2025
P-567. Baseline Patient and Clinician Results for the Pilot Project I-CARE-4-PAH (Intervention for Collaborative Care to Assess Risk and Eliminate polyPharmacy, Falls, and Fragility Fractures for People Aging with HIV)
Womack J, Johnson C, Danvers K, Hsieh E, Lauro M, Marottoli R, Murphy A, Payne E, Sheehan L, Stewart W, Virata M, Barakat L. P-567. Baseline Patient and Clinician Results for the Pilot Project I-CARE-4-PAH (Intervention for Collaborative Care to Assess Risk and Eliminate polyPharmacy, Falls, and Fragility Fractures for People Aging with HIV). Open Forum Infectious Diseases 2025, 12: ofae631.765. PMCID: PMC11777831, DOI: 10.1093/ofid/ofae631.765.Peer-Reviewed Original ResearchMedication reconciliationHIV cliniciansYears of ageHIV primary careIntersecting risk factorsAcademic HIV clinicPre-test assessmentPeripheral neuropathyClinician championsFall preventionPrimary careHealthcare providersIdentified polypharmacySmoking tobaccoAssociated with ageHIV clinicFRAX scorePlantar surfaceFragility fracturesQuarter of patientsRisk factorsDecreased sensationFracture riskHIVTraining resourcesTrends in Osteoporosis Drug Therapy Receipt Among Commercial and Medicare Advantage Enrollees in the United States, 2011-2022
Everhart A, Brito J, Clarke B, Herrin J, Karaca-Mandic P, Kennel K, Parimi N, Rosen C, Takagi M, McCoy R. Trends in Osteoporosis Drug Therapy Receipt Among Commercial and Medicare Advantage Enrollees in the United States, 2011-2022. The Journal Of Clinical Endocrinology & Metabolism 2025, dgae840. PMID: 39811927, DOI: 10.1210/clinem/dgae840.Peer-Reviewed Original ResearchOsteoporosis drug therapyFragility fracturesDocumented osteoporosisUndertreatment of osteoporosisMedicare Advantage enrolleesOptumLabs Data WarehouseUnderdiagnosis of osteoporosisHealth insuranceTherapy receiptPrimary outcomeRetrospective analysisDrug therapyOsteoporosisCuzick's testWomenMedicarePatientsUnderdiagnosisUnited StatesFilling rateSexLow rateAgeFractureYears
2024
Disparities in Dual-energy X-ray Absorptiometry Scan Utilization Across Race/Ethnic Groups Before and After Hip Fractures
Rudisill K, Ratnasamy P, Sanchez J, Grauer J. Disparities in Dual-energy X-ray Absorptiometry Scan Utilization Across Race/Ethnic Groups Before and After Hip Fractures. JAAOS Global Research And Reviews 2024, 8: e24.00052. PMID: 39303221, PMCID: PMC11419421, DOI: 10.5435/jaaosglobal-d-24-00052.Peer-Reviewed Original ResearchConceptsHip fracture populationHip fractureDEXA scanRace/ethnic groupsElixhauser Comorbidity IndexLesser oddsPatient ageFracture populationScan utilizationComorbidity indexTime of hip fractureBefore hip fractureStudy revealed disparitiesImprove medication accessDual X-ray absorptiometryHip fracture patientsGeriatric hip fracturesX-ray absorptiometryHip fragility fracturesMedication accessNon-white categorySentinel eventsHealthcare systemFragility fracturesFracture patients
2023
Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV
Womack J, Murphy T, Leo-Summers L, Kidwai-Khan F, Skanderson M, Gill T, Gulanski B, Rodriguez-Barradas M, Tien P, Yin M, Hsieh E. Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV. AIDS 2023, 37: 1399-1407. PMID: 37070536, PMCID: PMC10329997, DOI: 10.1097/qad.0000000000003566.Peer-Reviewed Original ResearchConceptsFracture Risk Assessment ToolMajor osteoporotic fractureRisk assessment toolCohort studyHip fractureOsteoporotic fracturesVeterans Aging Cohort StudyAging Cohort StudyMultivariable logistic regressionType of fractureRace/ethnicityAssessment toolGlucocorticoid useHIV cohortFragility fracturesPrevious fractureRheumatoid arthritisSmoking statusFracture riskModest discriminationOlder veteransLogistic regressionOccurrence of fracturesHIVAlcohol useAssessing the contributions of modifiable risk factors to serious falls and fragility fractures among older persons living with HIV
