Takeda Biopharma names Annapurna Das as General Manager for India Operations

Mumbai: Takeda Biopharmaceuticals India Pvt Ltd (formerly
known as Baxalta Bioscience India Private Limited), part of a global
values-based, R&D-driven biopharmaceutical leader – has announced the
appointment of Annapurna Das as General Manager for its India operations. In
her new role, Annapurna will lead the Company in India, ensuring patient access
to its highly innovative medicines and vaccines, and advancing valuable
collaborations to contribute to the growing domestic healthcare and
pharmaceutical market.

Annapurna comes with more than 20
years of experience in the pharmaceutical and biotechnology industry across
India and Southeast Asia. Before joining Takeda, she held key leadership
positions at various multinational healthcare companies, including Miltenyi Biotec,
Sanofi, GSK, MSD, Pfizer and Organon, where she demonstrated exceptional
leadership in sales, marketing, corporate strategy and business development
across both pharma and vaccines businesses.

Commenting on her new role,
Annapurna Das said, “I am truly honoured to be entrusted with this
responsibility by Takeda. India is one of the key countries for us, given its diverse
population and the significant healthcare challenges. We are fully committed to
serving patients in India by providing them with greater access to our
innovative medicines and vaccines, ensuring they receive the best possible
care. I look forward to working closely with our stakeholders and partners to
strengthen our commitment in India while positively impacting the lives of patients
across the country.”

Welcoming her on board, Dion
Warren, Area Head of India and Southeast Asia, at Takeda said, “We
are excited to welcome Annapurna to Takeda. Her vast experience and dedication
to patient-focused solutions will fuel our continued success and growth in
India. With her strategic leadership, we strive to positively impact patients’
lives with Takeda’s innovative healthcare solutions, and partnerships to
broaden sustainable and equitable access to medicines and vaccines. Annapurna’s
alignment with Takeda’s purpose and values reinforces our commitment to
fostering a diverse and inclusive workplace, enabling us to create long-term
value for patients and society. I am excited to partner with her to build on
our strong foundation and take us to the next level of growth in India.”

A part of Takeda Pharmaceutical
Company Ltd headquartered in Japan, Takeda India specialises in
gastrointestinal and inflammation, rare diseases, plasma-derived therapies, oncology
etc.

Read also: Takeda gets USFDA nod for Entyvio subcutaneous administration for Crohn’s disease

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KGMU Prof Kausar Usman conferred with Brian Chapman Scholarship by UK Royal College of Physicians

Lucknow: Prof Kausar Usman of King George’s Medical University (KGMU) Lucknow has been awarded
the esteemed Brian Chapman Scholarship from the Royal College of Physicians,
Edinburgh, UK. Prof Usman expressed his delight at receiving this honour and
reaffirmed his dedication to advancing the field of medicine.

“It is an honour for me to be selected from India, as it recognizes
academic achievement and potential in the field of geriatric medicine,” said
Prof Usman, a senior faculty member in KGMU told Times of India.  

Also Read:Renowned Urologist late Dr GG Lakshmana Prabhu conferred with President’s Award of Merit

He is presently working as a Professor of Internal
Medicine at one of the prestigious medical institutions, King George’s Medical University. He is actively involved in UG PG teaching training,
Clinical Services and Research. He is an MD, FICP, FACP, and FRCP (Edin). He has
worked at King George’s Medical University for 18 years. 

The Brian Chapman Scholarship, named after the distinguished Dr Brian
Chapman, is designed to support medical professionals who are committed to
improving healthcare for the elderly. Prof Usman’s recognition of this
scholarship highlights his significant contributions and ongoing efforts in
this crucial area of medical science. The scholarship aims to empower medical professionals by providing them
with the necessary resources and opportunities to enhance their skills and
knowledge in geriatric medicine. It is a testament to Prof Usman’s exemplary
work and his unwavering commitment to improving the lives of elderly patients. 

