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Multiple sclerosis fracture

Benjamin Hardy, Nicholas Sunderland, Mevan Perera, Kathryn Channing
A 56-year-old man presented having had two falls at home. He had a background of multiple sclerosis. After his second fall, during which he had fallen onto the toilet injuring his right chest, he was brought into the emergency department reporting pleuritic chest discomfort. Immediately evident was extensive swelling from his forehead to his thighs, which on palpation was found to be subcutaneous emphysema. A chest X-ray showed a large right-sided pneumothorax for which a chest drain was inserted. A CT revealed extensive surgical emphysema, pneumomediastinum, pneumoperitoneum and gas within the spinal canal...
December 2, 2016: BMJ Case Reports
Katharina D Hauck, Shaolin Wang, Charles Vincent, Peter C Smith
BACKGROUND: There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years. OBJECTIVE: To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days. RESEARCH DESIGN: The study used cross-sectional analysis of the medical records of all inpatients treated in 273 English hospitals...
February 2017: Medical Care
S Binks, R Dobson
Metabolic bone disease is a major public health concern, especially when it manifests as hip fracture which carries significant morbidity and mortality. Individuals with neurological disease are at higher risk of osteopenia, osteoporosis and fragility fracture compared to age-matched controls, yet this is under-appreciated by these patients. Clinician attention to this topic is therefore of importance and should address the bone health of men as well as women, a group in whom it may be an under-recognised problem...
October 2016: Current Osteoporosis Reports
Katarzyna Kępczyńska, Małgorzata Zajda, Zbigniew Lewandowski, Jerzy Przedlacki, Beata Zakrzewska-Pniewska
BACKGROUND: Vitamin D (VD), an important factor for bone health immobilization and immune regulation, has been shown to have low serum concentration in multiple sclerosis (MS) patients. Those patients have also multiple fracture risk factors, including progressive immobilization and long-term glucocorticoids treatment. The aim of the study was to analyze bone health (osteopenia or osteoporosis prevalence) and VD serum concentration in MS patients as well as the influence of disease activity and treatment on bone health...
July 2016: Neurologia i Neurochirurgia Polska
Markus Herrmann, Christopher-John L Farrell, Irene Pusceddu, Neus Fabregat-Cabello, Etienne Cavalier
In recent years it has been shown that vitamin D deficiency is associated with an increased incidence as well as the progression of a broad range of diseases including osteoporosis, rickets, cardiovascular disease, autoimmune disease, multiple sclerosis and cancer. Consequently, requests for the assessment of vitamin D status have increased dramatically. Despite significant progress in the analysis of vitamin D metabolites and an expansion of our pathophysiological knowledge of vitamin D, the assessment of vitamin D status remains a challenging and partially unresolved issue...
January 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
J Åivo, S Kurki, M-L Sumelahti, K Hänninen, J Ruutiainen, M Soilu-Hänninen
OBJECTIVES: Increased risk of osteoporotic fractures in multiple sclerosis (MS) patients compared with general population has been reported. The purpose of this study was to assess the risk of osteoporotic and other low-energy fractures in an MS cohort from a large hospital district in southwest Finland. Age-adjusted total and gender-specific prevalence for definite MS per 100 000 in a population of 472 139 was calculated as a point prevalence in December 31, 2012. MATERIALS AND METHODS: Patients with MS and comorbid fractures were identified by searching for ICD-9 and ICD-10 codes during a period from 2004 to 2012 from hospital administrative data in Turku University Hospital (TYKS) in southwest Finland Case ascertainment was performed by review of medical records...
June 22, 2016: Acta Neurologica Scandinavica
Beverlie L Ting, Marilyn Heng, Mark S Vrahas, Edward K Rodriguez, Mitchel B Harris, Michael J Weaver
OBJECTIVES: Avascular necrosis (AVN) of the femoral head is a devastating complication following fixation of femoral neck fractures in younger adults. In this study, we investigate the prognostic utility of disuse osteopenia. DESIGN: Retrospective study. SETTING: Three academic Level 1 trauma centers. PATIENTS: One hundred twenty patients younger than 60 years treated for a femoral neck fracture. INTERVENTION: N/A...
September 2016: Journal of Orthopaedic Trauma
Olwen Murphy, Michael S Zandi, Nitzan Lindenberg, Elaine Murphy, Jeremy Chataway
OBJECTIVES: To evaluate the bone health and vitamin D levels of a cohort of patients with relapses of multiple sclerosis (MS) and to propose an algorithm for the management of bone health in this patient group. METHODS: We prospectively studied 56 consecutive patients from our acute relapse clinic. 3 patients were excluded from analysis as they were not deemed to have experienced an acute MS relapse. Bone health was assessed with vitamin D levels and Dual Energy X-ray Absorptiometry (DEXA) scanning (10 patients failed to attend for DEXA)...
March 2016: Multiple Sclerosis and related Disorders
S T J Tsang, L A Mills, J Frantzias, J P Baren, J F Keating, A H R W Simpson
AIMS: The aim of this study was to identify risk factors for the failure of exchange nailing in nonunion of tibial diaphyseal fractures. PATIENTS AND METHODS: A cohort of 102 tibial diaphyseal nonunions in 101 patients with a mean age of 36.9 years (15 to 74) were treated between January 1992 and December 2012 by exchange nailing. Of which 33 (32%) were initially open injuries. The median time from primary fixation to exchange nailing was 6.5 months (interquartile range (IQR) 4...