Womack J, Murphy T, Leo‐Summers L, Bates J, Jarad S, Gill T, Hsieh E, Rodriguez‐Barradas M, Tien P, Yin M, Brandt C, Justice A. Assessing the contributions of modifiable risk factors to serious falls and fragility fractures among older persons living with HIV. Journal Of The American Geriatrics Society 2023, 71: 1891-1901. PMID: 36912153, PMCID: PMC10258163, DOI: 10.1111/jgs.18304.Peer-Reviewed Original ResearchConceptsModifiable risk factorsFragility fracturesRisk factorsAlcohol use disorderSerious fallsPhysiologic frailtyAntiretroviral therapyOlder PWHUse disordersVeterans Aging Cohort StudyMeasures of multimorbidityAging Cohort StudyBody mass indexMultivariable logistic modelAverage attributable fractionSuccessful prevention programsKey risk factorsOpioid prescriptionsCohort studyMass indexModifiable factorsSixth decadeAttributable fractionElevated riskICD9 codesBurden of bone disease in chronic pancreatitis: A systematic review and meta-analysis
Chhoda A, Hernandez-Woodbine M, Addo N, Nasir S, Grimshaw A, Gunderson C, Ahmed A, Freedman S, Sheth S. Burden of bone disease in chronic pancreatitis: A systematic review and meta-analysis. World Journal Of Gastroenterology 2023, 29: 1374-1394. PMID: 36925454, PMCID: PMC10011962, DOI: 10.3748/wjg.v29.i8.1374.Peer-Reviewed Original ResearchConceptsPrevalence of osteopeniaChronic pancreatitisFragility fracturesBone diseaseCP patientsClinical featuresPooled prevalenceSystematic reviewBaseline clinical featuresSignificant bone diseasePrevalence of osteoporosisBody mass indexCause of morbidityBone mineralization parametersRandom-effects modelPaucity of dataWeb of SciencePERT useSmoking exposureSystemic inflammationTherapy useMass indexTrue burdenCochrane LibraryMean age
2021
Brief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV?
Womack JA, Murphy TE, Ramsey C, Bathulapalli H, Leo-Summers L, Smith AC, Bates J, Jarad S, Gill TM, Hsieh E, Rodriguez-Barradas MC, Tien PC, Yin MT, Brandt C, Justice AC. Brief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV? JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 88: 192-196. PMID: 34506360, PMCID: PMC8513792, DOI: 10.1097/qai.0000000000002752.Peer-Reviewed Original ResearchConceptsSubsequent fragility fracturesFragility fracturesAntiretroviral therapySerious fallsRisk factorsVeterans Aging Cohort StudyAging Cohort StudyMultivariable logistic regressionUpper arm fracturesMiddle-aged populationYears of ageAlcohol use disorderCohort studyHip fractureVertebral fracturesArm fracturesInjury codesICD9 codesGeneral populationUse disordersLogistic regressionIntegrase inhibitorsOlder adultsRadiology reportsHIVUpdate on Osteoporosis Screening and Management
Anam AK, Insogna K. Update on Osteoporosis Screening and Management. 2021, 105: 1117-1134. PMID: 34688418, DOI: 10.1016/j.mcna.2021.05.016.ChaptersConceptsLimited alcohol intakeNew anabolic therapiesLow bone massDual-energy X-ray absorptiometry measurementsBone mineral densityMetabolic bone diseasePostmenopausal womenAnabolic therapyFragility fracturesMicroarchitectural deteriorationSevere osteoporosisBone healthAlcohol intakeOsteoporosis screeningSmoking cessationVitamin DMineral densityPharmacologic agentsBone massBone diseaseHigh riskAbsorptiometry measurementsGold standardOsteoporosisBone tissueBone mineral density and microarchitecture among Chinese patients with rheumatoid arthritis: a cross-sectional study with HRpQCT
