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https://www.readbyqxmd.com/read/28175979/mind-the-treatment-gap-a-global-perspective-on-current-and-future-strategies-for-prevention-of-fragility-fractures
#1
REVIEW
N C W Harvey, E V McCloskey, P J Mitchell, B Dawson-Hughes, D D Pierroz, J-Y Reginster, R Rizzoli, C Cooper, J A Kanis
This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into four distinct themes: (1) case finding and management of individuals at high risk of fracture, (2) public awareness of osteoporosis and fragility fractures, (3) reimbursement and health system policy and (4) epidemiology of fracture in the developing world. Findings from cohort studies, randomised controlled trials, systematic reviews and meta-analyses, in addition to current clinical guidelines, position papers and national and international audits, are summarised, with the intention of providing a prioritised approach to delivery of optimal bone health for all...
February 7, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28110293/increased-use-of-oral-anticoagulants-in-patients-with-atrial-fibrillation-temporal-trends-from-2005-to-2015-in-denmark
#2
Kasper Gadsbøll, Laila Staerk, Emil Loldrup Fosbøl, Caroline Sindet-Pedersen, Anna Gundlund, Gregory Y H Lip, Gunnar Hilmar Gislason, Jonas Bjerring Olesen
AIM: The aim of this study is to examine temporal trends in the use oral anticoagulants (OAC) as stroke prophylaxis in patients with atrial fibrillation (AF) and to examine factors associated with OAC initiation. METHODS AND RESULTS: From Danish nationwide registries, we identified patients diagnosed with AF at Danish hospitals and outpatient clinics between January 2005 and June 2015. OAC initiation was assessed from prescription fills ±180 days from date of AF diagnosis...
January 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28108441/child-with-multiple-fractures-a-rare-presentation-of-a-common-disease
#3
Filipa Dias Costa, Carla Maia, Susana Almeida, Ricardo Ferreira
Bone fractures are not uncommon in paediatric age. However, when recurrent, an underlying clinical condition must not be excluded. We describe the case of a boy aged 7 years, referred for investigation of recurrent bone fractures. Personal and family histories were unremarkable. Physical examination was normal. Almost all primary bone disorders were excluded. Additional laboratory investigations ruled out the majority of secondary causes of bone fragility. Coeliac disease (CD) serologies, however, were positive, and duodenal biopsies confirmed this diagnosis (Marsh III B)...
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28104509/morphometric-vertebral-fractures-in-breast-cancer-patients-treated-with-adjuvant-aromatase-inhibitor-therapy-a-cross-sectional-study
#4
Rebecca Pedersini, Sara Monteverdi, Gherardo Mazziotti, Vito Amoroso, Elisa Roca, Filippo Maffezzoni, Lucia Vassalli, Filippo Rodella, Anna Maria Formenti, Stefano Frara, Roberto Maroldi, Alfredo Berruti, Edda Simoncini, Andrea Giustina
BACKGROUND: The impact of long-term adjuvant therapy with aromatase inhibitors (AIs) on vertebral fracture (VF) risk is still unclear. OBJECTIVE: In this cross-sectional study, we explored the prevalence and determinants of VFs in breast cancer (BC) patients before and during AI therapy. Each woman underwent a dual-energy X-ray absorptiometry (DXA) to evaluate bone mineral density (BMD) and identify VFs by a quantitative morphometric approach. Blood samples were collected to measure serum hormone and calcium levels...
January 16, 2017: Bone
https://www.readbyqxmd.com/read/28099667/clinical-functional-vulnerability-index-20-ivcf-20-rapid-recognition-of-frail-older-adults
#5
Edgar Nunes de Moraes, Juliana Alves do Carmo, Flávia Lanna de Moraes, Raquel Souza Azevedo, Carla Jorge Machado, Dalia Elena Romero Montilla
OBJECTIVE: To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS: The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults...
December 22, 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28089404/the-schhs-hip-fracture-clinical-network-experience-improving-care-and-outcomes-through-an-interprofessional-approach
#6
Gillian Puckeridge, Morné Terblanche, Debbie Massey
BACKGROUND: Hip fractures are a major global health care issue, with the 1.26 million estimated cases in 1990 predicted to increase to 4.5 million by 2050. Varying models of care have been developed to improve outcomes following fragility hip fractures. Most of these care models embrace an interprofessional approach to care. Specialist orthopedic nurses play an important role in the management of fragility hip fracture patients and their contribution to the interprofessional health care team is an important predictor of patient outcomes...
