scholarly journals Epidemiology, classification, treatment, and mortality of adult femoral neck and basicervical fractures: an observational study of 40,049 fractures from the Swedish Fracture Register

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jonas Sundkvist ◽  
Anders Brüggeman ◽  
Arkan Sayed-Noor ◽  
Michael Möller ◽  
Olof Wolf ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Observational Study ◽  
Health Care Providers ◽  
Hip Arthroplasty ◽  
Primary Treatment ◽  
Current Treatment ◽  
Care Providers ◽  
Fracture Classification ◽  
Level Of Evidence ◽  
Fracture Register

Abstract Background Although femoral neck fractures (FNFs) are common in orthopedic departments, optimal treatment methods remain in dispute. There are few large nationwide studies, including basicervical FNFs (bFNFs), on epidemiology, treatment, and mortality. This nationwide study aims to describe the epidemiology, fracture classification, current treatment regimens, and mortality of undisplaced and minimally displaced (Garden I–II, uFNF), displaced (Garden III–IV, dFNF) and bFNFs in adults. Methods All FNFs, including bFNFs with a registered injury date between 1 April 2012 and 31 December 2020, were included in this observational study from the Swedish Fracture Register (SFR). Data on age, sex, injury mechanism, fracture classification, primary treatment, and seasonal variation were analyzed. Results Some 40,049 FNFs were registered in the SFR. The mean age of the patients in the register was 80.3 (SD 11) years and 63.8% (25,567) were female. Of all FNFs, 25.0% (10,033) were uFNFs, 63.4% (25,383) dFNFs, and 11.6% (4,633) bFNFs. Non-surgical treatment was performed in 0.6% (261) of the patients. Internal fixation (IF) (84.7%) was the main treatment for uFNFs and arthroplasty (87.3%) for dFNFs. For bFNFs, IF (43.8%) and hip arthroplasty (45.9%) were performed equally often. Of the 33,105 patients with a 1-year follow-up mortality at 1-year was 20.6% for uFNF, 24.3% for dFNF, and 25.4% for bFNF. Conclusion The main treatment of uFNFs is IF with screws or pins. Hip arthroplasty is the predominant treatment for dFNF. bFNF are more common than previously reported and treated with IF or arthroplasty, depending on patient age. These results may help health care providers, researchers and clinicians better understand the panorama of FNFs in Sweden. Level of Evidence IV, retrospective cohort study.

scholarly journals Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Johanna Rundgren ◽  
Alicja Bojan ◽  
Cecilia Mellstrand Navarro ◽  
Anders Enocson
Keyword(s):  
Observational Study ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Current Treatment ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Fracture Classification ◽  
Radius Fractures ◽  
Treatment Regimens ◽  
Fracture Register

Abstract Background Distal radius fractures are the most common of all fractures. Optimal treatment is still debated. Previous studies report substantial changes in treatment trends in recent decades. Few nation-wide studies on distal radius fracture epidemiology and treatment exist, none of which provide detailed data on patient and injury characteristics, fracture pattern and mortality. The aim of this study was to describe the epidemiology, fracture classification, current treatment regimens and mortality of distal radius fractures in adults within the context of a large national register study. Methods We performed a descriptive study using prospectively registered data from the Swedish fracture register. Included were all non-pathological distal radius fractures registered between January 1st 2015 and December 31st 2017 in patients aged 18 years and above. Nominal variables were presented as proportions of all registered fractures. Results A total of 23,394 distal radius fractures in 22,962 patients were identified. The mean age was 62.7 ± 17.6 years for all, 65.4 ± 16.0 for women and 53.6 ± 20.0 for men. A simple fall was the most common cause of injury (75%, n = 17,643/23,394). One third (33%, n = 7783/21,723) of all fractures occurred at the patients’ residence. 65% (n = 15,178/23,394) of all fractures were classified as extra-articular AO-23-A, 12% (n = 2770/23,394) as partially intra-articular AO-23-B and 23% (n = 5446/23,394) as intra-articular AO-23-C. The primary treatment was non-surgical for 74% (n = 17,358/23,369) and surgical for 26% (n = 6011/23,369) of all fractures. Only 18% of the AO-23-A fractures were treated surgically, compared to 48% of the AO-23-C fractures. The most frequently used surgical method was plate fixation (82%, n = 4954/5972), followed by pin/wire fixation (8.2%, n = 490/5972), external fixation (4.8%, n = 289/5972) and other methods (4.0%, n = 239/5972). The overall 30-day mortality was 0.4% (n = 98/23,394) and the 1-year mortality 2.9% (n = 679/23,394). Conclusion This nation-wide observational study provides comprehensive data on the epidemiology, fracture classification and current treatment regimens of distal radius fractures in a western European setting. The most common patient was an eldery woman who sustained a distal radius fracture through a simple fall in her own residence, and whose fracture was extra-articluar and treated non-surgically.

