RESUMO
OBJECTIVE: To evaluate the effect of common weight loss pharmacotherapies among low-income, racially diverse adult patients at an urban safety-net weight management clinic. METHODS: Our retrospective review from 2015 to 2019 examined patients who took either GLP-1 analog (GL) or phentermine/topiramate (PT) for ≥90 days and patients who exclusively pursued non-pharmacologic treatment for comparison. Changes in weight, blood pressure, and hemoglobin A1c at 1-year follow-up were reported. RESULTS: We analyzed 22 GL and 26 PT patients and included 40 patients who pursued only lifestyle modifications (LM). All three groups achieved significant weight loss at one year: GL -3.69 (interquartile range (IQR): -11.0, -1.77) kg (p=0.0004), PT -7.01 (IQR: -13.4, -1.45) kg (p<0.001), and LM -3.01 (IQR: -6.81, 1.13) kg (p=0.005). There was no significant difference in the median weight loss (p=0.11) between the three groups. We observed no significant changes in systolic blood pressure but saw a significant change of -0.75 in hemoglobin A1c (IQR: -1.35, -0.25) (p=0.01) among patients with diabetes in the GL group. CONCLUSIONS: Our real-world applications of GLP-1 and phentermine/topiramate suggest that both are effective weight loss medication regimens in low-socioeconomic status patients.
RESUMO
PURPOSE: To investigate the longitudinal changes in landing mechanics and knee kinematics for patients both before and 3 years after anterior cruciate ligament reconstruction (ACLR) and to investigate the association between changes in landing mechanics and magnetic resonance knee kinematics. METHODS: Thirty-one ACLR patients were included in the study. All patients underwent magnetic resonance imaging and biomechanical analysis of a drop-landing task using the injured knee and contralateral knee preoperatively and at 6 months and 3 years after ACLR. For evaluations of knee joint anteroposterior laxity, tibial position was calculated using quantitative loaded magnetic resonance methods. RESULTS: The ACLR knee exhibited a significantly lower peak vertical ground reaction force and peak external knee flexion moment and angle at 6 months compared with the contralateral knee; however, the differences were resolved at 3 years. Tibial position was significantly more anterior on the injured side, and the side-to-side difference (SSD) in tibial position exhibited a significant increase from 6 months to 3 years. Among ACLR knees, a greater SSD in peak knee flexion moment at 6 months was associated with an increase in the SSD in anterior tibial translation from 6 months to 3 years. CONCLUSIONS: Although landing mechanics and clinical outcomes recovered in patients with ACLR in this study, anteroposterior translation failed to be restored at 3 years after surgery. In addition, patients who have low knee flexion moments in early stages could have greater anteroposterior laxity. CLINICAL RELEVANCE: Because of the adverse consequences of abnormal knee kinetics on anterior laxity after ACLR, efforts to improve knee movement patterns should be initiated.
