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https://www.readbyqxmd.com/read/29776756/sex-hormone-binding-globulin-is-a-biomarker-associated-with-nonvertebral-fracture-in-men-on-dialysis-therapy
#1
Jasna Aleksova, Phillip Wong, Robert McLachlan, Kay Weng Choy, Peter R Ebeling, Frances Milat, Grahame J Elder
Gonadal hormones impact bone health and higher values of sex hormone-binding globulin (SHBG) have been independently associated with fracture risk in men without chronic kidney disease. People with chronic kidney disease have a greatly increased fracture risk, and gonadal dysfunction is common in men receiving dialysis treatment. Nevertheless, in these men the effect of gonadal steroids and SHBG on bone mineral density (BMD) and fracture risk is unknown. Here we investigate relationships between gonadal steroids, SHBG, BMD and fracture in men on long-term dialysis therapy, awaiting kidney or simultaneous pancreas kidney transplantation...
May 15, 2018: Kidney International
https://www.readbyqxmd.com/read/29769605/sex-difference-in-bone-architecture-and-bone-fragility-in-vietnamese
#2
Lan T Ho-Pham, Thao P Ho-Le, Linh D Mai, Tam M Do, Minh C Doan, Tuan V Nguyen
This study sought to define the sex-difference in trabecular and cortical bone parameters in Vietnamese individuals. The study involved 1404 women and 864 men aged between 20 and 86 years who were recruited from Ho Chi Minh City, Vietnam. Trabecular and cortical volumetric BMD were measured at the proximal tibia and proximal radius at 4%, 38%, and 66% points, using a peripheral quantitative computed tomography XCT2000 (Stratec, Germany). Polar strength strain index was estimated from cortical bone parameters...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29768364/comparative-effectiveness-of-fragility-fracture-integrated-rehabilitation-management-for-elderly-individuals-after-hip-fracture-surgery-a-study-protocol-for-a-multicenter-randomized-controlled-trial
#3
Sang Yoon Lee, Jaewon Beom, Bo Ryun Kim, Seung-Kyu Lim, Jae-Young Lim
INTRODUCTION: Although it is essential to provide comprehensive rehabilitation after hip fracture to restore the patient to preoperative physical functioning, feasibility issues remain. Here, we describe a protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of fragility fracture integrated rehabilitation management (FIRM) for elderly individuals after hip fracture surgery. We also examine the feasibility of applying FIRM in a chronic-care hospital or community-based setting...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29760963/effectiveness-of-a-day-rehabilitation-program-in-improving-functional-outcome-and-reducing-mortality-and-readmission-of-elderly-patients-with-fragility-hip-fractures
#4
Tak Man Wong, Frankie K L Leung, Tak Wing Lau, Christian Fang, Felix H W Chan, Jun Wu
Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29751644/protective-effects-of-selected-botanical-agents-on-bone
#5
REVIEW
James Jam Jolly, Kok-Yong Chin, Ekram Alias, Kien Hui Chua, Ima Nirwana Soelaiman
Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated fragility fractures result in high morbidity, mortality, and healthcare costs. Many plants used in herbal medicine contain bioactive compounds possessing skeletal protective effects. This paper explores the anti-osteoporotic properties of selected herbal plants, including their actions on osteoblasts (bone forming cells), osteoclasts (bone resorbing cells), and bone remodelling...
May 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29749006/predictors-of-recurrence-in-remitted-late-life-depression
#6
Yi Deng, Douglas R McQuoid, Guy G Potter, David C Steffens, Kimberly Albert, Meghan Riddle, John L Beyer, Warren D Taylor
BACKGROUND: Late-life depression (LLD) is associated with a fragile antidepressant response and high recurrence risk. This study examined what measures predict recurrence in remitted LLD. METHODS: Individuals of age 60 years or older with a Diagnostic and Statistical Manual - IV (DSM-IV) diagnosis of major depressive disorder were enrolled in the neurocognitive outcomes of depression in the elderly study. Participants received manualized antidepressant treatment and were followed longitudinally for an average of 5 years...
May 10, 2018: Depression and Anxiety
https://www.readbyqxmd.com/read/29730983/the-challenge-of-aging-and-pharmacoterapeutic-complexity-in-the-hiv-patient
#7
Ramón Morillo-Verdugo, José Ramón Blanco Ramos, Laila Abdel-Kader Martín, María Álvarez de Sotomayor
OBJECTIVE: To describe the current knowledge and management of aging and  pharmacotherapeutic complexity in HIV + patients. METHOD: A review of literature was carried out, including articles, originals or  reviews, published in English or Spanish, from 2007 to 2017, which analysed the aging and pharmacotherapeutic complexity in HIV + patients. The terms  «Polypharmacy»/»Polypharmacy», «Aging»/»Aging», «Frailty»/»Fragility»,  «Pharmacotherapeutic Complexity»/»Medication Regimen Complexity» and  «HIV»/"HIV» were combined...