scholarly journals Epidemiology, classification and treatment of olecranon fractures in adults: an observational study on 2462 fractures from the Swedish Fracture Register

2021 ◽  
Author(s):  
Anders Brüggemann ◽  
Sebastian Mukka ◽  
Olof Wolf
Keyword(s):  
Operative Treatment ◽  
Health Care Providers ◽  
Plate Fixation ◽  
High Energy ◽  
Injury Mechanism ◽  
Unstable Fracture ◽  
Care Providers ◽  
Fracture Classification ◽  
Fracture Register ◽  
Olecranon Fractures

Abstract Purpose This nationwide study aims to describe the epidemiology, fracture classification and current treatment regimens of olecranon fractures in adults. Methods We performed a descriptive study based on registered data from the Swedish Fracture Register (SFR). All non-pathological olecranon fractures reported between 1 January 2014 and 31 December 2018 in patients aged ≥ 18 years were included. Data on age, sex, injury mechanism, fracture classification (according to the modified Mayo classification system), primary treatment and seasonal variation were analyzed. We compared patients < 65 with those > 65 years regarding injury mechanism, distribution of fracture types and subsequent treatment. Results In total, 2462 olecranon fractures were identified in the SFR. Median age was 66 years and 65% were women. Of all fractures, 303 (12%) were proximal avulsion, 1044 (42%) simple central, 717 (29%) comminuted central and 398 (16%) distal olecranon fractures. Nonoperative treatment was performed in 21% of the patients < 65 and 35% of the patients > 65 years. Tension band wiring was used for most simple central fractures. Plate fixation was used in almost half of the operatively treated fractures classified as unstable comminuted central and distal olecranon fractures. Men show a higher proportion of high-energy trauma than women in both age groups. Conclusion Isolated fractures of the olecranon occur after a low-energy trauma, especially in older women (> 65 years). Non-operative treatment is common in uncomplicated fractures and operative treatment in more complex fractures nationwide. A shift to plate fixation in the more unstable fracture patterns is observed. These results may help health care providers and clinicians gain a better understanding of isolated olecranon fractures.

scholarly journals Outcome and complications of self-administration of over-the-counter abortion pills: an observational study in a tertiary care hospital of a medical college in New Delhi

2021 ◽  
Vol 10 (8) ◽  
pp. 3148
Author(s):  
Anjali Singh ◽  
Sruthi Bhaskaran ◽  
Anshuja Singla
Keyword(s):  
Observational Study ◽  
Health Care Providers ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Care Providers ◽  
Self Administration ◽  
Over The Counter ◽  
Gynecology And Obstetrics ◽  
Medical Termination

