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Fragility fractures

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https://www.readbyqxmd.com/read/29782984/design-and-development-of-novel-hyaluronate-modified-nanoparticles-for-combo-delivery-of-curcumin-and-alendronate-fabrication-characterization-and-cellular-and-molecular-evidence-of-enhanced-bone-regeneration
#1
Jinlei Dong, Hnin Ei Thu, Mohammed A S Abourehab, Zahid Hussain
Osteoporosis is a medical condition of fragile bones with an increased susceptibility to bone fracture. Despite having availability of a wide range of pharmacological agents, prevalence of this metabolic disorder is continuously escalating. Owing to excellent biomedical achievements of nanomedicines in the last few decades, we aimed combo delivery of bone anti-resorptive agent, alendronate (ALN), and bone density enhancing drug, curcumin (CUR), in the form of polymeric nanoparticles. To further optimize the therapeutic efficacy, the prepared ALN/CUR nanoparticles were decorated with hyaluronic acid which is a well-documented biomacromolecule having exceptional bone regenerating potential...
May 18, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29781519/assessment-of-vertebral-microarchitecture-in-overt-and-mild-cushing-s-syndrome-using-trabecular-bone-score
#2
Helene Vinolas, Virginie Grouthier, Nadia Mehsen-Cetre, Amandine Boisson, Renaud Winzenrieth, Thierry Schaeverbeke, Charles Mesguich, Laurence Bordenave, Antoine Tabarin
OBJECTIVE: Osteoporotic fractures associated with Cushing's syndrome (CS) may occur despite normal bone mineral density (BMD). Few studies have described alterations in vertebral microarchitecture in glucocorticoid-treated patients and during CS. Trabecular bone score (TBS) estimates trabecular microarchitecture from dual-energy X-ray absorptiometry acquisitions. Our aim was to compare vertebral BMD and TBS in patients with overt CS and mild autonomous cortisol secretion (MACE), and following cure of overt CS...
May 21, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29780142/diabetes-mellitus-induced-bone-fragility
#3
Ippei Kanazawa, Toshitsugu Sugimoto
Accumulating evidence has shown that the risk of osteoporotic fractures is increased in patients with diabetes mellitus (DM). Thus, DM-induced bone fragility has been recently recognized as a diabetic complication. Because the fracture risk is independent of the reduction in bone mineral density, deterioration of the bone quality may be the main cause of bone fragility. Although its mechanism remains poorly understood, accumulated collagen cross-links of advanced glycation end-products (AGEs) and dysfunctions of osteoblast and osteocyte may be involved...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29776756/sex-hormone-binding-globulin-is-a-biomarker-associated-with-nonvertebral-fracture-in-men-on-dialysis-therapy
#4
Jasna Aleksova, Phillip Wong, Robert McLachlan, Kay Weng Choy, Peter R Ebeling, Frances Milat, Grahame J Elder
Gonadal hormones impact bone health and higher values of sex hormone-binding globulin (SHBG) have been independently associated with fracture risk in men without chronic kidney disease. People with chronic kidney disease have a greatly increased fracture risk, and gonadal dysfunction is common in men receiving dialysis treatment. Nevertheless, in these men the effect of gonadal steroids and SHBG on bone mineral density (BMD) and fracture risk is unknown. Here we investigate relationships between gonadal steroids, SHBG, BMD and fracture in men on long-term dialysis therapy, awaiting kidney or simultaneous pancreas kidney transplantation...
