Bariatric Surgery Improves Total Joint Replacement Recovery in Obese Patients

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A recent study by Hospital for Special Surgery (HSS) found that weight loss surgery can reduce in-hospital recovery times and decrease postoperative complications associated with total joint replacement. However, it does not reduce the risk of needing revision surgery in the future.

Previous studies have linked obesity to postoperative infection, delayed recovery, decreased functionality, and the need for revision surgery after total knee or hip replacement. Obesity is also a significant risk factor for osteoarthritis, which contributes to joint pain and loss of cartilage.

HHS researchers used the New York Statewide Planning and Research Cooperative System (SPARCS) database to analyze all morbidly obese patients who underwent total knee or hip replacement surgery in New York State between 1997 and 2011. Researchers then compared the cost and treatment outcomes of patients who underwent total knee replacement with no prior weight loss to patients who underwent total knee replacement two years after bariatric surgery.

Using a statistical technique called propensity score matching, researchers determined that patients who underwent bariatric surgery were 75 percent less likely to suffer in-hospital complications after hip replacement surgery and 31 percent less likely to have complications from knee replacement surgery. The risk for developing 90-day postoperative complications was also much lower in this group, with a 14 percent decreased risk after hip replacement and a 61 percent decrease after knee replacement. Weight loss surgery did not, however, reduce the risk of hip dislocation or revision surgery.

“With our data, I think we can say with confidence that bariatric surgery prior to total joint replacement is not a harmful recommendation,” said orthopedic surgeon and lead study author Alexander McLawhorn, MD, MBA. “As an orthopedic surgeon, you are not going to compromise your joint replacement outcome if you advise a morbidly obese patient to seek an opinion from a bariatric surgeon.”

The findings of this study were presented at the American Academy of Orthopedic Surgeons Annual Meeting in March (Source: News-Medical.Net).

Vitamin D for Colon Health

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Several studies have shown that people who have higher levels of serum vitamin D have lower rates of colorectal cancer.

Vitamin D is a fat soluble vitamin that aids in the absorption of nutrients, promotes immune function, and maintains cell communication throughout the body. While vitamin D can be obtained from certain foods, it is also produced naturally when the body is exposed to sunlight.

Vitamin D was first identified as a potential preventive agent for colorectal cancer over twenty years ago. Researchers observed that individuals in the northern and northeastern United States had significantly higher mortality rates from colorectal cancer than those who lived in Hawaii, Florida and southwestern states. These figures were directly correlated with individuals’ serum vitamin D levels.

A more recent meta-analysis, which included data from five observational studies, found that increasing serum vitamin D levels to 34 ng/ml could reduce colorectal cancer incidence rates by half. Increasing serum vitamin D levels even higher produced greater colorectal cancer preventive benefits. Lead researcher Edward Gorham, Ph.D. explained, “We project a two-thirds reduction in incidence with serum levels of 46 ng/ml, which corresponds to a daily intake of 2,000 IU of vitamin D3. This would be best achieved with a combination of diet, supplements and 10 to 15 minutes per day in the sun” (Source: Johns Hopkins Medicine). 

Experts vary in their recommendations for daily vitamin D allowance. However, current guidelines by The Institute of Medicine recommend 600 IU daily for adults between the ages of 19 and 70. Adults over the age of 70 need 800 IU daily.

To meet your daily recommended intake of vitamin D, try to spend at least a few minutes outside soaking up the sun’s rays. Vitamin D production can vary based on season, location, weather conditions, skin tone, and sunscreen use, but estimates show that just 10 to 15 minutes of sun exposure to the arms and legs can produce 3,000 to 20,000 IU of vitamin D (Source: sunshinevitamin.org). You can also increase your vitamin D intake by consuming foods that are naturally rich in this nutrient. These include:

  • Fatty fish such as salmon, tuna, mackerel, and sardines
  • Beef liver
  • Egg yolks
  • Shitake mushrooms
  • Caviar
  • Cod liver oil
  • Vitamin D fortified foods including milk, cheese and orange juice

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Symptoms of Glaucoma

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Glaucoma is the world’s second-leading cause of blindness, affecting 64 million people. Glaucoma refers to a family of eye diseases that are characterized by eye pressure that damage the optic nerve, which is responsible for transmitting visual messages to the brain.

The two most common forms are primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG).

