Orthopedics

21 Aug

Posted at 20:21h in Author Interviews, Hip Fractures, Vegetarians
MedicalResearch.com Interview with: James Webster PhD Lead author Nutritional Epidemiology Group, University of Leeds MedicalResearch.com: What is the background for this study? Response: Hip fractures are the most severe consequence of osteoporosis and are a major public health problem. There are growing concerns of poor bone health and higher risk of fractures in vegetarians, but prospective studies comparing risk of hip fracture in vegetarians and meat-eaters over time are scarce and limited. A study of British men and women in the EPIC-Oxford cohort showed a greater risk of hip fracture in pescatarians, vegetarians, and vegans compared to meat-eaters. The only other study on the topic, the Adventist Health Study of US adults, found no clear evidence of a difference in hip fracture risk between vegetarians and meat-eaters, but identified hip fractures through questionnaires, which are susceptible to selective loss to follow-up. To build on previous research, we investigated the risk of hip fracture in occasional meat-eaters, pescatarians, and vegetarians compared to regular meat-eaters in middle-aged UK women, who are at a greater risk of hip fracture than men, with hip fractures accurately confirmed using objective and complete hospital records.

05 Aug

Posted at 12:28h in Author Interviews, BMJ, Diabetes, Osteoporosis

MedicalResearch.com Interview with: Stig Larsen
 PhD Professor Emeritus Controlled Clinical Research Methodology and Statistics Norwegian University of Life Sciences Oslo, Norway

MedicalResearch.com:? What are the main findings?

Response: Osteoporosis is a major problem among elderly and malnourished people. Calcium, Vitamin D and Vitamin K are beneficial for bone health. Vitamin D stimulates calcium absorption and studies have shown that poor Vitamin K status intake is linked to low bone mass. Osteocalcin (OC) is a protein hormone found in the blood in activated and inactivated form. The activated form of Osteocalcin (cOC) binds calcium to bone tissue and plays an important role in regulating the metabolism. In addition, low levels of cOC are associated with insulin resistance, diabetes, and metabolic syndrome. It is desirable to have largest possible uOC, and vitamin K2 central in this process. The most important vitamin K2 variants in Jarlsberg® are the long-chain MK-7, -8, -9 and -9(4H), where lactic acid bacteria produce the first three, while MK-9(4H) is produced by Propionibacterium freudenreichii. The latter bacterium also produces the substance "1,4-dihydroxy-2- naphthoic acid" (DHNA), which has previously been shown to increase bone density in experimental mice. Two previous studies related to Jarlsberg® intake have been published:

  • The first study showed that cOC in the blood increased with increasing Jarlsberg® dose up to a daily intake of 57 grams of Jarlsberg®. Even more startling was that the total OC (tOC) level increased significantly, and that triglycerides and cholesterol were significantly reduced.1
  • The second study reproduced the findings from the first study and demonstrated additionally that the Jarlsberg dose of 57g/day could be reduced to 45 grams after 6 weeks without reducing the achieved level of tOC and vitamin K2.2

The BMJ-study3: The central variables measured in this study were the serum bone turnover markers (BTM); tOC and cOC, procollagen type 1 N-terminal propeptide (PINP) and serum cross-linked C- telopeptide type I collagen (CTX). Additionally, Vitamin K2 and Vitamin K status, serum calcium and serum magnesium were recorded together with the development in glycated hemoglobin (HbA1c), lipids and protein turnover. The participants in the study were randomly divided into two groups. One group of 41 healthy volunteer women of childbearing age ate 57 grams of Jarlsberg® per day and the other group of 25 women ate 50 grams of Camembert for 6 weeks. The Camembert was manufactured with a starting culture not producing Vitamin K2. The fat, protein, and energy content of the daily consumption of Jarlsberg® and Camembert is approximately the same. After 6 weeks, Camembert was replaced with 57 grams of Jarlsberg® per day for another 6 weeks.

