scholarly journals Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

2021 ◽  
Author(s):  
John J Carey ◽  
Lan Yang ◽  
E. Erjiang ◽  
Tingyan Wang ◽  
Kelly Gorham ◽  
...  
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Vertebral Fractures ◽  
Fragility Fractures ◽  
Vertebral Fracture Assessment ◽  
International Studies ◽  
Men And Women ◽  
Women Subjects ◽  
The World ◽  
High Risk Populations

AbstractOsteoporosis is an important global health problem resulting in fragility fractures. The vertebrae are the commonest site of fracture resulting in extreme illness burden, and having the highest associated mortality. International studies show that vertebral fractures (VF) increase in prevalence with age, similarly in men and women, but differ across different regions of the world. Ireland has one of the highest rates of hip fracture in the world but data on vertebral fractures are limited. In this study we examined the prevalence of VF and associated major risk factors, using a sample of subjects who underwent vertebral fracture assessment (VFA) performed on 2 dual-energy X-ray absorptiometry (DXA) machines. A total of 1296 subjects aged 40 years and older had a valid VFA report and DXA information available, including 254 men and 1042 women. Subjects had a mean age of 70 years, 805 (62%) had prior fractures, mean spine T-score was − 1.4 and mean total hip T-scores was − 1.2, while mean FRAX scores were 15.4% and 4.8% for major osteoporotic fracture and hip fracture, respectively. Although 95 (7%) had a known VF prior to scanning, 283 (22%) patients had at least 1 VF on their scan: 161 had 1, 61 had 2, and 61 had 3 or more. The prevalence of VF increased with age from 11.5% in those aged 40–49 years to > 33% among those aged ≥ 80 years. Both men and women with VF had significantly lower BMD at each measured site, and significantly higher FRAX scores, P < 0.01. These data suggest VF are common in high risk populations, particularly older men and women with low BMD, previous fractures, and at high risk of fracture. Urgent attention is needed to examine effective ways to identify those at risk and to reduce the burden of VF.

scholarly journals Gender Differences in Individuals at High-Risk of Psychosis: A Comprehensive Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Ana Barajas ◽  
Susana Ochoa ◽  
Jordi E. Obiols ◽  
Lluís Lalucat-Jo
Keyword(s):  
Gender Differences ◽  
High Risk ◽  
Social Functioning ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Control Variable ◽  
Prodromal Phase ◽  
Men And Women ◽  
Conversion Rates ◽  
High Risk Populations

Introduction. To date, few studies have focused on the characterization of clinical phenomenology regarding gender in population at high-risk of psychosis. This paper is an attempt to summarize the findings found in the scientific literature regarding gender differences in high-risk populations, taking into account parameters studied in populations with schizophrenia and other psychotic disorders, such as incidence, clinical expression, duration of untreated illness (DUI), social functioning, and cognitive impairment prior to full-blown psychosis development.Method. Studies were systematically searched in PubMed. Studies using gender variable as a control variable were excluded. 12 studies met inclusion criteria.Results. Most of the studies found a differential pattern between women and men as regards clinical, social, and cognitive variables in the prodromal phase, with worse performance in men except in cognitive functioning (more severe negative symptoms, worse social functioning, and longer DUI in men). Similar conversion rates over time were found between men and women.Conclusions. Many of the studies analyzed suggest that differences between men and women in the expression of psychosis extend across a continuum, from the subclinical forms of illness to the debut of psychosis. However, the small number of studies and their significant methodological and clinical limitations do not allow for firm conclusions.

scholarly journals Failure in the application of fragility fracture prevention guidelines

2014 ◽  
Vol 96 (5) ◽  
pp. 381-385 ◽  
Author(s):  
MH Elvey ◽  
H Pugh ◽  
G Schaller ◽  
G Dhotar ◽  
B Patel ◽  
...  
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Fragility Fracture ◽  
Fragility Fractures ◽  
Fracture Prevention ◽  
Consecutive Series ◽  
National Guidelines ◽  
Fracture Population ◽  
The Mean ◽  
The Uk

