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Pathological fractures in elderly

Sara Guerri, Daniele Mercatelli, Maria Pilar Aparisi Gómez, Alessandro Napoli, Giuseppe Battista, Giuseppe Guglielmi, Alberto Bazzocchi
Bone and muscle are two deeply interconnected organs and a strong relationship between them exists in their development and maintenance. The peak of both bone and muscle mass is achieved in early adulthood, followed by a progressive decline after the age of 40. The increase in life expectancy in developed countries resulted in an increase of degenerative diseases affecting the musculoskeletal system. Osteoporosis and sarcopenia represent a major cause of morbidity and mortality in the elderly population and are associated with a significant increase in healthcare costs...
February 2018: Quantitative Imaging in Medicine and Surgery
Samuel P Prahlow, Joseph A Prahlow
As forensic scientists and physicians, forensic pathologists are duty-bound to perform their examinations with integrity and professionalism. The practice of medicine requires knowledge regarding the history and presentation of the patient. In forensic pathology, the history includes scene and other investigative information, and the decedent's medical and social history. Such information is important for the correct certification of the cause and manner of death. Herein, the authors present a case originally thought by police and death investigators to represent a sexual-assault-related homicide, as an elderly female's body was found partially nude, and apparently beaten, on the muddy floor of her horse barn...
March 8, 2018: Journal of Forensic Sciences
Arif Hussain, Candice Yong, Katherine H R Tkaczuk, Yi Qian, Jorge Arellano, C Daniel Mullins, Eberechukwu Onukwugha
OBJECTIVE: Real-world data regarding patient factors associated with the occurrence of spinal cord compression (SCC) or pathological fracture (PF), or need for bone surgery (BS), or use of radiation therapy (RAD) (i.e. skeletal complications and radiation therapy; SCRT) are limited for women with metastatic breast cancer (BCa). Given the substantial clinical and economic burden of these events in advanced BCa, we conducted the present study to understand the prevalence and identify the risk factors associated with these events among elderly women presenting with de novo metastatic BCa...
2018: PloS One
Nadim Tarazi, Sudarshan Munigangaiah, Aiden T Devitt, John P Mccabe
Background: Occipitocervical disease is common in the elderly population, and is on the rise due to an increasingly aging population. Methods: We retrospectively reviewed all patients who underwent occipitocervical fusion in our institution over a 20 year period (1996-2016) at a tertiary spinal referral centre. Patients were divided in 2 groups. Group A included all patient who underwent OCF in the first decade between 1996 and 2005. Group B was all patients who underwent OCF in the second decade between 2006 and 2016...
October 2017: Journal of Craniovertebral Junction and Spine
Ching-Di Chang, Jim S Wu, Jennifer Ni Mhuircheartaigh, Marry G Hochman, Edward K Rodriguez, Paul T Appleton, Colm J Mcmahon
PURPOSE: To investigate the relationship between sarcopenia with short-term surgical outcome in elderly patients with proximal femur fractures. METHODS AND MATERIALS: Following Institutional Review Board approval, a database of patients receiving a pelvis CT scan for acute trauma between January 2000-August 2016 was screened for an isolated proximal femur fracture. Patients were excluded if they were: < 50 years old, had conditions predisposing to sarcopenia (renal failure, congestive heart failure, muscular dystrophies), had undergone no surgical treatment, had other major traumatic injuries, or had a pathologic femur fracture...
December 15, 2017: Skeletal Radiology
Kristian Nikolaus Schneider, Benedikt Schliemann, Salomon M Manz, Pranai K Buddhdev, Georg Ahlbäumeri
Introduction: Bilateral shoulder dislocations are rare and a diagnostic as well as a therapeutic challenge. Case Report: We report the case of a 67-year-old male who fell while skiing and suffered a bilateral anterior shoulder dislocation associated with a four-part proximal humerus fracture on the left side and an osseous avulsion of the rotator cuff, a Pulley lesion, and a Hill-Sachs lesion on the right side. In addition, we searched the PubMed database using the terms "bilateral shoulder dislocation" and also "bilateral glenohumeral dislocation"...