27 Jul

Posted at 23:06h in Author Interviews, Brigham & Women's - Harvard, Endocrinology, Hip Fractures, NEJM, Osteoporosis, Vitamin D
MedicalResearch.com Interview with: [caption id="attachment_59361" align="alignleft" width="120"]Meryl S. LeBoff, MD Chief, Calcium and Bone SectionDirector of the Skeletal Health and Osteoporosis CenterDirector, Bone Density UnitDistinguished Chair in Skeletal Health and Osteoporosis Professor of Medicine, Harvard Medical School Endocrinology, Diabetes and Hypertension, Women's Health Brigham And Women's Hospital Dr. LeBoff[/caption] Meryl S. LeBoff, MD Chief, Calcium and Bone SectionDirector of the Skeletal Health and Osteoporosis CenterDirector, Bone Density UnitDistinguished Chair in Skeletal Health and Osteoporosis Professor of Medicine, Harvard Medical School Endocrinology, Diabetes and Hypertension, Women's Health Brigham And Women's Hospital [caption id="attachment_59356" align="alignleft" width="125"]JoAnn E. Manson, MD, DrPH Dr. Manson[/caption] JoAnn E. Manson, MD, DrPH Professor, Epidemiology, Harvard T.H. Chan School Of Public Health Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School Chief, Preventive Medicine, Brigham And Women's Hospital Co-Director, Womens Health, Brigham And Women's Hospital   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting. Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population. To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US.

20 Jan

Posted at 17:11h in Author Interviews, BMJ, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_58670" align="alignleft" width="150"]Prof. Matthew Costa Professor of Orthopaedic Trauma University of Oxford Honorary Consultant Trauma Surgeon, John Radcliffe Hospital, Oxford Prof. Costa[/caption] Prof. Matthew Costa Professor of Orthopaedic Trauma University of Oxford Honorary Consultant Trauma Surgeon, John Radcliffe Hospital, Oxford  MedicalResearch.com: What is the background for this study? Response: Fixation with metal implants provides reliable functional outcomes for patients after a manipulation of a displaced fracture of the distal radius, but such surgery carries risk for the patient and is expensive. A moulded plaster cast is a safer and cheaper intervention but may not provide the same functional outcome. It is not known which of these treatments is superior.

09 Jun

Posted at 00:32h in Author Interviews, Gout, Orthopedics, Rheumatology
MedicalResearch.com Interview with: Dr. Prof. Dr.  Gurkirpal Singh, MD Adjunct Clinical Professor of Medicine Stanford University MedicalResearch.com: What is the background for this study? Response: Joint damage from gout has been linked to a possible increase in knee and hip joint replacements. The strong association between gout and osteoarthritis could also lead to an increased risk of joint replacements in patients with gout as the presence of gout may accelerate or worsen osteoarthritis.[i] This study aimed to evaluate total or partial hip and knee joint replacements in patients with gout in the U.S. and to estimate their economic impact. Data was analyzed on hospitalizations in patients with gout with hip and knee joint replacements in 2018, using the Nationwide Inpatient Sample  (NIS) which is the largest publicly available all-payer inpatient healthcare database.

12 May

Posted at 00:13h in Author Interviews, Heart Disease, Menopause, Osteoporosis
MedicalResearch.com Interview with: [caption id="attachment_57338" align="alignleft" width="120"]Yeonyee E. Yoon, MD, PhD Associate Professor Division of Cardiology, Cardiovascular Center  Seoul National University Bundang Hospital South Korea Dr. Yoon[/caption] Yeonyee E. Yoon, MD, PhD Associate Professor Division of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital South Korea  MedicalResearch.com: What is the background for this study? Response: Although atherosclerotic cardiovascular disease (ASCVD) has been traditionally considered to affect men predominantly, it is nearly common in women. ASCVD is the leading cause of death in both men and women globally, and the population-adjusted risk of ASCVD mortality in women is significantly greater than that in men. Nevertheless, the current focus on the 10-year ASCVD risk estimated by a risk-scoring algorithm such as the Pooled Cohort Equation has shown unsatisfactory accuracy in women. Therefore, new strategies beyond the conventional risk stratification algorithm are needed to improve identification for women at high risk for ASCVD. ASCVD and osteoporosis are major age-related diseases contributing to significant morbidity and mortality in women, and previous epidemiologic studies have suggested a potential association between these diseases. Given that millions of women are screened for osteoporosis using dual-energy X-ray absorptiometry (DXA), potential associations between low bone mineral density (BMD) and ASCVD in women would provide an opportunity to improve the risk stratification of women without any additional costs. Therefore, we aimed to investigate whether the evaluation of BMD provides independent and incremental prognostic values for ASCVD prediction in women. 

