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Tag: Arthritis

  • Quarter of former Olympians suffer from osteoarthritis, study says

    Quarter of former Olympians suffer from osteoarthritis, study says

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    Newswise — One in four retired Olympians reported a diagnosis of osteoarthritis, the form of arthritis that causes changes in the joint and can lead to discomfort, pain and disability, the research found.

    Elite retired sportspeople who had experienced a sports-related injury had a higher chance of knee and hip osteoarthritis when compared with the general population.

    The athletes – who had competed at an Olympic level in 57 sports including athletics, rowing and skiing – also had an increased risk of lower back pain overall, and shoulder osteoarthritis after a shoulder injury.

    Researchers hope the findings will help develop new approaches in injury prevention for the benefit of athletes now and in retirement.

    The study – led by a University of Edinburgh based researcher – is the largest international survey of its kind, and the first to observe the consequences of osteoarthritis and pain in different joints from retired elite athletes across different summer and winter Olympic sports.

    Researchers quizzed 3,357 retired Olympians aged around 45 on injuries and the health of their bones, joints, muscles and spine. They were also asked if they were currently experiencing joint pain, and if they had an osteoarthritis diagnosis.

    For comparison, 1,735 people aged around 41 from the general population completed the same survey.

    Researchers used statistical models to compare the prevalence of spine, upper limb and lower limb osteoarthritis and pain in retired Olympians with the general population.  

    The team considered factors that could influence the risk of pain and osteoarthritis such as injury, recurrent injury, age, sex and obesity.

    They found that the knee, lumbar spine and shoulder were the most injury prone areas for Olympians. These were also among the most common locations for osteoarthritis and pain.

    After a joint injury the Olympians were more likely to develop osteoarthritis than someone sustaining a similar injury in the general population, the research found

    The sportspeople also had an increased risk of shoulder, knee, hip and ankle and upper and lower spine pain after injury, although this did not differ with the general population.

    Dr Debbie Palmer, of the University of Edinburgh’s Moray House School of Education and Sport, said: “High performance sport is associated with an increased risk of sport-related injury and there is emerging evidence suggesting retired elite athletes have high rates of post-traumatic osteoarthritis.

    “This study provides new evidence for specific factors associated with pain and osteoarthritis in retired elite athletes across the knee, hip, ankle, lumbar and cervical spine, and shoulder, and identifies differences in their occurrence that are specific to Olympians.”

    Researchers say the study may help people make decisions about recovery and rehabilitation from injuries in order to prevent recurrences, and to inform prevention strategies to reduce the risk and progression of pain and OA in retirement.

    Two linked studies are published in the British Journal of Sports Medicine.

    Open access version of the paper are available here: Part 1 –https://www.research.ed.ac.uk/en/publications/prevalence-of-and-factors-associated-with-osteoarthritis-and-pain

     Part 2 – https://www.research.ed.ac.uk/en/publications/prevalence-of-and-factors-associated-with-osteoarthritis-and-pain-2

    The World Olympians Association funded the Retired Olympian Musculoskeletal Health Study with a research grant from the International Olympic Committee.

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  • Have Celiac Disease? You May Need Screening for Other Disorders

    Have Celiac Disease? You May Need Screening for Other Disorders

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    SOURCES:

    Katarina Mollo, dietitian, Boston. 

    Alessio Fasano, MD, professor of pediatrics and gastroenterology, Massachusetts General Hospital; professor of nutrition, Harvard T.H. Chan School of Public Health; professor of pediatrics, Harvard Medical School. 

    Jolanda Denham, MD, pediatric gastroenterologist, Nemours Children’s Hospital, Florida.

    Benjamin Lebwohl, MD, president, Society for the Study of Celiac Disease; director of clinical research, Celiac Disease Center, Columbia University.

    Robert Rapaport, MD, pediatric endocrinologist, Kravis Children’s Hospital, New York City; professor of pediatric endocrinology and diabetes, Icahn School of Medicine, Mount Sinai. 

    Journal of Diabetes: “Screening for celiac disease in youth with type 1 diabetes: Are current recommendations adequate?”

    Edwin Liu, MD, pediatric gastroenterologist, Children’s Hospital Colorado; director, Colorado Center for Celiac Disease.

    Gastroenterology and Hepatology from Bed to Bench: “Prevalence of celiac disease serological markers in a cohort of Italian rheumatological patients.”

    Celiac Disease Foundation: “What is Celiac Disease?”

    Pediatric Rheumatology: “In a large Juvenile Idiopathic Arthritis (JIA) cohort, concomitant celiac disease is associated with family history of autoimmunity and a more severe JIA course: a retrospective study.”

