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older and fragility

R Y van der Velde, C E Wyers, E Teesselink, P P M M Geusens, J P W van den Bergh, F de Vries, C Cooper, N C Harvey, T P van Staa
INTRODUCTION: Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD). METHODS: We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000person-years (py)...
October 11, 2016: Bone
Robin S Mickelson, Kim M Unertl, Richard J Holden
BACKGROUND: Older adults with chronic disease struggle to manage complex medication regimens. Health information technology has the potential to improve medication management, but only if it is based on a thorough understanding of the complexity of medication management workflow as it occurs in natural settings. Prior research reveals that patient work related to medication management is complex, cognitive, and collaborative. Macrocognitive processes are theorized as how people individually and collaboratively think in complex, adaptive, and messy nonlaboratory settings supported by artifacts...
October 12, 2016: JMIR Human Factors
Y Su, J Leung, D Hans, B Aubry-Rozier, T Kwok
: The thresholds of trabecular bone score (TBS) require validation for clinical application in older Chinese people. The lower threshold of TBS significantly improved the accuracy of prediction by bone mineral density-based osteoporosis status for major osteoporotic fracture in older Chinese men. INTRODUCTION: Trabecular bone score (TBS) is a relatively new indicator of skeletal fragility. Its clinical application warrants further investigations. Our aim was to validate and recommend practical thresholds of TBS for fracture prediction in older Chinese people...
October 11, 2016: Osteoporosis International
Charline Estublier, Roland Chapurlat, Pawel Szulc
OBJECTIVE: Data on the relationship between disc degeneration (DD) and fragility fractures in men are limited. The aim of this study was to prospectively analyse the risk of vertebral and non-vertebral fractures in men with thoracolumbar DD according to the severity of its radiological signs: disc space narrowing (DSN), osteophytes and endplate sclerosis. METHODS: Men >50 years of age (n = 765) had lateral spine radiographs and DXA and were monitored prospectively...
October 3, 2016: Rheumatology
Adamah Amouzougan, Ludovic Lafaie, Hubert Marotte, Delphine Dẻnariẻ, Philippe Collet, Béatrice Pallot-Prades, Thierry Thomas
INTRODUCTION: Alzheimer's disease or other Dementias (ADD) and postmenopausal osteoporosis are two major public health problems with a huge impact on mortality. Here, we examined the prevalence of ADD in postmenopausal women with osteoporosis, monitored within a dedicated fracture liaison service. METHODS: We conducted a cross-sectional observational study in a population of 2041 women, visiting the university hospital of Saint-Etienne for a peripheral fragility fracture...
September 30, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Jessica Chen, Peter Smerdely
: Hypocalcaemia following denosumab therapy can be observed in older adults. This is more common if their pre-treatment corrected serum calcium concentrations are less than 2.28 mmol/L. Denosumab remains a safe treatment in older people but we recommend a cautious approach in people at risk. INTRODUCTION: Previous studies have indicated that denosumab, an anti-RANK ligand (RANKL) monoclonal antibody, for treatment of osteoporosis is well-tolerated. There is little data specifically regarding its adverse effect profile in a hospitalised older person...
September 28, 2016: Osteoporosis International
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
Laura K Bachrach, Catherine M Gordon
Concerns about bone health and potential fragility in children and adolescents have led to a high interest in bone densitometry. Pediatric patients with genetic and acquired chronic diseases, immobility, and inadequate nutrition may fail to achieve expected gains in bone size, mass, and strength, leaving them vulnerable to fracture. In older adults, bone densitometry has been shown to predict fracture risk and reflect response to therapy. The role of densitometry in the management of children at risk of bone fragility is less clear...
September 26, 2016: Pediatrics
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
Chu-Hsu Lin, Kai-Hua Chen, Chien-Min Chen, Chia-Hao Chang, Tung-Jung Huang, Hung-Chih Hsu, Shih-Yang Huang
BACKGROUND: The aim of this prospective study was to investigate the relationship between lifestyle factors including nutrition intake and the incidence of fall-related fragility fractures in postmenopausal women. METHODS: A total of 1169 female volunteers were recruited from participants at the morning health examinations held at each local public health center in the West Chiayi County of Taiwan at the beginning of the study. Laboratory examinations, anthropometric measurements, and questionnaire interviews inquiring about lifestyle factors, including weekly nutrition intake, were performed...
