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https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#1
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29789004/a-population-based-study-of-the-risk-of-osteoporosis-and-fracture-with-dutasteride-and-finasteride
#2
Tony Antoniou, Erin M Macdonald, Zhan Yao, Tara Gomes, Mina Tadrous, Joanne M-W Ho, Muhammad M Mamdani, David N Juurlink
BACKGROUND: Dutasteride is a potent inhibitor of 5-alpha reductase enzymes that reduces concentrations of dihydrotestosterone to a greater extent than finasteride. Whether this has adverse implications for bone health is unknown. We compared the risk of osteoporosis and fractures in older men treated with dutasteride or finasteride. METHODS: We conducted a population-based retrospective cohort study with high-dimensional propensity score matching of Ontario men aged 66 years or older who started treatment with dutasteride or finasteride between January 1, 2006 and December 31, 2012...
May 22, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29762165/improved-fracture-prediction-using-different-frax-adjustments-in-hiv-infected-women
#3
Jingyan Yang, Anjali Sharma, Qiuhu Shi, Kathryn Anastos, Mardge H Cohen, Elizabeth T Golub, Deborah Gustafson, Daniel Merenstein, Wendy J Mack, Phyllis C Tien, Jeri Nieves, Michael T Yin
OBJECTIVES: A Fracture risk assessment tool (FRAX®) using clinical risk factors (CRFs) alone underestimates fracture risk in HIV-infected men. Our objective was to determine whether accuracy of FRAX would be improved by considering HIV as a cause of secondary osteoporosis, and further improved with addition of DXA parameters in HIV-infected women. DESIGN: Subgroup analysis of Women's Interagency HIV Study. METHODS: We included 1148 women (900 HIV-infected and 248 uninfected) over age 40 with data to approximate FRAX CRFs and 10-year observational data for incident fragility fractures; 181 (20%) HIV-infected women had DXA data...
May 11, 2018: AIDS
https://www.readbyqxmd.com/read/29749006/predictors-of-recurrence-in-remitted-late-life-depression
#4
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/29741198/the-use-of-figurative-language-to-describe-frailty-in-older-adults
#5
B Buta, D Leder, R Miller, N L Schoenborn, A R Green, R Varadhan
INTRODUCTION: Frailty affects 15% of non-institutionalized older adults in the United States, yet confusion remains in defining and, in turn, assessing frailty. Figurative language, such as metaphor, can help to explain difficult scientific concepts and to form new theories. We aimed to examine the use of figurative language to describe frailty and to identify themes in the way figurative expressions are used. Understanding how frailty is described figuratively may offer insights for developing useful communication approaches in research settings...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29739655/identifying-research-priorities-around-psycho-cognitive-and-social-factors-for-recovery-from-hip-fractures-an-international-decision-making-process
#6
Mohammad Auais, Simon D French, Lauren Beaupre, Lora Giangregorio, Jay Magaziner
Hip fractures rank in the top ten disabling conditions worldwide. With an ageing population, this public health problem is expected to increase. Despite the success of surgery for hip fractures and the extensive health services utilisation, health outcomes are often poor. Considering the recovery process as multifactorial and intervening to address all relevant factors may improve recovery rates. However, we need first to fully understand the factors contributing to recovery after hip fractures, including psycho-cognitive and social factors...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29721333/diabetes-mellitus-and-bone-health-epidemiology-etiology-and-implications-for-fracture-risk-stratification
#7
Rodrigo J Valderrábano, Maria I Linares
Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice...
2018: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29699732/vertebral-fragility-fractures-vff-who-when-and-how-to-operate
#8
Opinder Sahota, Terence Ong, Khalid Salem
Vertebral Fragility Fractures (VFF) are common and lead to pain, long term disability and increased mortality. Most patients will have mild to moderate pain symptoms and can be managed conservatively. However, patients with severe pain who have minimal or no pain relief with potent analgesia, or who only achieve adequate pain relief with high doses of morphine based analgesia which results in significant adverse events, should be considered for vertebral augmentation. Ideally, for vertebral augmentation, patients should present within four months of the fracture (onset of acute pain) and have at least 3 weeks of failure of conservative treatment although early intervention may be more appropriate for hospitalised patients, who tend to be older, more frail and likely to be less tolerant to the adverse effects of conservative treatment...
