Author Interviews, JAMA, Orthopedics, Vitamin D / 26.12.2019

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.
Author Interviews, JAMA, Osteoporosis / 26.11.2019

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.
Author Interviews, JAMA, Osteoporosis, Weight Research / 01.11.2019

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.
Author Interviews, Exercise - Fitness, Heart Disease, Hip Fractures, JAMA, Menopause / 28.10.2019

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. 
Author Interviews, Education, Exercise - Fitness, Orthopedics, Pediatrics / 24.09.2019

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.  
Author Interviews, Orthopedics, PLoS / 12.08.2019

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.
Author Interviews, JAMA, Orthopedics, Pediatrics / 09.08.2019

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.
Author Interviews, Opiods, Orthopedics, Rheumatology / 09.07.2019

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. 
Author Interviews, Geriatrics, Hip Fractures, JAMA, Orthopedics, Osteoporosis / 17.06.2019

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.
Author Interviews, Brigham & Women's - Harvard, Opiods, Orthopedics, Pain Research, Surgical Research / 16.05.2019

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. 
Author Interviews, Brigham & Women's - Harvard, JAMA, Orthopedics, Osteoporosis, Surgical Research / 15.05.2019

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. 
Author Interviews, Hip Fractures, JAMA, Supplements / 13.05.2019