The Royal College of Physicians, Edinburgh, has a long-standing
tradition of recognizing and supporting outstanding medical professionals
worldwide. The Brian Chapman Scholarship is one of its many initiatives aimed
at fostering excellence and innovation in the medical field. With this prestigious scholarship, Prof Usman is set to continue his
pioneering work in geriatric healthcare, contributing to the betterment of
medical practices and the overall well-being of elderly patients.

Also Read: Renowned Urologist late Dr GG Lakshmana Prabhu conferred with President’s Award of Merit

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Mediterranean Diet Improves Type 1 Diabetes Control in Young Population, finds study

A recent study found the potential benefits of the Mediterranean diet (MD) for youths with Type 1 Diabetes Mellitus (T1DM). The findings of this study were published in the recent edition of BMC Endocrine Disorders.

This study conducted at İstanbul University Cerrahpaşa Medical Faculty Hospital focused on T1DM patients of 6 to 18 years to investigate the correlation between adherence to the Mediterranean diet and metabolic control, as well as body composition. The findings provide strong evidence for the positive impact of dietary habits on diabetes management among children and adolescents.

This research analyzed various demographic variables, anthropometric measurements, body composition and biochemical parameters like triglycerides, total cholesterol, HDL cholesterol, LDL cholesterol, AST, ALT and glycated hemoglobin (HbA1c). The study utilized continuous glucose monitoring to assess the time in range (TIR) of participants and employed the KIDMED questionnaire to evaluate adherence to the MD.

The results of the study revealed a clear association between adherence to the MD and improved health outcomes among T1DM youths. The patients with good adherence to the MD expressed larger height standard deviation scores (SDS) when compared to the participants with poor adherence. Also, poor adherence to the MD was linked to higher body fat percentages by highlighting the significant impact of dietary choices on body composition.

The positive correlation between TIR and KIDMED score indicated that adherence to the MD was associated with better glycemic control. Moreover, adherence to the MD was found to be negatively correlated with HbA1c levels for long-term blood sugar control. The regression analysis further confirmed the relationship by suggesting that each one-point increase in the KIDMED score led to a significant reduction in HbA1c levels.

The study emphasized the importance of raising awareness among children, adolescents with T1DM and their parents about the potential benefits of adhering to the Mediterranean diet. This can empower patients to take control of their diabetes management and improve overall health outcomes by promoting dietary habits that align with the principles of the MD. Overall, this study underlines the crucial role of nutrition in diabetes management and also highlights the potential of the Mediterranean diet as a valuable tool in effectively managing T1DM among youth.

Reference:

Güneş Kaya, D., Arslan, N., Ayyıldız, F., Bayramoğlu, E., Turan, H., & Ercan, O. (2024). The potential of the Mediterranean diet to improve metabolic control and body composition in youths with Type 1 Diabetes Mellitus. In BMC Endocrine Disorders (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12902-024-01593-6

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Can posture of Anaesthesiologist affect outcomes of laryngoscopy and tracheal intubation?

Recent study aimed to compare the ergonomic comfort and posture of anaesthesiologists during laryngoscopy and tracheal intubation in the head-elevated laryngoscopy position (HELP) and with a 25° backup. A total of 48 patients with normal airways and 12 experienced anaesthesiologists participated in the study. The anaesthesiologists’ posture was assessed by measuring various joint angles, and their subjective comfort was evaluated using a Likert scale. The Cormack-Lehane (CL) grading, haemodynamic stability, tracheal intubation time, and complications were also compared between the two positions.

Comparison of Posture and Comfort

The findings revealed that both positions, supine HELP and 25° backup HELP, demonstrated comparable anaesthesiologist posture and comfort. However, the 25° backup position significantly improved the Cormack-Lehane grades, with 68% of the patients achieving grade 1 compared to 31% in the supine HELP group. Haemodynamic stability and tracheal intubation time showed no significant differences between the groups, and no complications were reported in either group.

