scholarly journals Osteoporosis: A preventable silent killer but not well addressed

2016 ◽  
Vol 45 (2) ◽  
pp. 101-109
Author(s):  
Md Ismail Patwary ◽  
Mohammad Zabed Jillul Bari ◽  
Ishrat Tahsin Isha
Keyword(s):  
Public Health Problem ◽  
Bone Fragility ◽  
Pharmacological Interventions ◽  
Important Public Health Problem ◽  
Skeletal Fragility ◽  
Increased Risk ◽  
Minimal Trauma ◽  
Risk Patients ◽  
Favorable Safety ◽  
Reduce Fracture Risk

Osteoporosis is characterized by low bone density, micro-architectural deterioration of the bone tissue, enhanced bone fragility and increasing susceptibility to fracture. Osteoporosis is an important public health problem leading to an increased risk of developing spontaneous and traumatic fractures. It is a silent disease until it is complicated by fractures that can occur following minimal trauma. These fractures are common and place an enormous medical and personal burden on individuals during aging and a major economic toll on the nation. To reduce the burden high-risk patients must be identified, evaluated for factors contributing to skeletal fragility, and should be treated to reduce fracture risk. Osteoporosis is a preventable disease and can be diagnosed and treated before any fracture occurs. Importantly, even after the first fracture has occurred, there are effective treatments to decrease the risk of further fractures. Both Pharmacologic and non- pharmacological interventions can reduce the risk for fracture in appropriately selected patients, with a generally favorable safety profile.Bangladesh Med J. 2016 May; 45 (2): 101-109

scholarly journals Osteoporosis in Skin Diseases

2020 ◽  
Vol 21 (13) ◽  
pp. 4749 ◽  
Author(s):  
Maria Maddalena Sirufo ◽  
Francesca De Pietro ◽  
Enrica Maria Bassino ◽  
Lia Ginaldi ◽  
Massimo De Martinis
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Skin Diseases ◽  
Public Health Problem ◽  
Bone Fragility ◽  
Skeletal Disease ◽  
Metabolic Bone ◽  
Systemic Treatments ◽  
Increased Risk ◽  
Skeletal Homeostasis

Osteoporosis (OP) is defined as a generalized skeletal disease characterized by low bone mass and an alteration of the microarchitecture that lead to an increase in bone fragility and, therefore, an increased risk of fractures. It must be considered today as a true public health problem and the most widespread metabolic bone disease that affects more than 200 million people worldwide. Under physiological conditions, there is a balance between bone formation and bone resorption necessary for skeletal homeostasis. In pathological situations, this balance is altered in favor of osteoclast (OC)-mediated bone resorption. During chronic inflammation, the balance between bone formation and bone resorption may be considerably affected, contributing to a net prevalence of osteoclastogenesis. Skin diseases are the fourth cause of human disease in the world, affecting approximately one third of the world’s population with a prevalence in elderly men. Inflammation and the various associated cytokine patterns are the basis of both osteoporosis and most skin pathologies. Moreover, dermatological patients also undergo local or systemic treatments with glucocorticoids and immunosuppressants that could increase the risk of osteoporosis. Therefore, particular attention should be paid to bone health in these patients. The purpose of the present review is to take stock of the knowledge in this still quite unexplored field, despite the frequency of such conditions in clinical practice.

scholarly journals Factors Associated With Testing for Hepatitis C Infections Among a Commercially Insured Population of Persons With HIV, United States 2008–2016

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Hope King ◽  
Lara Bull–Otterson ◽  
Karen W Hoover ◽  
Huang Ya-Lin A Huang ◽  
Weiming Zhu ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Public Health Problem ◽  
Hcv Infection ◽  
Newly Diagnosed ◽  
National Guidelines ◽  
Hiv Diagnosis ◽  
Medical Claim ◽  
Important Public Health Problem ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Hepatitis C virus (HCV) infection is an important public health problem among people with HIV. People with HIV who are coinfected with HCV infection are at increased risk for cirrhosis, liver failure, and hepatitis C–related mortality; as such, national guidelines recommend that persons with HIV be tested for HCV infection. Methods Data from the 2003–2017 IBM Watson Health MarketScan database were used for this study. We used diagnostic, procedural, and drug codes to identify patients with ≥1 inpatient or outpatient medical claim of HIV diagnosis. Patients with prior HIV or hepatitis C diagnoses were excluded. We calculated hepatitis C testing rates among newly diagnosed HIV-infected persons within 12 months of the initial HIV diagnosis date (January 1, 2008–December 31, 2016). We used Poisson regression to identify the factors associated with hepatitis C testing. Lastly, we assessed hepatitis C testing trends using the Cochran-Armitage test. Results The prevalence of testing for hepatitis C in newly identified persons with HIV (n = 46 277) was 50% within 12 months of the index HIV diagnosis. From 2008 to 2017, the testing rate increased by 13%. Significant predictors of hepatitis C testing were age, sex, and urbanicity. Women with HIV were less likely to have been tested compared with men (relative risk, 0.79; 95% CI, 0.77–0.81). Only 40% of patients between 50 and 59 years of age were tested for hepatitis C within 12 months of the index HIV diagnosis, while 56% of persons with HIV aged 20–29 years were tested for hepatitis C. Conclusions Overall, 50% of newly diagnosed HIV patients were tested for hepatitis C within 12 months of HIV diagnosis. Although there were increases in hepatitis C testing rates over the study period, there were missed opportunities to detect HCV infection among people newly diagnosed with HIV.

