Neck of femur fractures (NOF) are common injuries sustained by older patients who are both more likely to have unsteadiness of gait and reduced bone mineral density, predisposing to fracture. Elderly osteoporotic women are at greatest risk.Epidemi...
about 7 years ago
Preterm birth remains a common complication of pregnancy and causes substantial neonatal morbidity and mortality. As improvements in the care of preterm neonates have outpaced efforts to prevent preterm birth, the numbers of survivors with neurologic sequelae that affect quality of life have increased. The main strategies to reduce the impact of neurologic complications of prematurity include prevention of preterm birth and protection of the developing fetal brain through antenatal administration of drugs. These strategies rely on a basic understanding of the intertwined pathophysiology of spontaneous preterm labor and perinatal brain injury, which will be reviewed here. The review will outline current methods for the prevention of prematurity and neuroprotection. The use of magnesium sulfate as a neuroprotective compound will be discussed, including concerns over its association with increased pediatric mortality and abnormalities in bone density.
almost 7 years ago
We read with great interest the pilot study on fracture risk in 46 critically ill patients by Rawal and colleagues . Bone mineral density (BMD) was assessed with portable calcaneal dual X-ray absorptiometry (DXA) on days 1 and 10. The authors found no overall change in BMD, but increased fracture risk in the subgroup with 'ARDS' (acute respiratory distress syndrome) (n = 34). There are several serious methodological problems: it is unclear if the group assignment is valid as only one of the four Berlin definition criteria  for the diagnosis of ARDS is given: oxygenation (no information on timing, chest imaging and origin of the edema). Although peripheral DXA devices are certainly an interesting option for BMD in critically ill and other patients , precision errors supplied by the manufacturer should not be used. In fact, each center must determine its (own) precision error and least significant change, which is also operator dependent . The manufacturer stated a 0.9 % coefficient of variation, which is not necessarily applicable to the study setting where it remains unclear how the measurements were performed. This could be an important limitation. Hence, it is unlikely that a 2 % BMD change within such a short time frame as described would reflect anything else other than random variability. Lastly, it is also unclear what the described statistical difference refers to - it should be noted that the smaller subgroup (n = 12) numerically increased their BMD. Undoubtedly, fracture risk following critical illness is a very important topic that requires further high-quality studies .
over 6 years ago
When bone mass declines with age, the risk of fractures increases. Birth control methods that have hormones may lead to changes in women’s bone density. Worry about fractures may limit the use of these effective methods. Observational studies can collect data on birth control use as well as fractures later in life. Through June 2015, we searched for such studies in several databases.
over 6 years ago
New clinical trial data for canagliflozin confirmed previously noted risk about fractures and reduced bone mineral density in the hip and spine, prompting the FDA to revise the product label.
about 6 years ago
Adolescent boys with an anterior cruciate ligament (ACL) repair may be at risk for lower bone mineral density (BMD) of the calcanei and associated fracture, according to a new study.
about 6 years ago