June 2016: Biomedical Journal
Saira A Mathew, Elise Gane, Kristiann C Heesch, Steven M McPhail
BACKGROUND: Older adults hospitalized with fragility fractures are at high risk of negative events that can culminate in re-presentations to hospital emergency departments or readmissions to hospital. This systematic review aimed to identify patient, clinical, or hospital-related factors that are identifiable at the index admission and that may be associated with re-presentations to hospital emergency departments or hospital readmissions in older adults following fragility fractures. METHODS: Four electronic databases (PubMed, CINAHL, Embase, and Scopus) were searched...
2016: BMC Medicine
Connie Bøttcher Berthelsen, Kirsten Frederiksen
The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim and Lundman...
May 4, 2016: International Journal of Orthopaedic and Trauma Nursing
Svetlana V Doubova, Sergio Sánchez-García, Claudia Infante-Castañeda, Ricardo Pérez-Cuevas
BACKGROUND: To analyze the factors associated with regular physical exercise and routine consumption of fruits and vegetables, and both healthy behaviors among Mexican older adults. METHODS: We conducted a secondary data analysis of the baseline data (2014) of the Study on Obesity, Sarcopenia and Fragility in older adults affiliated with the Mexican Institute of Social Security. The study included 948 adults who were ≥60 years of age. Multiple Poisson regression was performed...
2016: BMC Public Health
Bruno M L Rocha, Luiz Menezes Falcão
Heart failure (HF) is an increasingly prevalent syndrome and a leading cause of both first hospitalization and readmissions. Strikingly, up to 25% of the patients are readmitted within 30 to 60-days, accounting for HF as the primary cause for readmission in the adult population. Given its poor prognosis, one could describe it as a "malignant condition". Acute decompensation is intrinsically related to increased right heart tele-diastolic pressures and often related to congestive symptoms. In-hospital strategies to adequately compensate and timely discharge patients are limited...
November 15, 2016: International Journal of Cardiology
Suzanne M Dyer, Maria Crotty, Nicola Fairhall, Jay Magaziner, Lauren A Beaupre, Ian D Cameron, Catherine Sherrington
BACKGROUND: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. METHODS: Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review...
2016: BMC Geriatrics
Artem Vorobyev, Ralf J Ludwig, Enno Schmidt
INTRODUCTION: Epidermolysis bullosa acquisita (EBA) is a rare autoimmune blistering disease of skin and mucous membranes. EBA is caused by autoantibodies against type VII collagen, which is a major component of anchoring fibrils, attaching epidermis to dermis. Binding of autoantibodies to type VII collagen leads to skin fragility and, finally, blister formation. The clinical picture of EBA is polymorphic, with several distinct phenotypes being described. Despite recent progress in understanding the pathophysiology of EBA, its diagnosis is still challenging...
September 8, 2016: Expert Review of Clinical Immunology
Priscilla Rayanne E Silva Noll, Nusa de Almeida Silveira, Matias Noll, Patrícia de Sá Barros
Although several health-risk behaviors of adolescents have been described in the literature, data of high school students who reside at educational institutions in developing countries are scarce. This study aimed to describe behaviors associated with health risks among high school students who reside at an educational public institution and to associate these variables with the length of stay at the institution. This cross-sectional study was conducted during the year 2015 and included 122 students aged 14-19 years at a federal educational institution in the Midwest of Brazil; students were divided into residents of <8 months and those of >20 months...
2016: PloS One
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
G Cramarossa, M B Urowitz, J Su, D Gladman, Z Touma
BACKGROUND: Systemic lupus erythematosus (SLE) patients are often treated with glucocorticoids, which place them at risk of bone loss. OBJECTIVES: The objectives of this article are to determine: (1) the prevalence of low bone mineral density (BMD) and factors associated with low BMD and (2) the prevalence of symptomatic fragility fractures in inception patients of the Toronto Lupus Cohort (TLC). METHODS: Prospectively collected data from the TLC (1996-2015) of inception patients' first BMD were analyzed...
August 13, 2016: Lupus
M Gosch, Y Hoffmann-Weltin, T Roth, M Blauth, J A Nicholas, C Kammerlander
BACKGROUND: Fragility fractures are a major health care problem worldwide. Both hip and non-hip fractures are associated with excess mortality in the years following the fracture. Residents of long-term nursing homes represent a special high-risk group for poor outcomes. Orthogeriatric co-management models of care have shown in multiple studies to have medical as well as economic advantages, but their impact on this high-risk group has not been well studied. OBJECTIVE: We studied the outcome of long-term care residents with hip and non-hip fractures admitted to a geriatric fracture center...
October 2016: Archives of Orthopaedic and Trauma Surgery
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