April 22, 2018: Injury
https://www.readbyqxmd.com/read/29690569/geriatric-helper-an-mhealth-application-to-support-comprehensive-geriatric-assessment
#9
Samuel Silva, Rafael Felgueiras, Ilídio C Oliveira
The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary diagnosis approach that considers several dimensions of fragility in older adults to develop an individualized plan to improve their overall health. Despite the evidence of its positive impact, CGA is still applied by a reduced number of professionals in geriatric care in many countries, mostly using a paper-based approach. In this context, we collaborate with clinicians to bring CGA to the attention of more healthcare professionals and to enable its easier application in clinical settings by proposing a mobile application, Geriatric Helper, to act as a pocket guide that is easy to update remotely with up-to-date information, and that acts as a tool for conducting CGA...
April 22, 2018: Sensors
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#10
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29672393/prospective-prognostic-cohort-study-of-pressure-injuries-in-older-adult-patients-with-hip-fractures
#11
Cristiana Forni, Fabio D'Alessandro, Rossana Genco, Sandra Mini, Teresa Notarnicola, Arianna Vitulli, Daniela Capezzali, Mattia Morri
OBJECTIVE: The aim of this study was to assess the rate of pressure injury and real predictors thereof in the older adult population with hip fractures in an orthopedic hospital. METHODS: In this prospective prognostic cohort study, all patients admitted with fragility hip fractures were monitored over a 12-month period. On a daily basis, ward nurses and physiotherapists assessed the condition of the patients' skin and collected data about all the predictors connected to their healthcare and hospital organization until the patients were discharged from hospital or until the onset of pressure injury...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29669177/mutations-that-alter-the-carboxy-terminal-propeptide-cleavage-site-of-the-chains-of-type-i-procollagen-are-associated-with-a-unique-osteogenesis-imperfecta-phenotype
#12
Tim Cundy, Michael Dray, John Delahunt, Jannie Dahl Hald, Bente Langdahl, Chumei Li, Marta Szybowska, Shehla Mohammed, Emma L Duncan, Aideen M McInerney-Leo, Patricia G Wheeler, Paul Roschger, Klaus Klaushofer, Jyoti Rai, MaryAnn Weis, David Eyre, Ulrike Schwarze, Peter H Byers
Osteogenesis imperfecta (OI) is a genetic bone disorder characterized by fractures, low bone mass, and skeletal fragility. It most commonly arises from dominantly inherited mutations in the genes COL1A1 and COL1A2 that encode the chains of type I collagen. A number of recent reports have suggested that mutations affecting the carboxyl-terminal propeptide cleavage site in the products of either COL1A1 or COL1A2 give rise to a form of OI characterized by unusually dense bones. We have assembled clinical, biochemical, and molecular data from 29 individuals from 8 families with 7 different mutations affecting the C-propeptide cleavage site...
April 18, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29664526/-perioperative-care-of-older-patients-with-hip-fractures
#13
Francisco Bengoa, Marcela Carrasco, Pedro Pablo Amenábar, Daniel Schweitzer, Eduardo Botello, Ianiv Klaber
The number of osteoporotic fractures is increasing along with population aging. Most patients with these type of fractures are older than 65 years, with multiple chronic conditions and different degrees of disability. Hip fracture is the most relevant osteoporotic fracture due to its frequency, costs, severity and complications. Multidisciplinary management is of the utmost importance to obtain good therapeutic results. We herein review the management of this fracture. Orthogeriatric joint management should be incorporated in fragility fracture treatment...