Jin S, Li M, Wang Q, Zeng X, Xia W, Yu W, Guan W, Hsieh E. Bone mineral density and microarchitecture among Chinese patients with rheumatoid arthritis: a cross-sectional study with HRpQCT. Arthritis Research & Therapy 2021, 23: 127. PMID: 33894786, PMCID: PMC8067377, DOI: 10.1186/s13075-021-02503-0.Peer-Reviewed Original ResearchConceptsBone mineral densityRheumatoid arthritisRisk of fractureCross-sectional studyMineral densityFragility fracturesDistal radiusHealthy controlsBone microarchitectureBone strengthHigh-resolution peripheral quantitative computed tomographySex-matched healthy controlsPeripheral quantitative computed tomographyDual-energy X-ray absorptiometryVolumetric bone mineral densityFemale reproductive factorsRA-related characteristicsThoracolumbar X-rayTraditional risk factorsQuantitative computed tomographyX-ray absorptiometryCortical bone thicknessThin cortical boneGroup of ageChinese Registry
2020
Prevalence, screening, treatment, and complications of osteoporosis and osteopenia in Medicare patients with chronic lymphocytic leukemia (CLL).
Brander D, Oeffinger K, Greiner M, Dinan M. Prevalence, screening, treatment, and complications of osteoporosis and osteopenia in Medicare patients with chronic lymphocytic leukemia (CLL). Journal Of Clinical Oncology 2020, 38: e24050-e24050. DOI: 10.1200/jco.2020.38.15_suppl.e24050.Peer-Reviewed Original ResearchDual-energy X-ray absorptiometryChronic lymphocytic leukemiaFragility fracturesCumulative incidenceBone mineral density screeningComplications of osteoporosisUse of bisphosphonatesRoutine health maintenanceX-ray absorptiometryWilcoxon rank sum testChi-square testRank sum testCumulative incidence functionBisphosphonate useBaseline characteristicsMedicare 5Adverse outcomesBMD screeningTreatment advancesGray's testChronic cancerMedicare patientsDXA useLymphocytic leukemiaHigh riskAssociation between comorbidities and extraglandular manifestations in primary Sjögren’s syndrome: a multicenter cross-sectional study
Zhang Y, Li M, Zhang L, Li Q, Yang P, Kong X, Duan X, Zhang M, Li X, Wang Y, Xu J, Wang Y, Hsieh E, Zhao J, Xu D, Zhao Y, Zeng X. Association between comorbidities and extraglandular manifestations in primary Sjögren’s syndrome: a multicenter cross-sectional study. Clinical Rheumatology 2020, 39: 2677-2688. PMID: 32146615, DOI: 10.1007/s10067-020-04992-x.Peer-Reviewed Original ResearchConceptsExtraglandular manifestationsFragility fracturesCross-sectional studyThyroid disordersCardiovascular diseaseComorbidity burdenSjögren's syndromeMulticenter cross-sectional studyMethodThis cross-sectional studyComorbid cardiovascular diseasePrevalence of comorbiditiesPrimary Sjögren's syndromeAmerican-European criteriaMore comorbiditiesDisease durationBaseline prevalenceDisease characteristicsResultsA totalUnivariate analysisHigh prevalenceComorbiditiesHigh riskPatientsMultivariate analysisDemographic data
2019
Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty
Justice A, Tate J. Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty. AIDS Research And Human Retroviruses 2019, 35: 1023-1033. PMID: 31565954, PMCID: PMC7133454, DOI: 10.1089/aid.2019.0136.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort Study (VACS) IndexPhysiologic frailtyStudy indicesRoutine clinical laboratory testsClinical laboratory testsVACS IndexCause mortalityFragility fracturesHIV infectionFunctional declineCognitive declineSerious fallsFrailtyRelated outcomesEarly indicatorMortalityLaboratory testsIndexDeliriumHospitalizationPneumoniaHIVInfectionDiagnosis and Treatment of Osteoporosis: What Orthopaedic Surgeons Need to Know.