Importance of Patient Positioning

The study also highlighted the importance of proper patient positioning for optimal glottic visualisation and improved tracheal intubation success. The head-elevated laryngoscopy position (HELP) and a 25° backup were proposed to enhance glottic visualisation, and the 25° backup HELP was shown to provide better glottic visualisation and improve the Cormack-Lehane grades. The study concluded that anaesthesiologists’ posture and comfort during laryngoscopy and tracheal intubation are similar between supine and 25° backup positions in patients with easy airways.

Study Findings and Limitations

Overall, the study found no significant difference in the posture adopted by anaesthesiologists in either position during laryngoscopy and tracheal intubation. However, the 25° backup position significantly improved Cormack-Lehane grades, providing better glottic visualisation. The time to complete intubation was comparable between the groups, with all intubations performed in a single attempt. The study was conducted with a crossover design, standardised the adjustment of the table height, and employed both subjective and objective assessments, but had limitations related to the sample size and patient selection.

Key Points –

– The findings revealed that both positions, supine HELP and 25° backup HELP, demonstrated comparable anaesthesiologist posture and comfort. However, the 25° backup position significantly improved the Cormack-Lehane grades. Haemodynamic stability and tracheal intubation time showed no significant differences between the groups, and no complications were reported in either group.

– The study highlighted the importance of patient positioning for optimal glottic visualisation and improved tracheal intubation success. It suggested that the head-elevated laryngoscopy position (HELP) and a 25° backup could enhance glottic visualisation. The study concluded that anaesthesiologists’ posture and comfort during laryngoscopy and tracheal intubation are similar between supine and 25° backup positions in patients with easy airways. The study found no significant difference in the posture adopted by anaesthesiologists in either position during laryngoscopy and tracheal intubation. However, the 25° backup position significantly improved Cormack-Lehane grades, providing better glottic visualisation. The time to complete intubation was comparable between the groups, with all intubations performed in a single attempt. The study was conducted with a crossover design, standardised the adjustment of the table height, and employed both subjective and objective assessments, but had limitations related to the sample size and patient selection.

Reference –

Mookambika R, Kumar RV, Areti A, Jaya V. Comparing the posture and comfort of anaesthesiologists during laryngoscopy and tracheal intubation in the head elevated laryngoscopy position in supine position and with a 25° backup: A randomised clinical crossover trial. Indian J Anaesth 2024;68:547-52

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Blood pressure drugs more than double bone-fracture risk in nursing home patients: JAMA

Records from nearly 30,000 nursing home residents indicate that blood pressure medications more than double the risk of life-threatening bone fractures, according to Rutgers Health research.

The authors of the study, which appears in JAMA Internal Medicine, said the increased risk stems from the medications’ tendency to impair balance, particularly when patients first stand up and temporarily experience low blood pressure that deprives the brain of oxygen. Interactions with other drugs and low baseline balance in many nursing home patients compound the problem.

“Bone fractures often start nursing home patients on a downward spiral,” said Chintan Dave, academic director of the Rutgers Center for Health Outcomes, Policy and Economics and lead author of the study. “Roughly 40 percent of those who fracture a hip die within the next year, so it’s truly alarming to find that a class of medications used by 70 percent of all nursing home residents more than doubles the bone-fracture risk.”

While many patients have high enough blood pressure that the benefits of treatment outweigh these dangers, “Such patients require careful observation, particularly when treatment begins, and that’s not happening,” Dave said. “Caregivers think of blood pressure medication as very low risk, and that’s not true in this patient population.”

Dave’s team analyzed Veterans Health Administration data from 29,648 elderly patients in long-term care facilities from 2006 to 2019. Researchers compared the 30-day risk of fractures to the hip, pelvis, humerus (upper arm) radius or ulna (forearm) for patients who began using blood pressure medications with similar patients who didn’t. To maximize the chance that medication use-and not some other factor-drove the different outcomes, they adjusted for more than 50 baseline covariates, such as patient demographics and clinical history.