September 2017: Journal of Orthopaedic Case Reports
Vito Pavone, Gianluca Testa, Serena M C Giardina, Andrea Vescio, Domenico A Restivo, Giuseppe Sessa
Osteoporosis is the most common bone disease affecting millions of people worldwide, particularly in elderly or in post-menopausal women. The pathogenesis is useful to understand the possible mechanism of action of anti-osteoporotic drugs. Early diagnosis, possible with several laboratory and instrumental tests, allows a major accuracy in the choice of anti-osteoporosis drugs. Treatment of osteoporosis is strictly related to severity of pathology and consists on prevention of fragility fractures with a correct lifestyle and adequate nutritional supplements, and use of pharmacological therapy, started in patients with osteopenia and history of fragility fracture of the hip or spine...
2017: Frontiers in Pharmacology
Prasad Ellanti, Kunal Mohan, Andrew Moriarity, Niall Hogan, Tom McCarthy
INTRODUCTION: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain radiographs has been suggested to be a method for indicating osteoporosis and as a risk factor of hip fractures in the elderly. METHODS: A retrospective study was undertaken to assess the usefulness of the canal-diaphysis ratio (CDR) as a risk factor for developing a hip fracture, excluding patients presenting under 50 years old, following high-energy trauma or pathological fractures...
2017: SICOT-J
Yi-Lun Chen, Yao-Chung Liu, Chia-Hung Wu, Chiu-Mei Yeh, Hsun-I Chiu, Gin-Yi Lee, Yu-Ting Lee, Pei Hsu, Ting-Wei Lin, Jyh-Pyng Gau, Liang-Tsai Hsiao, Tzeon-Jye Chiou, Jin-Hwang Liu, Chia-Jen Liu
Vertebral fractures affect approximately 30% of myeloma patients and lead to a poor impact on survival and life quality. In general, age and body mass index (BMI) are reported to have an important role in vertebral fractures. However, the triangle relationship among age, BMI, and vertebral fractures is still unclear in newly diagnosed multiple myeloma (NDMM) patients. This study recruited consecutive 394 patients with NDMM at Taipei Veterans General Hospital between January 1, 2005 and December 31, 2015. Risk factors for vertebral fractures in NDMM patients were collected and analyzed...
November 6, 2017: Hematological Oncology
Yu-Hung Chen, Raymond Y Lo
Alzheimer's disease (AD) and osteoporosis are both common degenerative diseases in the elderly population. The incidence of both diseases increases with age and will be posing enormous societal burden worldwide. It may appear that AD and osteoporosis are two distinct diseases although many risk factors are shared. Previous observational studies have shown that patients with osteoporosis have higher risks of developing AD than those who do not have osteoporosis. Although osteoporosis, falls, and fractures are more often seen in patients with AD than other older adults, the association between these two diseases may be due to a pathophysiological link rather than one condition causing the other...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Laura Rosa Pisani, Marina Nikanorova, Cecilie Johannessen Landmark, Svein Ivar Johannessen, Francesco Pisani
BACKGROUND: Patient features, apart from the type of seizures/epilepsy, affect markedly antiepileptic drug (AED) choice and dosage. The present review focuses on gender, age and psychiatric comorbidities which play a leading role in influencing antiepileptic treatment. METHODS: Reviews with large population of patients, controlled clinical trials, observational investigations, experimental studies and experimental reviews of experimental data, where appropriated, were analysed and illustrated to produce the most homogeneous indications possible...
September 25, 2017: Current Pharmaceutical Design
Emmanuelle Magny, Helene Vallet, Judith Cohen-Bittan, Mathieu Raux, Antony Meziere, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.38 (95% CI 1.31-4.32%, p = 0.044). INTRODUCTION: Pressure ulcers in hip fracture patients are frequent and associated with a poor outcome. An orthogeriatric management, recommended by international guidelines in hip fracture patients and including pressure ulcer prevention and treatment, could influence causes and consequences of pressure ulcer...
