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Objective To develop and implement a protocol that improves recognition of osteoporosis in patients with fragility fractures. Methods The awareness protocol included 6 meetings with the clinical staff of the emergency department (ED) and the orthopedic department to discuss osteoporosis awareness, a poster placed in the ED triage and orthopedic residents’ rooms, monthly verbal awareness reminders, and distribution of pocket-sized poster copies to the residents. Results Two hundred ninety-one patients with fractures were admitted to Howard University Hospital from June 2005-December 2005. Fractures were evident in 11% (n = 32). All were admitted from the ED. Of the patients with fractures, 81% were African American—62.5% were women with a mean age of 73.3 ± 15.8 years; the mean age of the men, 59.3 ± 14.9 years. The orthopedists requested an endocrine consult for 8 patients. Osteoporosis was evident in 25% of the fracture patients (n = 8). One of these patients was diagnosed on the basis of risk factors, thus 22% were diagnosed on the basis of dual-energy x-ray absorptiometry and pathological findings. As compared with a prior study, this is a significant increase (13%, p = .02) in the diagnostic rate at this institution. Bisphosphonates were prescribed for 3 of the 32 patients (9%) prior to discharge. Conclusion This pilot study presents an easy-to-execute awareness protocol that significantly improved the diagnosis of osteoporosis in a predominantly African American population with fractures. The diagnosis of osteoporosis may be enhanced by cooperative efforts among ED, orthopedics, endocrinology, and other disciplines.

groups.We aimed to assess the availability and cost of GF foods across a range of supermarkets in a single UK city (Sheffield). We also aimed to assess the impact online retailers had on the GF food market.Methods: 67 supermarkets were analysed, including a range of categories, sizes and locations. 10 items were selected to represent a range of commonly bought GF foods and the price and availability of these items was recorded. Where any were found, the price of their gluten-containing counterpart was also recorded. Other data collected included the store size, location, length of any gluten free section(s) and total number of GF items on sale. The same factors were used to assess online retailers. Results: Of the 67 supermarkets visited, 27 (40.3%) stocked no GF items, with the remaining 40 (59.7%) stocking at least one. The mean number of GF items sold per store was 30, but this varied greatly by store category and size. None of the budget or corner supermarkets surveyed stocked any GF items. Regular and luxury supermarkets had a greater range (p

Background: Growth disorders are common in children with sickle cell disease (SCD). The etiology for growth disturbances in this population appears to be multifactorial. Recent evidence suggests abnormalities in the growth hormone (GH)/insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) axis may play a role. Objective: To measure GH levels through provocative stimulation in a group of patients with SCD with growth failure, and to evaluate response to treatment. Patients and Methods: Growth records were reviewed of 79 children with sickle cell hemoglobinopathies to identify children with growth failure. GH levels were measured in patients with SCD with and without growth failure using arginine and L-Dopa as provocative stimulation tests. Treatment with GH was offered to GH-deficient children with SCD and these patients were followed longitudinally over 5 years. Results: Of the 79 patients, 13 (16.5%, all SS) had heights less than -2 SD below the mean or a growth velocity < -2 SD below the mean for age. Seven of the 13 children with growth failure participated in this study. Five patients received GH for 3 or more years and demonstrated significant improvement in their height SDS. One of the two who declined treatment was lost to follow-up and the other had significant worsening of height SDS score. Conclusion: GH deficiency may be associated with growth failure in a some patients with SCD. These patients may benefit from treatment with GH.

Background: Although there is little evidence of effectiveness of Complementary and Alternative Medicine (CAM), there has been an increase in the number of patients turning to these largely unproven medical therapies. In this study, we sought to determine if those with a personal history of cancer were more likely to have utilized CAM as compared to those without a history of cancer. Methods: We analyzed the 2007 Health Information National Trends Survey (HINTS) and identified 976 respondents who were cancer survivors and 6,235 respondents without a personal history of cancer. We compared the demographic, lifestyle, and healthcare perceptions of these participants and used logistic regression models to evaluate the association of personal history of cancer, cancer treatment and the time since cancer treatment with CAM use. We used survey weights in all analysis and Taylor series linearization to perform variance estimations to account for the complex survey design. Results: Overall, cancer survivors were as likely as those without history of cancer to use CAM in the previous 12 months (27.1% vs. 25.2%; OR = 1.09; 95%CI: 0.86-1.38). Cancer treatment and time since cancer treatment was not associated with CAM use (Table 1). Conclusions: Cancer survivors were as likely as adults without a history of cancer to use complementary and alternative medicine irrespective of cancer treatment. Table 1. The effect of cancer treatment and time since treatment on CAM use among cancer survivors By cancer treatment Cancer survivor characteristics Weighted% with CAM use CAM use versus no CAM use OR (95% CI) No history of cancer (n = 6,235) 25.2% Reference No cancer treatment (n = 117) 32.6% 1.69 (0.82–3.47) Had cancer treatment (n = 847) 26.3% 1.01 (0.78–1.29) By time since cancer treatment No history of cancer (n = 6,235) Reference Still undergoing cancer treatment (n = 94) 29.4% 1.15 (0.50–2.63) Completed cancer treatment less than 1 year ago (n = 143) 22.6% 0.96 (0.55–1.66) Completed cancer treatment 1 or more years ago (n = 537) 26.5% 1.00 (0.72–1.41) Adjusted for respondent's age, sex, marital status, place of birth, race, income, education level, health insurance status, BMI, perception of health status, perception of health care quality received, and confidence in taking care of one's own health Citation Format: Maryam Laiyemo, Gail Nunlee-Bland, Frederick Lombardo, R. George Adams, Adeyinka Laiyemo. Complementary and alternative medicine use among cancer survivors in the United States. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2522. doi:10.1158/1538-7445.AM2013-2522