The 30-day fracture risk for residents who began blood pressure medication was 5.4 per 100 people per year and 2.2 per 100 people per year for patients who took no blood pressure medication.

Further analysis showed drug usage predicted particularly elevated fracture risk in certain subgroups. Patients with dementia, systolic blood pressure above 139 (the first number in the blood pressure reading), diastolic blood pressure above 79 (the second number) or no recent use of blood pressure medication all experienced at least triple the fracture risk of unmedicated patients.

About 2.5 million Americans live in nursing homes or assisted living facilities. Up to 50 percent suffer falls in any given year, and up to 25 percent of those falls result in serious injury.

The Rutgers Health study indicates that blood pressure medication causes many of those falls and that a combination of less medication and better support could significantly reduce the problem.

“Caregivers can’t strike this right balance of risk and reward if they don’t have accurate data about the risks,” Dave said. “I hope this study gives them information that helps them serve their patients better.”

Reference:

Dave CV, Li Y, Steinman MA, et al. Antihypertensive Medication and Fracture Risk in Older Veterans Health Administration Nursing Home Residents. JAMA Intern Med. Published online April 22, 2024. doi:10.1001/jamainternmed.2024.0507

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Guideline on glucocorticoid-induced adrenal insufficiency jointly released by European Society of Endocrinology and Endocrine Society

European Society of Endocrinology and Endocrine Society Release Joint Clinical Guideline on Glucocorticoid-induced Adrenal Insufficiency

USA: In a collaborative effort to address the complexities of glucocorticoid-induced adrenal insufficiency (GAI), the European Society of Endocrinology (ESE) and the Endocrine Society (ES) have unveiled a comprehensive clinical guideline aimed at improving the diagnosis and therapy of this condition. This joint initiative represents a significant advancement in managing a frequently encountered complication of glucocorticoid therapy.

Glucocorticoids, commonly prescribed for inflammatory and autoimmune conditions, have revolutionized the treatment of various diseases. However, their prolonged use can suppress the body’s natural production of cortisol, leading to adrenal insufficiency—a condition characterized by inadequate cortisol secretion from the adrenal glands.

The joint guideline, published in The Journal of Clinical Endocrinology & Metabolism and the European Journal of Endocrinology, is designed to help clinicians manage patients who have or are at risk of developing glucocorticoid-induced adrenal insufficiency. At least 1% of the global population uses chronic glucocorticoid therapy as an anti-inflammatory or immune-suppressive agent.

This guideline is the first developed and published jointly by the Endocrine Society and the European Society of Endocrinology. The Societies are planning to publish a new joint guideline each year to maximize outreach and cover potential differences in clinical practice between Europe and the United States.

The working group behind this joint guideline was led by co-chairs Tobias Else, M.D., of the University of Michigan in Ann Arbor, Mich., and Professor Felix Beuschlein, M.D., of the University Hospital Zurich in Zurich, Switzerland.

“Our starting point was to define the clinical problem and knowledge gaps that come with glucocorticoid-induced adrenal insufficiency, for which we set out to provide some guidance – even in the absence of strong scientific evidence. We also wanted to make sure that we had good representation from Europe and the U.S. to cover potential differences in clinical practice. In this, we were privileged to gather an excellent team of specialists with great knowledge, diligence, and enthusiasm—all of which is required to get through the process of writing a guideline from scratch,” said Beuschlein.

“The discussions between the panel members during the writing of the guideline, and the review process, which included all members of both societies, has resulted in a level of consensus that has not been reached before. I hope that the global reach of this joint guideline goes beyond what either Society could reach independently.”