Open-angle glaucoma

Open-angle glaucoma is often referred to as the “sneak thief of sight” because it has no symptoms until significant vision loss has occurred. Most people who have open-angle glaucoma feel completely normal and do notice any changes in their vision. This is because the condition develops slowly, and glaucoma affects peripheral vision first. At the point that a patient notices changes in their vision, the disease is often in an advanced stage. 

Angle-closure glaucoma

Unlike open-angle glaucoma which develops slowly and painlessly, angle-closure glaucoma often happens suddenly. Symptoms of acute angle-closure glaucoma may include

  • Hazy or blurred vision
  • The appearance of rainbow-colored circles around bright lights
  • Severe eye and head pain
  • Nausea or vomiting (accompanying severe eye pain)
  • Sudden sight loss

These symptoms should not be ignored, and the patient must seek medical attention immediately because permanent vision loss could occur.

The best defense against glaucoma is regular comprehensive eye exams. Because this disease can be challenging to detect and treat, you need the expertise of an eye doctor to diagnose it. Most comprehensive eye exams include tonometry, a test that measures the pressure inside your eye. If your eye pressure is elevated, your eye doctor can perform more tests to determine whether you have glaucoma. It is important to diagnose glaucoma in the early stages because glaucoma-related vision loss is irreversible. If it has been some time since you have had a comprehensive eye exam, contact your eye care professional to schedule a preventative check-up.

Weight Loss May Spare Knee Cartilage, Study Finds

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There are several factors that can contribute to the development of osteoarthritis, such as age, family history and previous injury, but one of the greatest risk factors is obesity.

Being overweight is recognized as one of the greatest contributors to the incidence and progression of osteoarthritis, particularly in the knees. Research shows that being just 10 pounds overweight places an additional 30 to 60 pounds of force on the knees with every step. Weight loss has long been recommended by doctors to ease joint pain and discomfort associated with osteoarthritis. Now, researchers have evidence showing that greater weight loss produces greater results.

A recent study evaluated the effects of weight loss in over 500 overweight and obese Americans who had been diagnosed with mild to moderate osteoarthritis or had risk factors for the disease. The subjects were randomly assigned to a group that lost more than 10 percent of their overall body weight, a group that lost a small amount of weight, or a control group that lost no weight.

After a follow-up period of four years, researchers noted that participants who lost a large amount of weight had more protection against cartilage degeneration than participants in other groups. Interestingly, participants who lost just 5 to 10 percent of their overall body weight had almost the same rate of cartilage degeneration as those who lost not weight at all.

Study author Dr. Alexandra Gersing, from the department of radiology and biomedical imaging at the University of California, San Francisco, said that weight loss, along with moderate exercise, is one of the best ways to prevent osteoarthritis. Weight loss not only slows down the rate of cartilage degeneration, but it helps to reduce disease risk overall (Source: WebMD).

Go Green! Why Avocados Could Keep Your Colon Healthy

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Plenty of foods have earned the honored title of “superfood,” but there’s arguably none more deserving than the avocado. Containing more potassium than a banana, more folate than peas, and more vitamin B6 than spinach, this petite green fruit packs a powerful punch in the nutrition department. Avocados are loaded with vitamins, nutrients and healthy fats, and just one medium-sized avocado contains 10 grams of fiber – a whopping 40 percent of your daily recommended intake.

Because of their impressive fiber content, avocados make a great addition to any colon-healthy diet. Research has shown that a low-fat, high-fiber diet rich in fruits, vegetables and whole grains is linked with a decreased risk of colon cancer. According to the American Institute for Cancer Research, for every 10 grams of fiber consumed daily, the risk of colorectal cancer reduces by 10 percent.

Some research suggests that avocados may also contain powerful cancer-fighting ingredients. The outermost flesh of the avocado contains carotenoids, fat-soluble pigments that produce a wealth of health benefits. According to the California Avocado Commission, peeling your avocado the right way will preserve the most beneficial part of the avocado flesh.

“California-grown avocados contain 11 carotenoids. According to USDA’s Agricultural Research Service, avocados contain a complex package of phytonutrients, including carotenoids that may provide numerous health benefits.

Carotenoids appear to protect humans against certain cancers, heart disease and age-related macular degeneration. The UCLA research showed that in California avocados, the greatest concentration of beneficial carotenoids is in the dark green fruit of the avocado closest to the peel.”

