Fragility Fractures and Imminent Fracture Risk in the Spanish Population: A Retrospective Observational Cohort Study

Fragility fractures constitute a major public health problem worldwide, causing important high morbidity and mortality rates. The aim was to present the epidemiology of fragility fractures and to assess the imminent risk of a subsequent fracture and mortality. This is a retrospective population-based cohort study (n = 1369) with a fragility fracture. We estimated the incidence rate of index fragility fractures and obtained information on the subsequent fractures and death during a follow-up of up to three years. We assessed the effect of age, sex, and skeletal site of index fracture as independent risk factors of further fractures and mortality. Incidence rate of index fragility fractures was 86.9/10,000 person-years, with highest rates for hip fractures in women aged ≥80 years. The risk of fracture was higher in subjects with a recent fracture (Relative Risk(RR), 1.80; p < 0.01). Higher age was an independent risk factor for further fracture events. Significant excess mortality was found in subjects aged ≥80 years and with a previous hip fracture (hazard ratio, 3.43 and 2.48, respectively). It is the first study in Spain to evaluate the incidence of major osteoporotic fractures, not only of the hip, and the rate of imminent fracture. Our results provide further evidence highlighting the need for early treatment.

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Childhood Injury Pattern During Covid 19 Pandemic: A Population - based Study in Rural Area in Basrah City (Iraq)

International Journal of Early Childhood Special Education ◽

10.9756/int-jecse/v13i2.211139 ◽

2021 ◽

Vol 13 (2) ◽

pp. 959-967

Author(s):

Amall Y. AL-Mulla

Keyword(s):

Incidence Rate ◽

Rural Area ◽

Public Health Problem ◽

Population Based ◽

Cross Sectional Study ◽

Urgent Care ◽

Major Public Health Problem ◽

Sectional Study ◽

Cross Sectional ◽

Childhood Injuries

Background: Children injuries are a major public health problem globally and considered as an important social health issue that needs an urgent care and action, regards as a health consideration in the whole world, influencing both developed and developing countries. The increased exposure to potentially hazardous home environments and activities caused by stay-at-home orders and closures of schools due to COVID-19 pandemic may be responsible for a new spate of injuries among children in 2020. method: population based cross sectional study done in rural area (Al-Jazeera/Shatt Al-Arab). This cross sectional study involved households with at least one child in age group of less than 18 years, in rural area in Basra city (2020). Objectives: To determine the magnitude of childhood injuries during COVID-19 pandemic in terms of incidence, to determine nature and causes of injuries and factors that may affect the incidence of childhood injuries that is associated with quarantine and homestay for long periods during pandemic. A total of 652 children under 18 years of age (according to the definition of WHO) were included in the study, 109 children had injuries during the pandemic year (2020). Result: The incidence rate of injury in the area was 167.1/ 1000 children, males show higher incidence rate of injury rather than females. the effect of child sex, mother education and age on the incidence of injury were highly significant, while age of child and birth order were not significant. Soft tissue injuries and burns were the leading causes of injuries in our household study. General improvement and modification of sociocultural environment are recommended, children and adolescent education about safety and necessary precaution. establishing of injury surveillance system is important for preventing and control of injuries Governments and healthcare authorities should proactively implement appropriate intervention programs and better resources to prevent these home injuries during lockdown.

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The status of strontium in biological apatites: an XANES/EXAFS investigation

Journal of Synchrotron Radiation ◽

10.1107/s1600577513023771 ◽

2013 ◽

Vol 21 (1) ◽

pp. 136-142 ◽

Cited By ~ 23

Author(s):

Dominique Bazin ◽

Arnaud Dessombz ◽

Christelle Nguyen ◽

Hang Korng Ea ◽

Frédéric Lioté ◽

...

Keyword(s):