    Therapeutic Advances in Gastroenterology: “Screening for celiac disease in average-risk and high-risk populations.” 

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  • Study Examines Total Knee Replacement in Patients Under 21

    Study Examines Total Knee Replacement in Patients Under 21

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    Newswise — A new study from researchers at Hospital for Special Surgery (HSS) has evaluated trends in the use of total knee arthroplasty (TKA) in patients under 21 in the United States. The study was reported at the American College of Rheumatology (ACR) Convergence 2022 meeting (abstract number 08780).

    According to Cynthia A. Kahlenberg, MD, MPH, an orthopedic surgeon at HSS and a coauthor of the study, TKA is rarely performed in patients under 21 years old but may be done in this population due to conditions such as inflammatory arthritis or juvenile idiopathic arthritis (JIA), malignant or non-malignant tumors, or trauma. However, the number of patients under the age of 21 undergoing TKA in the U.S. is unknown. In one of the largest U.S. studies of an institutional arthroplasty registry, only 19 TKAs were performed in patients under the age of 21 out of approximately 30,000 primary TKAs over 34 years—a majority of which were for JIA.

    The researchers retrospectively analyzed the Kids’ Inpatient Database (KID), a national weighted sample of all inpatient hospital admissions of patients under 21 years old in approximately 4,200 hospitals in 46 states. The researchers used International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 codes to identify patients undergoing TKA from 2000-2016 and determine primary diagnosis. Descriptive statistics such as means and percentages, along with their 95% confidence intervals (95% CI), were calculated using the appropriate sample weights as recommended by the Agency for Healthcare Research and Quality for use with the KID dataset.

    The total weighted number of TKAs performed in patients younger than 21 from 2000-2016 was 1,331; the number of TKAs performed per year in this age group remained relatively stable. The mean age of patients undergoing TKA was 14.8 years (95% CI, 14.4-15.2); 48.8% of the cohort was female. Among tumor patients, a higher proportion identified as Hispanic (22.1%) or other race (12.6%) compared to the non-tumor cohort; 70.3% of TKAs were performed for a primary diagnosis of a tumor; and the number of TKAs for malignant tumors increased slightly over the study period. In contrast, use of TKA for inflammatory arthritis / JIA decreased by more than 70% over the study period, likely due to improvements in medical management of inflammatory arthritis / JIA patients. The majority of TKAs were performed in urban teaching hospitals and in facilities with a large bed size, which likely reflects the complexity and rarity of these procedures.

    “This was one of the first studies to take an in-depth look at TKA in this very young population,” said Dr. Kahlenberg. “Our study was able to confirm that tumors were the most common reason for knee arthroplasty in this population.”

    “I think the biggest takeaway as a rheumatologist is that we are doing a good job treating these patients and over the years the treatments for inflammatory arthritis are really working well in this young population,” said Bella Mehta, MBBS, MS, rheumatologist at HSS and senior study author.

    About HSS

    HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

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    Hospital for Special Surgery

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  • Study Finds Chronic-Pain Management, Falls and Limited Access to Care Are Critical Issues Among Medically Underserved

    Study Finds Chronic-Pain Management, Falls and Limited Access to Care Are Critical Issues Among Medically Underserved

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    Newswise — To improve the health of a community, the first step is to identify its most pressing needs. To that end, in 2022 Hospital for Special Surgery (HSS) implemented a community-based participatory research (CBPR) approach to assess musculoskeletal health needs, identify health disparities and support the development of initiatives to address unmet needs.

    Critical issues included a lack of health education and awareness in managing arthritis and other painful conditions; a high incidence of falls in the community; and limited access to care among underserved populations.

    The study, “Assessing Musculoskeletal Health Needs of Underserved Patients & Community Members Using a Community Based Participatory Research Approach,” was presented virtually at ACR Convergence 2022, the annual meeting of the American College of Rheumatology in Philadelphia.

    “Musculoskeletal disorders are the most prevalent health conditions in the United States, resulting in financial and social burdens, especially in underserved communities,” explained Titilayo Adeniran, MPH, director of outcomes & data analytics at the HSS Education Institute. “Studies show that musculoskeletal health disparities disproportionately affect women, older adults and racial/ethnic minorities.”

    HSS researchers used a mixed-method approach to develop a Community Health Needs Assessment (CHNA). “For quantitative data, we distributed a community survey in four languages—English, Spanish, Chinese and Russian—to assess the socio-demographic characteristics of the populations we serve; health status and quality of life; health behavior and lifestyle; use of and access to care; and health education needs,” explained Adeniran. “For qualitative data, we conducted interviews with 22 community partners, including community-based organizations, city and state agencies and universities.”