MedicalResearch.com Interview with: [caption id="attachment_49114" align="alignleft" width="149"]Prof. Haakon E Meyer, PhDDepartment of Public Health and Global HealthNorwegian Institute of Public HealthOslo, Norway Prof. Meyer[/caption] Prof. Haakon E Meyer, PhD Department of Public Health and Global Health Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of high dose vitamin supplementation is popular in parts of the population, often without any clear indication and in the absence of clear evidence of benefit. However, side effects can occur, and in a previous published secondary analysis of double blinded randomized controlled trials, we found to our surprise an increased risk of hip fracture in those supplemented with high doses of vitamin B6 in combination with vitamin B12. This finding was re-assessed in the current study employing data from the large observational Nurses' Health Study. As in the previous study, we found that a combined high intake of vitamin B6 and B12 was associated with increased risk of hip fracture.
Author Interviews, Orthopedics, Pain Research / 19.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47992" align="alignleft" width="122"]Geoffrey Westrich, MDDirector of ResearchAdult Reconstruction and Joint Replacement ServiceHospital for Special SurgeryNYC Dr. Westrich[/caption] Geoffrey Westrich, MD Director of Research Adult Reconstruction and Joint Replacement Service Hospital for Special Surgery NYC  MedicalResearch.com: What is the background for this study? Response: Recent mortality trends in the U.S. associated with opioid use disorders have brought to the forefront of national debate the desirability of minimizing the use of potentially addictive pain management therapies.  Pain management after hip replacement surgery is an important part of patient care, and  opioids are frequently given as a major part of postoperative pain management. At the same time, multimodal analgesia, the administration of anesthetic agents and medications agents targeting multiple pain pathways, has seen increased popularity in pain management after hip replacement surgery.  At Hospital for Special Surgery (HSS), the multimodal protocol entails the use of several different anesthetic agents and medications both during and after surgery to control pain, minimize the use of opioids and reduce side effects. The use of non-opioid analgesics such as acetaminophen allows for a reduction in opioid administration after surgery [1]. Acetaminophen, commonly known as Tylenol, has traditionally been administered orally, but more recently an intravenous (IV) preparation has become available.  IV acetaminophen after major orthopedic surgery was shown to provide effective analgesia and reduce morphine administration by 33%, compared to placebo [2]. Unless a patient is unable to take acetaminophen, it is commonly used as part of the multimodal protocol due to its efficacy and minimal contraindications. Although intravenous (IV) acetaminophen presents pharmacokinetic benefits, such as increasing both serum blood and cerebrospinal fluid levels more rapidly, there is limited analysis of its potential clinical advantages compared to oral acetaminophen.  We hypothesized that there could be a reduction in pain with activity, opioid usage, or opioid- related side effects among patients receiving IV acetaminophen compared to oral acetaminophen following hip replacement surgery 
Author Interviews, Opiods, Orthopedics / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47877" align="alignleft" width="130"]Paul Cagle, Jr. MDAssistant Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Cagle[/caption] Paul Cagle, Jr. MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings ie What are some of the significant comorbidities?  Response: In this study our goal was to better understand what medical issues (medical comorbidities) can cause trouble or issue for patients with a proximal humerus fracture (shoulder fracture).  To tackle this issue we used a large national sample of patients and sorted our the different medical issues the patients had. We found that patients with increased medical issues had longer hospital stays and higher use of opioid medications (pain medications).
Author Interviews, Opiods, Orthopedics, Surgical Research / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47736" align="alignleft" width="130"]Dr. Alexis Colvin, MDAssociate Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Colvin[/caption] Dr. Alexis Colvin, MD Associate Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: 40% of all opioid overdose deaths involve a prescription opioid and orthopaedic surgeons are the 3rd highest prescribers of opioids.  Set guidelines for post surgery opioid prescriptions have not been established.  Arthroscopic knee meniscectomy is one of the most common orthopaedic procedures.  The purpose of this study was to determine how many opioids were being prescribed  among a group of six sports fellowship trained orthopaedic surgeons versus how many patients were actually using.
Author Interviews, Orthopedics, Pharmacology, Rheumatology / 28.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47695" align="alignleft" width="143"]Dr. Andrew Spitzer MDCo-director Joint Replacement ProgramCedars-Sinai Orthopedic CenterLos Angeles, CA Dr. Spitzer[/caption] Dr. Andrew Spitzer MD Co-director Joint Replacement Program Cedars-Sinai Orthopedic Center Los Angeles, CA MedicalResearch.com: What is the background for this study? How does this product differ from other steroid injections for inflammatory arthritis? Dr. Spitzer: Many patients receive repeat injections of intra-articular corticosteroids to manage recurrent osteoarthritis pain and other symptoms. However, in most clinical trials to date, patients only received a single corticosteroid injection, and patients were only followed for 12 to 24 weeks after treatment. For trials that have evaluated repeated injections of corticosteroids over a longer period of time—2 years, for example—injections were administered every 3 months, regardless of the timing of the return of OA symptoms. This is not reflective of what is done in clinical practice, where corticosteroids are administered again in response to the return of pain or a flare of inflammation in the knee. In this study, we used a flexible dosing schedule based on the patients’ symptoms, meaning that patients received the second injection of a recently approved extended-release corticosteroid only when their pain and/or symptoms returned, not before. Safety was monitored for 52 weeks—this length of time should be sufficient to identify any associated side effects, including any potential impact on the knee tissue. Triamcinolone acetonide extended-release (TA-ER; Zilretta®) was approved in late 2017 as an intra-articular injection for the management of osteoarthritis pain of the knee. The formulation utilizes microspheres which enable a slow release of the active agent (triamcinolone acetonide) into the synovial fluid for 12 weeks following injection. Previously, a Phase 3 study demonstrated safety and efficacy of a single injection of TA-ER (Conaghan PG, et al. J Bone Joint Surg Am. 2018;100:666-77). This is the first study evaluating the safety and patient response to repeat administration of TA-ER. This study also included patients that were more typical of who we see in the clinic—those who have higher body mass index, more severe disease, and received prior treatments for their osteoarthritis pain.
Author Interviews, Orthopedics, Technology / 02.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47270" align="alignleft" width="160"]Professor Sherry Towfighian PhD Mechanical Engineering Binghamton University   Prof. Towfighian[/caption] Professor Sherry Towfighian PhD Mechanical Engineering Binghamton University   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We wanted to avoid using batteries in a load monitor that can be placed in total knee replacement. We looked into energy scavenging technologies and studied the most appropriate one for this application. Energy scavenging is converting wasted energy such as walking to electricity for low power sensors. Our research study showed walking can provide enough electrical energy (about 6 microwatts) for low power load sensors. These load sensors are important in providing information about the mechanical load throughout different activities. It can be used in the future to create a self -awareness device for the patient to avoid certain activities. 
Author Interviews, BMJ, Orthopedics / 28.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47181" align="alignleft" width="200"]Tero Kortekangas, MD, PhD Orthopaedic trauma surgeon Oulu University Hospital Oulu, Finland Dr. Kortekangas[/caption] Tero Kortekangas, MD, PhD Orthopaedic trauma surgeon Oulu University Hospital Oulu, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Isolated, stable, Weber B type fibula fracture is by far the most common type of ankle fracture. Traditionally these fractures are treated with below the knee cast for six weeks. Although the clinical outcome of this treatment strategy has been shown to be generally favourable, prolonged cast immobilisation is associated with increased risk of adverse effects, prompting attempts to streamline the treatment. However, perhaps because of absence of high quality evidence on the effectiveness and safety of more simple non-operative treatment strategies, the current tenet of six weeks of cast immobilisation still remains the “gold standard” treatment of stable Weber B type fractures.
Author Interviews, Brain Injury, Orthopedics, Pediatrics, PNAS / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47062" align="alignleft" width="200"]Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba Dr. Russell[/caption] Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba MedicalResearch.com: What is the background for this study? Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life.  HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion.  Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician.  We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery. We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury.  We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.
Author Interviews, JAMA, Orthopedics, Pain Research, University of Pittsburgh / 09.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46849" align="alignleft" width="200"]Dr. Michael Schneider DC, PhD Associate Professor School of Health and Rehabilitation Sciences  University of Pittsburgh Dr. Schneider[/caption] Dr. Michael Schneider DC, PhD Associate Professor School of Health and Rehabilitation Sciences University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Lumbar spinal stenosis (LSS) is one of the fastest growing problems in the country due to its aging population. One third of Medicare users have the condition, and it is the number one reason for spine surgery in this population. Existing research evaluates the benefits of nonsurgical treatment options compared to surgery, but there was no existing research that compared the available nonsurgical options to each other to determine the best course of treatment for each patient. We studied three nonsurgical treatments for LSS: medical management with medications and/or epidural injections, individualized care with a physical therapist or chiropractor, and group exercise. We assessed each of these treatment methods with a questionnaire, a walking distance test, and a physical activity monitor. 
Author Interviews, Bone Density, NEJM, Orthopedics / 21.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46675" align="alignleft" width="200"]Prof Ian Reid Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand Prof. Reid[/caption] Prof Ian Reid MD Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand MedicalResearch.com: What is the background for this study?  Response: Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with osteopenia is unknown. Most fractures in postmenopausal women occur in osteopenic patients, so therapies with efficacy in osteopenia are needed.
Author Interviews, Orthopedics, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46653" align="alignleft" width="160"]Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 Dr. Duren[/caption] Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The motivation for this study is the apparent accelerated maturity in children in the United States. [caption id="attachment_46650" align="alignleft" width="139"]Radiogram of distal tibia (left) and fibula (right) showing two epiphyseal plates. Wikipedia Image Radiogram of distal tibia (left) and fibula (right) showing two epiphyseal plates.
Wikipedia Image[/caption]   We previously demonstrated that skeletal maturity (bone age) is more advanced in today’s children compared to children born in the first half of the 20thCentury (Duren et al., 2015). n the current study (Boeyer et al., 2018) we show that a significant component of this advanced maturity status is the timing of epiphyseal fusion. In our study, nearly half of the epiphyses of the hand and wrist began or completed fusion significantly earlier in children born after 1995 than those born in the early part of the century, with differences as great as six to ten months for some bones, and mean differences on the order of 4 months in boys and 6 months in girls. 
Author Interviews, Depression, Hip Fractures, Lancet / 06.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46429" align="alignleft" width="100"]Prof .Gillian Mead Chair of Stroke and Elderly Care Medicine Prof. Mead[/caption] Prof. Gillian Mead Chair of Stroke and Elderly Care Medicine [caption id="attachment_46430" align="alignleft" width="100"]Prof Martin Dennis Chair of Stroke Medicine Prof. Dennis[/caption] Prof. Martin Dennis Chair of Stroke Medicine Centre for Clinical Brain Sciences The University of Edinburgh   MedicalResearch.com: What is the background for this study? Response: We are both practicing stroke physicians as well as clinical trialists. Therefore our interest in this area was triggered by the exciting results of the FLAME trial in 2011. This appeared to indicate that fluoxetine might boost the recovery of stroke patients. Potentially this was very important given the increasing numbers of people having disability due to stroke, and the fact that fluoxetine is inexpensive and could be introduced very easily into clinical practice. We were further encouraged by the large numbers of small RCTs we identified when we carried out a Cochrane systematic review on the topic. These trials provided more evidence of potential benefit but there was evidence that trials of greater quality showed less benefit, and benefits were greater in patients who were depressed. We felt there was a need for more evidence derived from much larger numbers of patients.
Author Interviews, Cost of Health Care, Geriatrics, Osteoporosis / 08.10.2018