05 May

Posted at 23:13h in Author Interviews, Lancet, Menopause, Orthopedics, Osteoporosis, UCLA
MedicalResearch.com Interview with: [caption id="attachment_57332" align="alignleft" width="118"]Carolyn Crandall, M.D. Professor, Medicine Health Sciences Clinical Professor,  UCLA Dr. Crandall[/caption] Carolyn Crandall, M.D. Professor, Medicine Health Sciences Clinical Professor, UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously-published studies had not examined in detail the risk of subsequent fractures after initial fractures in a large national sample of women in the us. Clinical guidelines mostly emphasize initial hip and spine fractures, but they do not emphasize fractures of other types.  We hypothesized that subsequent fracture risk would be higher after initial fracture even at locations other than the hip or the spine.

20 Apr

Posted at 15:29h in Author Interviews, Nature, Nutrition, Orthopedics, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_57196" align="alignleft" width="200"]Efrat Monsonego Ornan, Ph.D  Head of School of Nutritional Sciences Institute of Biochemistry and Nutrition  The Robert H. Smith Faculty of Agriculture,  Food and Environment  The Hebrew University of Jerusalem Prof. Monsonego Ornan[/caption] Efrat Monsonego Ornan, Ph.D  Head of School of Nutritional Sciences Institute of Biochemistry and Nutrition The Robert H. Smith Faculty of Agriculture, Food and Environment The Hebrew University of Jerusalem MedicalResearch.com: What is the background for this study? Response: Food supplies in recent decades have been dominated by heavily processed, ready-to-eat products. Essentially, 75% of all world food sales are of processed foods. Over the past 30 years, children’s ultra-processed food intake has increased markedly, with 50% of the children in the US consuming these foods. Only in the US does UPF comprise 58% of energy intake, of which 90% is derived from added sugars. This reflects children’s excessive consumption of food and drink that are high in fat and refined sugars but do not provide appropriate levels of the proteins, vitamins and minerals required for growth. The negative health outcomes of excessive consumption of Ultra-processed food are well known, include obesity, metabolic syndrome and diabetes, and considered as the current world epidemic; the fact that children, during their postnatal development period (birth to adolescent), are the target of the Ultra-processed food industry is very disturbing in terms of public health. Bone development and growth are the characteristic phenomena of the childhood period. Yet, in spite of the huge importance of nutrition to bone development, the impact of Ultra-processed food consumption on skeleton development during childhood has never been studied directly, and this was the purpose of our study. To this end, we used young rats which are an excellent pre-clinical model for growth and fed them with either the recommended diet for their age or  a diet comprised of a typical Ultra-processed meal (a roll, hamburger, tomatoes, lettuce, ketchup and French fries) and a caloric soft drink.  

02 Feb

Posted at 11:19h in Author Interviews, CMAJ, Orthopedics, Rheumatology, Surgical Research
MedicalResearch.com Interview with: Codie Primeau, MSc Physical Therapy Student & Ph.D. Candidate (Combined MPT/Ph.D.) Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic Western University London, ON, Canada MedicalResearch.com: What is the background for this study? Response: High tibial osteotomy (HTO) is a surgery for patients with varus alignment (bowed legs) and earlier-stage knee osteoarthritis. By correcting alignment, HTO shifts load to less diseased parts of the knee. One of the goals of HTO is to delay or even prevent the need for knee replacement surgery later. 

18 Dec

Posted at 13:34h in Author Interviews, Genetic Research, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_56251" align="alignleft" width="200"]Karin Magnusson PT, PhD Associate Researcher Lund University and Norwegian Institute of Public Health Dr. Magnusson[/caption] Karin Magnusson PT, PhD Associate Researcher Lund University and Norwegian Institute of Public Health MedicalResearch.com: What is the background for this study? Response: Anterior cruciate ligament (ACL) injury is one of the most common knee injuries, for which very limited data has been presented on the genetic contribution. Based on our knowledge of the role of genetics in the development of ACL-rupture related traits, such as joint hypermobility and knee osteoarthritis, we hypothesized that heritability might play a role also in ACL injury. Using the Swedish Twin Registry, which is the world's largest twin registry and in this study including more than 88.000 twins, we had unique data to for the first time reliably estimate the heritability for this common knee injury. 