August 29, 2017: Archives of Osteoporosis
Melissa M Melough, Xin Sun, Ock K Chun
Age-related bone loss is a major factor in osteoporosis and osteoporotic fractures among the elderly. Because bone homeostasis involves a balance between bone formation and resorption, multiple mechanisms may induce age-dependent changes in bone. Oxidative stress is one such factor that contributes to the pathology of aging-associated osteoporosis (AAO). Advanced oxidation protein products (AOPP) are a biomarker of oxidant-mediated protein damage, and can also act to increase the production of reactive oxygen species (ROS), thereby perpetuating oxidative damage...
July 22, 2017: Nutrients
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
September 2017: International Orthopaedics
Candice L Downey, Adam Young, Emily F Burton, Simon M Graham, Robert J Macfarlane, Eva-Maria Tsapakis, Eleftherios Tsiridis
AIM: To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS: This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MED-LINE (1950 to June 2016) was conducted. The keywords "osteoporosis", "osteoporotic fracture", "dementia" and "Alzheimer's disease" (AD) were used to determine the theoretical links with the most significant evidence base behind them...
May 18, 2017: World Journal of Orthopedics
Vincenzo Malafarina, Francisco Uriz-Otano, Concetta Malafarina, J Alfredo Martinez, M Angeles Zulet
BACKGROUND AND OBJECTIVES: Functional deterioration and reduced mobility in elderly patients with a hip fracture are associated with a loss of both muscle mass and function (sarcopenia). The aim of this study was to assess whether oral nutritional supplementation (ONS) improves muscle mass and nutritional markers (BMI, proteins) in elderly patients with hip fracture. METHODS: Patients aged 65 years and over with hip fractures admitted to either of two rehabilitation facilities were included...
July 2017: Maturitas
Christina A Mosk, Marnix Mus, Jos Pam Vroemen, Tjeerd van der Ploeg, Dagmar I Vos, Leon Hgj Elmans, Lijckle van der Laan
BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc...
2017: Clinical Interventions in Aging
Bulent Ozkurt, Kerem Basarir, Bulent Yalcin, Abdullah Merter, Yusuf Yildiz, Yener Saglik
OBJECTIVE: In this study, we sought to review the clinical and histopathological features and the chemotherapy regimens in osteogenic sarcoma in patients over 40 years of age, and we aimed at identifying the possible prognostic factors in this particular group of patients. METHODS: We reviewed 287 patients with osteosarcoma treated between the year 1986 and 2010. Patients from this group who met the following criteria were considered eligible for our study; presence of primary OS, had typical histological and radiographic features of OS, no prior history of cancer or any treatment elsewhere and no prior history of preexisting bone abnormalities...
February 14, 2017: Acta Orthopaedica et Traumatologica Turcica
Babak Pourabbas, Mohammad Jafar Emami, Amir Reza Vosoughi, Hamid Namazi
BACKGROUND: Hip fracture and its consequences are one of the major causes of morbidity and disability in the elderly. The purpose of this study was to collect epidemiologic data and assess the daily activities and walking ability of patients 3 months and 1 year following surgery because of a hip fracture. MATERIAL AND METHODS: We prospectively obtained data of all consecutive patients more than 50 years of age with any type of hip fracture from 2008 to 2013. After excluding pathologic fractures, hip fracture dislocations, non-surgically treated cases, and dead patients, functional status of the subjects at 3 months and 1 year after surgery was evaluated using a 10-degree scale of pain, modified Barthel index of daily activity, and independent walking ability...
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
F Burget, O Foltán, J Kraus, K Kudrna, M Novák, J Ulrych
PURPOSE OF THE STUDY The incidence of geriatric fractures (proximal femur, distal radius, proximal humerus and thoracolumbar spine injuries) in the population increases with ageing. However, the role of weather conditions, such as icy and slippery winter, should not be overlooked. A deeper insight into this relationship may bring about a better understanding of the fracture aetiology and thus allow for improvement in the prevention of fractures in elderly people. MATERIAL AND METHODS This prospective study included 676 patients (469 women and 207 men) aged 65 and over...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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