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Query: UNIPROT:P50502 (
Hip
)
7,003
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The aim of all surgical procedures in the treatment of trochanteric fractures in elderly and even geriatric patients is achievement of initial stability. We examined in a clinical trial whether primary stability was achieved in all types of trochanteric fractures following osteosynthesis with the Dynamic
Hip
Screw (DHS). From 1994 to 1996, 122 patients with trochanteric fractures had osteosynthesis by dynamic hip screw. Patient records were evaluated and all data got registered with a standardized protocol;clinical radiological outcome was analysed after an average period of 1.9 years after injury according to the Traumatic
Hip
Rating Score. 22% of all patients died meantimes, 51.6% of the remaining 95 patients could get examined. The average age was 75.5 years, the patient population showed an increased preoperative morbidity (2.5 points) according to ASA-Score. 81% showed progressive osteoporosis. According to the AO-classification 47% stable fractures (type A-1) and 53% instable trochanteric fractures (type A-2 and A-3) occurred. Surgery lasted 77 minutes average in osteosynthesis of stable fractures. The duration of 108 minutes in instable fractures was significantly higher, as well as the blood loss was 43% increased in these complex fractures. Complications closely associated to the osteosynthesis appeared only in instable fractures (7%). Also common complications (24.6%) predominated with 15.6% in type A-2 and A-3 fractures versus 9% in type A-1 fractures; mortality was also different with 5.7% versus 1.6%. Assessment of the functional outcome according to THRS showed a significant deterioration of 20 points in 71% of all patients compared with the preoperative score. The results show that dynamic hip screw osteosynthesis in instable trochanteric fractures is associated to a higher incidence of complications. While the dynamic hip screw still represents the standard implant in stable fractures of the trochanteric region, being aware of improved intramedullary implants regarding biomechanical features and surgical technique, the results justify to critical consider the use of DHS for osteosynthesis in instable fractures of the trochanteric region.
Unfallchirurg 2000
Sep
PMID:[Stable and unstable pertrochanteric femoral fractures. Differentiated indications for the dynamic hip screw]. 1103 94
Models proposed so far for the pathogenesis of osteoporosis often do not take into account the factors underlying the different incidences of hip fracture in different populations. To address this issue, we identified 34 female patients with hip fracture (HF) and 16 women with at least four vertebral fractures (VF) in a population-based retrospective study. Each participant had a bone mineral density (BMD) measurement of the lumbar spine and hip using a Hologic QDR-2000 scanner, in single beam mode for the latter site.
Hip
axis length (HAL) was determined automatically (precision 1.5%). HAL derived from 149 normal subjects (age range 19-75 years) was 10.3 +/- 0.5 cm. BMD values found at the femoral neck were almost similar, but differed significantly at the spine between the two groups. Mean values of femur HAL in HF patients (10.55 +/- 0.5 cm) were significantly higher compared with VF patients (9.85 +/- 0.54 cm; p < 0.001). Interestingly, both mean values differed significantly from the mean for normal subjects. Our results demonstrate that patients with multiple vertebral fractures have significantly lower vertebral BMD values but similar femoral neck values compared with patients who fracture at the hip; furthermore, hip axis length was more than 1 SD higher in these latter patients compared with that of VF patients. These results suggest that the size and shape of the hip can explain part of the observed aetiologic differences between these two types of osteoporotic fractures.
Br J Radiol 2000
Sep
PMID:Hip axis length in an Italian osteoporotic population. 1106 50
The purpose of this study was to examine the effects of BMI (Body Mass Index) and WHR (Waist
Hip
Ratio) on average blood pressure and the prevalence of hypertension in middle-aged and elderly population in rural China. A total of 12955 subjects including 6276 males and 6688 females over 40 years of age were surveyed. Height, weight, waist circumference, hip circumference and blood pressure were measured. The association of BMI and WHR on average blood pressure levels and prevalence of hypertension were analyzed by dividing BMI and WHR into tertiles. The average blood pressure levels and the prevalence of hypertension in males and females increased significantly with the increase of BMI or WHR (P < 0.01), as well as with the increase of both of them (P < 0.01). The average blood pressure and the prevalence of hypertension stopped increasing when WHR was > or = 0.76, suggesting that WHR > or = 0.80 could be used as a cut-off value for the prediction of hypertension risk for both males and females. Therefore hypertension could be effectively prevented and controlled by controlling BMI and WHR.
