Lessons From The Conference: “Highlighting Massage Therapy In Complementary And Integrative Medicine”

A landmark conference, Highlighting Massage Therapy in Complimentary and Integrative Medicine, was held in Seattle, Washington, on May 13th–15th, 2010. The conference was designed to address the status of research related to massage therapy, as well as to have an open discussion regarding attitudes towards research and professional issues. Leaders from diverse manual therapy professions presented interesting and important data. The itinerary and summaries of the meeting can be found at http://www.massagetherapyfoundation.org/researchconference2010.html. In this brief report, rather than summarizing the presentations, we will share a combination of our observations and impressions, as well as suggestions for the direction of massage therapy research

Founder populations and their uses for breast cancer genetics

Numerous founder mutations have been reported in BRCA1 and BRCA2. For genetic screening of a population with a founder mutation, testing can be targeted to the mutation, allowing for a more rapid and less expensive test. In addition, more precise estimates of the prior probability of carrying a mutation and of the likelihood of a mutation carrier developing cancer should be possible. For a given founder mutation a large number of carriers are available, so that focused scientific studies of penetrance, expression, and genetic and environmental modifiers of risk can be performed. Finally, founder populations may be a powerful resource to localize additional breast cancer susceptibility loci, because of the reduction in locus heterogeneity

Risk Factors for Colorectal Cancer in Patients with Multiple Serrated Polyps: A Cross-Sectional Case Series from Genetics Clinics

Patients with multiple serrated polyps are at an increased risk for developing colorectal cancer (CRC). Recent reports have linked cigarette smoking with the subset of CRC that develops from serrated polyps. The aim of this work therefore was to investigate the association between smoking and the risk of CRC in high-risk genetics clinic patients presenting with multiple serrated polyps. Methods and Findings We identified 151 Caucasian individuals with multiple serrated polyps including at least 5 outside the rectum, and classified patients into non-smokers, current or former smokers at the time of initial diagnosis of polyposis. Cases were individuals with multiple serrated polyps who presented with CRC. Controls were individuals with multiple serrated polyps and no CRC. Multivariate logistic regression was performed to estimate associations between smoking and CRC with adjustment for age at first presentation, sex and co-existing traditional adenomas, a feature that has been consistently linked with CRC risk in patients with multiple serrated polyps. CRC was present in 56 (37%) individuals at presentation. Patients with at least one adenoma were 4 times more likely to present with CRC compared with patients without adenomas (OR = 4.09; 95%CI 1.27 to 13.14; P = 0.02). For females, the odds of CRC decreased by 90% in current smokers as compared to never smokers (OR = 0.10; 95%CI 0.02 to 0.47; P = 0.004) after adjusting for age and adenomas. For males, there was no relationship between current smoking and CRC. There was no statistical evidence of an association between former smoking and CRC for both sexes. Conclusion A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.Daniel D. Buchanan, Kevin Sweet, Musa Drini, Mark A. Jenkins, Aung Ko Win, Dallas R. English, Michael D. Walsh, Mark Clendenning, Diane M. McKeone, Rhiannon J. Walters, Aedan Roberts, Sally-Ann Pearson, Erika Pavluk, John L. Hopper, Michael R. Gattas, Jack Goldblatt, Jill George, Graeme K. Suthers, Kerry D. Phillips, Sonja Woodal, Julie Arnold, Kathy Tucker, Amanda Muir, Michael Field, Sian Greening, Steven Gallinger, Renee Perrier, John A. Baron, John D. Potter, Robert Haile, Wendy Franke, Albert de la Chapelle, Finlay Macrae, Christophe Rosty, Neal I. Walker, Susan Parry and Joanne P. Youn