April 2016: Bone & Joint Journal
G Michael Allan, Lynda Cranston, Adrienne Lindblad, James McCormack, Michael R Kolber, Scott Garrison, Christina Korownyk
Over the past decade, a large body of observational evidence has suggested an association between lower vitamin D status (25-hydroxyvitamin D) and multiple acute and chronic disorders, including cancer, multiple sclerosis, depression and respiratory tract infections. This evidence has fostered the hypothesis that increasing vitamin D intake may treat and prevent such disorders. Our objective was to perform a critical analysis of the highest-level evidence for ten common beliefs regarding vitamin D for the prevention of falls, fractures and respiratory tract infections, the reduction of cancer incidence/mortality and overall mortality, and the prevention or treatment of depression/mental well-being, rheumatoid arthritis and multiple sclerosis, as well as maximum dosing and regular testing...
July 2016: Journal of General Internal Medicine
Deepak M W Balak, Jan Nico Bouwes Bavinck, Aiko P J de Vries, Jenny Hartman, Hendrik A Martino Neumann, Robert Zietse, Hok Bing Thio
BACKGROUND: Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. METHODS: Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases...
February 2016: Clinical Kidney Journal
John P Ney, Barbara Johnson, Tom Knabel, Karolina Craft, Joel Kaufman
OBJECTIVE: To determine the value of neurologist ambulatory care in chronic neurologic diseases in a large administrative claims dataset detailing costs, adverse events, and health care utilization. METHODS: The Optum proprietary claims dataset (2010-2012) was examined to describe direct health care costs, as well as specific outcome metrics for a large population of persons with chronic neurologic illnesses. In phase I of the study, we detail neurologist involvement and differences in annualized allowed third--party payments within episode treatment groups (ETGs) for 10 neurologic illnesses...
January 26, 2016: Neurology
Josiah D Sault, James M Elliott
The patient was a 60-year-old woman, with long-standing balance deficits due to multiple sclerosis, referred to physical therapy by her primary care physician secondary to increasing fall frequency. Following evaluation, the physical therapist escorted the patient to her primary care physician's office, where a computed tomography scan was immediately performed, revealing a comminuted C2 articular pillar fracture.
December 2015: Journal of Orthopaedic and Sports Physical Therapy
J Borggrefe, S Giravent, G Campbell, F Thomsen, D Chang, M Franke, A Günther, M Heller, A Wulff
PURPOSE: In patients with multiple myeloma (MM), computed tomography is widely used for staging and to detect fractures. Detecting patients at severe fracture risk is of utmost importance. However the criteria for impaired stability of vertebral bodies are not yet clearly defined. We investigated the performance of parameters that can be detected by the radiologist for discrimination of patients with and without fractures. METHODS AND MATERIALS: We analyzed 128 whole body low-dose CT of MM patients...
November 2015: European Journal of Radiology
Etienne J Bisson, Elizabeth W Peterson, Marcia Finlayson
OBJECTIVES: To determine (1) the prevalence of lying on the floor or ground for ≥10 minutes (delayed initial recovery [IR]) and for >1 hour (long lie) after a fall; and (2) the factors associated with delayed IR among people with multiple sclerosis (PwMS). DESIGN: A secondary analysis of data available from a national, cross-sectional descriptive study of PwMS. Information regarding postfall experiences was extracted from open-ended questions about participants' most recent fall...
August 2015: Archives of Physical Medicine and Rehabilitation
Caitlin McArthur, John Hirdes, Katherine Berg, Lora Giangregorio
PURPOSE: To describe the proportion of residents receiving occupational therapy (OT) and physical therapy (PT) and the factors associated with receiving PT in long-term care (LTC) facilities across five provinces and one territory in Canada. METHODS: Using a population-based, retrospective analysis of cross-sectional data, the proportion of LTC facility residents in each province or territory receiving three different amounts (time and frequency) of PT, OT, or both before July 1, 2013, was calculated according to the Resource Utilization Groups-III rehabilitation classifications...
2015: Physiotherapy Canada. Physiothérapie Canada
Anil Agarwal, Kumar Shashi Kant, Tarun Suri, Neeraj Gupta, Indreshwar Verma, Abbas Shaharyar
PURPOSE: To review 10 children with calcaneal tuberculosis in terms of presentation, healing, and functional outcome. METHODS: Medical records of 7 boys and 3 girls aged 7 to 12 (mean, 9.8) years who presented with calcaneal tuberculosis were reviewed. The erythrocyte sedimentation rate of all patients was elevated. All patients presented with pain and swelling around the lateral malleolus and a 'heal-up' sign; 7 of them presented with an additional discharging sinus...
April 2015: Journal of Orthopaedic Surgery
Guixian Dong, Ning Zhang, Zhanpo Wu, Yumin Liu, Litao Wang
PURPOSE: The association between multiple sclerosis (MS) and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed. METHOD: Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated...
2015: BioMed Research International
Behzat Ozkan
Nutritional rickets (NR) remains the most common form of developmental bone disease, in spite of the efforts of clinicians and health care providers to reduce the incidence of the disease in Turkey. Today, it is well known that the etiology of NR exists along a spectrum ranging from isolated vitamin D deficiency to isolated calcium deficiency. In Turkey, almost all NR results from vita-min D deficiency that may have temporary but profound effects on short- and long-term skeletal development. Recent evidence suggests that vitamin D deficiency during infancy may predispose a patient to diseases such as diabetes mellitus, cancer, multiple sclerosis, etc...
August 2010: Eurasian Journal of Medicine
Shile Su, Hao Liu
Sever studies were performed to assess the association between multiple sclerosis (MS) and fracture risk. However, the results were inconsistent and inconclusive. In the present study, the possible association was investigated by a meta-analysis. Eligible articles were identified for the period up to August 2014. Pooled risk ratios (RR) with 95% confidence intervals (CI) were appropriately derived from random-effects models. Nine studies with more than 9,000,000 subjects were eligible. We found that MS was significant associated with fracture risk in overall population (OR = 1...
2014: International Journal of Clinical and Experimental Medicine
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