Biomed Environ Sci 2000
Sep
PMID:The association of BMI and WHR on blood pressure levels and prevalence of hypertension in middle-aged and elderly people in rural China. 1119 20
The American Association of
Hip
and Knee Surgeons (AAHKS) distributed a survey to its members exploring practice patterns implemented to prevent venous thromboembolic disease (VTED) in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Of 720 (33%) members, 236 responded. Prophylaxis was prescribed for 100% of patients during the course of hospitalization for THA and TKA. Warfarin was the commonest pharmacologic treatment used for THA (66%) and TKA (59%) patients. Low-molecular-weight heparin was used in 16% of THA patients and 18% of TKA patients. The most commonly employed mechanical modality was pneumatic devices in THA (51%) and TKA (50%). Universal acceptance of the need for prophylaxis administration for patients undergoing THA and TKA is shown. The method and duration remain highly variable; although the survey illustrates such variation, it suggests there is no one best method of prophylaxis.
J Arthroplasty 2001
Sep
PMID:Venous thromboembolic disease management patterns in total hip arthroplasty and total knee arthroplasty patients: a survey of the AAHKS membership. 1154 65
During the past 40 years, improvements have been made in the technique, implant, and surgical environment for total hip replacement, which today is one of the most cost-effective operations done. The aim of this study was to compare different outcome measurement methods and to develop recommendations for optimal followup of total hip replacement. The study involved the outcome of 2604 randomly selected patients in Sweden treated surgically with a modern technique. General questionnaires (the Medical Outcomes Study 36-Item Short-Form Health Survey and the Nottingham Health Profile) were compared with disease-specific questionnaires (the Western Ontario and McMaster University Osteoarthritis Index and the Harris hip score). The study showed a good correlation between the studied questionnaires, and all questionnaires used could be suitable for followup study after hip replacement surgery. In clinical practice and for research, a general and disease-specific self-administered score should be used. Some patients (older and low cerebral capacity) have difficulties answering questions on these questionnaires. A new short self-administered general and disease-specific questionnaire was designed: the Total
Hip
Replacement score. The Total
Hip
Replacement score provides information about the result of the hip arthroplasty, and the results can be compared with results of other surgical interventions.
Clin Orthop Relat Res 2001
Sep
PMID:Outcome of total hip replacement: a comparison of different measurement methods. 1155 Aug 62
Carboxypeptidase U (EC 3.4.17.20, CPU, TAFIa) is a novel determinant of the fibrinolytic rate. It circulates as an inactive zymogen, procarboxypeptidase U, which becomes active during the process of coagulation. We developed a high throughput method on microtiter plates for the determination of the procarboxypeptidase U concentration in human plasma samples. Following activation of procarboxypeptidase U by thrombin-thrombomodulin, the resulting enzyme activity cleaves p-OH-
Hip
-Arg and the generated p-OH-hippuric acid is converted by hippuricase to p-hydroxybenzoic acid and glycine. Finally, oxidative coupling of p-hydroxybenzoic acid with 4-aminoantipyrine by NaIO4 forms the quinoneimine dye. The absorbance of the latter dye is determined at 506 nm in a microtiter plate reader. A mean value of 620 U/l was found, with a CV of 3.0% within-run and 4.3% between-run. The assay showed a good correlation with the activities observed using a HPLC assay as reference method (n = 25, r = 0.979). The presented method enables the routine analysis of large sample pools in clinical setting.
Clin Chem Lab Med 2001
Sep
PMID:Fast homogeneous assay for plasma procarboxypeptidase U. 1160 77
Hip
fractures are one of the most common and potentially devastating injuries in the geriatric population. The incidence, morbidity, and health care costs associated with hip fracture among older persons are well recognized. Because of the complex health care needs of the elderly, rehabilitation after a hip fracture can present a challenge at a time when the nursing workforce and health care funding are declining. Aggressive rehabilitation focusing on continuity of care and attention to the cognitive as well as physiologic status results in effective and cost-effective rehabilitation.
