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November 12, 2015

Research Notes

Bariatric surgery leads to joint pain reduction

In the three years following bariatric surgery, the majority of patients experience an improvement in pain and walking ability, according to the preliminary results of a Graduate School of Public Health-led analysis.

The study, funded by the National Institutes of Health (NIH), identified key patient characteristics that can indicate which people are the most and the least likely to see improvement, a finding that could allow clinicians to identify patients who may require additional interventions to improve outcomes.

Said lead author Wendy King, epidemiology faculty member: “Our study found that clinically meaningful improvements in bodily pain, specific joint pain and both perceived and objectively measured physical function are common following bariatric surgery. In particular, walking is easier, which impacts patients’ ability to adopt a more physically active lifestyle. However, some patients continue to have significant pain and disability. Our hope is that these data will help patients and clinicians develop realistic expectations regarding the impact of bariatric surgery on these aspects of their lives.”

King and her colleagues followed 2,221 patients participating in the Longitudinal Assessment of Bariatric Surgery-2 prospective study of patients undergoing weight-loss surgery at one of 10 different hospitals across the U.S.

Through three years of follow-up, 50-70 percent of adults with severe obesity who underwent bariatric surgery reported clinically important improvements in bodily pain, physical function and usual walking speed.

About three-quarters of the participants with severe knee and hip pain or disability before surgery experienced improvements in symptoms indicative of osteoarthritis. In addition, over half of participants who had a mobility deficit prior to surgery did not have the deficit post-surgery.

Older age, lower income, more depressive symptoms and pre-existing medical conditions, including cardiovascular disease and diabetes before surgery, were among the factors independently associated with a lower likelihood of improvement in pain and mobility post-surgery, while greater weight loss, greater reduction in depressive symptoms and remission or improvement in several medical conditions were associated with greater likelihood of improvement.

Said study co-author Anita Courcoulas, chief of minimally invasive bariatric and general surgery in the School of Medicine: “Functional status is an extremely important aspect of health that has not been as well-studied as other conditions that change following bariatric surgery and this study sheds light on specific factors that may affect improvements in individuals with joint pain who undergo these procedures.”

Additional Pitt investigators on this research were Jia-Yuh Chen, Steven H. Belle and William F. Gourash. Also contributing were colleagues from Weill Cornell Medical College, Pacific University, University of Washington, Neuropsychiatric Research Institute, Oregon Health and Science University and the National Institute of Diabetes and Digestive and Kidney Disease. NIDDK funded the study.

Therapies against biowarfare to be tested

The Department of Defense (DOD) has awarded a $7.6 million grant to a collaborative group of scientists in the Center for Vaccine Research (CVR) for work that could lead to countermeasures against bioterrorism attacks.

The latest DOD-funded project in CVR will seek to accelerate development of drugs and vaccines against alphaviruses, about 30 different viruses that mainly are transmitted by mosquitoes. This group includes eastern, western and Venezuelan equine encephalitis viruses, which are rare but very deadly and cause periodic natural outbreaks in the Americas.

Amy L. Hartman, a member of CVR and faculty member in infectious disease and microbiology, will be principal investigator.  She’ll be assisted by co-principal investigator Kate D. Ryman and co-investigator William Klimstra, faculty members in microbiology and molecular genetics in the School of Medicine and alphavirus experts. They’ll be joined by co-investigator Douglas Reed, aerosol director for the Regional Biocontainment Laboratory and an immunology faculty member  in the School of Medicine, who has experience working with infectious diseases that cause disease through inhalation.

Said Hartman, who also is research manager of the Regional Biocontainment Laboratory: “These viruses could be dangerous as bioweapons, so it is important that we work toward developing therapies against them. Our goal is to better understand the biological mechanisms through which the virus harms people when it is inhaled, determine the proper timing for giving antiviral medications to people infected with the virus, and test potential therapies so that, if successful, they’ll be ready for human clinical trials.”

Discovering the mechanical behavior of nanodevices

Tevis Jacobs of mechanical engineering and material science at the Swanson School of Engineering has received a three-year $298,834 grant from the National Science Foundation to observe and measure nanoscale contact inside an electron microscope, enabling for the first time visualization of the atomic structure of the component materials while they are in contact.

Technologically, nanoscale contacts are found both in advanced microelectronic devices as well as in emerging nanoprobe-based technologies used to make those devices. By using a nanoprobe to make contact, device manufacturers can measure and manipulate behavior down to the atomic scale. Jacobs and his team will investigate the physics, chemistry and materials science of nanoscale devices during contact.

Said Jacobs: “We are studying the fundamental nature of contact at the nanoscale. There are some basic questions, such as the shape and size of the contacting region, which we understand well for large-scale objects but cannot predict or even accurately measure for nanoscale bodies. Scanning probe microscopy is commonly used to characterize surfaces. In this, you are dragging a sharp tip across a surface to determine its texture or other properties, but there’s no way to directly observe the contact. We are making scanning-probe contact inside a transmission electron microscope while taking ultra-high resolution photos and videos.”

Jacobs is principal investigator of “Collaborative Research: Understanding the Formation and Separation of Nanoscale Contacts.” His team will collaborate with a researcher from the University of California-Merced, who will replicate the experiments using molecular dynamics computer simulations to reveal atomic-scale detail about the phenomena occurring inside the nanomaterials.

Currently, there are competing theories to describe nanoscale adhesion and deformation in response to the applied force of a probe, and each theory predicts different behavior. Jacobs’ experiments will provide the data to confirm or refute these hypotheses in a variety of chemically and structurally diverse materials.

—Compiled by Marty Levine


The University Times Research Notes column reports on funding awarded to Pitt researchers as well as findings arising from University research.

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