Characterization of Opioid Prescribing Tendencies Among Orthopaedic Surgeons: A National Perspective

There has been increasing pressure on healthcare providers to exhibit restraint when prescribing opioids for pain control. However, data that characterizes the differences between orthopaedic providers and their accompanying prescription rates is not well developed. This study accessed Medicare Provider Utilization and Payment Data from 2015 to collect the number of prescriptions for opioid-based medications administered by orthopaedic surgeons across the country. A total of 19,410 orthopaedic providers were identified as opioid prescribers from the 2015 Medicare Part D Database. Providers averaged an opioid prescription every 10.9 days, with 94.7% of prescribers (18,387) having written more than 10 opioid prescriptions. Regionally, the Southern United States had the highest percentage of providers prescribing an opioid greater than 10 times at 96.4%. Female orthopaedic surgeons prescribed just over half the number of scripts that male surgeons did (79.4 vs. 154.2, p < 0.001). (Journal of Surgical Orthopaedic Advances 32(3):199-201, 2023).

Very low density lipoprotein receptor (VLDLR) expression is a determinant factor in adipose tissue inflammation and adipocyte-macrophage interaction

Obesity is associated with adipose tissue remodeling, characterized by adipocyte hypertrophy and macrophage infiltration. Previously, we have shown that very low density lipoprotein receptor (VLDLR) is virtually absent in preadipocytes but is strongly induced during adipogenesis and actively participates in adipocyte hypertrophy. In this study, we investigated the role of VLDLR in adipose tissue inflammation and adipocyte-macrophage interactions in wild type and VLDLR-deficient mice fed a high fat diet. The results show that VLDLR deficiency reduced high fat diet-induced inflammation and endoplasmic reticulum (ER) stress in adipose tissue in conjunction with reduced macrophage infiltration, especially those expressing pro-inflammatory markers. In adipocyte culture, VLDLR deficiency prevented adipocyte hypertrophy and strongly reduced VLDL-induced ER stress and inflammation. Likewise, cultures of primary peritoneal macrophages show that VLDLR deficiency reduced lipid accumulation and inflammation but did not alter chemotactic response of macrophages to adipocyte signals. Moreover, VLDLR deficiency tempered the synergistic inflammatory interactions between adipocytes and macrophages in a co-culture system. Collectively, these results show that VLDLR contributes to adipose tissue inflammation and mediates VLDL-induced lipid accumulation and induction of inflammation and ER stress in adipocytes and macrophages.