The key recommendations are given below:

  • The researchers recommend that in general, patients on, or tapering off glucocorticoids for non-endocrine conditions do not need to be evaluated by an endocrinology specialist.
  • They recommend that clinicians who implement treatment with glucocorticoids educate patients about various endocrine aspects of glucocorticoid therapy.
  • It is recommended that patients on glucocorticoid therapy have access to current up-to-date, and appropriate information about different endocrine aspects of glucocorticoid therapy.
  • The researchers suggest not to taper glucocorticoids in patients on short-term glucocorticoid therapy of <3-4 weeks, irrespective of the dose. In these cases, glucocorticoids can be stopped without testing due to low concern for HPA axis suppression.
  • Glucocorticoid taper for patients on long-term glucocorticoid therapy should only be attempted if the underlying disease for which glucocorticoids were prescribed is controlled, and glucocorticoids are no longer required. In these cases, glucocorticoids are tapered until approaching the physiologic daily dose equivalent is achieved (eg, 4-6 mg prednisone).
  • They recommend consideration of glucocorticoid withdrawal syndrome that may occur during glucocorticoid taper. When glucocorticoid withdrawal syndrome is severe, glucocorticoid dose can be temporarily increased to the most recent one that was tolerated, and the duration of glucocorticoid taper could be increased.
  • They recommend against routine testing for adrenal insufficiency in patients on supraphysiologic doses of glucocorticoids, or if they are still in need of glucocorticoid treatment for the underlying disease.
  • They suggest that patients taking long-acting glucocorticoids (eg, dexamethasone or betamethasone) should be switched to shorter-acting glucocorticoids (eg, hydrocortisone or prednisone) when long-acting glucocorticoids are no longer needed.
  • If confirmation of recovery of the HPA axis is desired, morning serum cortisol as the first test is recommended. The value of morning serum cortisol should be considered as a continuum, with higher values more indicative of HPA axis recovery.
  • They recommend that patients with current or recent glucocorticoid use who did not undergo biochemical testing to rule out glucocorticoid-induced adrenal insufficiency should receive stress dose coverage when they are exposed to stress.
  • They suggest that patients aiming to discontinue glucocorticoids, but without recovery of the HPA axis in one year while on physiologic daily dose equivalent, should be evaluated by an endocrinology specialist. It is suggested that an endocrinology specialist evaluate patients on glucocorticoids and history of adrenal crisis.
  • The researchers suggest that patients with current or previous glucocorticoid treatment presenting with signs and symptoms of exogenous Cushing syndrome are assumed to have glucocorticoid-induced adrenal insufficiency.

In 2025, the Societies plan to publish a joint guideline on diabetes in pregnancy; in 2026, a joint guideline on arginine vasopressin resistance and arginine vasopressin deficiency; and in 2027, a joint guideline on male hypogonadism.

Reference:

1) Beuschlein, F., Else, T., Bancos, I., Hahner, S., Hamidi, O., Van Hulsteijn, L., Husebye, E. S., Karavitaki, N., Prete, A., Vaidya, A., Yedinak, C., & Dekkers, O. M. European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgae250

2) Beuschlein, F., Else, T., Bancos, I., Hahner, S., Hamidi, O., Van Hulsteijn, L., Husebye, E. S., Karavitaki, N., Prete, A., Vaidya, A., Yedinak, C., & Dekkers, O. M. (2024). European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency. European Journal of Endocrinology, 190(5), G25-G51. https://doi.org/10.1093/ejendo/lvae029

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High-power as good as low-power thulium laser enucleation for relieving bladder outlet obstruction due to BPH: Study

A significant study regarding the treatment of large-volume benign prostatic hyperplasia (BPH) revealed that low-power Thulium:YAG VapoEnucleation (ThuVEP) is just as effective and safe as its high-power counterpart. This finding published in the recent edition of World Journal of Urology could influence future treatment protocols and equipment choices for urological surgeries across the world.

The study focused on a total of 80 patients who suffered from symptomatic benign prostatic obstruction (BPO) with prostate volumes exceeding 80 ml. They were randomly assigned into a group receiving low-power and the other group who received high-power ThuVEP treatment. The data analyzed over a 12-month follow-up period highlighted the perioperative and functional outcomes of these two surgical methods.