Public Health ◽

Experimental Data ◽

Molecular Mechanisms ◽

Fourier Transforms ◽

Public Health Problem ◽

Osteoporotic Fractures ◽

Fragility Fractures ◽

Major Public Health Problem ◽

X Ray ◽

Public Health Burden

Osteoporosis represents a major public health problem through its association with fragility fractures. The public health burden of osteoporotic fractures will rise in future generations, due in part to an increase in life expectancy. Strontium-based drugs have been shown to increase bone mass in postmenopausal osteoporosis patients and to reduce fracture risk but the molecular mechanisms of the action of these Sr-based drugs are not totally elucidated. The local environment of Sr2+cations in biological apatites present in pathological and physiological calcifications in patients without such Sr-based drugs has been assessed. In this investigation, X-ray absorption spectra have been collected for 17 pathological and physiological calcifications. These experimental data have been combined with a set of numerical simulations using theab initioFEFF9X-ray spectroscopy program which takes into account possible distortion and Ca/Sr substitution in the environment of the Sr2+cations. For selected samples, Fourier transforms of the EXAFS modulations have been performed. The complete set of experimental data collected on 17 samples indicates that there is no relationship between the nature of the calcification (physiological and pathological) and the adsorption mode of Sr2+cations (simple adsorption or insertion). Such structural considerations have medical implications. Pathological and physiological calcifications correspond to two very different preparation procedures but are associated with the same localization of Sr2+versusapatite crystals. Based on this study, it seems that for supplementation of Sr at low concentration, Sr2+cations will be localized into the apatite network.

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Epidemiology of osteoporotic fractures in Brazil: what we have and what we need

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302010000200012 ◽

2010 ◽

Vol 54 (2) ◽

pp. 164-170 ◽

Cited By ~ 23

Author(s):

Marcelo de Medeiros Pinheiro ◽

Sérgio Ragi Eis

Keyword(s):

Femoral Fractures ◽

Public Health Problem ◽

Osteoporotic Fractures ◽

Fragility Fractures ◽

Healthcare Services ◽

Bone Fragility ◽

High Rate ◽

Physical Impairment ◽

Public Healthcare ◽

Major Public Health Problem

The epidemiology of osteoporotic fractures varies widely among countries and is primarily related to differences in the population and utilization of public healthcare services. Since 1994, over 200 studies about osteoporosis and fractures have been conducted in Brazil, among which 60 have described the current epidemiological status. This work is a compilation of studies published in scientific journals (PubMed, MedLine, Lilacs, SciELO Database) with the respective highlights. Overall, these studies show moderate incidence of hip fracture in subjects over 50 years old. However, the prevalence of all types of bone fragility fracture is higher, ranging from 11% to 23.8%. In addition, there is a high incidence of recurrent falls, which are the main extra-skeletal factor associated with these fractures. According to the national studies, 12 months after femoral fractures, the mortality rate ranged between 21.5% and 30%, and there was also a high rate of physical impairment, deterioration of the quality of life and excessive burden to the healthcare system. Considering its high prevalence and associated mortality and physical impairment, osteoporosis and its main consequence, bone fragility fractures, must be considered a major public health problem in our country.

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Chinese Herbal Medicine as an Adjunctive Therapy Ameliorated the Incidence of Chronic Hepatitis in Patients with Breast Cancer: A Nationwide Population-Based Cohort Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/1052976 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Kuo-Chin Huang ◽

Hung-Rong Yen ◽

Jen-Huai Chiang ◽

Yuan-Chih Su ◽

Mao-Feng Sun ◽

...

Keyword(s):

Breast Cancer ◽

Chronic Hepatitis ◽

Cohort Study ◽

Herbal Medicine ◽

Incidence Rate ◽

Chinese Herbal Medicine ◽

Therapeutic Potential ◽

Population Based ◽

Research Database ◽

Chinese Herbal

We conducted a National Health Insurance Research Database-based Taiwanese nationwide population-based cohort study to evaluate whether Chinese herbal medicine (CHM) treatment decreased the incidence of chronic hepatitis in breast cancer patients receiving chemotherapy and/or radiotherapy. A total of 81171 patients were diagnosed with breast cancer within the defined study period. After randomly equal matching, data from 13856 patients were analyzed. Hazard ratios of incidence rate of chronic hepatitis were used to determine the influence and therapeutic potential of CHM in patients with breast cancer. The patients with breast cancer receiving CHM treatment exhibited a significantly decreased incidence rate of chronic hepatitis even across the stratification of age, CCI score, and treatments. The cumulative incidence of chronic hepatitis for a period of seven years after initial breast cancer diagnosis was also reduced in the patients receiving CHM treatment. The ten most commonly used single herbs and formulas were effective in protecting liver function in patients with breast cancer, where Hedyotis diffusa and Jia-Wei-Xiao-Yao-San were the most commonly used herbal agents. In conclusion, our study provided information that western medicine therapy combined with CHM as an adjuvant modality may have a significant impact on liver protection in patients with breast cancer.