May 15, 2018: Kidney International
https://www.readbyqxmd.com/read/29768364/comparative-effectiveness-of-fragility-fracture-integrated-rehabilitation-management-for-elderly-individuals-after-hip-fracture-surgery-a-study-protocol-for-a-multicenter-randomized-controlled-trial
#5
Sang Yoon Lee, Jaewon Beom, Bo Ryun Kim, Seung-Kyu Lim, Jae-Young Lim
INTRODUCTION: Although it is essential to provide comprehensive rehabilitation after hip fracture to restore the patient to preoperative physical functioning, feasibility issues remain. Here, we describe a protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of fragility fracture integrated rehabilitation management (FIRM) for elderly individuals after hip fracture surgery. We also examine the feasibility of applying FIRM in a chronic-care hospital or community-based setting...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29762165/improved-fracture-prediction-using-different-frax-adjustments-in-hiv-infected-women
#6
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/29760963/effectiveness-of-a-day-rehabilitation-program-in-improving-functional-outcome-and-reducing-mortality-and-readmission-of-elderly-patients-with-fragility-hip-fractures
#7
Tak Man Wong, Frankie K L Leung, Tak Wing Lau, Christian Fang, Felix H W Chan, Jun Wu
Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29759964/risk-of-fragility-fracture-among-patients-with-gout-and-the-effect-of-urate-lowering-therapy
#8
Alyshah Abdul Sultan, Rebecca Whittle, Sara Muller, Edward Roddy, Christian D Mallen, Milica Bucknall, Toby Helliwell, Samantha Hider, Zoe Paskins
BACKGROUND: Previous studies that quantified the risk of fracture among patients with gout and assessed the potential effect of urate-lowering therapy have provided conflicting results. Our study aims to provide better estimates of risk by minimizing the effect of selection bias and confounding on the observed association. METHODS: We used data from the Clinical Practice Research Datalink, which records primary care consultations of patients from across the United Kingdom...
May 14, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29753194/targeting-wnt-signaling-in-the-treatment-of-osteoporosis
#9
REVIEW
Roland Baron, Francesca Gori
Osteoporosis is a widespread chronic disease characterized by low bone density, altered microstructure and bone fragility, leading to low impact fractures in affected individuals. The discovery of a few mutations that cause extremely rare human diseases has identified the WNT signaling pathway as a candidate for therapeutic intervention aimed at increasing bone mass and strength. In particular, inhibition of sclerostin, a WNT antagonist secreted by osteocytes, has proven in clinical trials to be a very efficient osteo-anabolic approach...
May 9, 2018: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29751644/protective-effects-of-selected-botanical-agents-on-bone
#10
REVIEW
James Jam Jolly, Kok-Yong Chin, Ekram Alias, Kien Hui Chua, Ima Nirwana Soelaiman
Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated fragility fractures result in high morbidity, mortality, and healthcare costs. Many plants used in herbal medicine contain bioactive compounds possessing skeletal protective effects. This paper explores the anti-osteoporotic properties of selected herbal plants, including their actions on osteoblasts (bone forming cells), osteoclasts (bone resorbing cells), and bone remodelling...
May 11, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29747415/patient-related-factors-associated-with-adherence-to-recommendations-made-by-a-fracture-liaison-service-a-mixed-method-prospective-study
#11
Mireille Luc, Hélène Corriveau, Gilles Boire, Johanne Filiatrault, Marie-Claude Beaulieu, Isabelle Gaboury
A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals from FLS in three health regions of the province of Quebec (Canada). Participants were recruited between January 2013 and April 2015...
May 9, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29744522/-impact-of-thyroid-diseases-on-bone
#12
REVIEW
E Tsourdi, F Lademann, H Siggelkow
Thyroid hormones are key regulators of skeletal development in childhood and bone homeostasis in adulthood, and thyroid diseases have been associated with increased osteoporotic fractures. Hypothyroidism in children leads to an impaired skeletal maturation and mineralization, but an adequate and timely substitution with thyroid hormones stimulates bone growth. Conversely, hyperthyroidism at a young age accelerates skeletal development, but may also cause short stature because of a premature fusion of the growth plates...
May 9, 2018: Der Internist
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
#13
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/29736760/assessment-of-bone-quality-in-patients-with-diabetes-mellitus
#14
REVIEW
N Jiang, W Xia
Substantial evidence exists that diabetes mellitus is associated with an increased risk of osteoporotic fractures. Low bone strength as well as bone extrinsic factors are probably contributing to the increased bone fragility in diabetes. Bone density and quality are important determinants of bone strength. Although bone mineral density (BMD) and the fracture risk assessment tool (FRAX) are very useful clinical tools in assessing bone strength, they may underestimate the fracture risk in diabetes mellitus. Through advances in new technologies such as trabecular bone score (TBS) and peripheral quantitative computed tomography (pQCT), we can better assess the bone quality and fracture risk of patients with diabetes mellitus...