November 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29658144/bone-fragility-in-turner-syndrome-fracture-prevalence-and-risk-factors-determined-by-a-national-patient-survey
#14
Halley Wasserman, Philippe F Backeljauw, Jane C Khoury, Heidi J Kalkwarf, Catherine M Gordon
OBJECTIVE: Osteoporosis is considered a comorbidity of adult women with Turner Syndrome (TS). Limited data are available on fracture prevalence in girls and women with this diagnosis. We aimed to determine the prevalence of fractures in individuals with TS in the United States and identify risk factors for fracture. DESIGN: Girls and women with TS were invited to participate in an anonymous, self-report, national survey from November 2016 to March 2017. Non-TS controls were obtained through direct contacts of TS participants...
April 15, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29651599/-spirituality-in-old-age-as-dynamic-aging-task
#15
Anna Janhsen, Heidrun Golla, Vanessa Romotzky, Christiane Woopen
BACKGROUND: A multitude of studies have demonstrated a positive effect of spirituality for dealing with difficult situations in life; however, specific studies on spirituality in older age are exceptionally rare within the German gerontological research landscape. The theory of gerotranscendence by Tornstam indicates that spirituality is of particular importance for maintaining life satisfaction especially in older age, due to a change in perspective. OBJECTIVES: This study looked into the research questions of how spirituality is presented in the oldest old (80 years and older) in Germany and to what extent its characteristics are specific to older age...
April 12, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29643155/femoral-nerve-block-intervention-in-neck-of-femur-fracture-finof-a-randomised-controlled-trial
#16
Martin Rowlands, Gerrie van de Walt, Jim Bradley, Alexa Mannings, Sarah Armstrong, Nigel Bedforth, Iain K Moppett, Opinder Sahota
OBJECTIVE: Fractured neck of femur is a severely painful condition with significant mortality and morbidity. We investigated whether early and continuous use of femoral nerve block can improve pain on movement and mobility after surgery in older participants with fragility neck of femur fracture. DESIGN: Prospective single-centre, randomised controlled pragmatic trial. SETTING: Secondary care, acute National Health Service Trust, UK. PARTICIPANTS: Participants admitted with a history and examination suggesting fractured neck of femur...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29623238/the-effectiveness-of-osteoporosis-screening-and-treatment-in-the-midwest
#17
Dharmik Patel, John R Worley, David A Volgas, Brett D Crist
Introduction: With osteoporosis on the rise across the United States, the goal of this prospective study is to determine the effectiveness of our Midwest level-1 trauma center in diagnosing, treating, and educating osteoporosis patients after fracture with the use of questionnaires. Secondarily, we aimed to identify barriers that prevent our patients from complying with bone health recommendations. Methods: One hundred participants (≥55 years) were given 2 questionnaires (Fracture Risk Assessment Tool and a study-specific questionnaire) that were administered during the patient's visit to the orthopedic trauma clinic...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29599828/age-related-changes-of-the-spinal-cord-a-biomechanical-study
#18
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/29572662/clinical-pharmacokinetics-of-amikacin-in-pediatric-patients-a-comprehensive-review-of-population-pharmacokinetic-analyses
#19
REVIEW
Sílvia M Illamola, Catherine M Sherwin, J G Coen van Hasselt
Amikacin plays a key role in the treatment of severe hospital-acquired infections with Gram-negative bacteria. Therapeutic use of amikacin is challenged by high inter-individual variability (IIV) combined with a narrow therapeutic spectrum. Pediatric patients represent a particularly fragile population where adequate dosing is crucial yet challenging to achieve due significant IIV associated with developmental processes and other factors. The current review provides an overview of parametric population pharmacokinetic analyses of amikacin in pediatric patients and associated patient-specific determinants of IIV...
March 23, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29570545/developing-and-testing-an-international-audit-of-nursing-quality-indicators-for-older-adults-with-fragility-hip-fracture
#20
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Orthopaedic Nursing
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