Read by QxMD icon Read

Fragile elder

Eric Leblanc, Fabrice Narducci, Lucie Bresson, Delphine Hudry
OBJECTIVE: To explore the feasibility of an oncologically acceptable management for an intermediate-risk endometrial cancer (EC) in an elderly, using the combination of transvaginal single-port laparoscopy and sentinel node policy. METHODS: For this 85-years old patient, BMI 32kg/m(2), with IB grade 2 endometrioid EC, a single vaginal approach was attempted [1] to perform a total hysterectomy, bilateral salpinago-oophorectomy and pelvic node assessment guided by SND [2]...
October 13, 2016: Gynecologic Oncology
Corinne E Wee, Tyler D Ames, Khoi M Le, Tiffany Wang, Laura S Phieffer, Carmen E Quatman
Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures...
October 2016: Aging and Disease
Akeem A Yusuf, Thomas J Matlon, Andreas Grauer, Richard Barron, David Chandler, Yi Peng
: Osteoporosis medications are recommended for elderly patients after a fragility fracture. However, we found substantial under-treatment in the post-fracture year, especially among patients who had not previously received such medications. Improved treatment of elderly patients experiencing fragility fractures is needed. INTRODUCTION: Osteoporosis medications are recommended for elderly patients after a fragility fracture, but under-treatment is common. We determined osteoporosis medication use after fragility fractures and examined associated factors...
December 2016: Archives of Osteoporosis
Richard Eastell, Terence W O'Neill, Lorenz C Hofbauer, Bente Langdahl, Ian R Reid, Deborah T Gold, Steven R Cummings
Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and micro-architectural deterioration of bone tissue. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The incidence of fractures varies greatly by country, but on average up to 50% of women >50 years of age are at risk of fractures. Fractures severely affect the quality of life of an individual and are becoming a major public health problem owing to the ageing population...
2016: Nature Reviews. Disease Primers
Alexis Schnitzler, Aurelie Diebold, Bernard Parratte, Laurent Tliba, Francois Genêt, Philippe Denormandie
OBJECTIVE: Almost 10% of older adults in nursing homes have a fixed flexion deformity of the fingers (claw hand). Such contractures have important functional consequences, often leading to hygiene difficulties. Medical treatment (such as botulinum toxin injections, physiotherapy or positioning) is not always effective and surgery is often not possible in such fragile patients. Microinvasive tenotomy with a large needle could be a useful alternative because it can be carried out in an ambulatory setting under local anaesthesia...
September 2016: Annals of Physical and Rehabilitation Medicine
Xiaoming Yuan, Guangrong Zhou, Yan He, Aiwen Feng
BACKGROUND: Epithelial dysplasia and adenomatous polyps of colorectum are precancerous lesions. Surgical removal is still one of the important treatment approaches for colorectal polyps. CASE PRESENTATION: A male patient over 78 years was admitted due to bloody stool and abdominal pain. Colonoscopic biopsy showed a high-grade epithelial dysplasia in an adenomatous polyp of sigmoid colon. Anemia, COPD, ischemic heart disease (IHD), arrhythmias, and hypoproteinemia were comorbidities...
September 26, 2016: World Journal of Surgical Oncology
Armando Luis Negri, Juan Carlos Ayus
Hip fractures represent a serious health risk in the elderly, causing substantial morbidity and mortality. There is now a considerable volume of literature suggesting that chronic hyponatremia increases the adjusted odds ratio (OR) for both falls and fractures in the elderly. Hyponatremia appears to contribute to falls and fractures by two mechanisms. First, it produces mild cognitive impairment, resulting in unsteady gait and falls; this is probably due to the loss of glutamate (a neurotransmitter involved in gait function) as an osmolyte during brain adaptation to chronic hyponatremia...
September 24, 2016: Reviews in Endocrine & Metabolic Disorders
M Chakhtoura, W D Leslie, M McClung, A M Cheung, G El-Hajj Fuleihan
: We describe our approach to develop FRAX-based osteoporosis treatment guidelines in Lebanon, a country with low-moderate fracture rates. A hybrid assessment algorithm that combines a fixed 10 % intervention threshold until age 70 years, and an age-dependent threshold thereafter, was deemed most suitable. INTRODUCTION: The FRAX risk calculator is used to guide intervention thresholds in several national osteoporosis guidelines. This study aimed to describe the approach in developing FRAX-based osteoporosis treatment guidelines in Lebanon, a country with relatively low fracture rates...
September 20, 2016: Osteoporosis International
Zdeněk Zadák
UNLABELLED: Sarcopenia is one of the severe disorders associated with nutritional imbalance. While sarcopenia is an inseparable part of the process of ageing as people get older, it plays a vital role in pathological situations such as protein-calorie and kwashiorkor malnutrition, it accompanies various diseases of rheumatic character and is an almost ever-present feature of the clinical picture of oncological patients. Sarcopenia in people under strain is fatally manifested mainly in the elderly, medically fragile patients...
2016: Vnitr̆ní Lékar̆ství
Roberto Castelli, Laurenzia Ferraris, Giuseppe Pantaleo, Giorgio Lambertenghi Deliliers, Marco Cicardi
BACKGROUND: Rituximab-containing chemotherapies are offered to elderlies for treatment of non-Hodgkin lymphomas (NHL). From 0.7 to 27% of patients with "resolved" HBV infection develop HBV reactivation and related hepatitis during Rituximab-containing chemotherapies. Currently, several antiviral drugs are available for the prophylaxis of patients at risk for HBV reactivation, which include lamivudine, tenofovir, entecavir, and adefovir. Viral breakthrough may occur during therapy, which is defined as an abrupt increase in serum HBV DNA levels after a period of persistent suppression...