A Novel Method for Evaluating Postoperative Adhesions in Rats

Purpose/Aim: Postoperative adhesions remain an undesirable and commonly symptomatic side effect of abdominopelvic surgeries. Animal models of postoperative adhesions typically yield heterogeneous adhesions throughout the abdominal cavity and are not easily quantified. Here we present a novel method of postoperative adhesion assessment and report its reliability and measurement error. Materials and Methods: A model of cecal abrasion with partial sidewall attachment was performed on female rats. After 1, 2, 4, or 7 days of recovery, the rats were euthanized and their abdominopelvic cavities were systematically evaluated for postoperative adhesions. The necropsy was recorded through the surgical microscope. Four raters were trained to use a ballot to capture key factors of the adhesions as they viewed the recordings. Their ratings were compared for measurement error and reliability (using Bland-Altman plots and intraclass correlation coefficients, respectively) and for the ability to discriminate differences in experimental groups. A subset of the data was analyzed to determine practical utility. Results: The rating system was shown to have low measurement error and high inter-rater reliability for all parameters measured. Applied practically, the system was able to discriminate groups in a manner that was expected. Conclusions: We have developed and validated a rating system for postoperative adhesions and shown that it can detect group differences. This method can be used to quantify postoperative adhesions in rodent models

Attenuation Of Postoperative Adhesions Using A Modeled Manual Therapy (Data Files)

These files include data and figures utilized to research and communicate the following: Postoperative adhesions are pathological attachments that develop between abdominopelvic structures following surgery. Considered unavoidable and ubiquitous, postoperative adhesions lead to bowel obstructions, infertility, pain, and reoperations, and represent a substantial health care challenge. Despite over a century of research, no preventive treatment exists. Based on the hypothesis that postoperative adhesions develop from a lack of movement of the abdominopelvic organs, we proposed a relatively simple treatment approach using a modified manual therapy technique that mobilizes abdominopelvic structures in the immediate postoperative period while they are otherwise rendered immobile by surgery and opiates. In a modified rat cecal abrasion model, we found that this treatment reduced the development of the most problematic type of adhesion. This effect was associated with a delay in the appearance of trophic macrophages. In a separate experiment using a strictureplasty model we showed that the treatment did not inhibit healing or induce undesirable complications. We can conclude that the treatment, which we have called modeled manual therapy, has potential as an effective preventive for postoperative adhesions. Our results support the hypothesis that maintained movements of the damaged structures can attenuate postoperative adhesion development, and lay the groundwork for further research, including mechanical and pharmacologic approaches

Experimental methods.

<p>A. To create the cecal hinge, the abraded cecum was stitched in two places (arrows) to appose a 1 cm X 2 cm area where the peritoneum had been removed. B. Quantification of the primary adhesion. The free cecum was cut from the adhesion area, the contents removed, and the edges trimmed. The adhesion was outlined and the area recorded. C. Completed strictureplasty surgery. D. The intestinal segment 7 days following strictureplasty was instrumented and inflated until suture failure. The sutures can be seen beneath the fatpad adhesion that encased the suture line. E. Sample trace of intraluminal pressure. The first dip (arrow) was associated with mesothelial splitting at a different site from the suture line. This sample withstood a pressure of 179 mmHg.</p

Relative expression of M1 or M2 markers by intraperitoneal macrophages.

<p>Intraperitoneal macrophages were isolated by peritoneal lavage at postoperative days specified in the X-axes. Cells were stained with anti-CD11b to positively identify monocyte lineage cells and anti-HIS48 to exclude neutrophils. Expression levels of the indicated markers (A) arginase, (B) CD163, (C) CD86, (D) iNOS are depicted as fold changes normalized to expression by intraperitoneal macrophages isolated from naïve rats. n = 7/group, means ± SEM. * p<0.05 post hoc test.</p

Statistical results for video ratings (Fig 4).

<p>Statistical results for video ratings (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178407#pone.0178407.g004" target="_blank">Fig 4</a>).</p

Ratings of necropsy videos 7 days following adhesiolysis.

<p>There were no differences between treated (n = 15) and untreated (n = 12) rats in adhesion parameters following adhesiolysis (means ± SEM). These results are comparable to those reported in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0178407#pone.0178407.g004" target="_blank">Fig 4</a>.</p