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Biomedical subjects

Karim Khan

Publications and source records attributed to Karim Khan.

9 recordsLinked to original sources

Are cardiovascular disease and osteoporosis directly linked?

For years, osteoporosis and cardiovascular disease were thought to be two independent consequences of aging; however, mounting evidence supports an association between these diseases. Recently, a widespread class of cholesterol-lowering drugs known as statins have demonstrated (in rodents and cell cultures) the ability to induce bone formation. This finding is significant since current therapies are limited to the prevention or slowing down of bone loss rather than (enhancing/improving) bone formation. In humans, the ability of statins to generate new bone has not been consistent; however, several investigations have demonstrated a dramatic decrease in fracture risk. Although it has been proposed that statins induce new bone via increased bone morphogenetic protein-2, other conditions affected by statins such as dyslipidaemia, vascular calcification, endothelial dysfunction and impaired nitric oxide expression, may also contribute to the cardiovascular and bone health paradigm. Furthermore, the role of physical activity and its influence on cardiovascular and bone health, especially in postmenopausal women, may contribute to the discrepancy of findings in human data. In summary, it remains to be determined if statins contribute to bone health via improvements in vascular health or by pleiotropic properties unique to their pharmacology. This review provides information on our current understanding of the bone and cardiovascular association, as well as on novel areas of research to further our current understanding of these conditions.

Animals↗

The painful nonruptured tendon: clinical aspects.

Tendon conditions cause a great deal of morbidity in both elite and recreational athletes, and outcome of treatment is often unsatisfactory. Evidence that the common clinical conditions (e.g., Achilles, patellar, elbow and rotator cuff tendinopathies) are due to tendinosis has been present for many years, yet the misnomer "tendinitis" is still widely used for these conditions in clinical practice. Clinical practice remains very different from evidence-based recommendations [8], but this is a common challenge in medical practice. Thus, in addition to further research in an area of medicine rife for such endeavor, there must be attention to knowledge translation--ensuring that the patient benefits from what is already known.

Humans↗

Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations?

Low-trauma fractures of elderly people are a major public health burden worldwide, and as the number and mean age of older adults in the population continue to increase, the number of fractures is also likely to increase. Epidemiologically, however, an additional concern is that, for unknown reasons, the age-standardized incidence (average individual risk) of fracture has also risen in many populations during the recent decades. Possible reasons for this rise include a birth cohort effect, deterioration in the average bone strength by time, and increased average risk of (serious) falls. Literature provides evidence that the rise is not due to a birth cohort effect, whereas no study shows whether bone fragility has increased during this relatively short period of time. This osteoporosis hypothesis could, however, be tested if researchers would now repeat the population measurements of bone mass and density that were made in the late 1980s and the 1990s. If such studies proved that women's and men's age-standardized mean values of bone mass and density have declined over time, the osteoporosis hypothesis would receive scientific support. The third explanation is based on the hypothesis that the number and/or severity of falls has risen in elderly populations during the recent decades. Although no study has directly tested this hypothesis, a great deal of indirect epidemiologic evidence supports this contention. For example, the age-standardized incidence of fall-induced severe head injuries, bruises and contusions, and joint distortions and dislocations has increased among elderly people similarly to the low-trauma fractures. The fall hypothesis could also be tested in the coming years because the 1990s saw many research teams reporting age- and sex-specific incidences of falling for elderly populations, and the same could be done now to provide data comparing the current incidence rates of falls with the earlier ones.

Accidental Falls↗

Wristwatch-distal radial fracture as a marker for osteoporosis investigation: a controlled trial of patient education and a physician alerting system.

This article reports a controlled trial to investigate the effectiveness of patient education and a physician alerting system in altering secondary osteoporosis prevention after a low-trauma (fragility) wrist fracture and to record the current rate of osteoporosis investigation following such fractures. Fifty-one women and men aged 50 years or older with a low-trauma wrist fracture were identified (41 women and 10 men; mean age [95% CI], 71.51 [67.31-74.81]). The intervention group received a four-part intervention aimed at both the patient and the family physician in addition to the usual care for the fracture. The control group only received usual care for the fracture. Data were collected for both groups at six weeks and six months. Results indicate that 92% of the intervention subjects were investigated for osteoporosis, compared with the usual-care group, in which only 23% were investigated. Early osteoporosis intervention has the potential to limit disease impact, and hand therapists can play a key role in early identification of osteoporosis.

Aged↗