Background: Due to unrestricted free availability of abortion pills, despite of national policies, guidelines and medical termination of pregnancy (MTP) act, unsafe abortions by self-administration of these drugs for termination of unwanted pregnancies without prescription are becoming common in our country, leading to associated morbidity and mortality.Methods: A prospective Observational study was done at Guru Teg Bahadur hospital, university college of medical sciences, New Delhi, from November 2019 to April 2020, in the department of gynecology and obstetrics, on women visiting the outpatient department and casualty department with the history of self-administration of medical termination pills without prescription. This study was done to study the outcome and complications occurring due to self-administration of over-the-counter abortion pills that are freely available in the market. 95 women were included in study and data was collected regarding age, education level, parity, presenting complaints, complications and their management. Descriptive analysis of the collected data was done.Results: In this study 95 women were included 71.6% took pills before 8 weeks of gestation, 1% took in second trimester. 46.3% landed up in incomplete abortion and 33.68% needed surgical evacuation, 8.42% had ectopic out, 2.1% had scar site pregnancy and 7.36% needed laparotomy, 1.05% had rupture uterus followed by abortion pill intake while 1.05% suffered from acute kidney injury (AKI). There was no ICU admission nor any mortality.Conclusions: There is urgent need of strict legislation to curtail this bad practice and free availability of over-the-counter abortion pills which leads to unexpected morbidity and mortality, such drugs should be given only by health care providers under supervision, there is need of community level awareness so as to impart knowledge regarding this problem. 

Immersive Virtual Environments, Avatars, and Agents for Health

2017 ◽  
Author(s):  
Sun Joo (Grace) Ahn ◽  
Jesse Fox
Keyword(s):  
Virtual Environments ◽  
Health Care Providers ◽  
Sensory Information ◽  
Physical World ◽  
Autism Spectrum ◽  
Current Treatment ◽  
Care Providers ◽  
Individual Level ◽  
Immersive Virtual Environments ◽  
Treatment Regimens

Immersive virtual environments (IVEs) are systems comprised of digital devices that simulate multiple layers of sensory information so that users experience sight, sound, and even touch like they do in the physical world. Users are typically represented in these environments in the form of virtual humans and may interact with other virtual representations such as health-care providers, coaches, future selves, or treatment stimuli (e.g., phobia triggers, such as crowds of people or spiders). These virtual representations can be controlled by humans (avatars) or computers algorithms (agents). Embodying avatars and interacting with agents, patients can experience sensory-rich simulations in the virtual world that may be difficult or even impossible to experience in the physical world but are sufficiently real to influence health attitudes and behaviors. Avatars and agents are infinitely customizable to tailor virtual experiences at the individual level, and IVEs are able to transcend the spatial and temporal boundaries of the physical world. Although still preliminary, a growing number of studies demonstrate IVEs’ potential as a health promotion and therapy tool, complementing and enhancing current treatment regimens. Attempts to incorporate IVEs into treatments and intervention programs have been made in a number of areas, including physical activity, nutrition, rehabilitation, exposure therapy, and autism spectrum disorders. Although further development and research is necessary, the increasing availability of consumer-grade IVE systems may allow clinicians and patients to consider IVE treatment as a routine part of their regimen in the near future.

scholarly journals Do health care providers give sufficient information and good counseling during ante-natal care in Lao PDR?: an observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sysavanh Phommachanh ◽  
Dirk R. Essink ◽  
E. Pamela Wright ◽  
Jacqueline E. W. Broerse ◽  
Mayfong Mayxay
Keyword(s):  
Health Care ◽  
Observational Study ◽  
Health Care Providers ◽  
Lao Pdr ◽  
Sufficient Information ◽  
Care Providers ◽  
Natal Care

scholarly journals Self-Management Maintenance Inhalation Therapy With eHealth (SELFIE): Observational Study on the Use of an Electronic Monitoring Device in Respiratory Patient Care and Research (Preprint)

2019 ◽  
Author(s):  
Esther Kuipers ◽  
Charlotte C Poot ◽  
Michel Wensing ◽  
Niels H Chavannes ◽  
Peter AGM de Smet ◽  
...  
Keyword(s):  
Observational Study ◽  
Positive Predictive Value ◽  
Health Care Providers ◽  
Predictive Value ◽  
Electronic Monitoring ◽  
False Negative ◽  
Inhalation Therapy ◽  
Care Providers ◽  
Convenience Sample ◽  
Patient Reported