August 20, 2016: Digestive and Liver Disease
Umberto Tarantino, Cecilia Rao, Valerio Tempesta, Elena Gasbarra, Maurizio Feola
INTRODUCTION: Osteoporosis is characterised by poor bone quality arising from alterations to trabecular bone. However, recent studies have also described an important role of alterations to cortical bone in the physiopathology of osteoporosis. Although dual-energy X-ray absorptiometry (DXA) is a valid method to assess bone mineral density (BMD), real bone fragility in the presence of comorbidities cannot be evaluated with this method. The aim of this study was to evaluate if cortical thickness could be a good parameter to detect bone fragility in patients with hip fracture, independent of BMD...
August 21, 2016: Injury
Christian David Weber, Christian Herren, Thomas Dienstknecht, Frank Hildebrand, Sebastian Keil, Hans-Christoph Pape, Philipp Kobbe
BACKGROUND: Life-threatening arterial bleeding from fragility fractures of the pelvis are very rare but associated with significant mortality, especially in anticoagulated patients. CASE DESCRIPTION: We report the successful interdisciplinary management of a 78-year-old woman under anticoagulation and antiplatelet therapy who had life-threatening arterial hemorrhage from the pubic rami following a fragility fracture of the pelvis. Our management strategy included early hemorrhage control by means of selective arterial embolization followed by surgical fracture stabilization and surgical hematoma evacuation...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
P Duriez, T Devaux, C Chantelot, N Baudrier, J-Y Hery, D Mainard, T Favier, P Massin
INTRODUCTION: Although internal fixation is the reference treatment for extracapsular fracture of the upper femur, indications for arthroplasty are broadening, especially in unstable comminutive fracture in fragile bone. The present study hypothesis was that arthroplasty reduces early mortality and morbidity and provides better recovery of autonomy in over-80 year-old patients than does internal fixation. MATERIAL AND METHODS: A prospective multicenter study was conducted on 8 sites...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Zahra Alsadat Hejazi, Forough Namjooyan, Marjan Khanifar
BACKGROUND: A systemic skeletal disease is characterized by low bone mass and micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Asia has the highest increment in the elderly population; therefore, osteoporotic fracture should be a noticeable health issue. The incidence rate of hip fractures in Asia could rise to 45% by the year 2050. Complementary and alternative medicine (CAM) is a group of various medical and health care systems, practices, and products that are not presently considered as part of formal medicine...
May 2016: Iranian Journal of Medical Sciences
Sahana Shetty, Nitin Kapoor, Joseph Dian Bondu, Belavendra Antonisamy, Nihal Thomas, Thomas Vizhalil Paul
: Bone turnover markers (BTMs) provide important insights into the dynamics of bone remodelling and are subjected to preanalytical and ethnic variations in addition to influence of genetic and environmental factors. AIM/OBJECTIVES: To derive ethnicity specific reference range for BTMs and to study their correlation with Bone Mineral Density (BMD) in a cohort of healthy postmenopausal women and their premenopausal daughters and to look at the impact of maternal bone mineral status on daughters bone health...
November 2016: Clinical Endocrinology
Craig R Louer, Sean L Boone, Andre K Guthrie, John R Motley, Ryan P Calfee, Lindley B Wall
BACKGROUND: The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture. METHODS: This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population...
July 20, 2016: Journal of Bone and Joint Surgery. American Volume
Andrea Galassi, Maria Enrica Giovenzana, Federico Prolo, Anna Maria Colombo, Luciano Orsi, Sergio Fucci, Loredana Sorbara, Silvia Viganò, Chiara Clementi, Susi Falcaro, Sara Auricchio, Beatrice Dozio, Renzo Scanziani
The rate of fragile elderly patients affected by chronic kidney disease stage 5-5D is rapidly increasing. The decision making process regarding the start and the withdrawal of dialysis is often difficult for all those involved: patients, relatives, nephrologists and renal nurses. Therefore nephrologists and renal nurses are called to rapidly improve their theoretical and practical competence about the end-of-life care. The quality of clinical intervention and management requires a sound expertise in the ethical, legal, organizational and therapeutic aspects, not trivial nor even deductible from purely private and individual opinions nor from traditional medical practice...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
L G Machado, D S Domiciano, C P Figueiredo, V F Caparbo, L Takayama, R M Oliveira, J B Lopes, P R Menezes, R M R Pereira
: The present study investigates the relationship between visceral fat measured by dual-energy X-ray absorptiometry (DXA) and the incidence of non-spine fractures in community-dwelling elderly women. We demonstrated a potential negative effect of visceral fat on bone health in nonobese women. INTRODUCTION: The protective effect of obesity on bone health has been questioned because visceral fat has been demonstrated to have a deleterious effect on bone. The aim of this study was to investigate the association of visceral fat measured by DXA with the incidence of non-spine fractures in community-dwelling elderly women...
June 28, 2016: Osteoporosis International
Amina Benyahia, Éliane Abraham
Backup territorial coordination provides accompaniment and support for professionals who work with the fragile elderly people in an area. It aligns the sanitary, medical-social and social approaches, and mobilizes useful resources to optimize the treatment pathway. It has been implemented in the Nancy urban area by an operational team including nurses and a geriatric physician.
June 2016: Soins; la Revue de Référence Infirmière
Christian von Rüden, Peter Augat
This manuscript will provide an overview of how the age and osteoporosis related changes in mechanical properties of bone affect the stability of osteosynthesis constructs, both from a mechanical as well as from a clinical perspective. The manuscript will also address some of the principles of fracture fixation for osteoporotic fractures and discuss applications of osteoporotic fracture fixation at sites typically affected by fragility fractures, namely the distal radius, the proximal humerus, the femur and the spine...
June 2016: Injury
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"