18 Nov

Posted at 11:08h in Author Interviews, Orthopedics, Radiology, Rheumatology, UCSF, Weight Research
MedicalResearch.com Interview with: Silvia Schirò MD Department of Radiology and Biomedical Imaging University of California, San Francisco MedicalResearch.com: What is the background for this study?  Response: Knee osteoarthritis (OA) is worldwide the second most frequent cause of lower extremity disability, and it has a global incidence of 199 cases per 100.000, including over 14 million people with symptomatic knee OA in the US. Overweight and obese individuals have a higher incidence of knee OA due to excessive knee joint load. The association between physical activity and knee OA, has not been systematically addressed in overweight and/or obese subjects and its association seems to be controversial. On the one hand, mild to non-weight-bearing physical activities have been found to be beneficial in the management knee homeostasis, the physiologic knee joint load providing an optimized environment for the joint tissues. On the other hand, excessive fast-paced physical activity with high load-joint torsion such as racquet sports, ball sports and running have been found to have an increased incidence of knee injury compared to mild-moderate exercise such as swimming, bicycling and low-impact aerobics independent of body weight.

21 Oct

Posted at 21:46h in Asthma, Author Interviews, BMJ, Osteoporosis
MedicalResearch.com Interview with: [caption id="attachment_55667" align="alignleft" width="200"]Christos Chalitsios B.Sc, M.Sc PhD student Funded by British Medical Association (BMA) School of Medicine Division of Respiratory Medicine University of Nottingham City Hospital,Nottingham Christos V. Chalitsios[/caption] Christos Chalitsios B.Sc, M.Sc PhD student Funded by British Medical Association (BMA) School of Medicine Division of Respiratory Medicine University of Nottingham City Hospital,Nottingham MedicalResearch.com: What is the background for this study? Response: Inhaled (ICS) and oral (OCS) corticosteroids play a crucial role in the control of airway inflammation in asthma. Given that the use of ICS in asthma is likely to increase with the recent change in GINA guidance recommending combined long-acting-β2-agonists with ICS at step 1 and the upward trend in prescribing of OCS, we sought to clarify the link between steroids, osteoporosis and FF in patients with asthma, stratifying the risk by dose, number of courses and type of steroids. The prevalence of patients receiving at least one bisphosphonate was also calculated.

10 Aug

Posted at 19:08h in Author Interviews, NYU/NYMC, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_55060" align="alignleft" width="149"]Bruce N. Cronstein, MD Paul R. Esserman Professor of Medicine NYU School of Medicine Director, NYU-H+H Clinical and Translational Science Institute Director, Division of Translational Medicine NYU Langone Health New York, NY 10016 Dr. Cronstein[/caption] Bruce N. Cronstein, MD Paul R. Esserman Professor of Medicine NYU School of Medicine Director, NYU-H+H Clinical and Translational Science Institute Director, Division of Translational Medicine NYU Langone Health New York, NY 10016  MedicalResearch.com: What is the background for this study? Response: Osteoarthritis is the most common type of arthritis affecting about 10% of the adult population and 25% of the population over 60. We had previously found that adenosine, a molecule generated by nearly all cell types, is critical for maintaining cartilage health by activating specific adenosine receptors on the surface of cells (A2A receptors). Moreover, giving adenosine into the joint could prevent deterioration of cartilage (progression of osteoarthritis) in a rat model of osteoarthritis. Because people do not usually go for treatment of osteoarthritis until they have developed symptoms we asked whether administration of adenosine or adenosine that had been modified to be a more potent and specific stimulus for A2A receptors, carried in fat bubbles called liposomes, could reverse osteoarthritis after it had already started.

28 Jul

Posted at 09:58h in Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Osteoporosis
MedicalResearch.com Interview with: [caption id="attachment_54915" align="alignleft" width="133"]Daniel Hal Solomon, MD, MPH Associate Physician, Brigham and Women's Hospital Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Rheumatology, Immunology Boston, MA 02115 Dr. Solomon[/caption] Daniel Hal Solomon, MD, MPH Associate Physician, Brigham and Women's Hospital Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Rheumatology, Immunology Boston, MA 02115 Editor’s note: Prolia® is the trade name for denosumab.  MedicalResearch.com: What is the background for this study? Response: We conducted this study to assess whether delays in denosumab (injections were associated with an increased risk of fractures. In a prior study, we found that the improvements in bone mineral density were reduced among patients who delayed injections.