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CECT in Pulmonary Thrombolism

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i53b33709 ◽

2021 ◽

pp. 284-293

Author(s):

Shaha Pramod ◽

Ragi Skanda ◽

Bhoite Amol ◽

Tamboli Asif ◽

Gautama Amol

Keyword(s):

Pulmonary Embolism ◽

Public Health Problem ◽

Pulmonary Angiography ◽

High Morbidity ◽

Major Public Health Problem ◽

Medical Sciences ◽

Non Invasive ◽

Highly Sensitive ◽

Associated Conditions

Introduction: Pulmonary embolism (PE) is the third most common acute heart disease after myocardial infarction and stroke and is a major public health problem. PE is a disease that has high morbidity and mortality, yet it is challenging to obtain a diagnosis. Objective: The study aims to assess the role of MDCT-PA in the diagnosis of pulmonary embolism, and it's associated conditions in suspected cases of pulmonary embolism. Materials and Methods: The study was conducted in the department of radiology in KRISHNA INSTITUTE OF MEDICAL SCIENCES DEEMED TO BE UNIVERSITY situated in KARAD equipped with a 16 slice MDCT scanner (EMOTION) manufactured by Siemens. Results: Through the study period of one and half year and have met the inclusion criteria, a total of 90 consecutive patients who presented with suspicion of PE were referred for MDCT-PA in the department of radio-diagnosis, Krishna Hospital, Karad. A review of all the cases was done, and the results were presented in the form of tables. Conclusion: Multidetector computed tomography pulmonary angiography can be used to confidently diagnose pulmonary embolism in which it is not contraindicated. MDCT-PA is the investigation of choice because it is a rapid, non-invasive study, highly sensitive and specific.

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Opportunistic Infections and Associated Factors among HIV/AIDS Patients taking Ante-Retroviral Therapy at Selected Hospitals in Sidama Zone, Southern Ethiopia: A facility-based cross-sectional study

10.21203/rs.2.17125/v1 ◽

2019 ◽

Author(s):

Demelash Wachamo ◽

Fisseha Bonja

Keyword(s):

Associated Factors ◽

Opportunistic Infections ◽

Public Health Problem ◽

Cross Sectional Study ◽

High Morbidity ◽

Major Public Health Problem ◽

Sectional Study ◽

Aids Patients ◽

Cross Sectional ◽

Hiv Aids

Abstract Background Opportunistic infections are late complications of HIV infection is the depletion of the immune system. It is a major public health problem and high morbidity AIDS patients die of AIDS-related infections in developing countries like Ethiopia. Identification of opportunistic infections (OIs) is important to develop a specific intervention. Therefore, this study aimed to assess the burden and associated factors of opportunistic infections.Method A facility-based cross-sectional study was conducted on 420 randomly selected HIV/AIDS patients taking anti-retroviral therapy. Data was collected from selected hospitals in Sidama Zone based on population proportion to size. Data was collected by a pre-tested questionnaire and a pre-tested checklist from the medical records of patients. Data entry and analyzed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.Result The magnitude of opportunistic infections was 39.6%. Major identified OIs was oral candidacies 23.2%, recurrent bacterial pneumonia 21.5%, Herpes zoster 6.3%, and Pulmonary Tuberculosis 6.0%.The magnitude of opportunistic associated with; older age [AOR=2.69, 95% CI: 1.33-5.43], No formal education [AOR=3.12, 95% CI: 1.06-9.25], Low monthly income [AOR=2.27, 95%CI:1.35-3.83], initial CD4 count less than 200 cells/mm3 [AOR=1.91, 95% CI:1.05-3.46), WHO clinical stage II [AOR=2.43, 95% CI:1.34-4.42] and stage III and IV [AOR=4.27, 95% CI: 2.12-8.59], had no extra medicine additional to ART (prophylaxis) had [AOR= 5.91, 95% CI: 3.31-10.56], who interrupt ART medicines [AOR=2.03, 95% CI: 1.09- 3.80] and Khat chewing [AOR=5.48, 95% CI: 2.32-12.96] when compared to their counterparts.Conclusions The overall magnitude of opportunistic infections was high when compared with other studies. Health officials and clinicians need to give attention on the strengthening of the provision if ART with prophylaxis on early-stage and adhrerence, implementation of the TB/HIV collaboration activity, and early initiation of ART to reduce opportunistic infections.

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Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽

10.3390/nu13113832 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3832

Author(s):

Amy Hofman ◽

Marlou A. M. Limpens ◽

Tosca O. E. de Crom ◽

Mohammad Arfan Ikram ◽

Annemarie I. Luik ◽

...

