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Query: UNIPROT:P50502 (
Hip
)
7,003
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The serum concentration of 25-hydroxyvitamin D level and plasma albumin-adjusted calcium, phosphate, and alkaline phosphatase levels were studied in 200 patients with hip fracture (age range 49-93 years) and 427 elderly subjects living in the community (age range 60-90 years). The mean serum 25-hydroxyvitamin D levels in controls were higher than in temperate countries, but the 25-hydroxyvitamin D concentration was significantly lower in the patients than the controls for all sex and age groups. There was little difference in albumin-adjusted calcium and alkaline phosphatase levels, but the phosphate level was higher in the patients than in the controls. None of the patients with a low 25-hydroxyvitamin D level had a blood picture suggestive of osteopathy resulting from
vitamin D deficiency
or frank osteomalacia.
Hip
fracture patients with a low 25-hydroxyvitamin D level were much less ambulant and went outdoors much less frequently than hip fracture patients with a normal vitamin D level. A low vitamin D level was a risk factor for hip fracture in Hong Kong Chinese, and may be prevented by frequent outdoor exposure.
...
PMID:Plasma 25-hydroxyvitamin D concentration in patients with hip fracture in Hong Kong. 258 33
The most common nutritional problems in nursing home residents are weight loss and concomitant protein energy undernutrition. Although the causes of weight loss in these patients can usually be treated, they are rarely identified in the nursing home. Depression and adverse drug effects are the most common causes of weight loss. We discuss the appropriate use of feeding tubes in the nursing home and the early use of enteral feeding to prevent the development of severe protein energy undernutrition. Vitamin deficiencies, especially folate and pyridoxine deficiencies, frequently develop in nursing home residents.
Hip
fractures are often associated with
vitamin D deficiency
. Trace mineral deficiencies (for example, zinc deficiency) can aggravate immune deficiency and slow wound healing. Inadequate fluid intake leads to dehydration, hypotension, and, in persons with diabetes mellitus, hyperosmolarity. Finally, food intake itself can cause postprandial hypotension (which in turn may precipitate falls), produce electrolyte shifts, and result in aspiration pneumonia. Physical activity programs are an important component of nursing home care that may have an effect on nutritional status, and simple, cost-effective programs may be as beneficial as high-technology programs. Careful attention to the nutritional intake of nursing home residents is both a clinical and a quality-of-life issue.
...
PMID:Nutritional issues in nursing home care. 748 69
Hip
fracture is the most important skeletal problem in elderly people. Its two main determinants are falls and bone loss leading to an intrinsic bone fragility. Bone fragility results from postmenopausal and senile bone loss. The latter is increased by the secondary hyperparathyroidism of elderly persons which is induced by a combination of
vitamin D deficiency
and calcium intake, both very common in old age, particularly in Europe. Prophylactic strategies should be based on prevention of falls and of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal oestrogen replacement therapy and a late prevention of senile secondary hyperparathyroidism by vitamin D and calcium supplements which have recently been shown to reduce by 25% the number of hip fractures in a prospective study performed in a large population of institutionalized women. Therefore, it is never too early to pay attention to the risk of osteoporosis, and never too late to prevent hip fractures.
...
PMID:[Physiopathology and prevention of fractures of the proximal end of the femur]. 779 35
Osteoporosis is a public health scourge that is usually eminently preventable. Some risk factors, such as low calcium intake,
vitamin D deficiency
, and physical inactivity, are amenable to early interventions that will help maximize peak bone density. Other risk factors subject to modification are cigarette smoking and excessive consumption of protein, caffeine, and alcohol.
Hip
fractures are the most serious outcome of osteoporosis, with enormous personal and public health consequences. The ongoing Study of Osteoporotic Fractures has identified additional independent predictors of hip fracture risk, including maternal hip fracture, absence of significant weight gain since age 25, height, hyperthyroidism, use of long-acting benzodiazepines or anticonvulsants, spending < 4 hours a day on one's feet, inability to rise from a chair without using one's arms, poor visual depth perception and contrast sensitivity, and tachycardia. In an individual perimenopausal woman, the risk of osteoporotic fracture and the urgency of estrogen replacement therapy can be best estimated on the basis of bone mineral density, as measured by dual-energy x-ray absorptiometry, coupled with the presence or absence of existing fractures and clinical risk factors evident from the history and physical examination. Estrogen, calcitonin, and bisphosphonates have all been proved effective in retarding postmenopausal bone loss and therefore reducing the risk of fracture. The use of sodium fluoride is more controversial, although a recent study has suggested a possible role for slow-release fluoride combined with high-dose calcium supplementation.