May 1, 2018: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/29721240/mexican-patients-with-hiv-have-a-high-prevalence-of-vertebral-fractures
#8
José Antonio Mata-Marín, Carla I Arroyo-Anduiza, María de Los Ángeles Berrospe-Silva, Alberto Chaparro-Sánchez, Ana Gil-Avila, Jesús Gaytán-Martínez
Low bone mineral density (BMD) and fragility fractures are common in individuals infected with HIV, who are undergoing antiretroviral therapy (ART). In high-income countries, dual energy X-ray absorptiometrry is typically used to evaluate osteopenia or osteoporosis in HIV infected individuals. However, this technology is unavailable in low andmiddle income countries, so a different approach is needed. The aim of this study was to use X-ray scans of the spine to determine the prevalence of and associated risk factors for vertebral fractures in HIVinfected patients in a tertiary-care hospital in Mexico...
March 29, 2018: Infectious Disease Reports
https://www.readbyqxmd.com/read/29700604/fragility-fractures-of-the-sacrum-occur-in-elderly-patients-with-severe-loss-of-sacral-bone-mass
#9
Daniel Wagner, Alexander Hofmann, Lukas Kamer, Takeshi Sawaguchi, R Geoff Richards, Hansrudi Noser, Dominik Gruszka, Pol M Rommens
INTRODUCTION: Patients suffering from osteoporosis-associated fragility fractures of the sacrum (FFS; also termed sacral insufficiency fractures) are increasingly observed. They have typical fracture patterns with fracture lines located in the sacral ala. When treating these patients operatively, iliosacral screw loosening is not uncommon. We aimed to study the sacral bone mass in patients presenting with a FFS using 3D statistical models. MATERIALS AND METHODS: 3D models of averaged Hounsfield units (HU) were generated based on CT scans from 13 patients with a unilateral FFS (mean age 79...
April 26, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29667007/failure-in-diagnosis-and-under-treatment-of-osteoporosis-in-elderly-patients-with-fragility-fractures
#10
Sofia Bougioukli, Panagoula Κollia, Theodora Koromila, Sokratis Varitimidis, Michael Hantes, Theofilos Karachalios, Κonstantinos Ν Malizos, Zoe H Dailiana
We evaluated whether osteoporosis is adequately managed and treated in patients suffering from fragility fractures. Factors that influenced osteoporosis diagnosis and treatment rates were also assessed. To this end, patients with the principal diagnosis of low-energy hip, vertebral, or distal radius fractures were recruited for the study. Collected data included risk factors for osteoporosis, history of previous fractures, known history of osteoporosis, and osteoporosis treatment at the time of admission. The patients' prefracture risk profile was also assessed to determine whether osteoporosis could have been identified prior to the index fracture...
April 17, 2018: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/29629551/totally-thoracoscopic-left-atrial-occlusion-concomitant-to-endoscopic-atraumatic-coronary-artery-bypass-grafting-eacab
#11
Piotr Suwalski, Anna Witkowska
Atrial fibrillation, as the most prevalent arrhythmia, has more impact on morbidity and mortality than any other rhythm disorder. It is often concomitant with structural heart diseases like coronary artery disease. The worst complication of atrial fibrillation is stroke, but the double or triple antithrombotic therapy especially in fragile and elderly patients is associated with significant risk of bleeding. The left atrial appendage occlusion may reduse both the risk of stroke and drug intake. Here we present, to our knowledge, the first description of a simultaneous totally thoracoscopic 3D augmented coronary artery bypass grafting and left atrial appendage occlusion...
March 15, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29626027/lesson-of-the-month-1-massive-spontaneous-haematomas-in-an-elderly-man
#12
Francesco Fiorini, Louise Braddick, Hasnain Hashim, Robert M Ayto, Alana Jacobs, Yetunde Baoku, Shahir S Hamdulay
A 73-year-old man presented with bilateral leg pain and swelling, and no history of trauma or bleeding disorders. Clinical examination, biochemistry and magnetic resonance imaging of the thighs were suggestive of muscle haematomas. These progressed significantly during the admission, requiring blood transfusion. Normal vascular anatomy on computed tomography, renal and liver function, and absence of infection made a bleeding diathesis more likely. This may be caused by coagulation defects, platelet disorders and vascular fragility...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29609083/constructional-apraxia-in-elderly-patients-with-brain-tumors-considerations-with-an-up-to-date-review-of-the-literature
#13
Giorgia Abete Fornara, Andrea Di Cristofori, Giulio Andrea Bertani, Giorgio Carrabba, Barbara Zarino
BACKGROUND: Constructional apraxia (CA) is a neuropsychological impairment of either basic perceptual and motor abilities, or executive functions, in absence of any kind of motor or perceptual deficit. Considering patients with focal brain tumors, CA is common in left or right parietal and parieto-occipital lesions. In neuropsychology, Rey-Osterrieth Complex Figure test (ROCF) (or parallel forms) is commonly used for the assessment of CA. This study stems from a clinical observation of a difficulty with CA tests for the majority of neurosurgical elderly patients without occipito-parietal lesions...