MedicalResearch.com Interview with: [caption id="attachment_45111" align="alignleft" width="129"]Kandice A. Kapinos, Ph.D. Economist Professor RAND Corporation Pardee RAND Graduate School  Dr. Kapinos[/caption] Kandice A. Kapinos, Ph.D. Economist Professor RAND Corporation Pardee RAND Graduate School  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The economic burden of osteoporotic fractures is substantial with studies estimating the annual healthcare cost burden between $10 to 17 billion. Although estimates from individual studies vary, most studies assessing costs after a fracture only explore up to twelve months following a fracture. There is little investigation of how fracture patients’ costs evolve over a longer post-fracture period. As osteoporotic fractures are one of the most common causes of disability among older adults and can translate into greater medical costs, we focused on studying Medicare beneficiaries. In fact, previous research has suggested that most of the increase in Medicare spending over time can be explained from costs associated with treating higher risk Medicare beneficiaries. Our objective in this study was to compare health care costs over a 3-year period of those who experienced a fracture to those who did not among a sample of Medicare beneficiaries who were at an increased risk of having a fracture. Consistent with previous studies, we found a significant increase in expenditures in the year immediately following a fracture relative to controls: almost $14,000 higher for fractures relative to controls. However, at 2 and 3-years post-fracture, there were no significant differences in the change in expenditures between fracture cases and controls. We note that these findings may be different for beneficiaries living in skilled nursing facilities or other non-community-based settings.
Author Interviews, NEJM, Osteoporosis / 04.10.2018

