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The Chartered Care Collection (04/06/2021)

The Chartered Care Collection provides a review of the latest, pertinent publications from the medical literature on aging. I have selected interesting articles that describe some of the most current research that may be relevant to the loved one in your care. Each article will be referenced if you desire to read more of the study, but I will give a brief synopsis of each study so you are aware of the latest research. Let’s get to The Collection!

The Chartered Care Collection

The first article, published in the journal Spine, looked back at two different groups of patients with lumbar disc herniation (LDH): those who were treated with open lumbar microdiscectomy (OLMD) and those treated with percutaneous endoscopic lumbar discectomy (PELD). OLMD is the more common of the two surgical treatments and involves a partial laminectomy (removal of part of the vertebra), pulling back the nerve and then removal of a portion of the affected disc. The PELD is a minimally invasive procedure that involves making a very small incision and inserting a small surgical needle between the vertebrae into the middle of the disc then using an endoscope to see within the disc and remove the herniated lumbar disc.

Four different data points were collected for each surgical group. On the day after surgery and three months after surgery, pain scales were better for those who underwent the PELD. At 12 months and 24 months, pain scores did not significantly differ between the two groups. As I have stated in previous research updates, one person might require one particular surgery for specific medical reasons. If given the option, however, it would certainly be worth considering the PELD procedure for faster pain results and, thus, presumably faster return to normal life activities. 

The next article was yet another study on the consumption of eggs. This study looked at a compilation of medical publications comparing egg consumption and cardiovascular disease, coronary artery disease, acute coronary symptoms, stroke, or heart failure. In total, there were 23 prospective studies whose results were combined. All together, the mean follow-up was just over 12 years. The pooled subjects totaled 1,415,839 in total. Of those individuals, the findings showed no significant association between egg consumption and increased rate of overall cardiovascular disease events. Those who consumed greater than one egg per day had a significantly decreased risk of coronary artery disease than those who consumed zero to one egg per day. There was no difference between the two groups in regards to the risk of stroke. Personally, I love eggs, so anything supporting the daily consumption of eggs is worth mentioning, in my opinion!

I think this next article is quite interesting in that I see several patients in rehabilitation following hospitalization with sepsis (blood infection). Gundula Seidel and colleagues looked at brain aging in sepsis survivors in the study titled, Accelerated Brain Aging in Sepsis Survivors with Cognitive Long-Term Impairment. In this study, it was found that the BrainAGE of survivors of sepsis was 4.5 years greater than that of the controls. The BrainAGE is the difference between the estimated age and the true chronologic age. The estimated age was determined by having subjects complete cognitive domain testing to get a sum score and then an MRI with brain age analysis. There were 20 sepsis survivors who were compared to 40 age-matched, healthy controls. In addition, the findings also showed stronger cognitive impairment associated with greater brain atrophy.  In my opinion, this study solidifies the need of a speech and language pathologist in the rehabilitation of a patient who has experienced a prolonged hospitalization due to sepsis. Not only is there physical debility, but there the brain has also been “debilitated.”

For those of you who are more active and might experience “tennis elbow,” this one is for you. This study compared dry needling to corticosteroid injections in the treatment of lateral epicondylitis (tennis elbow). The study compared 52 patients who underwent dry needling to 49 who underwent steroid injection. All participants had tried and failed anti-inflammatory medications and a forearm brace. They were then divided into the above two treatment groups. Both groups did display significant improvement from their baseline. At weeks three and 24, the dry needling group had significantly better pain-rated scores than the steroid group. It should be noted that the steroid injection was completed with one treatment, whereas the dry needling occurred twice weekly for a total of five sessions, with each session lasting ten minutes. I am a big advocate for keeping people active at the things they love to do. The saying, “use it or lose it” becomes more true the older we get, so finding the most effective treatments to keep a person moving is of utmost importance.

That’s all for this month’s Collection. Feel free to read each of these studies in more detail by referring to the articles as listed below.

References:

Jarebi M., et al. A Mathced Comparison of Outcomes between Percutaneous Endoscopc Lumbar Discectomy and Open Lmbar Microdiscectomy for the Treatment of Lumbar Disc Herniation: A Two-Year Retrospective Cohort Study. Spine. 2021 Jan; 21(1): 114-121.

Krittanawong. C., et al. Association between Egg Consumption and Risk of Cardiovascular Outcomes: A Systematic Review and Meta-analysis. Am J Med. Jan; 134 (1): 76-83.

Seidel, G., et al. Accelerated Brain Aging in Sepsis Survivors with Cognitive Long-Term Impairment. Eur J Neurosci. 2020, November, 52(10): 4395-4402.

Uygur, E., et al. The Use of Dry Needling versus Corticosteroid Injection to Treat Lateral Epicondylitis: A Prospective, Randomized, Controlled Study. J Shoulder Elbow Surg. 2021, Jan; 30(1): 134-139.

Share your thoughts on these articles in the Comments section.

© 2021 Jessica Kluetz, DO