Introduction The cost of fragility fractures to the UK economy is predicted to reach £2.2 billion by 2025. We studied our hip fracture population to establish whether national guidelines on fragility fracture prevention were being followed, and whether high risk patients were identified and treated by local care services. Methods Data on a consecutive series of trauma hip fracture admissions were collected prospectively over 14 months. National Institute for Health and Care Excellence (NICE) and National Osteoporosis Guideline Group (NOGG) recommendations and FRAX® risk calculations were applied to patients prior to their admission with a new hip fracture. Results Overall, 94 patients were assessed against national guidelines. The mean population age was 77 years. Almost a quarter (22%) of patients had suffered a previous fragility fracture. The mean FRAX® ten-year probability of hip fracture was 7%. According to guidelines, 45% of the study population required treatment, 35% fulfilled criteria for investigation and reassessment, and 20% needed no further management. In practice, 27% received treatment, 4% had undergone dual energy x-ray absorptiometry and were untreated, and 69% had not been investigated and were untreated. In patients meeting intervention thresholds, only 33% of those who required treatment were receiving treatment in practice. Conclusions In conjunction with NICE and NOGG recommendations, FRAX® was able to identify 80% of our fracture population as intermediate or high risk on the day of fracture. Correct management was evident in a third of cases with a pattern of inferior guideline compliance seen in a London population. There remains a lack of clarity over the duty of care in fragility fracture prevention.

Prevalence and burden of vertebral fractures in older men and women with hip fracture: A cross-sectional study

2015 ◽  
Vol 16 (3) ◽  
pp. 352-357 ◽  
Author(s):  
Marco Di Monaco ◽  
Carlotta Castiglioni ◽  
Roberto Di Monaco ◽  
Rosa Tappero
Keyword(s):  
Hip Fracture ◽  
Vertebral Fractures ◽  
Older Men ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Men And Women ◽  
Older Men And Women

scholarly journals SUN-388 Role of QUS and Functional Tests in Evaluating Fracture Risk Based on Frax Tool

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Eduardo Medeiros Ferreira Gama ◽  
Leandro Kasuki Jomori de Pinho ◽  
Miguel Madeira ◽  
Carlos Duarte ◽  
Girlene Canhete Pessoa ◽  
...  
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Fracture Risk ◽  
Hip Fractures ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
High Fracture ◽  
Calcaneal Ultrasound ◽  
T Score ◽  
Handgrip Test

Abstract Background: Osteoporosis is common among elderly people, and identifying those at high risk for fracture is very important. Aim: To evaluate whether the use of quantitative calcaneal ultrasound (QUS), the Sitting–rising test (SRT) and handgrip test (HT) are additional tools for tracking fragility fracture risk when compared to FRAX and NOGG. Methods: During the national campaign against osteoporosis, held in 2018 in Rio de Janeiro, participants were randomly selected to perform QUS, SRT and HT, besides categorization of the risk of major and hip fractures by FRAX and NOGG. The following adequacy values ​​were used: QUS T-score&gt; -1.05 (adequate) or ≤ -1.05 (inadequate); Sitting – rising test (SRT) (composite score): age-reference values at quartiles 3 and 4 (adequate); quartiles 1 and 2 (inadequate); best result 3 attempts of the dominant arm handgrip test, according to age and gender: percentile ≥50 (adequate) and &lt;50 (inadequate); FRAX tool: suggests high risk for major osteoporotic fractures if &gt; 20% and for hip fractures when &gt; 3%; NOGG (complement to FRAX): patient′s risk for major and for hip fractures considered as low (green zone), medium (yellow zone) or high (red zone). Qui square test was used for associations. Results: We included 162 individuals: 118 females, mean age 66.8 years and 44 males, mean age 71.8 years. High risk of hip fractures by FRAX was observed in 51% of those patients with a QUS T-score ≤-1.05 while it was observed in 28% of those with a QUS T-score&gt; -1.05 (p=0.005). An inadequate QUS T-score was also associated with a higher risk of hip fracture by NOGG (p=0.007). An inadequate SRT and HT were not associated with a high fracture risk. Conclusions: As densitometry, a method established in clinical practice for the diagnosis of osteoporosis, has limitations in its use, other tools are necessary for tracking the risk of fragility fractures in these events. Quantitative calcaneal ultrasound was a good predictor of hip fracture risk, while SRT and HT were not capable of evaluate for fracture risk stratification in our study, reinforcing the need for QUS for screening in large populations. Having strength and functional ability did not eliminate the need for investigation.