MedicalResearch.com Interview with: [caption id="attachment_44909" align="alignleft" width="200"]Prof Ian Reid Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand  Prof. Reid[/caption] Prof Ian Reid Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with less marked bone loss (referred to as osteopenia) is unknown. Most fractures in postmenopausal women occur in osteopenic patients, so therapies with efficacy in osteopenia are needed.
Author Interviews, JAMA, Orthopedics, Surgical Research / 03.10.2018

MedicalResearch.com Interview with: "Meniscus adalah tisu/rawan berbentuk huruf C yang berfungsi mencegah dua tulang bergesel di antara satu sama lain di bahagian lutut. Tisu meniscus yang koyak berpunca kebiasaannya daripada bersukan yang melibatkan pergerakan lutut yang banyak. Warga emas" by Rawatan Alternatif Shah Alam is licensed under CC BY 2.0 Victor A. van de Graaf, MD OLVG Ziekenhuis Amsterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although meniscal surgeries are among the most frequently performed surgical procedures in orthopedic surgery, until just recently there were hardly any randomized trials proving its superiority over conservative treatment. In this randomized clinical trial, including 321 patients with non-obstructive (e.g. no locking of the knee joint) meniscal tears, we found physical therapy non-inferior to arthroscopic partial meniscectomy. 
Author Interviews, Emory, JAMA, Orthopedics / 25.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44772" align="alignleft" width="200"]Dr-David-Howard Dr. Howard[/caption] Prof. David H. Howard PhD Department of Health Policy and Management Emory University Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a lot of skepticism that physicians respond to evidence, especially when trials report that widely-used, separately-reimbursed procedures are not effective. Physicians are reluctant to abandon treatments. This study shows that in the case of knee arthroscopy, evidence has made a difference. The use of knee arthroscopy declined by 23% in Florida between 2002 and 2015. This change occurred despite increases in the prevalence of osteoarthritis. 
Author Interviews, Genetic Research, Osteoporosis, PLoS, Stanford / 29.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43561" align="alignleft" width="150"]Stuart Kim - PhD Professor of Developmental Biology, Emeritus Bio-X Affiliated Faculty James H. Clark Center Stanford University Dr. Kim[/caption] Stuart Kim PhD Professor of Developmental Biology, Emeritus Bio-X Affiliated Faculty James H. Clark Center Stanford University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Osteoporosis is caused by a reduction in bone mass, and leads to a high incidence of bone fracture because the weakened bone is less able to withstand the stress of slips and falls. Osteoporosis affects millions of elderly, is responsible for as many as 50% of fractures in women and 25% of fractures in men over the age of 50, and accounts for $19 billion in annual health care costs in the US. Identification of people with an increased genetic risk for osteoporosis could reduce the incidence of bone fracture. Low BMD is also a risk factor for stress fractures. For athletes and military personnel undergoing harsh rigors of training, stress fractures are common injuries that limit playing time, military effectiveness and competitive success. Using data from UK Biobank, a genome-wide association study identified 1,362 independent SNPs that clustered into 899 loci of which 613 are new. These data were used to train a genetic algorithm using 22,886 SNPs as well as height, age, weight and sex as predictors. Individuals with low genetic scores (about 2% of those tested) showed a 17-fold increase in risk for osteoporosis and about a 2-fold increase in risk of fractures.