1,723,215 research outputs found
The epidemiology of hip fractures in the elderly
No full textThis thesis addresses three issues which are fundamental to the design of preventive strategies for hip fractures in the elderly: the independent contribution of osteoporosis to the risk of hip fracture, the roles of low dietary calcium intake and physical inactivity as risk factors for hip fracture, and the geographic variation in hip fracture incidence within England and Wales. Femoral neck bone mass was measured in 708 elderly people who had fallen and injured a hip. Bone mass was lower in those who had sustained a hip fracture than in those who did not. There was a steep increase in the risk of fracture with reduced bone mass at younger ages. At older ages, the risk gradient was less steep. The results suggest that osteoporosis contributes to the risk of hip fracture in the elderly independently of the risk of falling. Other age-related factors become increasingly important above the age of around 75 years. A case-control comparison between 300 elderly men and women with hip fractures and 600 age and sex matched community controls showed that physical inactivity and reduced grip strength were associated with statistically significant (p< 0.01) increases in fracture risk. In women, dietary calcium intake did not influence the risk of fracture. Men with daily calcium intakes above one gram had lower risks. Examination of death certification from hip fracture in England and Wales showed major inaccuracies which limit the usefulness of mortality rates as indices of the incidence of the condition. These studies suggest that the risk of hip fracture in the elderly depends upon an interaction between osteoporosis, the risk of falling and other age-related factors. Physical inactivity and concomitant muscle weakness are important individual risk factors for hip fracture. They may influence fracture risk through an effect on bone mass, the risk of falling or both of these. The results support the maintenance of activity and muscle strength in the elderly. Such a strategy requires prospective evaluation.</p
Osteoporosis: best practice & research compendium
No full textContents:
Epidemiology of osteoporosis
Fractures in the elderly: epidemiology and demography
Pathogenesis of osteoporosis
Prenatal and childhood influences on osteoporosis
Corticosteroid osteoporosis
Lower peak bone mass and its decline
The role of bone turnover markers and risk factors in the assessment of osteoporosis and fracture risk
The use of bone densitometry in clinical practice
Role of biochemical markers in the management of osteoporosis
Glucocorticoid-induced osteoporosis
Osteoporosis in men
Osteoporosis in childhood diseases: prevention and therapy
Post-menopausal osteoporosis
How to prevent fractures in the individual with osteoporosis
Non-pharmacological interventions
Phyto-oestrogens
Oestrogen and selective receptor modulators
(SERMS): current roles in the prevention and treatment of osteoporosis
Role of bisphosphonates and calcitonin in the prevention and treatment of osteoporosis
Biologic therapies in osteoporosis
Anabolic bone binding treatment [PTH] analogues and strontium
Cost utility of treatment of osteoporosis
Risk assessment in osteoporosis
Future methods in the assessment of bone mass and structur
Osteoporosis research thrives: IOF WCO-ECCEO10
No full textThe recent World Congress on Osteoporosis (IOF WCO-ECCEO10), held in Florence on 5–8 May 2010, not only drew a record number of researchers and clinicians, it also attracted a far greater number of scientific abstracts than ever before (850). Needless to say, the organizing societies, the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), were delighted to welcome a record number of attendees (5500). The record numbers suggest that research in the field is thriving and that there is strong interest in the epidemiology, diagnosis and management of osteoporosis and fragility fractures around the world. This is reflected in the attendance statistics, which showed that, as expected, the largest delegation of participants (73.89%) was from Europe, with comparatively large delegations from Asia (8.20%) and North America (6.35%). Researchers and clinicians from South America and the Middle East (3% each) were also in attendance. Participants experienced an enriching scientific program featuring a broad range of topics covered in 12 plenary sessions, 19 primarily clinically oriented meet-the-expert topics in multiple sessions, and eight special sessions and symposia. A total of 12 satellite symposia enhanced the program by offering a wealth of information and practical new knowledge for clinicians.<br/
Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017
No full textBackground: assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally.Methods: the GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950.Findings: globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development.Interpretation: this analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing
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