To prepare your avocado:

  • Cut it lengthwise around the pit
  • Twist the halves of the avocado apart
  • Embed a knife into the avocado pit and twist gently until the pit becomes dislodged
  • Cut each avocado half lengthwise to create quarters
  • Use your fingers to peel the skin off each slice

Whether you enjoy your avocado on salads, in sandwiches, in guacamole, or just on its own, you’re sure to enjoy a range of health benefits from eating this unique fruit. Its versatility and mild flavor makes it the perfect addition to any dish, and its nutrition content makes it a no-brainer for a healthy diet. Give it a try, and you just might find yourself saying, “An avocado a day keeps the doctor away.”

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Advice for Caregivers during Cataract Awareness Month

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It can be rewarding and exhausting at the same time.

In the midst of caring for others, it is essential to remember your own health needs as well. June is Cataract Awareness Month. This condition affects one in every six Americans over the age of 40. A cataract is a clouding of the eye lens, a condition which is unnoticeable at first but can lead to complete vision loss if left untreated.

The development of a cataract is slow, which means it probably will not cause sudden vision changes. Over time, however, objects will appear more blurry, colors will look faded, and seeing at night will be increasingly difficult. The best gift that you can give is to schedule a comprehensive eye exam for yourself and your loved one. During your eye exam, your doctor will be able to diagnose refractive errors, focusing problems and eye diseases such as cataracts. This means that you both can leave the eye care center with the most updated information on your eye health. If either of you is developing a cataract, your doctor can present treatment options and a timeline that fits your schedule and budget.

Being a caregiver is one of the most important jobs that exists, so don’t let cataracts get in the way. Compromised vision puts your loved one at risk for a debilitating fall or another type of accident in the home. For you as a caregiver, cataracts could prevent you from being able to drive at night or react quickly in an emergency. Take a proactive step toward eye health and schedule two comprehensive eye exams in the month of June. You’ll be glad you did. Thank you for all you do as a loving caregiver.

HCV Infection May Increase Risk of Cataracts

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A team of researchers conducted a population-based study with 11,652 HCV-infected patients for just over five years. All participants were registered with the National Health Insurance (NHI) database of Taiwan and were matched against a control group of correlating age and gender.

The research team found that the HCV-infected patients were 1.36 times more likely to develop cataracts than non-HCV infected patients. Interestingly, patients who were undergoing a specific treatment with interferon-ribavirin therapy were at the greatest risk of developing cataracts. Using interferon-ribavirin therapy to treat HCV almost doubled the risk for developing cataracts compared to patients who were not infected with HCV. After the research was compiled, the researchers did not discourage the use of interferon-ribavirin therapy even though this treatment increased risk of cataract development.

The team defended their position in not discouraging the use of interferon-ribavirin therapy by writing, “Considering the surgical curability of cataract and serious HCV infection-related morbidity, we do not discourage the use of anti-HCV therapy for HCV-infected patients. Instead, we recommend routine screening of these HCV patients for ocular problems, especially those who received interferon alpha–ribavirin therapy.”

The exact connection between these two seemingly unrelated conditions still remains to be seen. What the research suggests is that HCV increases oxidative stress, which can affect multiple body systems. Cataract development is also linked to oxidative stress. However, there are very few studies that link these two conditions, so further research will need to be completed (Source: Hepatitis News Today).

Study Links Anti-Inflammatory Diet to Reduced Bone Loss in Women

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Osteoporosis is a major health concern for women over the age of 50, but this degenerative bone disease isn’t just limited to females. The National Institutes of Health (NIH) estimates that 53 million Americans currently have osteoporosis or are at risk of developing the disease. At least 1 in 3 women and 1 in 5 men will have an osteoporotic fracture at some point in their lifetime.

A recent study at Ohio State University evaluated the effects that diet has on osteoporosis. Tonya Orchard, an assistant professor of human nutrition at Ohio State University, and colleagues analyzed data from the Women’s Health Initiative study and compared levels of inflammatory nutrients in the diet to bone mineral density and incidence of fractures.

The researchers found that women who adhered to anti-inflammatory diets – which are high in fruits, vegetables, fish, and whole grains – lost less bone density during a six year follow-up than women who consumed the highest inflammatory diets, even if they started with lower bone density overall.

“This suggests that as women age, healthy diets are impacting their bones,” said Orchard in a press release. “I think this gives us yet another reason to support the recommendations for a healthy diet in the Dietary Guidelines for Americans.”

Rebecca Jackson, director of Ohio State’s Center for Clinical and Transitional Science, national chair of the Women’s Health Initiative steering committee and senior study author, said these findings confirm previous studies which have linked osteoporosis to inflammatory factors.