BACKGROUND Electronic inhalation monitoring devices (EIMDs) are available to remind patients with respiratory diseases to take their medication and register inhalations for feedback to patients and health care providers as well as for data collection in research settings. OBJECTIVE This study aimed to assess the validity as well as the patient-reported usability and acceptability of an EIMD. METHODS This observational study planned to include 21 community pharmacies in the Netherlands. Patient-reported inhalations were collected and compared to EIMD registrations to evaluate the positive predictive value of these registrations as actual patient inhalations. Patients received questionnaires on their experiences and acceptance. RESULTS A convenience sample of 32 patients was included from across 18 pharmacies, and 932 medication doses were validated. Of these, 796 registrations matched with patient-reported use (true-positive, 85.4%), and 33 inhalation registrations did not match with patient-reported use (false-positive, 3.5%). The positive predictive value was 96.0%, and 103 patient-reported inhalations were not recorded in the database (false-negative, 11.1%). Overall, patients considered the EIMD to be acceptable and easy to use, but many hesitated to continue its use. Reminders and motivational messages were not appreciated by all users, and more user-tailored features in the app were desired. CONCLUSIONS Patients’ interaction with the device in real-world settings is critical for objective measurement of medication adherence. The positive predictive value of this EIMD was found to be acceptable. However, patients reported false-negative registrations and a desire to include more user-tailored features to increase the usability and acceptability of the EIMD.

scholarly journals Total Hip Arthroplasty for Bilateral Femoral Neck Stress Fracture: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Kevin Moerenhout ◽  
Georgios Gkagkalis ◽  
G.-Yves Laflamme ◽  
Dominique M. Rouleau ◽  
Stéphane Leduc ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Treatment Options ◽  
Primary Treatment ◽  
Review Of The Literature ◽  
Total Hip ◽  
Femoral Neck Stress Fracture ◽  
Type 3

Femoral neck stress fractures (FNSFs) can be treated conservatively or surgically, depending on initial displacement and patient condition. Surgical treatment options include internal fixation, with or without valgus osteotomy or hip arthroplasty, either hemi or total. The latter is mainly considered when initial treatment fails. A review of the literature shows that total hip arthroplasty (THA) is only considered as primary treatment in displaced fractures (type 3) in low-demand patients. We present a case of successive bilateral FNSF in a young active patient, where a THA was performed on one side, after failed internal fixation, and where it was chosen as primary treatment on the other side after failed conservative treatment.

Patient Perceptions of Diabetes Treatment Goals

1989 ◽  
Vol 15 (5) ◽  
pp. 440-443 ◽  
Author(s):  
Gaila. D'Eramo-Melkus ◽  
Penelope Demas
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Current Treatment ◽  
Dependent Diabetes Mellitus ◽  
Treatment Goals ◽  
Type Ii ◽  
Diabetes Treatment ◽  
Care Providers ◽  
Glucose Levels ◽  
Study Participants

The current treatment of type II noninsulin dependent diabetes mellitus (NIDDM) and obesity involves complex regimens for weight reduction and improvement in metabolic control that necessitate active partici pation by the patient in estab lishing treatment goals and strategies. However, well- documented rates of nonad herence suggest that weaknesses may exist in patient-provider communications that preclude such patient participation. This study examines patient percep tions of diabetes treatment goals as established with their health care providers. Fifty-four individuals with type II NIDDM and obesity were surveyed. To determine the degree of congruence between patient and health care provider, the physi cians of study participants were also surveyed. A 53 % discrepancy rate was found to exist in the area of overall treatment goals. In addition, a 57% and 43 % rate of discrepancy was found for the specific goals of weight loss and blood glucose levels, respectively. Further findings and the implica tions for practice are discussed in this paper.

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