New Research States Smoking Decreases Hip Replacement Risk
Smoking is bad for your health, but also bad for your hips? A new study from down under Australia has found that men who smoke are less likely than nonsmokers to require total hip or knee replacement. Who knew. The researchers also found that being overweight or doing vigorous physical activity actually increased the likelihood of joint replacement.
George Mnatzaganian, a Ph.D. student stated:
"Our study is the first to demonstrate a strong inverse correlation between smoking duration and risk of total joint replacement. The independent inverse associations of smoking with risk of total joint replacement were evident also after adjusting for major confounders and after accounting for the competing mortality risk in this elderly [group] of men. Further investigation is needed to determine how smoking impacts the development of osteoarthritis (OA)."
Often, the cause of OA is unknown. It is mainly related to aging. The symptoms of OA usually appear in middle age. Almost everyone has some symptoms by age 70. However, these symptoms may be minor. Before age 55, OA occurs equally in men and women. After age 55, it is more common in women.
Australian researchers analyzed the medical records of 11,388 men who were followed from 1996-1999 to March 2007. During that time, 857 of the men had either total knee replacement (59%) or total hip replacement (41%).
The investigators found that being overweight independently increased the risk of total joint replacement, while smoking lowered the risk. This reduced risk was most evident after 23 years of smoking, and men who smoked 48 years or more were up to 51% less likely to undergo joint replacement than men who never smoked, the study showed.
According to the 2007 National Hospital Discharge Survey, about 230,000 Americans had hip replacements and 543,000 had knee replacements that year. Severe osteoarthritis was the most common reason for the procedures.
Total hip replacement is most commonly used to treat joint failure caused by osteoarthritis. Other indications include rheumatoid arthritis, avascular necrosis, traumatic arthritis, protrusio acetabuli, certain hip fractures, benign and malignant bone tumors, arthritis associated with Paget's disease, ankylosing spondylitis and juvenile rheumatoid arthritis.
The aims of the procedure are pain relief and improvement in hip function. Hip replacement is usually considered only once other therapies, such as physical therapy and pain medications, have failed.
A total hip replacement (total hip arthroplasty) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently the most successful and reliable orthopaedic operation with 97% of patients reporting improved outcome.
Source: The American College of Rheumatology
Most Obese States, Least Active Named In New Fitness Report
In two new reports, the most obese and the least active states have been named. Sixteen out of the 50 U.S. states have gotten fatter according to a new report released this week. Thus, obesity rates in a dozen states have risen about 30% with Mississippi being the largest state in the commonwealth overall. Jackson, MI comes in as the nation's fourth least active city in parallel.Mississippi has an adult obesity rate of 34.4% and Colorado is winning with a rate of 19.8% obesity level overall, being the only state with an adult obesity rate below 20%. Four years ago, only one U.S. state had an adult obesity rate above 30%, according to the report.
The study also explained that over the past 15 years, seven states have doubled their rate of obesity and 10 states have doubled their rate of diabetes, and since 1995, obesity rates have risen fastest in Oklahoma, Alabama and Tennessee, while Colorado, Connecticut and Washington, D.C., had the slowest increases.
This somewhat coincides with a similar study presented by Men's Health Magazine last month that listed Jackson, Mississippi as the third least active city in The Union.
Lexington, Kentucky, with its really blue bluegrass, world class horse farms and home of the University of Kentucky Wildcats, ranks as the absolutely laziest city in the United States. Indianapolis in Indiana and Jackson, Mississippi also ranked among the least active, while Seattle, San Francisco and Oakland, California were the most physically active.
Editors looked at how often residents exercise, the number of households that watched 15 hours of cable television a week and bought more than 11 video games a year, and the rate of DVT, a blood clot in a vein, usually in the leg, which is associated with inactivity. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage
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Steroid Testing For New Jersey Police Officers
In response to a report that revealed officers routinely using state health benefits to acquire steroids, New Jersey Attorney General, Paula Dow announces plans to test police officers for illegal steroid use. Anabolic steroids and human growth hormone will be added to the list of tested substances.The tests will be funded by local departments, which effectively means they can decide when the tests are carried out, and even whether or not to do them.