The key findings include the mean age of participants at 68 years and an average prostate volume of 112 cc, with no significant initial differences between the two groups. Surgical and enucleation times were slightly shorter in the low-power group, but the differences were not statistically significant. Both groups showed considerable improvements in prostate-related symptoms post-surgery which was measured by metrics like the quality of life (QoL), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax) and post-voiding residual urine (PVR).

Also, both surgical techniques demonstrated low complication rates which were similar across both the groups. This aspect is crucial as it suggests that the lower power setting does not compromise patient safety or the efficacy of the procedure. The findings of this study are pivotal for medical facilities considering the cost-effectiveness and accessibility of surgical equipment. Low-power ThuVEP not only requires less energy but might also lead to a lowered wear and tear on valuable medical instruments by potentially lowering operating costs without sacrificing clinical outcomes.

As the results of this study are critical, this could help the medical community prompt a reevaluation of current surgical standards and practices for treating large-volume BPH. This study adds valuable data to the existing pool of urological research and additionally opens the door for future studies to further refine and optimize the treatment of prostate enlargement for the best possible patient outcomes with consideration of economic factors in healthcare delivery.

Reference:

Abdelaziz, A. Y., Kamal, I., Abdelhakim, M. A., Abdelmohsen, M., Meshref, A., Naser, I., & Morsy, S. (2024). A prospective analysis of thulium laser enucleation in benign prostatic hyperplasia comparing low- and high-power approaches for prostates exceeding 80 g. In World Journal of Urology (Vol. 42, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s00345-024-04901-w

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Sedentary lifestyle puts strain on young hearts, claims study

According to a recent Finnish study, high levels of sedentary behaviour and physical inactivity from childhood strain the heart in adolescence. High cardiac workload predicts heart failure and other heart diseases. In light of the findings, increasing moderate and vigorous physical activity from childhood onwards is particularly important in preventing heart diseases.

In a collaborative study by the Faculty of Sport Sciences at the University of Jyväskylä and the Institute of Biomedicine at the University of Eastern Finland, sedentary behaviour and physical activity were followed from childhood to adolescence for eight years. The study showed that adolescents accumulating high levels of sedentary behaviour and low levels of moderate to vigorous physical activity from childhood onwards had a higher cardiac workload in adolescence. Cardiac workload was particularly high in adolescents accumulating low levels of vigorous physical activity.

In addition, high levels of sedentary behaviour and low levels of physical activity were associated with a higher total body fat percentage. Body fat percentage partly explained the associations between sedentary behaviour, physical activity, and cardiac workload. Light physical activity was not associated with cardiac workload.

The results emphasise the importance of increasing physical activity, especially moderate and vigorous activity, reducing sedentary behaviour, and preventing overweight from childhood to prevent heart diseases.

“Youth spend nine to ten hours a day being sedentary,” says Dr. Eero Haapala from the Faculty of Sport and Health Sciences at the University of Jyväskylä, “and only one in ten adolescents accumulated 60 minutes of daily moderate to vigorous physical activity. These are worrying figures.”

“High levels of daily moderate to vigorous physical activity should be a normal part of childhood and adolescence as it improves heart health, but also general well-being,” Haapala emphasises.

The study is based on the ongoing Physical Activity and Nutrition in Children (PANIC) study conducted at the Institute of Biomedicine at the University of Eastern Finland. Sedentary behaviour and physical activity levels were followed for eight years from childhood to adolescence in 153 adolescents. Heart function and strain were measured in adolescence. The study was published in the Journal of the American Heart Association.   

Reference:

Eero A. Haapala, Marja H. Leppänen, Earric Lee, Kai Savonen, Jari A. Laukkanen, Mika Kähönen, Soren Brage and Timo A. Lakka, Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence, Journal of the American Heart Association, https://doi.org/10.1161/JAHA.123.031837

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High femoral offset has 3.7-fold increased probability for aseptic femoral component loosening: study

Lateralized stems in primary cementless total hip arthroplasty (THA) are associated with aseptic femoral loosening.