19 May

Posted at 16:57h in Author Interviews, JAMA, Orthopedics, Race/Ethnic Diversity, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_54220" align="alignleft" width="200"]Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University  Dr. Cavanaugh[/caption] Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University MedicalResearch.com: What is the background for this study? Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites? Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery.

23 Mar

Posted at 18:22h in Author Interviews, Orthopedics, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_53608" align="alignleft" width="200"]Daniel Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery, University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery,  ICES, Toronto, Ontario, Canada Dr. Pincus[/caption] Pincus MD PhD Division of Orthopaedic Surgery, Department of Surgery University of Toronto Sunnybrook Health Sciences Centre, Division of Orthopaedic Surgery ICES, Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Controversy exists among arthroplasty surgeons and patients about the best surgical approach for total hip arthroplasty (THA) - one of the most common operations performed worldwide. In the last few years, the direct anterior approach has become increasingly popular compared to posterior and lateral approaches, partially as a result of advertising to patients.  We sought to determine whether a direct anterior surgical approach was associated with lower surgical complications compared to lateral and posterior approaches.

17 Mar

Posted at 16:34h in Author Interviews, Gastrointestinal Disease, JAMA, Orthopedics, Pediatrics
[caption id="attachment_53500" align="alignleft" width="150"]Yun-Han Wang PhD Student Karolinska Institute Yun-Han Wang[/caption] MedicalResearch.com Interview with: Yun-Han Wang, PhD Student Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Proton pump inhibitor (PPI) use has been linked to increased risk of fracture in adults. Despite an increasing trend in prescription of PPIs in children, there is scarce evidence regarding this safety concern in pediatric patients.

31 Jan

Posted at 20:01h in Author Interviews, Hip Fractures, JAMA, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_53034" align="alignleft" width="142"]Alison M. Cogan, PhD, OTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Alexandria, Virginia Dr. Cogan[/caption] Alison M. Cogan, PhD, OTR/L Polytrauma/TBI Advanced Fellow Washington DC VA Medical Center Washington DC MedicalResearch.com: What is the background for this study? Response: Medicare is shifting from a volume- to value-based payment for postacute care services, in which value is determined by patient characteristics and functional outcomes. Matching therapy time and length of stay (LOS) to patient needs is critical to optimize functional outcomes and manage costs. The objective of this study was to investigate the association among therapy time, LOS, and functional outcomes for patients following hip fracture surgery. This retrospective cohort study analyzed data on patients from 4 inpatient rehabilitation facilities and 7 skilled nursing facilities in the eastern and midwestern United States. Participants were patients aged 65 years or older who received inpatient rehabilitation services for hip fracture and had Medicare fee-for-service as their primary payer. We categorized patients into nine recovery groups based on low, medium, and high therapy minutes per day and low, medium, or high rate of functional gain per day. We measured the groups for functional mobility independence and self-care capabilities at the time each patient was discharged.

26 Dec

Posted at 12:48h in Author Interviews, JAMA, Orthopedics, Vitamin D
MedicalResearch.com Interview with: [caption id="attachment_52550" align="alignleft" width="200"]Robert Clarke MD, FRCP, FFPH, FFPHI, MSc, DCH Professor of Epidemiology and Public Health Medicine Clinical Trial Service Unit (CTSU) Nuffield Department of Population Health University of Oxford Dr. Clarke[/caption] Robert Clarke MD, FRCP, FFPH, FFPHI, MSc, DCH Professor of Epidemiology and Public Health Medicine Clinical Trial Service Unit (CTSU) Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? Response: Approximately 1 in 2 women and 1 in 5 men aged 50 years or older will suffer from an osteoporotic fracture in their remaining lifetime. Hip fracture is the most serious type of osteoporotic fracture with an approximately 30% risk of death in the year following a hip fracture. Vitamin D is essential for optimal musculoskeletal health by promotion of calcium absorption, and mineralisation of osteoid tissue formation in bone and maintenance of muscle function. Low vitamin D status causes secondary hyperparathyroidism, bone loss and muscle weakness. Observational studies have reported that lower blood concentrations of vitamin D are associated with higher risks of falls and fractures. Combined supplementation with 800 IU/day vitamin D and 1200 mg/day calcium has been recommended for prevention of fractures in older adults living in institutions and in those with low vitamin D status. However, previous trials and meta-analyses of vitamin D alone, or in combination with calcium for prevention of fracture in either community-dwelling or general population settings reported conflicting results, with some reporting protective effects against fractures, but others demonstrated no beneficial effects. However, most of the previous trials had only limited power to detect differences in risk of fracture predicted by the observational studies, largely because of a combination of small sample size, relatively low equivalent daily doses of vitamin D, intermittent dosing regimens (>1 month), and short duration of follow-up. In addition, interpretation of the results of previous meta-analyses of such trials is complicated by use of variable inclusion criteria, inappropriate statistical methods, inclusion of multiple small trials with very few fracture events, in addition to failure to report achieved differences in blood 25(OH)D concentrations. We summarised the available evidence to guide clinical practice and future research, by conducting parallel meta-analyses of:
  • (i) observational studies of risks of fracture associated with prolonged differences in blood concentrations of 25(OH)D;
  • (ii) randomised trials of vitamin D alone versus placebo or no treatment for prevention of fracture; and
  • (iii) randomised trials of calcium and vitamin D versus placebo or no treatment for prevention of fracture.In addition, we reviewed the design of the ongoing randomised trials assessing the effects of higher doses of vitamin D alone or in combination with calcium for prevention of fracture.