scholarly journals Involvement in Physical Fights among School Attending Adolescents: A Nationally Representative Sample from Kuwait

2020 ◽  
Vol 10 (1) ◽  
pp. 29
Author(s):  
Masood Ali Shaikh ◽  
Anne P. Abio ◽  
Adebola A. Adedimeji ◽  
Michael Lowery Wilson
Keyword(s):  
Interpersonal Violence ◽  
Representative Sample ◽  
Public Health Problem ◽  
Total Sample ◽  
Recall Period ◽  
Important Public Health Problem ◽  
Fighting Behavior ◽  
Increased Risk ◽  
Nationally Representative ◽  
The Individual

Background: Interpersonal violence in school settings is an important public health problem worldwide. This study investigated the individual and social correlates for being involved in a physical fight amongst a nationally representative sample of school-attending adolescents in Kuwait. Methods: We carried out bivariate and multivariate analyses to determine the strength and direction of associations with adolescent involvement in problematic fighting behavior within a 12-month recall period. Results: Within a total sample of 3637, n = 877 (25.2%) of school-attending adolescents reported being involved in two or more physical fights during the recall period. The multivariate analysis indicated that being male (OR = 2.71; CI = 1.88–3.90), a victim of bullying (OR = 2.77; CI = 2.14–3.58), truancy (OR = 2.52; CI = 1.91–3.32), planning a suicide (OR = 2.04; CI = 1.49–2.78) and food deprivation (OR = 1.91; CI = 1.37–2.65) were associated with an increased risk of involvement in physical fighting. Peer support in the form of having close friends (OR = 0.85; CI = 0.76–0.96) was found to be associated with a reduced involvement in fighting behavior. Conclusion: The results, when taken together, suggest that supportive school environments may represent important settings for violence mitigation and prevention strategies.

scholarly journals Variables de riesgo y protección relacionadas con la tentativa de suicidio

2019 ◽  
Vol 23 (3) ◽  
pp. 221
Author(s):  
David Sánchez-Teruel ◽  
José Antonio Muela-Martínez ◽  
Ana García-León
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Suicidal Attempt ◽  
Important Public Health Problem ◽  
Psychological Variables ◽  
Completed Suicide ◽  
Increased Risk ◽  
Predictive Behavior

Abstract: Risk and protection variables related to suicidal attempt. Suicide is an important public health problem, being the suicidal attempt the most predictive behavior of completed suicide. The aim of this study was to detect if there are differences in psychosocial and emotional variables in people with and without suicidal ideation and attempt. The sample consisted of 166 participants (86.36% women), aged between 20 and 77 years (M= 36, SD= 14.12) with and without suicide attempts, which was in turn divided into three groups through the Scale of Suicidal Ideation. The results show that there are important differences between the three groups in the psychological variables measured. We discuss the role of psychosocial variables, which are at the base of the increased risk or protection towards the ideation or suicidal attempt, to promote public suicide prevention policies more focused on those clinical subpopulations with specific risk profiles.Resumen: El suicidio es un importante problema de salud pública, siendo la tentativa de suicidio la conducta más predictiva del suicidio consumado. Mediante el presente estudio se pretende detectar si existen diferencias en variables psicosociales y emocionales en personas con y sin ideación y tentativa suicida.  La muestra estuvo constituida por 166 participantes (86.36 % mujeres), con edades comprendidas entre los 20 y 77 años (M= 36; DT= 14.12) con y sin tentativas suicidas, que fue a su vez dividida en tres grupos a través de la Escala de Ideación Suicida. Los resultados muestran que existen importantes diferencias entre los tres grupos en las variables psicológicas medidas. Se discute el papel de las variables psicosociales, que están en la base del incremento del riesgo o protección hacia la ideación o tentativa suicida, para propiciar políticas públicas de prevención del suicidio más centradas en aquellas subpoblaciones clínicas con perfiles de riesgo concretos.

