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Article: Mayo Clinic office visit. Vitamin D deficiency. An interview with Kurt Kennel, M.D.

Kennel, Kurt

2011 Volume 15, Issue 5, Page(s) 6

MeSH term(s)	Bone Density Conservation Agents/administration & dosage ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Nutrition Policy ; Skin Pigmentation ; Sunlight ; United States ; Vitamin D/administration & dosage ; Vitamin D/analogs & derivatives ; Vitamin D Deficiency/diagnosis ; Vitamin D Deficiency/prevention & control
Chemical Substances	Bone Density Conservation Agents ; Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2011-05
Publishing country	United States
Document type	Interview
ZDB-ID	2192476-4
ISSN	1091-0220
ISSN	1091-0220
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Article ; Online: Optimizing DXA to Assess Skeletal Health: Key Concepts for Clinicians.

Kennel, Kurt A / Sfeir, Jad G / Drake, Matthew T

The Journal of clinical endocrinology and metabolism

2020 Volume 105, Issue 12

Abstract: Context: The diagnosis of osteoporosis and assessment of fracture risk prior to a sentinel fracture was transformed by the widespread clinical use of dual-energy X-ray absorptiometry (DXA) for the assessment of bone mineral density (BMD).: Evidence ... ...

Abstract	Context: The diagnosis of osteoporosis and assessment of fracture risk prior to a sentinel fracture was transformed by the widespread clinical use of dual-energy X-ray absorptiometry (DXA) for the assessment of bone mineral density (BMD). Evidence acquisition: This review is based on a collection of primary and review literature gathered from a PubMed search of "dual energy X-ray absorptiometry," "trabecular bone score," and "atypical femur fracture" among other keywords. PubMed searches were supplemented by the authors' prior knowledge of the subject. Evidence synthesis: While uncertainty exists for some aspects of osteoporosis care, patient and clinician familiarity with BMD assessment for screening and monitoring is firmly established. Beyond BMD, lateral spine images obtained with DXA can diagnose osteoporosis and refine fracture risk through the detection of unrecognized vertebral fractures. In addition, analysis of DXA lumbar spine images can reflect changes in trabecular bone microarchitecture, a component of bone "quality" that predicts risk of fracture independent of BMD. Finally, monitoring of bone health by DXA may be extended to include assessment of the femoral cortices for rare but serious adverse effects associated with antiresorptive therapies. Conclusions: Increasing technologic sophistication requires additional consideration for how DXA imaging is performed, interpreted and applied to patient care. As with any test, clinicians must be familiar with DXA performance, pitfalls in analysis, and interpretation within each clinical context in which DXA is applied. With this perspective, care providers will be well positioned to contribute to continuous improvement of DXA performance and, in turn, quality of osteoporosis care.
MeSH term(s)	Absorptiometry, Photon/methods ; Absorptiometry, Photon/standards ; Bone Density ; Bone Diseases/diagnosis ; Bone and Bones/diagnostic imaging ; Bone and Bones/physiology ; Calibration ; Humans ; Physicians/standards ; Practice Patterns, Physicians'/standards
Language	English
Publishing date	2020-09-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgaa632
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Article ; Online: Authors' reply to Minisola and colleagues, Kausar, and Sharvill.

Kennel, Kurt A / Maraka, Spyridoula

BMJ (Clinical research ed.)

2015 Volume 351, Page(s) h5873

MeSH term(s)	Bone Density Conservation Agents/therapeutic use ; Diphosphonates/therapeutic use ; Female ; Humans ; Osteoporosis/drug therapy ; Osteoporosis/prevention & control
Chemical Substances	Bone Density Conservation Agents ; Diphosphonates
Language	English
Publishing date	2015-11-04
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.h5873
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Article ; Online: Bisphosphonates for the prevention and treatment of osteoporosis.

Maraka, Spyridoula / Kennel, Kurt A

BMJ (Clinical research ed.)

2015 Volume 351, Page(s) h3783

Abstract: Osteoporosis is a systemic skeletal disorder characterized by bone loss, which leads to impaired bone strength and an increased risk of fractures. Two million fractures are attributed to osteoporosis annually in the United States and they are associated ... ...

Abstract	Osteoporosis is a systemic skeletal disorder characterized by bone loss, which leads to impaired bone strength and an increased risk of fractures. Two million fractures are attributed to osteoporosis annually in the United States and they are associated with serious morbidity and mortality. Bisphosphonates reduce the risk of fracture by suppressing bone resorption and increasing bone strength, and they have been widely used for the prevention and treatment of osteoporosis. However, the use of these drugs for the management of osteoporosis remains a clinical challenge. There are several important considerations including appropriate patient selection, pretreatment evaluation, potential adverse effects, patient preferences, and adherence. This review will discuss the evidence informing the clinical strategy for using bisphosphonates in patients with osteoporosis and those at high risk of fracture, focusing on the benefits and risks of treatment. We will also consider issues related to the monitoring and duration of treatment.
MeSH term(s)	Bone Density/drug effects ; Bone Density Conservation Agents/adverse effects ; Bone Density Conservation Agents/therapeutic use ; Diphosphonates/adverse effects ; Diphosphonates/therapeutic use ; Female ; Fractures, Bone/etiology ; Fractures, Bone/prevention & control ; Humans ; Osteoporosis/complications ; Osteoporosis/drug therapy ; Osteoporosis/prevention & control
Chemical Substances	Bone Density Conservation Agents ; Diphosphonates
Language	English
Publishing date	2015-09-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.h3783
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Article ; Online: Type 2 diabetes remission after Roux-en-Y gastric bypass: a multicentered experience with long-term follow-up.