...
PMID:Osteoporosis: prevention, diagnosis, and management. 921 58
Hip
fractures in men account for one third of all hip fractures and have a higher mortality than in women. The public health burden will increase as the increase in the numbers of elderly men in the community increases. In addition, the age-specific incidence of hip fractures may be increasing in some, but not all, countries. Vertebral fractures may be a public health problem as recent studies suggest that the prevalence in the community is 20-30%, similar to that reported in women. Forearm fractures should probably not be regarded as a public health problem. Peak bone mass is higher in men than women because men have bigger bones. Peak bone mineral density is the same. The amount of trabecular bone lost at the spine and iliac crest during ageing is similar in men and women. Cortical bone loss is less in men because endocortical resorption is less and periosteal formation is greater. Bone loss accelerates in elderly men because endocortical resorption and increasing cortical porosity increase the surface available for resorption. Bone fragility is less in men than women because: (a) the cross-sectional surface of the bone is larger; (b) trabecular bone loss is less as a percentage of the higher peak bone mass; (c) trabecular bone loss occurs by thinning rather than perforation; and (d) periosteal appositional growth compensates for endocortical resorption by maintaining the bending strength of bone. Reduced BMD in men with fractures may be due to reduced peak bone size and mass, and bone loss. Bone loss occurs by reduced bone formation. Whether men with fractures have increased bone fragility due to reduced periosteal appositional growth during ageing is unknown. The age-related decline in testosterone, adrenal androgens, growth hormone, and insulin-like growth factor 1 may contribute to reduced bone formation and bone loss. Men with vertebral fractures often have hypogonadism or illnesses with few clinical features that should be considered with a high index of suspicion (alcoholism, myeloma, malabsorption, primary hyperparathyroidism, haemochromatosis, Cushing's disease). Secondary hyperparathyroidism may contribute to bone loss by activating bone turnover and so increasing the number of bone remodelling units with impaired bone formation in each. There is no proven treatment for osteoporosis in men because there have been no trials using anti-fracture efficacy as an end point. Testosterone replacement should be considered in men with proven hypogonadism and
vitamin D deficiency
should be corrected if present. Calcium supplements and bisphosphonates are reasonable options given the lack of information.
...
PMID:Osteoporosis in men. 936 40
Hip
fracture is one of the severest consequences of osteoporosis affecting elderly women, but abnormalities of bone turnover responsible for bone loss have not been clearly defined. This study evaluated the relationship of bone turnover parameters to hip fracture in postmenopausal elderly women. We also investigated the effects of endogenous hormones and
vitamin D deficiency
on osteoporotic hip fracture. The subjects were 21 osteoporotic patients with hip fracture (study group) and 20 healthy postmenopausal women (control group). We measured osteocalcin levels, total and bone alkaline phosphatase (T-ALP and B-ALP), calcitonin, intact parathyroid hormone (iPTH), serum 25 hydroxyvitamin D (25OHD), urinary free deoxypyridinoline (D-pyr) and cross-linked N-telopeptides of type 1 collagen (NTx) levels. Serum T-ALP and B-ALP levels in the study group were lower than those of the control group. The mean serum 25OHD levels in the study group were not significantly different from the control group, but in five cases the mean serum iPTH level was increased. The mean urinary NTx levels were significantly increased in the study group compared with the control group (p<0.05). There was no significant increase in urinary free D-pyr between the two groups. There was significant correlation between serum T-ALP levels and B-ALP levels and between serum iPTH levels and B-ALP levels. The mean serum SHBG level in the study group was higher than in the control group (p<0.05). These data suggest that postmenopausal hip fracture patients have biochemical evidence of decreased bone formation and increased bone resorption compared with postmenopausal healthy subjects. We suggest these abnormalities play a role in the decrease of bone mass and the consequent increase in bone fragility that characterises osteoporotic hip fracture.
