems to track how ten couples' spines moved when attempting five common sex positions. The findings were used to create an atlas, or set of guidelines, that recommends different sex positions and thrusting techniques based on what movements trigger a patient's pain. Pictured: Professor Stuart McGill demonstrates the motion of the spine during sex.  
Credit: University of Waterloo

Contrary to popular belief, spooning is not always the best sex position for those with a bad back, according to new research from the University of Waterloo.

For the first time ever, scientists have successfully documented the way the spine moves during sex and discovered exactly why certain positions are better than others when it comes to avoiding back pain.

"Any family doctor will tell you that couples often ask them how to manage their back pain during and after sex. Many couples will remain celibate because one night of love-making can lead to months of back agony," said Professor Stuart McGill, of Waterloo's Faculty of Applied Health Sciences. "Until now, doctors have never had any hard science to base their recommendations upon."

The pioneering study combined infrared and electromagnetic motion capture systems -- like those used in the creation of video games -- to track how 10 couples' spines moved when attempting five common sex positions. The findings were used to create an atlas, or set of guidelines, that recommends different sex positions and thrusting techniques based on what movements trigger a patient's pain.

"Before now, spooning was often recommended by physicians as the one position that fit all. But as we've discovered, that is not the case," said Natalie Sidorkewicz, a PhD candidate at Waterloo and lead author on the paper. "Sex positions that are suitable for one type of back pain aren't appropriate for another kind of pain."

The atlas recommends that men who are flexion-intolerant -- meaning those whose back pain is made worse by touching their toes or sitting for long periods of time, for example -- replace spooning with doggy-style sex. The guide recommends that these men use a hip-hinging motion rather than thrusting with their spines.

"For the first time ever, we now have very solid science to guide clinicians on their recommendations for patients who suffer debilitating back pain, but still want to be intimate," said Sidorkewicz. "This has the potential to improve quality of life -- and love-life -- for many couples."

According to Statistics Canada, four of every five people will experience at least one episode of disabling low back pain in their lifetime. Up to 84 per cent of men with low back pain and 73 per cent of women report a significant decrease in the frequency of intercourse when suffering back pain.

The study also shed light for the first time on the mechanics of the male orgasm. Electrodes hooked up to the male participants' muscles revealed that it is abdominal and buttock, not back muscles, that are most active during orgasm. Spine motion, on the other hand, varied with the individual. For some males, a drastic increase in flexion or extension was seen, while for others spine motion did not change much at all.

"Many of the back pain patients that we see have told us that they experience elevated levels of pain during orgasm, to the point where they will avoid having one during sex with their partner," said Sidorkewicz. "These initial findings help us to begin to understand what might be provoking their pain during the moment of climax."

A paper documenting male spine movement was published in the journal Spine. Female findings are expected to be published in the coming months. The next phase of the study will involve recruiting patients with hip pain and additional categories of back pain to further develop the guidelines.

Source: University of Waterloo

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First contracting human muscle grown in laboratory

This is a microscopic view of lab-grown human muscle bundles stained to show patterns made by basic muscle units and their associated proteins (red), which are a hallmark of human muscle.
Credit: Nenad Bursac, Duke University

In a laboratory first, Duke researchers have grown human skeletal muscle that contracts and responds just like native tissue to external stimuli such as electrical pulses, biochemical signals and pharmaceuticals.

The lab-grown tissue should soon allow researchers to test new drugs and study diseases in functioning human muscle outside of the human body.

The study was led by Nenad Bursac, associate professor of biomedical engineering at Duke University, and Lauran Madden, a postdoctoral researcher in Bursac's laboratory. It appears January 13 in the open-access journal eLife

"The beauty of this work is that it can serve as a test bed for clinical trials in a dish," said Bursac. "We are working to test drugs' efficacy and safety without jeopardizing a patient's health and also to reproduce the functional and biochemical signals of diseases -- especially rare ones and those that make taking muscle biopsies difficult."

Bursac and Madden started with a small sample of human cells that had already progressed beyond stem cells but hadn't yet become muscle tissue. They expanded these "myogenic precursors" by more than a 1000-fold, and then put them into a supportive, 3D scaffolding filled with a nourishing gel that allowed them to form aligned and functioning muscle fibers.

"We have a lot of experience making bioartifical muscles from animal cells in the laboratory, and it still took us a year of adjusting variables like cell and gel density and optimizing the culture matrix and media to make this work with human muscle cells," said Madden.

Madden subjected the new muscle to a barrage of tests to determine how closely it resembled native tissue inside a human body. She found that the muscles robustly contracted in response to electrical stimuli -- a first for human muscle grown in a laboratory. She also showed that the signaling pathways allowing nerves to activate the muscle were intact and functional.

To see if the muscle could be used as a proxy for medical tests, Bursac and Madden studied its response to a variety of drugs, including statins used to lower cholesterol and clenbuterol, a drug known to be used off-label as a performance enhancer for athletes.

The effects of the drugs matched those seen in human patients. The statins had a dose-dependent response, causing abnormal fat accumulation at high concentrations. Clenbuterol showed a narrow beneficial window for increased contraction. Both of these effects have been documented in humans. Clenbuterol does not harm muscle tissue in rodents at those doses, showing the lab-grown muscle was giving a truly human response.

"One of our goals is to use this method to provide personalized medicine to patients," said Bursac. "We can take a biopsy from each patient, grow many new muscles to use as test samples and experiment to see which drugs would work best for each person."

This goal may not be far away; Bursac is already working on a study with clinicians at Duke Medicine -- including Dwight Koeberl, associate professor of pediatrics -- to try to correlate efficacy of drugs in patients with the effects on lab-grown muscles. Bursac's group is also trying to grow contracting human muscles using induced pluripotent stem cells instead of biopsied cells.

"There are a some diseases, like Duchenne Muscular Dystrophy for example, that make taking muscle biopsies difficult," said Bursac. "If we could grow working, testable muscles from induced pluripotent stem cells, we could take one skin or blood sample and never have to bother the patient again."

Other investigators involved in this study include George Truskey, the R. Eugene and Susie E. Goodson Professor of Biomedical Engineering and senior associate dean for research for the Pratt School of Engineering, and William Krauss, professor of biomedical engineering, medicine and nursing at Duke University.

The research was supported by NIH Grants R01AR055226 and R01AR065873 from the National Institute of Arthritis and Musculoskeletal and Skin Disease and UH2TR000505 from the NIH Common Fund for the Microphysiological Systems Initiative.

Source: Duke University

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