December 18, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28068558/targeted-next-generation-sequencing-of-the-entire-vitamin-d-receptor-gene-reveals-polymorphisms-correlated-with-vitamin-d-deficiency-among-older-filipino-women-with-and-without-fragility-fracture
#7
Mark Pretzel Zumaraga, Paul Julius Medina, Juan Miguel Recto, Lauro Abrahan, Edelyn Azurin, Celeste C Tanchoco, Cecilia A Jimeno, Cynthia Palmes-Saloma
This study aimed to discover genetic variants in the entire 101 kB vitamin D receptor (VDR) gene for vitamin D deficiency in a group of postmenopausal Filipino women using targeted next generation sequencing (TNGS) approach in a case-control study design. A total of 50 women with and without osteoporotic fracture seen at the Philippine Orthopedic Center were included. Blood samples were collected for determination of serum vitamin D, calcium, phosphorus, glucose, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase and as primary source for targeted VDR gene sequencing using the Ion Torrent Personal Genome Machine...
December 21, 2016: Journal of Nutritional Biochemistry
https://www.readbyqxmd.com/read/28068425/predictive-factors-for-pressure-ulcers-in-an-older-adult-population-hospitalized-for-hip-fractures-a-prognostic-cohort-study
#8
Paolo Chiari, Cristiana Forni, Monica Guberti, Domenica Gazineo, Sabrina Ronzoni, Fabio D'Alessandro
BACKGROUND: Older adult patients with fragility hip fractures constitute a population at high risk for complications, in particular pressure ulcers. The aim was to evaluate the incidence of pressure ulcers and potential predictive factors. METHODS AND FINDINGS: A prospective multicentric prognostic cohort study in orthopedic wards in three Italian public hospitals. Participants were all consecutive patients 65 years of age or older diagnosed with a fragility hip fracture...
2017: PloS One
https://www.readbyqxmd.com/read/28039870/outcomes-of-treated-hypertension-at-age-80-and-older-cohort-analysis-of-79-376-individuals
#9
João Delgado, Jane A H Masoli, Kirsty Bowman, W David Strain, George A Kuchel, Kate Walters, Louise Lafortune, Carol Brayne, David Melzer, Alessandro Ble
OBJECTIVES: To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN: Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING: Primary care practices in England (Clinical Practice Research Datalink). PARTICIPANTS: Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end-stage renal failure at baseline...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28032704/treatment-and-management-of-osteoporotic-fractures-a-nation-wide-survey-of-484-senior-orthopaedists-in-china
#10
Yi Man, Wei Pan, Jin Lu, Sen-Yuan Li, Pian Zhang, Jun-Zhe Guo, Shu-Fang Yu, Bei Zhang, En Xiao, Chao Zhang, Wei Zuo, He-Juan Jin, Yi Chen, Bin Wu, Xiao-En Shi, Di Hong, Xun Liu, Ying-Xu Gao, Jing Li, Lu Yin, Qing-Yun Xue
OBJECTIVE: To investigate the treatment given to osteoporotic fracture patients by orthopaedists at major hospitals in China. METHODS: A 25-item quantitative questionnaire survey, categorized into five domains, including primary purpose of osteoporosis treatment, anti-osteoporosis therapy, calcium and vitamin D supplement, monitoring of osteoporosis, and knowledge of osteoporosis treatment, was designed to elicit information on orthopaedists' views on the treatment of osteoporotic fracture...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28007756/eular-efort-recommendations-for-management-of-patients-older-than-50%C3%A2-years-with-a-fragility-fracture-and-prevention-of-subsequent-fractures
#11
W F Lems, K E Dreinhöfer, H Bischoff-Ferrari, M Blauth, E Czerwinski, Jap da Silva, A Herrera, P Hoffmeyer, T Kvien, G Maalouf, D Marsh, J Puget, W Puhl, G Poor, L Rasch, C Roux, S Schüler, B Seriolo, U Tarantino, T van Geel, A Woolf, C Wyers, P Geusens
The European League Against Rheumatism (EULAR) and the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) have recognised the importance of optimal acute care for the patients aged 50 years and over with a recent fragility fracture and the prevention of subsequent fractures in high-risk patients, which can be facilitated by close collaboration between orthopaedic surgeons and rheumatologists or other metabolic bone experts. Therefore, the aim was to establish for the first time collaborative recommendations for these patients...