Hage, Karl / Ikemiya, Kayla / Ghusn, Wissam / Lu, Lauren / Kennel, Kurt A / McKenzie, Travis J / Kellogg, Todd A / Abu Dayyeh, Barham K / Higa, Kelvin D / Spaniolas, Konstantinos / Ma, Pearl / Ghanem, Omar M

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

2023 Volume 19, Issue 12, Page(s) 1339–1345

Abstract: Background: Roux-en-Y gastric bypass (RYGB) is associated with short- and mid-term type 2 diabetes (T2D) remission. Long-term outcomes and predictive parameters associated with remission following RYGB have not been well elucidated.: Objective: ... ...

Abstract	Background: Roux-en-Y gastric bypass (RYGB) is associated with short- and mid-term type 2 diabetes (T2D) remission. Long-term outcomes and predictive parameters associated with remission following RYGB have not been well elucidated. Objective: Determining the overall long-term T2D remission rates following RYGB and identifying predictive variables associated with remission. Setting: Multicentered study including patients who underwent RYGB at 3 tertiary referral centers for bariatric surgery. Methods: We performed a retrospective cohort study between 2008-2017 to allow a minimum of 5 years of follow-up. We evaluated long-term T2D remission rates and annual T2D clinical and metabolic parameters up to 14 years after surgery. Predictors of remission were assessed using multivariate logistic regression. Patients were divided into 4 groups based on quartiles of total body weight loss percentage (%TBWL) to compare remission rates between groups. Results: A total of 815 patients were included (68.9% female, age 52.1 ± 11.5 yr; body mass index 45.1 ± 7.7 kg/m Conclusions: Longer duration and higher severity of T2D were negatively associated with remission while higher %TBWL had a positive association. A significant proportion of patients in all quartiles experienced long-term remission after RYGB with a greater likelihood of remission correlated with greater weight loss.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Male ; Gastric Bypass ; Diabetes Mellitus, Type 2/complications ; Follow-Up Studies ; Retrospective Studies ; Hypoglycemic Agents/therapeutic use ; Treatment Outcome ; Obesity, Morbid/surgery ; Obesity, Morbid/complications
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2274243-8
ISSN	1878-7533 ; 1550-7289
ISSN (online)	1878-7533
ISSN	1550-7289
DOI	10.1016/j.soard.2023.09.025
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Article ; Online: Opportunistic CT-Based Hounsfield Units Strongly Correlate with Biomechanical CT Measurements in the Thoracolumbar Spine.

Martini, Michael L / Mikula, Anthony L / Lakomkin, Nikita / Pennington, Zach / Everson, Megan C / Hamouda, Abdelrahman M / Bydon, Mohamad / Freedman, Brett / Sebastian, Arjun S / Nassr, Ahmad / Anderson, Paul A / Baffour, Francis / Kennel, Kurt A / Fogelson, Jeremy / Elder, Benjamin

Spine

2023

Abstract: Study design: Retrospective cohort study.: Objective: Hounsfield units (HUs) are known to correlate with clinical outcomes, no study has evaluated how they correlate with BCT and DXA measurements.: Summary of background: Low bone mineral density ( ... ...