Lukas Jud et al conducted a study to analyze the impact of high femoral offset (hFO) combinations, formed by lateralized stems or large femoral head lengths, on aseptic femoral component loosening.

The study was conducted at Balgrist University Hospital, Department of Orthopedics, University of Zurich, Forchstrasse, Zürich, Switzerland. The article has been published in ‘International Orthopaedics.’

Retrospective cohort study was performed including all patients that underwent primary cementless THA. Only adult patients (i.e., ≥ 18 years) and patients referred to a postoperative standard protocol were included. Patients were screened for aseptic femoral component loosening and grouped in aseptic loosening (AL) and non-aseptic loosening (nAL) group. Medical records were screened; implant details were noted and classified in hFO and standard femoral offset (sFO) combinations. Supposed risk factors for aseptic loosening were analyzed.

Key findings of the study were:

• Two thousand four hundred fifty-nine THA could be included, containing 14 THA (0.6%) with aseptic femoral component loosening.

• The AL group contained 11 hFO combinations (78.6%), whereas in the nAL group, 1315 hFO combinations (53.8%) were used.

• Subgroup analysis showed significant difference between two groups for hFO combinations (p = 0.014), age (p = 0.002), NSAR (p = 0.001), and bilateral THA on same day (p = 0.001).

• The multiple logistic regression analysis showed that hFO combination was the only variable for increased probability of aseptic loosening (OR, 3.7; p = 0.04).

The authors concluded – “High femoral offset combinations, formed by lateralized stems or large femoral head lengths in our collective of standard straight stems implanted by an anterior approach, show a 3.7-fold increased probability for aseptic femoral component loosening. Adjustment of the postoperative protocol may be considered in these cases to ensure proper stem ingrowth.”

Further reading:

High femoral offset as a risk factor for aseptic femoral component loosening in cementless primary total hip arthroplasty

Lukas Jud et al

International Orthopaedics (2024) 48:1217–1224

https://doi.org/10.1007/s00264-024-06116-5

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NEJM study reveals Link between COVID-19 vaccine complication and rare ‘common cold’ blood disease

New research led by Flinders University and international experts is expanding understanding of vaccine-induced immune thrombocytopenia and thrombosis known as VITT.

At the height of the COVID-19 pandemic in 2021,VITT emerged as a new disease following adenovirus vector-based vaccines-notably the Oxford-AstraZeneca vaccine.

VITT was found to be caused by an unusually dangerous blood autoantibody directed against a protein termed platelet factor 4 (or PF4).

In separate research in 2023, researchers from Canada, North America, Germany and Italy described a virtually identical disorder with the same PF4 antibody that was fatal in some cases after natural adenovirus or common cold infection.

Flinders University researchers Dr Jing Jing Wang and Flinders Professor Tom Gordon, Head of Immunology at SA Pathology in South Australia, led a previous study in 2022 which cracked the molecular code of the PF4 antibody and identified a genetic risk factor related to an antibody gene termed IGLV3.21*02.

Now, the Flinders group has collaborated with this international group of researchers to find that the PF4 antibodies in both adenovirus infection-associated VITT and classic adenoviral vectored VITT share identical molecular fingerprints or signatures.

The research will also have implications for improving vaccine development, says Flinders University researcher Dr Wang, first author on the new article to be published in the eminent New England Journal of Medicine on Thursday.

“These findings, using a completely new approach for targeting blood antibodies developed at Flinders University, indicate a common triggering factor on virus and vaccine structures that initiates the pathological pF4 antibodies,” explains Professor Gordon.

“Indeed, the pathways of lethal antibody production in these disorders must be virtually identical and have similar genetic risk factors.

“Our findings have the important clinical implication that lessons learned from VITT are applicable to rare cases of blood clotting after adenovirus (a common cold) infections, as well as having implications for vaccine development,” he says.

Reference:

Antibody Fingerprints Linking Adenoviral Anti-PF4 Disorders, New England Journal of Medicine, DOI: 10.1056/NEJMc2402592

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