26 Nov

Posted at 21:06h in Author Interviews, JAMA, Osteoporosis
MedicalResearch.com Interview with: [caption id="attachment_52292" align="alignleft" width="150"]Pamela L. Lutsey, PhD Associate Professor Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis Dr. Lutsey[/caption] Pamela L. Lutsey, PhD Associate Professor Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis MedicalResearch.com: What is the background for this study? Response: Warfarin is prescribed to atrial fibrillation (AF) patients for the prevention of cardioembolic complications. However, whether it adversely impacts bone health is controversial. With the availability of alternate direct oral anticoagulant (DOAC) options, it is now possible to evaluate the comparative safety of warfarin in relation to fracture risk.

01 Nov

Posted at 13:24h in Author Interviews, JAMA, Osteoporosis, Weight Research
MedicalResearch.com Interview with: Radhika Seimon, PhD Research Fellow at the University of Sydney Amanda Salis, PhD - Professor of Obesity Research at the University of Sydney Senior Research Fellow National Health and Medical Research Council of Australia  MedicalResearch.com: What is the background for this study? Response: Total meal replacement diets are severely energy-restricted diets that involve replacing all or almost all foods with nutritionally replete meal replacement products such as shakes, soups, or bars (i.e. total diet replacement). They are the most effective dietary treatment for obesity, resulting in greater short- and long-term weight loss compared with conventional food-based diets. However, there are concerns that total meal replacement diets may adversely affect body composition, notably lean mass and bone mineral density.

28 Oct

Posted at 14:43h in Author Interviews, Exercise - Fitness, Heart Disease, Hip Fractures, JAMA, Menopause
MedicalResearch.com Interview with: [caption id="attachment_51934" align="alignleft" width="140"]Jean Wactawski-Wende PhD Dean, SUNY Distinguished Professor Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo Dr. Wactawski-Wende[/caption] Jean Wactawski-Wende PhD Dean, SUNY Distinguished Professor Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study included data from the Women’s Health Initiative, a prospective study of postmenopausal women from across the United States. We assessed physical activity in 77,206 women over an average of 14 years of follow-up. Approximately 1/3 of these women (average age 63.4 years) had at least one fracture occur. Higher physical activity levels were associated with  lower risk of hip and total fracture. Even levels of activity that were moderate, including regular walking and doing household chores, were beneficial. 

24 Sep

Posted at 15:55h in Author Interviews, Education, Exercise - Fitness, Orthopedics, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_51581" align="alignleft" width="200"]Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI  Prof. Field[/caption] Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI  MedicalResearch.com: What is the background for this study? Response: Over past couple of decades there has been a large change in youth sports from playing different sports in each season to more and more specialization where children are playing the same sport for three or more seasons. The concern with that change is that specialization at young ages will lead to more injuries, as well as athlete burnout.  

12 Aug

Posted at 13:51h in Author Interviews, Orthopedics, PLoS
MedicalResearch.com Interview with: [caption id="attachment_50683" align="alignleft" width="157"]Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University Prof. Mechlenburg[/caption] Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traditionally, displaced 2-part humerus fractures have been operatively treated using a metal plate and screws. However, there are no studies showing a benefit of operation of those fractures. Therefore, we were interested in investigating, in a direct comparison between operation and non-operative treatment, whether there was a difference in patient-reported function, pain and health-related quality of life two years after the fracture. In this Nordic research collaboration http://nitep.eu/en/ between Finland, Sweden, Estonia and Denmark we showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures. In the study, only fractures with a significant displacement between bone fragments were included. In the non-operative treatment group, patients used a collar and cuff sling for three weeks and underwent instructed physiotherapy.