Matzkin E, DeMaio M, Charles J, Franklin C. Diagnosis and Treatment of Osteoporosis: What Orthopaedic Surgeons Need to Know. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: e902-e912. PMID: 31021891, DOI: 10.5435/jaaos-d-18-00600.Peer-Reviewed Original ResearchConceptsOsteoporotic fracturesOrthopaedic surgeonsIncreased risk of fragility fracturesIncidence of osteoporotic fracturesRisk of fragility fracturesLoss of bone massManagement of osteoporosisTreatment of osteoporosisMusculoskeletal careFragility fracturesAssess osteoporosisBone massOsteoporosis epidemicCondition of boneIncreased riskSilent diseaseRisk factorsOsteoporosisSurgeonsEstimated 9BoneReview articleTreatmentSystem conditionsRisk
2018
Update on the Comprehensive Approach to Fragility Fractures
Cohn M, Gianakos A, Grueter K, Rosen N, Cong G, Lane J. Update on the Comprehensive Approach to Fragility Fractures. Journal Of Orthopaedic Trauma 2018, 32: 480-490. PMID: 30036208, DOI: 10.1097/bot.0000000000001244.Peer-Reviewed Original ResearchConceptsFragility fracturesAnabolic agentsDual-energy x-ray absorptiometry screeningFracture Liaison Service (FLS) modelNew anabolic agentsFirst-line treatmentFracture liaison serviceBone density lossAntiosteoporotic medicationAntiresorptive agentsNonpharmacologic treatmentsFracture careVitamin DSurgical historyTreatment optionsAntisclerostin antibodiesBone densityBone diseaseEffective treatmentLiaison servicePhysician extendersFracture healingPotential treatmentDensity lossTreatment
2016
HIV and ageing
Althoff KN, Smit M, Reiss P, Justice AC. HIV and ageing. Current Opinion In HIV And AIDS 2016, 11: 527-536. PMID: 27367780, PMCID: PMC5084838, DOI: 10.1097/coh.0000000000000305.Peer-Reviewed Original ResearchConceptsQuality of lifeAge-associated conditionsGeriatric syndromesHIV infectionCombination antiviral therapyModifiable risk factorsAge-associated comorbiditiesRole of HIVComplexity of careEvidence-based strategiesHarmful health behaviorsPhysiologic frailtyViral suppressionTreatment toxicityAntiretroviral agentsFragility fracturesAntiviral therapyViral coinfectionEffects of exposureRisk factorsCognitive dysfunctionHigh prevalenceHIVControllable illnessHealth behaviorsFracture Prediction With Modified-FRAX in Older HIV-Infected and Uninfected Men
Yin MT, Shiau S, Rimland D, Gibert CL, Bedimo RJ, Rodriguez-Barradas MC, Harwood K, Aschheim J, Justice AC, Womack JA. Fracture Prediction With Modified-FRAX in Older HIV-Infected and Uninfected Men. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2016, 72: 513-520. PMID: 27003493, PMCID: PMC4942335, DOI: 10.1097/qai.0000000000000998.Peer-Reviewed Original ResearchConceptsUninfected menOlder HIVSecondary osteoporosisFRAX calculationVeterans Aging Cohort Study Virtual CohortFracture Risk CalculatorIncident fragility fracturesMajor osteoporotic fractureIncident fracturesPharmacologic therapyFragility fracturesHip fractureHIV statusFracture preventionOsteoporotic fracturesRisk calculatorFracture ratesBone densityCase findingFRAXHIVVirtual cohortOsteoporosisComplete dataMenBisphosphonate Treatment in Osteoporosis: Optimal Duration of Therapy and the Incorporation of a Drug Holiday