scholarly journals One-year mortality among elderly people after hospitalization due to fall-related fractures: comparison with a control group of matched elderly

2012 ◽  
Vol 28 (4) ◽  
pp. 801-805 ◽  
Author(s):  
Evandro Silva Freire Coutinho ◽  
Katia Vergetti Bloch ◽  
Claudia Medina Coeli
Keyword(s):  
Local Community ◽  
Public Health Problem ◽  
The Elderly ◽  
Control Group ◽  
Important Public Health Problem ◽  
Elderly Individuals ◽  
Risk Of Death ◽  
Increased Risk ◽  
One Year ◽  
The One

Fall-related fractures among the elderly represent an important public health problem. Severe fractures have been related to increased risk of death. In order to investigate the mortality profile of elderly individuals with severe fractures, 250 patients aged 60 years and over, hospitalized due to fall-related fractures and 250 elderly without fractures living in the local community were followed-up for one year. They were matched according to sex, age, time of hospitalization and neighborhood. Deaths were identified using probabilistic linkage of the research dataset and the local mortality registry. The one-year cumulative mortality was 25.2% in the case of individuals with severe fractures and 4% for those individuals without. The mortality distribution was not homogeneous across the follow-up period. Two-thirds of deaths among the elderly individuals hospitalized due to fracture occurred within the first 3 months, whereas mortality among those individuals without fractures took place later. Heart disease, pneumonia, GI bleeding, sepsis, and pulmonary embolism, diabetes and stroke were important causes of one-year mortality.

scholarly journals Lipotoxicity, a Potential Risk Factor for the Increasing Prevalence of Subclinical Hypothyroidism?

2015 ◽  
Vol 100 (5) ◽  
pp. 1887-1894 ◽  
Author(s):  
Meng Zhao ◽  
Xulei Tang ◽  
Tao Yang ◽  
Bingchang Zhang ◽  
Qingbo Guan ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Subclinical Hypothyroidism ◽  
Odds Ratio ◽  
Conditional Logistic Regression ◽  
Serum Triglyceride ◽  
Public Health Problem ◽  
Nutrition Status ◽  
Important Public Health Problem ◽  
Iodine Nutrition ◽  
Increased Risk

Abstract Context: Subclinical hypothyroidism (SCH) is an important public health problem worldwide for its increasing prevalence and potential deleterious effects, whereas its etiology has not been fully elucidated. Lipotoxicity exerts extensive and serious impact on human health, but so far, the potential effect of lipotoxicity on thyroid is unclear. Objective: The objective of the study was to assess the association between serum triglyceride levels and the risk for SCH. Design, Participants, and Methods: We conducted a population-based case-control study. A total of 24 100 subjects with similar and stable iodine nutrition status were recruited from China. Cases of 5033 SCH patients were identified and equal controls were matched by age, gender, and region. Conditional logistic regression was used to analyze the association between serum triglyceride levels and risk for SCH. Results: Hypertriglyceridemia was associated with an approximately 35% increased risk for SCH in both men (odds ratio 1.325; 95% confidence interval 1.002–1.753) and women (odds ratio 1.397; 95% confidence interval 1.217–1.604), even after adjustment for potential confounders. Notably, the risk for SCH increased progressively following the elevation of serum triglyceride levels. Compared with individuals with serum triglyceride levels less than 0.97 mmol/L, the risk for SCH increased approximately 1.9-fold in men and 1.4-fold in women, respectively, when triglyceride levels were greater than 1.99 mmol/L. Conclusion: Our findings suggested that hypertriglyceridemia was positively associated with the risk for SCH.

scholarly journals The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity

2020 ◽  
Vol 63 (12) ◽  
pp. 477-482
Author(s):  
Maximilian Andreas Storz
Keyword(s):  
Public Health ◽  
Childhood Obesity ◽  
Large Scale ◽  
Public Health Problem ◽  
Obesogenic Environment ◽  
Public Health Importance ◽  
Important Public Health Problem ◽  
Obesity Epidemic ◽  
Increased Risk ◽  
The Impact

The childhood obesity pandemic has emerged as an important public health problem in many countries. Obese children are likely to become obese adults, and adult obesity is associated with an increased risk of morbidity. Therefore, controlling the childhood obesity epidemic has become a top public health priority worldwide. The current coronavirus disease 2019 (COVID-19) pandemic may significantly impede this important mission and constitute an unprecedented tragedy in the global battle against childhood obesity. This manuscript presents evidence that the COVID-19 pandemic will aggravate the childhood obesity epidemic and lead to significant weight gain in school children by creating an unprecedented obesogenic environment. Within the last few months, many countries took uncompromising measures in response to the COVID-19 pandemic, including school closures and quarantine. While these steps are often necessary to ensure infection control, they may have a significant negative effect on children's mental and physical health. Physical, nutritional, and psychosocial factors that promote obesity in children during this special situation complementarily contribute to an unprecedented obesogenic environment. Large-scale quarantine and home confinement will impose new and unfamiliar stressors on children, thereby worsening the childhood obesity epidemic. Most importantly, adverse childhood events resulting from a predicted increase in domestic violence within the next few months will significantly contribute to this concern. The scenario presented in this review is of paramount public health importance and must be considered during future pandemic planning. Involved stakeholders, including governments, schools, and families, must make all possible efforts to minimize the impact of the COVID-19 epidemic on childhood obesity.