“By looking at the full diet rather than individual nutrients, these data provide a foundation for studying how components of the diet might interact to provide benefit and better inform women’s health and lifestyle choices,” she adds.

The findings of this study are published in the Journal of Bone and Mineral Density (Source: Medical News Today).

5 Recent Developments in Colorectal Cancer Incidence and Prevention

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Statistics show that colorectal cancer rates have dropped by 23 percent over the last two decades. But despite this promising trend, colorectal cancer remains the third most common cancer in American men and women today. According to the American Cancer Society’s estimates, 95,520 new cases of colon cancer and 39,910 cases of rectal cancer will be diagnosed this year alone.

Medical information and technology are always changing, and as a result, we’ve seen significant improvements in colorectal cancer screenings, treatments and survival rates over the past several years. The following are some of the most recent trends in colorectal cancer incidence, screening and prevention:

Colorectal cancer rates are declining older adults but increasing in younger adults

Colorectal cancer incidence and mortality rates have dropped significantly in adults over the age of 50, but researchers have noticed a sharp increase in young and middle-aged adults. According to recent findings, people born in 1990 are twice as likely to be diagnosed with colon cancer and four times as likely to be diagnosed with rectal cancer as adults born in the 1950s. Researchers remain unsure as to why young adults are at increased risk, but poor lifestyle choices such as smoking, unhealthy diet, alcohol use, and sedentary lifestyle are possible explanations.

Research links smoking to synchronous colorectal cancers

A prospective study linked cigarette smoking with an increased risk for synchronous colorectal cancers. The study also found that smoking cessation may stop and even reverse these effects. “…these findings also highlight the importance of smoking cessation and abstinence as a component of CRC prevention strategies,” researchers said.

Sigmoidoscopy provides extended protection against colorectal cancer

The U.K. Flexible Sigmoidoscopy Screening Trial found that one sigmoidoscopy exam reduced the risk of colorectal cancer by one-third and provided 17 years of protection against colorectal cancer diagnosis and mortality. However, current screening guidelines by the American Cancer Society recommend:

  • Flexible sigmoidoscopy every 5 years
  • Colonoscopy every 10 years
  • Double-contrast barium enema every 5 years
  • CT colonography every 5 years

Fecal immunochemical testing (FIT) advocacy addresses racial disparities in colorectal cancer

A study published in JAMA Internal Medicine found that promoting FIT testing improved screening rates in underserved Haitian and Hispanic populations. Late-stage diagnosis and poor survival outcomes in these communities are typically due to lack of access to preventive screening. Researchers noted an 85 percent participation rate when screening tests were made available to study participants, most of whom were uninsured and lived below the poverty line.

Aspirin may reduce colorectal cancer risk

Findings presented at the Gastrointestinal Cancers Symposium suggest that a long-term aspirin regimen decreases the risk of developing colorectal cancer. However, this treatment also increases the risk for gastrointestinal bleeding. Physicians should weigh the potential risks and benefits of this particular treatment before prescribing an aspirin regimen (Source: Healio).

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See the World through Someone Else’s Eyes

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Sometimes you need to see the world from someone else’s point of view—literally. These three conditions are among the leading causes of blindness and vision loss in the world.

This useful tool allows you to virtually walk around streets with the vision of someone affected by cataracts, glaucoma or retinopathy. You can also adjust the severity of each condition so you can be more sympathetic to others who are affected by degenerative eye disease.

Here is what the street will look like with the three conditions:

  • Cataracts. A cataract is a clouding of the lens of the eye. Seeing through the cataract lens makes the street look fuzzy and blurred.
  • Glaucoma. Glaucoma refers to a family of diseases that damage the optic nerve when eye pressure increases to a dangerous level. Using the glaucoma lens makes the street look bright in certain areas and darker in others.
  • Retinopathy. This condition is characterized by blood vessel damage or leaking blood vessels in the back of the eye. The retinopathy lens shows spots or dark strings floating in your visual field.

Jeff Todd, the COO and vice president of partner organization Prevent Blindness said, “The simulator is one way to bring attention to these problems so someone with normal vision can type in their home address and see how much more challenging it is to see what you see on a daily basis.”

Keeping your vision healthy and strong is just a phone call away. The best way to prevent these three eye conditions is by scheduling regular comprehensive eye exams with your doctor. A comprehensive eye exam includes screenings for all three of these conditions. Vision damage from certain degenerative eye diseases can be irreversible, so get screened regularly to preserve your precious gift of sight (Source: Daily Mail).