Crit Care Nurs Clin North Am 2001
Sep
PMID:Rehabilitation after a hip fracture. Special needs of the elderly. 1185 71
Elective total hip and total knee arthroplasty surgeries are associated with an extraordinarily high incidence of asymptomatic venous thromboembolism (VTE). Symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) is diagnosed in only 2%-4% of these patients. A number of studies have defined the incidence and time course of symptomatic thromboembolism after these procedures. Knee arthroplasty is associated with a very high incidence of asymptomatic calf vein thrombosis, with almost all symptomatic VTE events diagnosed in the first 21 days after surgery.
Hip
arthroplasty, however, is associated with a higher incidence of asymptomatic proximal thrombi and a modestly higher incidence of symptomatic VTE events, many diagnosed up to 6 or 8 weeks after hospital discharge. Extended medical thromboprophylaxis has been shown to reduce the incidence of symptomatic and asymptomatic VTE among hip arthroplasty patients but not among knee arthroplasty patients. Risk factors for VTE after knee arthroplasty are not well defined. Important risk factors that have been shown to be associated with the development of VTE after hip surgery include (1) a history of prior VTE, (2) obesity (body mass index > 25), (3) delay in ambulation after surgery, and (4) female sex. Factors associated with lower risk include (1) Asian/Pacific Islander ethnicity, (2) use of pneumatic compression among non-obese patients after surgery, and (3) extended thromboprophylaxis after hospital discharge.
Curr Opin Pulm Med 2002
Sep
PMID:Risk factors for venous thromboembolism after total hip and knee replacement surgery. 1217 37
In contrast to adult rheumatoid arthritis, hips are commonly affected joints in severe, destructive, juvenile rheumatoid arthritis (JRA).
Hip
disease develops in 30 to 50% of children with JRA. Because of the importance of the hip joint in weight bearing the advent of hip disease in a child with JRA warns of future disability [1, 2]. The challenges for the clinician are to prevent significant hip involvement, to halt further damage when hip disease is noted, and in the event that conservative treatment fails, to guide the child and family through hip arthroplasty and rehabilitation. Recent trends suggest that today's more aggressive treatment approach and more effective drugs are resulting in fewer children with JRA developing into severe hip disease requiring hip surgery. Similarly, with improvements in orthopedic surgery, the results of hip arthroplasty have improved.
Curr Opin Rheumatol 2002
Sep
PMID:Hip disease in juvenile rheumatoid arthritis. 1219 51
Hip
fracture is associated with a higher mortality rate in men than in women. However, mean age of men and women with hip fracture differs markedly. Thus, some of the differences in the clinical pattern and outcome between genders could be related to different ages. To avoid the influence of age on gender-specific outcome, we analyzed prefracture conditions and hip fracture outcome in a cohort of men and of age-matched women. Risk factors for low bone mass were recorded in 106 men (mean age +/- SD, 80.3 +/- 9.3 years) and 264 age-matched women (mean age 81.4 +/- 8.0) with hip fracture. We compared mortality rate, survival, years of potential life lost and modification of housing conditions. These outcomes were prospectively assessed during an average 3.6 years follow-up (up to 7 years). Men with hip fracture differed from age-matched hip-fractured women by a higher alcohol and tobacco consumption, a greater frequency of living in couple, and by less prevalent fractures. Mortality rate after hip fracture was significantly higher in men (RR = 1.74, 95% CI 1.34-2.24). Since mortality is higher in the general male population, we compared reduction in life expectancy taking into account the gender-specific mortality rate. The excess mortality in each age-group of hip-fractured patients, which was measured during the whole follow-up period, and is an estimate of death attributable to fracture, did not differ between genders. Reduction in life expectancy due to hip fracture was similar in both genders (5.9 +/- 4.5 and 5.8 +/- 4.8 years, in men and women, respectively; NS), but the proportion of the years of life lost was higher in men (70 +/- 33%) than in women (59 +/- 42%, p < 0.01). It was concluded that for the same age, mortality rate after hip fracture was higher in men than in women. Although the reduction in life expectancy was similar in both genders, the proportion of the years of life lost was higher in men, suggesting a worse impact of hip fracture on survival in men, even after consideration of the higher mortality rate in the general male population.
Osteoporos Int 2002
Sep
PMID:Survival and potential years of life lost after hip fracture in men and age-matched women. 1219 37
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