    The survey was distributed in various ways, including online, via email, using Alchemer panels, in person, and through the mail over a four-week period from January 15 to February 15, 2022. A total of 18,248 patients and community members completed the surveys, with 57% representing a diverse and underserved population.

    In addition to the surveys, interviews with community partners provided valuable insights into unmet health needs, Adeniran noted. Community organizations represented all five boroughs of New York City, as well as surrounding areas serving racially/ethnically diverse populations. They represented all age, gender, and socioeconomic groups.

    Key findings:

    • Chronic pain, osteoarthritis or another form of arthritis were the most common musculoskeletal conditions reported in the survey.
    • Among respondents with a musculoskeletal condition, a lack of confidence in managing symptoms emerged as a health need, particularly among medically underserved community members.
    • Almost one-third of all respondents reported falling in the past year.
    • Those with chronic pain, fibromyalgia or lupus were more likely to report two or more weeks of poor physical and mental health.
    • Medically underserved respondents diagnosed with lupus, chronic pain or rheumatoid arthritis were more likely to have used a prescription opioid to manage pain.
    • Health education emerged as a major need, with 70% of respondents reporting no participation in health education in the past 12 months. The top reasons were fear of COVID-19 and not knowing about educational programs.
    • The top issues impacting respondents’ health and well-being were COVID-19 related issues, social isolation/loneliness, limited places to exercise, and limited access to healthy foods.
    • The survey identified a need to address access to healthcare, with 42% of respondents reporting they could not access healthcare in the past 12 months, compared to 8% in a previous survey conducted in 2019. The top barriers were difficulty getting an appointment, lack of affordability or a service not covered by insurance. The need for transportation was also cited among the medically underserved.
    • The most common type of discrimination reported in medical settings was that a doctor or nurse was not listening to the respondent. More than half of those taking the survey cited this issue.

    “Broad community engagement is crucial to the success of any CBPR approach when assessing the health needs of the community and identifying health disparities,” said Sandra Goldsmith, MA, MS, RD, assistant vice president at the HSS Education Institute. “The results of our study will enable us to raise awareness about disparities that continue to affect our diverse and underserved populations and help us develop community-based initiatives to promote health equity.”

     

    Titilayo Adeniran, Bertilia Trieu, Sandra Goldsmith and Laura Robbins, Hospital for Special Surgery, New York, NY

    About HSS

    HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

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    Hospital for Special Surgery

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  • HSS Rheumatologists, Social Worker Honored by American College of Rheumatology

    HSS Rheumatologists, Social Worker Honored by American College of Rheumatology

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    Newswise — The American College of Rheumatology (ACR) and the Association of Rheumatology Professionals (ARP) have honored two rheumatologists and a social worker at Hospital for Special Surgery (HSS) with prestigious awards. Each year, the ACR and ARP recognize members who have made outstanding contributions to the field of rheumatology. The ceremony took place at the ACR Convergence meeting in Philadelphia on November 12.

    Michael Lockshin, MD, received the ACR Distinguished Clinician Scholar Award, which honors a rheumatologist who has made outstanding contributions in clinical medicine, clinical scholarship or education.

    Melanie Smith, MD, PhD, received the ACR Distinguished Fellow Award, which recognizes clinical and research fellows who are in a rheumatology fellowship training program and have performed meritoriously.

    Adena Batterman, LCSW, MSW, received the ARP Distinguished Clinician Award. It is presented to an ARP member who is engaged in clinical practice and demonstrates outstanding clinical expertise in arthritis and the rheumatic diseases.

    “HSS is extremely proud of our team members who have been honored with these notable awards,” said Louis A. Shapiro, president and CEO of HSS. “We warmly congratulate them for their contributions and achievements in patient care, research, support and education.”

    Michael Lockshin, MD

    Dr. Lockshin’s award follows a career spanning more than four decades at HSS. When asked about receiving the honor, he said, “I think it honors those who surrounded and challenged me more than it does me—patients who asked hard questions; the team led by Charles Christian that trained me and with whom I was privileged to work; intellectually curious colleagues, students and fellows; Hospital for Special Surgery, which gave me freedom to pursue goals I thought were worthwhile; and my wonderful family.”

    Director emeritus of the Barbara Volcker Center for Women and Rheumatic Disease at HSS, Dr. Lockshin is a preeminent expert in the long-term care of chronically ill patients. His research enabled him to develop special expertise in solving health-care issues associated with systemic lupus erythematosus, antiphospholipid antibody syndrome and other autoimmune diseases that predominantly affect women.

