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Bisphosphonates have been associated with a decreased risk of revision surgery after total joint arthroplasty of the hip or knee (TJA) because of their effects on decreased periprosthetic bone loss and prosthetic migration. However, the results in the early literature are inconsistent, and the influence of bisphosphonates on associated complications and subsequent TJA remains unknown. This study investigated the association between the use of bisphosphonates and the risk of adverse outcomes after primary TJA. This matched cohort study utilized the National Health Insurance Research Database in Taiwan to identify patients who underwent primary TJA over a 15-year period (January 2000-December 2015 inclusive). Study participants were further categorized into two groups, bisphosphonate users and nonusers, using propensity score matching. The Kaplan-Meier curve analysis and adjusted hazard ratios (aHRs) of revision surgery, adverse outcomes of primary surgery and subsequent TJA were calculated using Cox regression analysis. This study analyzed data from 6485 patients who underwent total hip arthroplasty (THA) and 20,920 patients who underwent total knee arthroplasty (TKA). The risk of revision hip and knee arthroplasty was significantly lower in the bisphosphonate users than in the nonusers (aHR, 0.54 and 0.53, respectively). Furthermore, the risk of a subsequent total joint arthroplasty, adverse events and all-cause mortality were also significantly reduced in the bisphosphonate users. This study, involving a large cohort of patients who underwent primary arthroplasties, revealed that bisphosphonate treatment may potentially reduce the risk of revision surgery and associated adverse outcomes. Furthermore, the use of bisphosphonates after TJA is also associated with a reduced need for subsequent arthroplasty.Research Registration Unique Identifying Number (UIN): ClinicalTrials.gov Identifier-NCT05623540 ( https://clinicaltrials.gov/show/NCT05623540 )., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Bones are the third most common site of metastasis, although bone metastasis (BM) incidence varies widely. This study investigated the incidence of BM in the most common cancers in Taiwan to present the recent treatment landscape in patients with organ-specific cancers., Methods: Data from the National Health Insurance Research Database of Taiwan were used to identify adult patients diagnosed with organ-specific cancers between January 1, 2000 and December 31, 2015. Kaplan-Meier analysis was used to quantify cumulative BM incidence at follow-up. BM incidences associated with different cancers were calculated comprehensively and stratified by sex, age group and follow-up periods, and age- and sex-adjusted hazard ratios (HRs) of BM were calculated using multivariate Cox regression analysis., Results: Among 938 776 participants (mean follow-up, 9.2 years), liver (19.6%), colorectal (17.1%) and lung (15.1%) cancers were most commonly associated with BM. The mean interval between a primary cancer diagnosis and BM was 2 years. BM incidence varied widely among cancers; lung cancer (3213 per 10 5 person-years) was associated with the highest BM risk, followed by oesophageal, prostate and breast cancer. HRs of BM were significantly higher for lung cancer (HR = 8.1) than for other cancers., Conclusion: The estimated BM incidence provided insight into oncological clinical practice trends in the Asia-Pacific region. BM incidence may vary among populations. Understanding the principles of clinical evaluation in patients with cancer of unknown primary origin can facilitate appropriate treatment recommendations., (© 2021 John Wiley & Sons Ltd.)

Background: Objective smell tests not only identify levels of smelling ability but also provide information on changes in olfaction after treatment. Odor identification is strongly socially and culturally dependent; therefore, the odorants used in a smell identification test should be familiar to the test population. We developed this smell test for Taiwanese populations with two aims: the test odors should be familiar to Taiwanese and the test should be easily and quickly administered in a busy clinic., Methods: Additives that are familiar to Taiwanese people were selected for this smell identification test. Subsequently, the test was validated with the traditional Chinese version of the University of Pennsylvania Smell Identification Test (TC-UPSIT). Finally, this Taiwan Smell Identification Test (TWSIT) was implemented in daily clinical use, and cut-off points of "normosmia," "hyposmia," and "anosmia" were established., Results: A total of 1000 subjects were included in the market survey to identify commonly recognized odors. Eight odorants with identification rate greater than 95% were selected. The TWSIT is an array of multiple-choice questions to select the odor. In addition, patient also reported the strength of the odor. The full score was 48. Thirty-seven patients simultaneously received both TWSIT and TC-UPSIT, and the correlation was high (r = 0.874). Based on the testing results of an additional 187 subjects, we concluded that scores of 47-48, 15-44, and 2-12 corresponded to normosmia, hyposmia, and anosmia, respectively. Patients with scores falling in the gaps require retesting at a later time., Conclusion: The TWSIT is a quick, office-based, and useful odor identification tool for Taiwanese. The experience of developing a culturally specific olfaction test like the TWSIT can be applied in different countries and cultures.