December 22, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28002377/own-the-bone-a-system-based-intervention-improves-osteoporosis-care-after-fragility-fractures
#12
Andrew D Bunta, Beatrice J Edwards, William B Macaulay, Kyle J Jeray, Laura L Tosi, Clifford B Jones, Debra L Sietsema, John D Kaufman, Sarah A Murphy, Juhee Song, James A Goulet, Gary E Friedlaender, Marc F Swiontkowski, Douglas R Dirschl
BACKGROUND: The goal of this study was to evaluate the effectiveness of the American Orthopaedic Association's Own the Bone secondary fracture prevention program in the United States. METHODS: The objective of this quality improvement cohort study was dissemination of Own the Bone and implementation of secondary prevention (osteoporosis pharmacologic and bone mineral density [BMD] test recommendations). The main outcome measures were the number of sites implementing Own the Bone and implementation of secondary prevention, i...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27973563/frequent-use-of-emergency-departments-by-the-elderly-population-when-continuing-care-is-not-well-established
#13
Jacopo M Legramante, Laura Morciano, Francesca Lucaroni, Francesco Gilardi, Emanuele Caredda, Alessia Pesaresi, Massimo Coscia, Stefano Orlando, Antonella Brandi, Germano Giovagnoli, Vito N Di Lecce, Giuseppe Visconti, Leonardo Palombi
INTRODUCTION: The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users"...
2016: PloS One
https://www.readbyqxmd.com/read/27933155/a-quality-improvement-initiative-on-the-management-of-osteoporosis-in-older-people-with-parkinsonism
#14
Inderpal Singh, Rachel Fletcher, Linda Scanlon, Mandy Tyler, Shridhar Aithal
The risk of falls is higher in patients with people with Parkinsonism (PwP) compared to those without Parkinsonism, and leads to adverse outcomes including fragility fractures. Osteoporosis is under-recognised, and the prevalence of fragility fractures in not well studied. The primary aim of this project is for 100% of new patient referrals to, and 80% of follow up patients within the movement disorder (MD) service with osteoporosis to be treated in accordance with evidence based osteoporosis guidance. Routinely captured information regarding demographics and fragility fractures was retrospectively extracted from the clinical workstation, clinic letters, and clinical coding between July and November 2015...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#15
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
January 2017: Drugs & Aging
https://www.readbyqxmd.com/read/27904025/early-raas-blockade-exerts-renoprotective-effects-in-autosomal-recessive-alport-syndrome
#16
Nao Uchida, Naonori Kumagai, Kandai Nozu, Xue Jun Fu, Kazumoto Iijima, Yoshiaki Kondo, Shigeo Kure
Alport syndrome is a progressive renal disease caused by mutations in COL4A3, COL4A4, and COL4A5 genes that encode collagen type IV alpha 3, alpha 4, and alpha 5 chains, respectively. Because of abnormal collagen chain, glomerular basement membrane becomes fragile and most of the patients progress to end-stage renal disease in early adulthood. COL4A5 mutation causes X-linked form of Alport syndrome, and two mutations in either COL4A3 or COL4A4 causes an autosomal recessive Alport syndrome. Recently, renin-angiotensin-aldosterone system (RAAS) blockade has been shown to attenuate effectively disease progression in Alport syndrome...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27875831/social-support-systems-and-social-network-characteristics-of-older-adults-with-hiv
#17
Mark Brennan-Ing, Liz Seidel, Stephen E Karpiak
Social networks of older adults with HIV have been characterized as fragile, with a greater reliance on friends as compared to family. However, we know little about the subgroup differences in the social network constellations of this population, how such characteristics are related to social support resources, and their relationship with psychosocial well-being. We developed a typology of social networks of older HIV-positive adults and examined if they would be related to receipt of informal assistance, perceptions of support sufficiency, and psychosocial well-being...
2017: Interdisciplinary Topics in Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27852598/frailty-and-bone-health-in-european-men
#18
Michael J Cook, Alexander Oldroyd, Stephen R Pye, Kate A Ward, Evelien Gielen, Rathi Ravindrarajah, Judith E Adams, David M Lee, Gyorgy Bartfai, Steven Boonen, Felipe Casanueva, Gianni Forti, Aleksander Giwercman, Thang S Han, Ilpo T Huhtaniemi, Krzysztof Kula, Michael E Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Frederick C Wu, Terence W O'Neill
BACKGROUND: frailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health. METHODS: men aged 40-79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA)...