Departments are being encouraged locally to have officers self-report steroid usage.
Police officers who are found to have steroids or growth hormones in their blood will have to produce a doctor's letter showing that a prescription was issued, and that the medication had a clinical reason. The letter must also state that the treatment will not undermine how that officer carries out his/her duties.
As soon as the reform is in place, the Attorney General will issue a communiqué explaining the administrative action and what penalties users may face if they illegally use or acquire steroids or human growth hormones.
According to a Star Ledger report last year, hundreds of police officers in New Jersey acquired steroids through Dr. Joseph Colao, who apparently made false diagnoses. Their prescriptions were filled through police public health plans.
The steroids and human growth hormones were used for enhance muscle growth.
A subsequent investigation found that officers' medical claims appeared to go through without much scrutiny. Additionally, the investigation found that doctors who issued fake prescriptions were not penalized.
In 2010, the state of New Jersey spent $11.2 million covering human growth hormone (200 employees) and steroid prescriptions (6,000 employees).
The new legislation will facilitate the prosecution of police officers who use steroids illegally.
Attorney General Dow said:
"It is important that we strengthen oversight, regulation and investigation in order to discourage the improper use of steroids throughout New Jersey's law enforcement community and ensure the public's confidence. Law enforcement holds a special trust based on its authority and must be held to the highest standard of professionalism. These reforms tighten the safeguards against abuse not only by law enforcement, but by other members of public health plans and doctors who improperly prescribe these substances."
"Attorney General Announces Strict Reforms to Curtail Improper Steroid Use Among Law Enforcement in New Jersey."
Department of Law and Public Safety - Office of the Attorney Genera, New Jersey
Written by Christian Nordqvist
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Europe's Suicide Rates Up Following Financial Crisis
Suicide rates among the under-65s in the European Union (EU) rose markedly between 2007 and 2009, with Greece, Ireland and Latvia rising the most, say researchers who have been taking a first look at how the financial crisis affected deaths in the EU. The period also saw an increase in road deaths, especially in new member countries, probably due to a greater number of unemployed people making fewer car journeys.
Writing in The Lancet this week, Dr David Stuckler from the University of Cambridge, Professor Martin McKee of the London School of Hygiene and Tropical Medicine, both in the UK, and Dr Sanjay Basu, from the University of California San Francisco, in the US, and colleagues, say that up to 2007 there had been a steady decline in suicide rates among people aged 65 and under in the EU, but it reversed after that.
Rates of unemployment fell by 2.6% between 2007 and 2009, a 35% relative increase, across the whole of the EU. The reversal in suicide trends coincides with this, say the authors.
They looked at the EU as two groups: the "old" member states, and the "new" ones who joined in 2004, and found that the 2008 increase in suicide from 2007 was less than 1% in the new member states, but nearly 7% in the old ones. And in both groups the rates went up further in 2009.
"Among the countries studied, only Austria had fewer suicides (down 5%) in 2009 than in 2007 [despite a simultaneous increase in unemployment of 0.6%]. In each of the other countries the increase was at least 5%," they write.
They refer to an earlier paper where they propose that strong social support networks and social protection measures, including active labour market policies, can help prevent suicides, and perhaps this explains the figures for Austria.
In the past, Finland, a country that also has a strong social protection system, has also shown resilience against suicide during times of economic downturn, but in this latest financial crisis, they saw an unexpected increase in suicides of over 5%.
One of the problems the authors faced in their analysis is because data is more detailed from some countries than others, this affects the overall pattern. For instance, among the "old" members, the UK has the biggest influence, and Romania's data has the biggest effect on the "new" member patterns.
They say they will update their figures as more data becomes available from other countries, but they maintain the current figures are good enough to see that:
"... countries facing the most severe financial reversals of fortune, such as Greece and Ireland, had greater rises in suicides (17% and 13%, respectively) than did the other countries, and in Latvia suicides increased by more than 17% between 2007 and 2008."