09 Aug

Posted at 18:13h in Author Interviews, JAMA, Orthopedics, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_50635" align="alignleft" width="200"]Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol Dr. Elhakeem[/caption] Dr Ahmed Elhakeem PhD Senior Research Associate in Epidemiology University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that the denser (stronger) your bones are, the less likely they are to break (fracture). We also have reliable evidence that later maturing adolescents tend on average to have lower bone density than their earlier maturing peers. We wanted to find out how the timing of puberty might influence the development of bone density throughout adolescence and into early adult life. We did this by following up a large group of young people born in the early 90s around Bristol, UK that took part in a unique study (the Children of the 90s study) that included repeated density scans over a 15-year period from age ten to 25. We found that those later maturing adolescents that got their growth spurt at an older age tended to catch-up to some degree to their earlier maturing peers during puberty however, they continued on average to have lower bone density than average for several years into adulthood.

09 Jul

Posted at 23:01h in Author Interviews, Opiods, Orthopedics, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_50189" align="alignleft" width="200"]Professor Martin Englund MD PhD Department of Orthopaedics Lund University Prof. Englund[/caption] Professor Martin Englund MD PhD Department of Orthopaedics Lund University  MedicalResearch.com: What is the background for this study? Response: Currently, there is lack of knowledge of opioid usage in osteoarthritis patients. Opioids are typically not recommended for the treatment of osteoarthritis pain. 

17 Jun

Posted at 20:06h in Author Interviews, Geriatrics, Hip Fractures, JAMA, Orthopedics, Osteoporosis
MedicalResearch.com Interview with: [caption id="attachment_49813" align="alignleft" width="132"]Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System Dr. Ensrud[/caption] Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System  MedicalResearch.com: What is the background for this study? Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population.

16 May

Posted at 22:58h in Author Interviews, Brigham & Women's - Harvard, Opiods, Orthopedics, Pain Research, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_49201" align="alignleft" width="135"]Marilyn M. Heng, MD, MPH, FRCSCOrthopaedic Trauma SurgeonAssistant Professor of Orthopaedic SurgeryHarvard Medical School Dr. Heng[/caption] Marilyn M. Heng, MD, MPH, FRCSC Orthopaedic Trauma Surgeon Assistant Professor of Orthopaedic Surgery Harvard Medical School  MedicalResearch.com: What is the background for this study?   Response: The ultimate background for this study does come from the larger context of the opioid epidemic that is seen worldwide but particularly in North America. Orthopaedic surgeons should take responsibility as being among the top prescribers of opioids. The more specific background that led to this specific study was the observation that several colleagues would insist that a drug like hydromorphone was so dangerous that they would not prescribe it but seemed okay prescribing large amounts of oxycodone.  It seemed like an urban myth that the type of opioid was what made it dangerous, so that led us to do the study to see if there was evidence for that. 

15 May

Posted at 17:17h in Author Interviews, Brigham & Women's - Harvard, JAMA, Orthopedics, Osteoporosis, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_49152" align="alignleft" width="135"]Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density CenterEndocrine Unit, Massachusetts General Hospital  Dr. Elaine Yu[/caption] Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density Center Endocrine Unit, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Roux-en-Y gastric bypass (RYGB) is a popular surgical weight loss procedure.  We have previously shown that gastric bypass leads to rapid high-turnover bone loss. Bariatric procedures are being increasingly performed in older adults, and the clinical consequences of gastric bypass-associated skeletal changes in this vulnerable population have been unclear to date.  Thus, we used Medicare claims data to investigate fracture risk among older adults after gastric bypass, and in comparison to adults who received another bariatric procedure called adjustable gastric banding (AGB), which is thought to have fewer negative bone effects. In our analysis, we found that patients undergoing Roux-en-Y gastric bypass were 73% more likely to fracture than those undergoing AGB. Importantly, we found that hip fracture risk increased nearly 180% after RYGB, and that fracture rates in patients aged 65 or older were similar to the overall group.