Villa J, Gianakos A, Lane J. Bisphosphonate Treatment in Osteoporosis: Optimal Duration of Therapy and the Incorporation of a Drug Holiday. HSS Journal ® 2016, 12: 66-73. PMID: 26855630, PMCID: PMC4733702, DOI: 10.1007/s11420-015-9469-1.Peer-Reviewed Original ResearchRecent fragility fractureDrug holidayBisphosphonate treatmentFragility fracturesBone deficiencyQuestions/PurposesThe purposeHigh fracture riskBone turnover rateRisk of fractureBone mass measurementsBisphosphonate therapyDrug discontinuationPeer-reviewed journalsCase seriesDrug therapyFracture riskPurposesThe purposeClinical trialsInclusion criteriaCase controlExclusion criteriaMethodsA reviewHuman studiesPatientsElectronic databases
2015
Osteoporosis and Hip Fractures
Olgun D, Gianakos A, Jo J, Galmer L, Lane J. Osteoporosis and Hip Fractures. 2015, 141-158. DOI: 10.1007/978-3-319-19905-4_8.Peer-Reviewed Original ResearchHip fractureFragility fracturesFragility fracture risk factorsOsteoporosis-related fragility fracturesMajor public health concernFracture risk factorsFracture liaison serviceMajority of patientsOsteoporotic fragility fracturesResidual functional impairmentOsteoporotic hip fracturesPublic health concernOsteoporosis managementPatient mortalityRisk factorsPatient outcomesPharmacological strategiesFunctional impairmentLiaison serviceSubsequent fracturesGreater riskHealth concernHealthcare expendituresOsteoporosisBone evaluation
2013
Physiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans
Womack JA, Goulet JL, Gibert C, Brandt CA, Skanderson M, Gulanski B, Rimland D, Rodriguez-Barradas MC, Tate J, Yin MT, Justice AC, Team F. Physiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans. Clinical Infectious Diseases 2013, 56: 1498-1504. PMID: 23378285, PMCID: PMC3634308, DOI: 10.1093/cid/cit056.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusVACS Index scoreFragility fracturesPhysiologic frailtyVACS IndexMale veteransInhibitor useFracture riskRisk factorsVeterans Aging Cohort Study (VACS) IndexIndex scoreFragility fracture risk factorsICD-9-CM codesProtease inhibitor useFracture risk factorsMarkers of inflammationBody mass indexUpper arm fracturesAlcohol-related diagnosesCox regression modelFirst fragility fractureCause mortalityHIV RNAHemoglobin levelsMass index
2011
Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male Veterans
Womack JA, Goulet JL, Gibert C, Brandt C, Chang CC, Gulanski B, Fraenkel L, Mattocks K, Rimland D, Rodriguez-Barradas MC, Tate J, Yin MT, Justice AC, . Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male Veterans. PLOS ONE 2011, 6: e17217. PMID: 21359191, PMCID: PMC3040233, DOI: 10.1371/journal.pone.0017217.Peer-Reviewed Original ResearchConceptsBody mass indexHIV infectionUninfected menFragility fracturesFracture riskRisk factorsMale veteransVeterans Aging Cohort Study Virtual CohortCurrent protease inhibitor useFragility fracture risk factorsMedian body mass indexHIV-specific factorsAdjusted hazard ratioProtease inhibitor useFracture risk factorsFragility fracture riskIncident hipHazard ratioInhibitor useUnadjusted riskHIV statusMass indexAlcohol abuseHIVUpper arm
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