The authors note that road traffic deaths in the EU also fell substantially, particularly in the new member countries, where they were very high at first. Thus deaths on the roads of Lithuania, a new member to the EU, fell rapidly, by almost 50%, whereas in the Netherlands, an "old" member country, where road deaths were already low, they fell hardly at all.
The analysis appears to echo what is happening outside the EU. For instance in the US, road deaths fell by 10% between 2007 and 2009. This is thought to be due to less use of the car at times of higher unemployment.
The fall in road deaths has reduced the availability of organs for transplant. This problem has particularly affected Spain and Ireland, where road deaths have fallen by more than 25% between 2007 and 2009.
Apart from the increase in suicide rates and reduction in road deaths, the authors say they can see no other major deviations from past trends in deaths from all causes.
They conclude that their findings "reveal the rapidity of the health consequences of financial crises".
The authors are now working on a more detailed analysis of the health effects of the crises, using a number of information sources, including individual level data from European household surveys together with results on the effects various policies.
They want to find out why some individuals, communities and societies seem to be more vulnerable while others appear more resilient to economic shocks. And also how different measures taken by governments influence health.
"There is clearly much more to be written on the health consequences of the events of 2008," they write.
"Effects of the 2008 recession on health: a first look at European data."
David Stuckler and others.
The Lancet Vol 378, published online 9 July 2011.
Source : The Lancet Press Office.
Written by: Catharine Paddock, PhD
Man Receives New Windpipe Made From His Own Stem Cells And Artificial Material
Last month in Sweden, a man suffering from late-stage tracheal cancer received a new windpipe made in the lab from a synthetic scaffold with flesh grown from his own stem cells. This is the first successful transplant in the world of a tissue-engineered trachea that does not use a scaffold made from a donor organ.The 36-year-old man is due to be discharged today: he is not taking immunosuppressant drugs because the transplanted tissue was made with his own cells, said the hospital.
The operation took place on 9 June 2011 at the Karolinska University Hospital in Huddinge, Stockholm. Professor Paolo Macchiarini, who works at the Hospital and the Karolinska Institutet, led the international transplant team.
Macchiarini, a world expert in regenerative medicine, has successfully transplanted tissue-engineered tracheas before, for instance at the Hospital Clinic of Barcelona. But those tissue-engineered windpipes used "scaffolds" from trachea taken from organ donors. In those procedures the donated windpipe has the donor cells stripped away, leaving just the extracellular matrix, and then the recipient's stem cells are used to seed new tissue onto the scaffold.
This new operation is a world first because it used an artificial scaffold made from a nanocomposite polymer material (a sort of spongy and flexible plastic made of extremely small building blocks).
Also on the team were Professor Alexander Seifalian of University College London in the UK, who designed and built the Y-shaped scaffold, and members from Harvard Bioscience in Boston in the US, who custom-produced the bioreactor that, in only two days, grew the flesh onto the scaffold from the patient's own stem cells.
The man's cancer had progressed to the point where he needed a transplant but no suitable donor organ was available. The tumor in his trachea was about 6 cm long and beginning to spread to a main bronchus, a tube that leads to a lung. He had received maximum treatment with radiotherapy, but to no avail.
The tissue-engineered option was the only one left to save his life. He was receiving cancer treatment at Landspitali University Hospital in Iceland, under the supervision of Professor Tomas Gudbjartsson who referred him to the Swedish hospital. Gudbjartsson was also on the transplant team.
The successful transplant brings hope to thousands of other patients who have late-stage tracheal cancer or other conditions that block the passage of air into the lungs. Children in particular would benefit from having this option, since child donor tracheas are much harder to obtain.
In a CNN-reported comment to the media about the significance of the operation, Macchiarini described it as a "beautiful international collaboration":
"If scientists and clinicians work together, we can help humanity," he said.
Source : Karolinska University Hospital, CNN.
Written by: Catharine Paddock, PhD