Suicide on the Indian Subcontinent

Crisis ◽  
2002 ◽  
Vol 23 (3) ◽  
pp. 104-107 ◽  
Author(s):  
Murad M. Khan
Keyword(s):  
Sri Lanka ◽  
Mental Health Professionals ◽  
Indian Subcontinent ◽  
Interpersonal Relationship ◽  
Public Health Problem ◽  
Elderly Subjects ◽  
Important Public Health Problem ◽  
Policy Makers ◽  
Formidable Challenge ◽  
Causative Factors

Summary: The Indian subcontinent comprises eight countries (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, and the Maldives) and a collective population of more than 1.3 billion people. 10% of the world's suicides (more than 100,000 people) take place in just three of these countries, viz. India, Sri Lanka, and Pakistan. There is very little information on suicides from the other four countries. Some differences from suicides in Western countries include the high use of organophosphate insecticides, larger numbers of married women, fewer elderly subjects, and interpersonal relationship problems and life events as important causative factors. There is need for more and better information regarding suicide in the countries of the Indian subcontinent. In particular, studies must address culture-specific risk factors associated with suicide in these countries. The prevention of this important public health problem in an area of the world with myriad socio-economic problems, meager resources, and stigmatization of mental illness poses a formidable challenge to mental health professionals, policy makers, and governments of these countries.

Therapeutic options in male osteoporosis

2013 ◽  
Vol 22 (04) ◽  
pp. 271-276 ◽  
Author(s):  
P. Farahmand ◽  
J. D. Ringe
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Public Health Problem ◽  
Male Osteoporosis ◽  
Individual Risk ◽  
Modes Of Action ◽  
Increased Risk ◽  
Study Results ◽  
Long Term Treatment ◽  
Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

A cluster-controlled clinical trial of two prophylactic silicone sacral dressings to prevent sacral pressure injuries in critically ill patients

2019 ◽  
pp. 21-26 ◽  
Author(s):  
Monica Stankiewicz ◽  
Jodie Gordon ◽  
Joel Dulhunty ◽  
Wendy Brown ◽  
Hamish Pollock ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Similar Efficacy ◽  
Care Patient ◽  
Controlled Clinical Trial ◽  
Cost Difference ◽  
Increased Risk ◽  
Pressure Injury ◽  
Risk Patients ◽  
The Mean

Objective Patients in the intensive care unit (ICU) have increased risk of pressure injury (PI) development due to critical illness. This study compared two silicone dressings used in the Australian ICU setting for sacral PI prevention. Design A cluster-controlled clinical trial of two sacral dressings with four alternating periods of three months' duration. Setting A 10-bed general adult ICU in outer-metropolitan Brisbane, Queensland, Australia. Participants Adult participants who did not have a sacral PI present on ICU admission and were able to have a dressing applied for more than 24 hours without repeated dislodgement or soiling in a 24-hour period (>3 times). Interventions Dressing 1 (Allevyn Gentle Border Sacrum™, Smith & Nephew) and Dressing 2 (Mepilex Border Sacrum™, Mölnlycke). Main outcomes measures The primary outcome was the incidence of a new sacral PI (stage 1 or greater) per 100 dressing days in the ICU. Secondary outcomes were the mean number of dressings per patient, the cost difference of dressings to prevent a sacral PI and product integrity. Results There was no difference in the incidence of a new sacral PI (0.44 per 100 dressing days for both products, p = 1.00), the mean number of dressings per patient per day (0.50 for both products, p = 0.51) and product integrity (85% for Dressing 1 and 84% for Dressing 2, p = 0.69). There was a dressing cost difference per patient (A$10.29 for Dressing 1 and A$28.84 for Dressing 2, p < 0.001). Conclusions Similar efficacy, product use and product integrity, but differential cost, were observed for two prophylactic silicone dressings in the prevention of PIs in the intensive care patient. We recommend the use of sacral prophylactic dressings for at-risk patients, with the choice of product based on ease of application, clinician preference and overall cost-effectiveness of the dressing.

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