    Dr. Lockshin continues to conduct research and engage in mentoring activities at HSS. His current work focuses on diagnostic uncertainty, the topic of an international conference he organized last year. He has also published a white paper and written a book on the subject.

    Melanie Smith, MD, PhD

    Dr. Smith describes her Distinguished Fellow award as an incredible honor. “It is a testament to the opportunities I have had during my fellowship training and the amazing group of mentors that have supported my development as both a physician and a scientist,” she said. “I am excited to embark on a career dedicated to understanding mechanisms of disease with the goal of improving care for our patients.”

    Dr. Smith, now a staff rheumatologist at HSS, specializes in treating inflammatory arthritic conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Sjogren’s syndrome and gout/pseudogout. She also treats patients with osteoarthritis. Her research focuses on how cells that make up the healthy joint lining change when an individual develops rheumatoid arthritis.

    Adena Batterman, LCSW, MSW

    Adena Batterman, recognized with the ARP Distinguished Clinician Award, is senior manager of the Inflammatory Arthritis Support and Education Programs at HSS. “I feel honored and grateful to be recognized for clinical work and research that enhances the lives, and elevates the voices, of patients,” she said. “I’m grateful to be engaged in work made possible by colleagues and mentors that continues to have deep personal and professional meaning to me.”

    Ms. Batterman develops and oversees support and education programs designed to address the multifaceted needs of patients with inflammatory arthritis during the many stages of their illness. The programs provide essential information to help participants make informed decisions about management and treatment; offer peer support and coping strategies; and create a forum in which members can share their experiences and feelings.

    “I commend our HSS colleagues who have been honored by two of the foremost organizations advancing the field of rheumatology,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. “Our colleagues’ hard work, skill and dedication have enabled them to excel in their respective specialties. Their contributions have helped HSS achieve a leadership role in rheumatology to improve the lives of patients with exceptional care and vital research.”

    About HSS

    HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 13th consecutive year), No. 3 in rheumatology by U.S. News & World Report (2022-2023), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2022-2023). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a third consecutive year (2023). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.

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    Hospital for Special Surgery

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  • Genetic twist: Medieval plague may have molded our immunity

    Genetic twist: Medieval plague may have molded our immunity

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    Our Medieval ancestors left us with a biological legacy: Genes that may have helped them survive the Black Death make us more susceptible to certain diseases today.

    It’s a prime example of the way germs shape us over time, scientists say in a new study published Wednesday in the journal Nature.

    “Our genome today is a reflection of our whole evolutionary history” as we adapt to different germs, said Luis Barreiro, a senior author of the research. Some, like those behind the bubonic plague, have had a big impact on our immune systems.

    The Black Death in the 14th century was the single deadliest event in recorded history, spreading throughout Europe, the Middle East and northern Africa and wiping out up to 30% to 50% of the population.

    Barreiro and his colleagues at the University of Chicago, McMaster University in Ontario and the Pasteur Institute in Paris examined ancient DNA samples from the bones of more than 200 people from London and Denmark who died over about 100 years that stretched before, during, and after the Black Death swept through that region.

    They identified four genes that, depending on the variant, either protected against or increased susceptibility to the bacteria that causes bubonic plague, which is most often transmitted by the bite of an infected flea.

    They found that what helped people in Medieval times led to problems generations later — raising the frequency of mutations detrimental in modern times. Some of the same genetic variants identified as protective against the plague are associated with certain autoimmune disorders, such as Crohn’s disease, rheumatoid arthritis and lupus. In these sorts of diseases, the immune system that defends the body against disease and infection attacks the body’s own healthy tissues.

    “A hyperactive immune system may have been great in the past but in the environment today it might not be as helpful,” said Hendrik Poinar, an anthropology professor at McMaster and another senior author.

    Past research has also sought to examine how the Black Death affected the human genome. But Barreiro said he believes theirs is the first demonstration that the Black Death was important to the evolution of the human immune system. One unique aspect of the study, he said, was to focus on a narrow time window around the event.

    Monica H. Green, an author and historian of medicine who has studied the Black Death extensively, called the research “tremendously impressive,” bringing together a wide range of experts.

    “It’s extremely sophisticated” and addresses important issues, such as how the same version of a gene can protect people from a horrific infection and also put modern people — and generations of their descendants — at risk for other illnesses, said Green, who was not involved in the study.

    All of this begs the question: Will the COVID-19 pandemic have a big impact on human evolution? Barreiro said he doesn’t think so because the death rate is so much lower and the majority of people who have died had already had children.

    In the future, however, he said more deadly pandemics may well continue to shape us at the most basic level.

    “It’s not going to stop. It’s going to keep going for sure.”

    ———

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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