Keyword(s):

Physical Activity ◽

The Netherlands ◽

Latent Class ◽

Multinomial Logistic Regression ◽

Public Health Problem ◽

Population Based ◽

World Health ◽

Major Public Health Problem ◽

Middle Aged ◽

Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

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Heart Failure Is a Clinically and Densitometrically Independent Risk Factor for Osteoporotic Fractures: Population-Based Cohort Study of 45,509 Subjects

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2011-3055 ◽

2012 ◽

Vol 97 (4) ◽

pp. 1179-1186 ◽

Cited By ~ 34

Author(s):

Sumit R. Majumdar ◽

Justin A. Ezekowitz ◽

Lisa M. Lix ◽

William D. Leslie

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cohort Study ◽

Osteoporotic Fractures ◽

Population Based ◽

Recent Onset ◽

Major Osteoporotic Fractures ◽

Hip Bmd ◽

Osteoporosis Risk Factors ◽

Osteoporosis Risk

Objective: The aim of the study was to determine whether heart failure is associated with an increased risk of major osteoporotic fractures that is independent of bone mineral density (BMD). Methods: We conducted a population-based cohort study in Manitoba, Canada, by linking a clinical registry of all adults 50 yr of age and older who underwent initial BMD testing from 1998–2009 with administrative databases. We collected osteoporosis risk factors, comorbidities, medications, and BMD results. Validated algorithms identified recent-onset heart failure before the BMD test and new fractures after. The main outcome was time to major osteoporotic fractures (i.e. clinical vertebrae, distal forearm, humerus, and hip), and multivariable proportional hazards models were used for analyses. Results: The cohort consisted of 45,509 adults; 1,841 (4%) had recent-onset heart failure. Subjects with heart failure were significantly (P < 0.001) older (74 vs. 66 yr) and had more previous fractures (21 vs. 13%) and lower total hip BMD [T-score, −1.3 (sd 1.3) vs. −0.9 (sd 1.2)] than those without. There were 2703 incident fractures over the 5-yr observation. Overall, 10% of heart failure subjects had incident major fractures compared with 5% of those without [unadjusted hazard ratio (HR), 2.45; 95% confidence interval (CI), 2.11–2.85]. Adjustment for osteoporosis risk factors, comorbidities, and medications attenuated but did not eliminate this association (HR, 1.33; 95% CI, 1.11–1.60), nor did further adjustment for total hip BMD (HR, 1.28; 95% CI, 1.06–1.53). Conclusions: Heart failure is associated with a 30% increase in major fractures that is independent of traditional risk factors and BMD, and it also identifies a high-risk population that may benefit from increased screening and treatment for osteoporosis.

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Incidence of Second Primary Malignancies in Patients with Castration-Resistant Prostate Cancer: An Observational Retrospective Cohort Study in the United States

Prostate Cancer ◽

10.1155/2019/4387415 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Catherine W. Saltus ◽

Zdravko P. Vassilev ◽

Jihong Zong ◽

Brian Calingaert ◽

Elizabeth B. Andrews ◽

...

Keyword(s):

Prostate Cancer ◽

United States ◽

Cohort Study ◽

Incidence Rate ◽

Retrospective Cohort ◽

Population Based ◽

Second Primary ◽

Castration Resistant Prostate Cancer ◽

Castration Resistant ◽

Second Primary Malignancies

Background. New therapies for castration-resistant prostate cancer (CRPC) may be associated with increased risk of second primary malignancies (SPM). We therefore estimated the population-based incidence of SPM among patients with CRPC in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. We also estimated the proportion of men with CRPC with bone metastases and overall survival. Methods. We conducted a retrospective cohort study of United States (US) men aged ≥ 65 years with CRPC. Cohort entry was from January 1, 2000, to December 31, 2011, with follow-up through December 31, 2013. Castration resistance was defined by treatment with second-line systemic therapy (after surgical or medical castration). SPM were diagnoses of primary cancers (other than prostate) in SEER or Medicare data. Results. Altogether 2,234 patients met eligibility criteria. Most (1,887; 84.5%) had evidence of bone metastases in Medicare claims. SPM occurred in 172 patients (incidence rate 5.9 per 100 person-years; 95% confidence interval [CI], 5.0-6.8; standardized incidence ratio = 3.1, 95% CI, 2.8-3.6, based on SEER incidence rate of all malignancies except prostate cancer among men aged ≥ 65 years). The most common SPM were lung/bronchus (n = 29, 16.9%), urinary bladder (n = 22, 12.8%), and colon/rectum (n = 21, 12.2%). Median survival was 1.2 years (95% CI, 1.1-1.3); 5-year survival was 9% (95% CI, 7-11%). Conclusions. This study provides the first estimate of SPM risk in older men with CRPC in the US. The incidence rate is approximately threefold higher than the population-based cancer incidence among men without prostate cancer.

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