Abstract	Study design: Retrospective cohort study. Objective: Hounsfield units (HUs) are known to correlate with clinical outcomes, no study has evaluated how they correlate with BCT and DXA measurements. Summary of background: Low bone mineral density (BMD) represents a major risk factor for fracture and poor outcomes following spine surgery. Dual-energy x-ray absorptiometry (DXA) can provide regional BMD measurements but has limitations. Opportunistic HUs provide targeted BMD estimates; however, they are not formally accepted for diagnosing osteoporosis in current guidelines. More recently, biomechanical computed tomography (BCT) analysis has emerged as a new modality endorsed by the International Society for Clinical Densitometry (ISCD) for assessing bone strength. Methods: Consecutive cases from 2017-2022 at a single institution were reviewed for patients who underwent BCT in the thoracolumbar spine. BCT-measured vertebral strength, trabecular BMD, and the corresponding American College of Radiology (ACR) Classification were recorded. DXA studies within three months of the BCT were reviewed. Pearson Correlation Coefficients were calculated, and receiver-operating characteristic curves were constructed to assess the predictive capacity of HUs. Threshold analysis was performed to identify optimal HU values for identifying osteoporosis and low BMD. Results: Correlation analysis of 114 cases revealed a strong relationship between HUs and BCT vertebral strength (r=0.69; P<0.0001; R2=0.47) and trabecular BMD (r=0.76; P<0.0001; R2=0.58). However, DXA poorly correlated with opportunistic HUs and BCT measurements. HUs accurately predicted osteoporosis and low BMD (Osteoporosis: C=0.95, 95% CI 0.89-1.00; Low BMD: C=0.87, 95% CI 0.79-0.96). Threshold analysis revealed that 106 and 122 HUs represent optimal thresholds for detecting osteoporosis and low BMD. Conclusion: Opportunistic HUs strongly correlated with BCT-based measures, while neither correlated strongly with DXA-based BMD measures in the thoracolumbar spine. HUs are easy to perform at no additional cost and provide accurate BMD estimates at non-instrumented vertebral levels across all ACR-designated BMD categories.
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000004822
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Article: Review: several pharmacologic therapies promote modest weight loss.

Kennel, Kurt A

ACP journal club

2005 Volume 143, Issue 2, Page(s) 50

Language	English
Publishing date	2005-09
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	1061215-4
ISSN	1539-8560 ; 1056-8751
ISSN (online)	1539-8560
ISSN	1056-8751
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Article: Review: sparse high-quality evidence supports surgery for obesity.

Kennel, Kurt A

ACP journal club

2005 Volume 143, Issue 2, Page(s) 51

Language	English
Publishing date	2005-09
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	1061215-4
ISSN	1539-8560 ; 1056-8751
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ISSN	1056-8751
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Article ; Online: Vitamin D in the cancer patient.

Kennel, Kurt A / Drake, Matthew T

Current opinion in supportive and palliative care

2013 Volume 7, Issue 3, Page(s) 272–277

Abstract: Purpose of review: To briefly review recent work within the vitamin D and cancer field, whereas also providing context relating how these findings may impact clinical care and future research efforts.: Recent findings: Vitamin D has now been ... ...

Abstract	Purpose of review: To briefly review recent work within the vitamin D and cancer field, whereas also providing context relating how these findings may impact clinical care and future research efforts. Recent findings: Vitamin D has now been convincingly shown both in vitro and in preclinical animal models to alter the differentiation, proliferation, and apoptosis of cancer cells. Whether vitamin D prevents cancer in humans or limits cancer progression, however, remain open questions. Epidemiologic and observational data relating circulating 25(OH)D levels and cancer risk suggest an inverse relationship for most cancers including breast, colorectal, leukemia and lymphoma, and prostate, although for each malignancy there also exist studies that have failed to demonstrate such an inverse relationship. Likewise, a more recent report failed to confirm a previously reported association of increased pancreatic cancer risk in patients with higher 25(OH)D levels. A large prospective study in which patients aged at least 50 years receive 2000 IU vitamin D3 daily for 5 years, with cancer as a primary endpoint, has recently been launched. Summary: Although much effort has attempted to delineate a causal relationship between vitamin D and a wide array of human cancers, we await large-scale randomized controlled trial data for definitive answers.
MeSH term(s)	Apoptosis/drug effects ; Breast Neoplasms/drug therapy ; Breast Neoplasms/prevention & control ; Clinical Trials as Topic ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/prevention & control ; Female ; Hematologic Neoplasms/drug therapy ; Hematologic Neoplasms/prevention & control ; Humans ; Male ; Neoplasms/drug therapy ; Neoplasms/prevention & control ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/prevention & control ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/prevention & control ; Receptors, Calcitriol/metabolism ; Risk Factors ; Skin Neoplasms/drug therapy ; Skin Neoplasms/prevention & control ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D/pharmacology ; Vitamin D/therapeutic use
Chemical Substances	Receptors, Calcitriol ; Vitamin D (1406-16-2) ; 1,25-dihydroxyvitamin D (66772-14-3)
Language	English
Publishing date	2013-08-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2633726-5
ISSN	1751-4266 ; 1751-4258
ISSN (online)	1751-4266
ISSN	1751-4258
DOI	10.1097/SPC.0b013e3283640f74
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Article ; Online: Persistent hyperparathyroidism due to ectopic parathyroid gland.

Jasim, Sina / Kennel, Kurt

Endocrine

2017 Volume 55, Issue 1, Page(s) 322–323

MeSH term(s)	Choristoma/complications ; Choristoma/diagnostic imaging ; Choristoma/surgery ; Female ; Humans ; Hyperparathyroidism/diagnostic imaging ; Hyperparathyroidism/etiology ; Hyperparathyroidism/surgery ; Mediastinum/diagnostic imaging ; Mediastinum/surgery ; Middle Aged ; Parathyroid Glands ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome
Language	English
Publishing date	2017-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-016-1143-y
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