Treatment Interventions for PTSD in Difficult or High Risk Populations

2009 ◽  
Author(s):  
Keri Pinna ◽  
Maria Pacella ◽  
Norah Feeny ◽  
Brittain Lamoureux
Keyword(s):  
High Risk ◽  
Treatment Interventions ◽  
High Risk Populations

Two Years after the Crisis: Do Risks of the Second Wave Become Stronger?

2011 ◽  
pp. 4-20
Author(s):  
M. Ershov
Keyword(s):  
High Risk ◽  
World Economy ◽  
External Shocks ◽  
Global Imbalances ◽  
Russian Economy ◽  
The World ◽  
The Future ◽  
Second Wave

With signs of normalization seemingly in place in the world economy, a number of problems show the possibility of aggravation in the future. The volume of derivatives in American banks grows significantly, high risk instruments are back in place and their use becomes more active, global imbalances increase. All of the above requires thorough approaches when creating mechanisms which can neutralize external shocks for the Russian economy and make it possible to develop in the new post-crisis environment.

ANALYSIS OF THE COMPETITIVE ACTIVITIES OF THE WORLD STRONGEST BELT WRESTLERS

2020 ◽  
Vol 8 (1) ◽  
pp. 38-45
Author(s):  
Mariya Sedunova ◽  
Liliya Konovalova
Keyword(s):  
Female Athletes ◽  
Group Differences ◽  
Men And Women ◽  
World Championship ◽  
Left Handed ◽  
Competitive Activity ◽  
The World ◽  
The Right ◽  
Competitive Activities ◽  
Distinguishing Features

International potential and consequent greater competition in belt wrestling increase the significance of assessing quantitative and qualitative indicators of competitive activity of the strongest wrestlers in the world. It is important to identify the sport development trends and to search for effective ways and tools for achievement of the sport excellence. Purpose: to reveal the features of efficient competitive activities of the world leading wrestlers on the basis of analysis of group differences in technical and tactical excellence indicators. Materials and methods of research. We analyzed videos of 285 events with participation of 197 wrestlers competing at the Belt Wrestling World Championship 2019 in Kazan. We registered the following indicators of competitive activity: the total and average number of fighting techniques, including techniques executed to the right and to the left side within 4 minutes of combat; number and types of technical actions of competition winners among men and women. Research results and discussion. The paper focuses on the comparative analysis of technical and tactical skills of men and women, the winners of the Belt Wrestling World Championship. The research revealed distinguishing features of the winner’s technical toolkit including the diversity of technical and tactical actions, a balance in the knowledge of the right and left-handed techniques. At the same time, the analysis of technical and tactical actions in women wrestling shows the backlog of female athletes in these components of technical fitness.

A review study of nasal endoscopy protocol during the COVID-19 pandemic

2020 ◽  
Vol 2 (CSI) ◽  
pp. 38-41
Author(s):  
Rafid Jabbar
Keyword(s):  
High Risk ◽  
Health Services ◽  
Paranasal Sinus ◽  
Medical Staff ◽  
Nasal Endoscopy ◽  
Paranasal Sinus Diseases ◽  
The World ◽  
Major Procedure ◽  
Risk Of Exposure ◽  
Review Study

During ENT practice, we have to examine the nose and perform several nasal procedures in our clinics. Otolaryngologists are at a high risk of exposure to the COVID-19 virus. Nasal endoscopy is a major procedure for the diagnosis of the nasal and paranasal sinus diseases and introducing proper health services for our patients. In addition, the world is living the era of the COVID-19 pandemic, for which we have to protect ourselves, educate our medical staff, and work together against the spread of this severely contagious disease within our communities. The main purpose of this study is to review the protocol of nasal endoscopy in the ENT clinic and enhance the safest way to deal with patients during this pandemic.(1)

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