November 16, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27823868/effects-of-glimepiride-versus-saxagliptin-on-%C3%AE-cell-function-and-hypoglycemia-a-post-hoc-analysis-in-older-patients-with-type-2-diabetes-inadequately-controlled-with-metformin
#19
Shira Perl, William Cook, Cheryl Wei, Peter Ohman, Boaz Hirshberg
PURPOSE: The management of hyperglycemia is challenging in older patients with type 2 diabetes owing to excess fragility and risk for adverse outcomes should hypoglycemia episodes occur. We evaluated baseline β-cell function as a potential risk factor for the development of hypoglycemia when saxagliptin or glimepiride was added in patients aged ≥65 years whose type 2 diabetes was poorly controlled on stable metformin monotherapy. METHODS: A post hoc analysis of data from the GENERATION (Efficacy and Tolerability of Saxagliptin Compared with Glimepiride in Elderly Patients with Type 2 Diabetes: A Randomized, Controlled Study) trial, which enrolled 720 patients aged ≥65 years, was conducted...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27818369/french-law-what-about-a-reasoned-reimbursement-of-serum-vitamin-d-assays
#20
Jean-Claude Souberbielle, Claude Laurent Benhamou, Bernard Cortet, Mickael Rousière, Christian Roux, Vered Abitbol, Cédric Annweiler, Maurice Audran, Justine Bacchetta, Pierre Bataille, Olivier Beauchet, Rémi Bardet, Alexandra Benachi, Francis Berenbaum, Hubert Blain, Françoise Borson-Chazot, Véronique Breuil, Karine Briot, Philippe Brunet, Jean-Claude Carel, Philippe Caron, Olivier Chabre, Philippe Chanson, Roland Chapurlat, Pierre Cochat, Régis Coutant, Sophie Christin-Maitre, Martine Cohen-Solal, Christian Combe, Catherine Cormier, Marie Courbebaisse, Grégory Debrus, Brigitte Delemer, Georges Deschenes, Marc Duquenne, Guillaume Duval, Patrice Fardellone, Denis Fouque, Gérard Friedlander, Jean-Bernard Gauvain, Lionel Groussin, Pascal Guggenbuhl, Pascal Houillier, Thierry Hannedouche, William Jacot, Rose-Marie Javier, Guillaume Jean, Claude Jeandel, Dominique Joly, Peter Kamenicky, Bertrand Knebelmann, Marie-Hélène Lafage-Proust, Yves LeBouc, Erick Legrand, Florence Levy-Weil, Agnès Linglart, Laurent Machet, Emmanuel Maheu, Eric Mallet, Christian Marcelli, Pierre Marès, Christophe Mariat, Gérard Maruani, Yves Maugars, France Montagnon, Bruno Moulin, Philippe Orcel, Henri Partouche, Virginie Personne, Charles Pierrot-Deseilligny, Michel Polak, Claire Pouteil-Noble, Dominique Prié, Agathe Raynaud-Simon, Yves Rolland, Jean-Louis Sadoul, Bernard Salle, Corinne Sault, Anne-Marie Schott, Isabelle Sermet-Gaudelus, Martin Soubrier, Ivan Tack, Eric Thervet, Isabelle Tostivint, Philippe Touraine, Florence Tremollières, Pablo Urena-Torres, Jean-Paul Viard, Jean-Louis Wemeau, Georges Weryha, Norbert Winer, Jacques Young, Thierry Thomas
The number of serum 25-hydroxyvitamin D (25OHD) assays has increased tenfold in France in less than 10 years, sometimes for invalidated reasons. In 2013, the French National Authority for Health (Haute autorité de santé, or HAS) limited the indications for serum 25OHD measurements to rickets/osteomalacia, older adults with recurrent falls, monitoring of kidney transplant in adults, and surgical treatment of obesity in adults. Our aim here was to note that other indications for serum 25OHD measurements are supported by previous literature and by a number of national and international recommendations, in particular the following: any situation of bone fragility, any chronic renal failure <45 mL/min/1...
December 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
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