...
PMID:Relationship of bone turnover parameters, endogenous hormones and vit D deficiency to hip fracture in elderly postmenopausal women. 1213 39
Incidence of a fracture, particularly in the hip joint, is high in elderly women with Parkinson's disease (PD), and this is due to the immobilization-induced bone resorption and
vitamin D deficiency
with reduced bone mineral density (BMD). The objective of this study was to address the possibility that treatment with alendronate and vitamin D2 may reduce the incidence of hip fractures in elderly women with PD. PD patients were randomly assigned to daily treatment with 5 mg alendronate (n = 144) or a placebo combined with 1,000 IU of vitamin D2 (n = 144) and followed for 2 years. Incidence of hip fractures in the two patient groups during the 2-year follow-up period was studied. At baseline, both groups of patients had low BMD with high levels of serum-ionized calcium and urinary deoxypyridinoline (D-Pyr).
Hip
fractures occurred in 14 patients in the placebo group and 4 in the alendronate group. The relative risk for hip fractures in the alendronate group as compared with the placebo group was 0.29 (95% CI, 0.10-0.85). The number of hip fracture per 1,000 patient-years was 14 and 49 for the alendronate and placebo groups, respectively. In the alendronate group, serum calcium and urinary D-Pyr levels decreased significantly during the follow-up period, while the levels in the placebo group were increased. BMD increased by 3.1% in the alendronate group and decreased by 2.8% in the placebo group (P < 0.01). Treatment with alendronate and vitamin D2 increases BMD in elderly women with PD and leads to the prevention of hip fractures.
...
PMID:Alendronate and vitamin D2 for prevention of hip fracture in Parkinson's disease: a randomized controlled trial. 2737 61
Hip
fractures in the young are exceedingly rare and are usually seen in instances of high energy trauma or metabolically altered bone states. In this case report, we present an occult femoral neck fracture, diagnosed by magnetic resonance imaging, in an otherwise healthy, young, active duty male patient with an isolated
vitamin D deficiency
treated using cannulated percutaneous screws.
...
PMID:Occult femoral neck fracture associated with vitamin D deficiency diagnosed by MRI: case report. 2264 90
Asia is witnessing a rapid growth in its aging population. Yet osteoporosis in this region has received relatively little attention.
Hip
fracture rates have increased by 2- to 3-fold in most Asian countries during the past 30 years. Lack of quality epidemiologic data, widespread
vitamin D deficiency
, low dietary calcium intakes, and uneven access to diagnostic and therapeutic facilities are some of the major challenges faced in this region. Osteoporotic fractures constitute a huge medical, social, and economic burden in Asia. There is an urgent need to promote research, spread awareness, and build national health programs to check this growing problem.
...
PMID:Osteoporosis in Asia: a call to action. 2289 71
Hip
fractures and dementia increase exponentially with age, and patients who are afflicted by both conditions suffer significant morbidity and mortality. The aging of our population heightens the need to recognize the interaction of these conditions in order to improve our efforts to prevent hip fractures, provide acute care that improves outcomes, and provide secondary prevention and rehabilitation that returns patients to their previous level of functioning. Identification and treatment of
vitamin D deficiency
and osteoporosis and assessment and interventions to reduce falls in patients with dementia can significantly impact the incidence of first and subsequent hip fractures. Acute management of hip fractures that focuses on comanagement by orthopedic surgeons and geriatricians and uses protocol-driven geriatric-focused care has been shown to decrease mortality, length of hospitalization, readmission rates, and complications including delirium. Patients with mild-to-moderate dementia benefit from intensive geriatric rehabilitation to avoid nursing home placement. Recognizing the need to optimize primary and secondary prevention of hip fractures in patients with dementia and educating providers and families will lead to improved quality of life for patients affected by dementia and hip fractures.
...
PMID:Prevention and clinical management of hip fractures in patients with dementia. 2356 64
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