May 7, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29736627/expressed-information-needs-of-patients-with-osteoporosis-and-or-fragility-fractures-a-systematic-review
#15
REVIEW
Grace Raybould, Opeyemi Babatunde, Amy L Evans, Joanne L Jordan, Zoe Paskins
This systematic review identified patients have unmet information needs about the nature of osteoporosis, medication, self-management and follow-up. Clinician knowledge and attitudes appear to be of key importance in determining whether these needs are met. Unmet information needs appear to have psychosocial consequences and result in poor treatment adherence. PURPOSE: Patient education is an integral component of the management of osteoporosis, yet patients are dissatisfied with the information they receive and see this as an area of research priority...
May 8, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29735496/glucosuria-without-diabetes-key-to-the-diagnosis-of-fragility-fractures-due-to-fanconi-syndrome
#16
Lilluck F Alacapa, Mark Anthony Santiago Sandoval, Coralie Therese D Dimacali, Nathaniel Jr S Orillaza
A 64-year-old woman had fragility fractures which caused her to have gross deformities and confined her to bed. These were initially ascribed to vitamin D deficiency. However, despite correction of the deficiency, she did not improve. A review of previous records already showed glucosuria in the absence of diabetes, but this finding was overlooked. Eight years into the disease, it was realised that the glucosuria despite normal blood sugar could also mean that the patient was losing other substances needed for proper bone formation...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29727737/morbidity-and-mortality-after-fragility-hip-fracture-surgery-in-patients-receiving-vitamin-k-antagonists-and-direct-oral-anticoagulants
#17
Tal Frenkel Rutenberg, Steven Velkes, Maria Vitenberg, Avi Leader, Yael Halavy, Pia Raanani, Mustafa Yassin, Galia Spectre
INTRODUCTION: Early surgical treatment is recommended to reduce morbidity and mortality in patients with fragility hip fractures. Anticoagulation treatment poses a surgical challenge. While the action of vitamin K antagonists (VKAs) can be reversed, for direct oral anticoagulants (DOACs) antidote is only available for dabigatran. We aimed to assess the outcomes of patients treated with VKAs or DOACs undergoing surgical treatment for fragility hip fractures. MATERIALS AND METHODS: A retrospective study of patients presenting with proximal femoral fractures between January 2012 and June 2016...
June 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29727238/treatment-of-osteoporosis-whom-how-and-for-how-long
#18
Anastasia D Dede, Margaret Callan
Identification of patients at risk for fragility fractures is the first important step in the management of osteoporosis. Bisphosphonates have been the mainstay of treatment for decades, whereas denosumab and selective oestrogen receptor modulators are other available licensed antiresorptive drugs. Currently teriparatide is the only approved anabolic agent in Europe, while abaloparatide and romosozumab are awaiting approval and might be available in the near future. For bisphosphonates, current guidance suggests an initial treatment course of 3-5 years and more prolonged treatment should be pursued in patients with higher fracture risk...
May 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29726441/how-to-measure-physical-motion-and-the-impact-of-individualized-feedback-in-the-field-of-rehabilitation-of-geriatric-trauma-patients
#19
Amelie Altenbuchner, Sonja Haug, Rainer Kretschmer, Karsten Weber
BACKGROUND: This preparatory study accelerates an implementation of individualized monitoring and feedback of physical motion using conventional motion trackers in the rehabilitation process of geriatric trauma patients. Regaining mobility is accompanied with improved quality of life in persons of very advanced age recovering from fragility fractures. OBJECTIVES: Quantitative survey of regaining physical mobility provides recommendations for action on how to use motion trackers effectively in a clinical geriatric setting...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29721333/diabetes-mellitus-and-bone-health-epidemiology-etiology-and-implications-for-fracture-risk-stratification
#20
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
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