Racial/ethnic disparity in total joint arthroplasty (TJA) has grown over the last two decades as studies have documented the widening gap between Blacks and Whites in TJA utilization rates despite the known benefits of TJA. Factors contributing to this disparity have been explored and include demographics, socioeconomic status, patient knowledge, patient preference, willingness to undergo TJA, patient expectation of post-arthroplasty outcome, religion/spirituality, and physician-patient interaction. Improvement in patient knowledge by effective physician-patient communication and other methods can possibly influence patient's perception of the procedure. Such interventions can provide patient-relevant data on benefits/risks and dispel myths related to benefits/risks of arthroplasty and possibly reduce this disparity. This review will summarize the literature on racial/ethnic disparity on TJA utilization and outcomes and the factors underlying this disparity.

The goal of emerging therapies is to address the unsatisfactory control of serum uric acid in patients with symptomatic hyperuricemia such as those with gout, to provide better tolerability compared to traditional agents and minimize the risk of adverse events, especially in patients with comorbidities and the elderly. Some drugs like arhalofenate, ulodesine (BCX-4208) and lesinurad are in or have completed Phase II and Phase III trials. The growing knowledge about the urate transporters in the kidney have advanced our knowledge of pathophysiology of hyperuricemia and have led to the development of several new potential treatment options. Availability of new drugs will lead to better management and address the unmet need in patients with symptomatic hyperuricemia in the coming years.

Background: Galectin 3, a fibrosis biomarker, has found to have significant prognostic value in predicting all cause mortality in heart failure patients. However, its role in predicting the risk for new onset heart failure is not well established. We conduct a meta-analysis to analyze the correlation of increase in serum Galectin 3 levels from baseline and development of new onset heart failure. Methods: MEDLINE, EMBASE, CINAHL, Web of Science, meeting abstracts and Cochrane central databases were searched from inception till May 2017. 6 studies were included in the study. Hazard ratio, random effects model was used to estimate the correlation of increase in Galectin 3 levels with development of new onset heart failure. Between studies heterogeneity was assessed by I 2 method. Results: Pooled patient population comprised of 24,297 patients (mean age 59.1 years, 50.6% male). 1444 (5.9%) patients develop new onset heart failure. Mean baseline Galectin 3 levels were 16.7 ug/L. Patients were followed up for mean duration of 5 years. Increase in Galectin 3 levels from baseline was associated with significant increase in risk of new onset heart failure (1.86 [1.36-2.54], p = 0.0002). We noted considerable heterogeneity 80% between studies. Conclusion: This meta analysis showed that galectin 3 levels were directly associated with risk of new onset heart failure. Therefore, galectin 3 can help in early detection of new onset heart failure and hence can help in providing preventive strategies.