March 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29599828/age-related-changes-of-the-spinal-cord-a-biomechanical-study
#14
Tomoya Okazaki, Tsukasa Kanchiku, Norihiro Nishida, Kazuhiko Ichihara, Itsuo Sakuramoto, Junji Ohgi, Masahiro Funaba, Yasuaki Imajo, Hidenori Suzuki, Xian Chen, Toshihiko Taguchi
Although it is known that aging plays an important role in the incidence and progression of cervical spondylotic myelopathy (CSM), the underlying mechanism is unclear. Studies that used fresh bovine cervical spinal cord report the gray matter of the cervical spinal cord as being more rigid and fragile than the white matter. However, there are no reports regarding the association between aging an tensile and Finite Element Method (FEM). Therefore, FEM was used based on the data pertaining to the mechanical features of older bovine cervical spinal cord to explain the pathogenesis of CSM in elderly patients...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29573870/what-low-back-pain-is-and-why-we-need-to-pay-attention
#15
REVIEW
Jan Hartvigsen, Mark J Hancock, Alice Kongsted, Quinette Louw, Manuela L Ferreira, Stéphane Genevay, Damian Hoy, Jaro Karppinen, Glenn Pransky, Joachim Sieper, Rob J Smeets, Martin Underwood
Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause...
March 20, 2018: Lancet
https://www.readbyqxmd.com/read/29566917/therapeutic-challenges-in-the-mature-patient
#16
Zrinka Bukvić Mokos, Anamaria Jović, Romana Čeović, Krešimir Kostović, Ivica Mokos, Branka Marinović
With the tremendous increase in the proportion of seniors in the global population, geriatric health care has become of greater interest and concern. Increased emphasis on geriatric medicine, along with the growth in the development of age-related skin disorders, has led to particular attention for geriatric, dermatology and dermatopharmacology. An aging population has brought many therapeutic challenges that we need to recognize and overcome by applying geropharmacologic principles. The purpose of this paper is to inform dermatologists of the age-related changes in the pharmacokinetics of common dermatologic drugs, their various interactions potentially occurring in the elderly, and the principles and evidence-based strategies for detection, management, and prevention to improve medication adherence...
March 2018: Clinics in Dermatology
https://www.readbyqxmd.com/read/29562393/-fragile-organs-protection-for-elderly-patients-blocking-perioperative-noxious-stimulus-to-organs
#17
T L Wang
No abstract text is available yet for this article.
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29548964/surgical-treatment-of-the-septuagenarian-patients-suffering-from-brain-metastases-a-large-retrospective-observational-analytic-cohort-comparison-study
#18
Alessandro Frati, Alessandro Pesce, Mauro Palmieri, Megi Celniku, Antonino Raco, Maurizio Salvati
BACKGROUND: The benefits associated to the surgical treatment of brain metastases (BMs) in elderly patients has been extensively debated due to their higher biological fragility, but we still miss a "threshold." The aim of this study is to evaluate their outcomes by a systematic comparison with a cohort of the youngest patients of our series of BMs. METHODS: The surgical, radiologic, and oncologic outcomes of patients suffering from BM have been retrospectively reviewed for the present study...
March 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29542359/non-vitamin-k-antagonist-oral-anticoagulants-for-pulmonary-embolism-who-where-and-for-how-long
#19
Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; should patients be treated as inpatients or outpatients; and how long should patients be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
May 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29530286/-the-suitability-of-sending-nursing-home-residents-over-75-to-emergency-departments
#20
Anne Dang, Stéphane Sanchez, Michèle Collart, Rachid Mahmoudi, David Laplanche
The care provided to elderly people aged over 75 must be specific and multidisciplinary. An emergency department, which is seeing increasing numbers of patients passing through its doors, notably with the provision of an ambulatory care service, would not appear to be a suitable place for this fragile population, often with multiple pathologies. A study is looking at the suitability of the emergency department for nursing home residents, who have regular access to medical care, unlike elderly people living at home...
March 2018: Soins. Gérontologie
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