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Query: UNIPROT:P50502 (
Hip
)
7,003
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hip
fractures are a growing problem and new models of care have been called for. However, patients from residential care are rarely considered in these discussions.
Hip
fracture is a common serious problem for older people in residential care with profound effects on subsequent mobility and quality-of-life. There are no Australian data documenting differences in hospital treatments offered to patients from the community and residential care to inform discussions. In a prospective audit we describe the treatment and 4 month outcomes of patients with fractured hips who were admitted to Flinders Medical Centre in South Australia from the community and residential care between August 1998 and June 1999. Information was collected on prefracture health, types of surgical and rehabilitation treatments and dependency. Of the 215 older adults who were admitted during this time, 183 agreed to participate (119 from community and 64 from residential care). Surgical management of the fracture was not affected by admission accommodation. Those from residential care had short hospital stays, less rehabilitation and access to physiotherapy. Although 61% of those from residential care were classified as independently mobile prefracture, by 4 months this had declined to 32% of survivors. Strategies to improve outcomes in those from residential care include: early identification of those walking independently prefracture with assessment by rehabilitation teams. Inclusion of liaison with community therapists in the clinical pathway and in selected cases use of 'rehabilitation at home' services to provide physiotherapy services should be considered.
J Qual Clin Pract 2000
Dec
PMID:Hip fracture treatments--what happens to patients from residential care? 1120 57
The ubiquitin-proteasome system catalyses the immediate destruction of misfolded or impaired proteins generated in cells, but how this proteolytic machinery recognizes abnormality of cellular proteins for selective elimination remains elusive. Here, we report that the C-terminus of
Hsc70-interacting protein
(CHIP) with a U-box domain is an E3 ubiquitin-ligase collaborating with molecular chaperones Hsp90 and Hsc70. Thermally denatured firefly luciferase was multiubiquitylated by CHIP in the presence of E1 and E2 (Ubc4 or UbcH5c) in vitro, only when the unfolded substrate was captured by Hsp90 or Hsc70 and Hsp40. No ubiquitylating activity was detected in CHIP lacking the U-box region. CHIP efficiently ubiquitylated denatured luciferase trapped by the C-terminal region of Hsp90, which contains a CHIP binding site. CHIP also showed self-ubiquitylating activity independent of target ubiquitylation. Our results indicate that CHIP can be regarded as 'a quality-control E3' that selectively ubiquitylates unfolded protein(s) by collaborating with molecular chaperones.
EMBO Rep 2001
Dec
PMID:CHIP is a chaperone-dependent E3 ligase that ubiquitylates unfolded protein. 1174 28
The purpose of this study was to determine if a single measurement of metacarpal cortical area could predict the subsequent risk of hip fracture over a long-term follow-up period. Thirteen hundred eighty-six women and 1014 men (mean age [+/- SD] 61 +/- 8 years) underwent posteroanterior hand radiography between 1966 and 1970 as part of the Framingham Study. Measurements of cortical bone width (external width and medullary width) were made at the midpoint of the second metacarpal with a digital caliper to the nearest 0.1 mm.
Hip
fracture occurrence was ascertained on all survivors through December 1995. Surprisingly, in women, there was no significant increase in hip fracture according to metacarpal cortical area measurements (per SD decrease) in either age-adjusted (hazard ratio [HR] = 1.13; 95% CI, 0.94-1.35) or multivariate-adjusted models (HR = 1.06; 95% CI, 0.88-1.27). The same results were seen when considering only those women who were > or = 65 years of age at the time of their X-ray or when considering only the first 10 years of follow-up. When the type of hip fracture was considered in women, after adjustment for other risk factors, there appeared to be an association between metacarpal cortical area and intertrochanteric fracture risk (HR = 1.24; 95% CI, 0.91-1.71) but not femoral neck fracture risk (HR = 0.93; 95% CI, 0.71-1.22). In men, the age-adjusted risk of hip fracture was increased modestly per SD decrease in metacarpal cortical area (HR = 1.38; 95% CI, 1.02-1.87), and this remained true after adjustment for potential confounders. In this prospective cohort study with up to 30 years of follow-up, metacarpal cortical area in men predicted hip fracture risk. In women, the only association between metacarpal cortical area and fracture risk was observed for intertrochanteric fractures and was not significant when adjusting for multiple potential confounders. We conclude that this peripheral measure of bone status is not a potent predictor of hip fracture over a long period of follow-up.
J Bone Miner Res 2001
Dec
PMID:Can metacarpal cortical area predict the occurrence of hip fracture in women and men over 3 decades of follow-up? Results from the Framingham Osteoporosis Study. 1176 Aug 40
We evaluated the clinical and radiographic results of 103 (88 patients) cementless Lord total hip arthroplasty after a mean follow-up period of 12.5 (10-16) years. 77 hips had arthrosis, 15 rheumatoid arthritis and 11 osteonecrosis. The preoperative mean Harris
Hip
Score improved from 47 (19-66) to 87 (62-99) at 5 years, but declined to 77 (56-97) at the final examination. The survivorship of the cup, using radiographically confirmed aseptic loosening as the end point, was 63% at 10 years and 45% at 15 years and the survivorship of the stem was 97% at 10 years and 96% at 15 years. The low figures of the cup may be due to insufficient contact between the smooth-surfaced threads of the cup and the acetabular bone. Thinner polyethylene, insufficient initial bone coverage, and larger femoral head diameter were significantly related to the occurrence of loosening. We can not recommend this smooth-surfaced threaded cup because of its high failure.
Acta Orthop Scand 2001
Dec
PMID:Cementless Lord total hip arthroplasty: cup loosening common after minimum 10-year follow-up of 103 hips. 1181 72
Hip
fracture is the most serious consequence of osteoporosis, frequently occurring in the elderly; however, no research has been performed to identify the fall characteristics, functional mobility and bone mineral density (BMD) concurrently as risk factors. We investigated the risk factors of hip fractures using a multifactorial approach for a further preventive strategy. This age- and sex-matched case-control study was conducted in a community-based general hospital. A total of 252 consecutive community-dwelling ambulatory elderly, aged between 65 and 85 years, were studied: 127 patients (faller with hip fracture) and 125 controls (faller without hip fracture). Body mass index (BMI), predisposing medical conditions, fall characteristics, functional mobility and BMD of the hip were evaluated by direct interview and clinical examination. In the final model of multivariate regression analysis, risk factors for hip fracture were direct hip impact (adjusted odds ratio (OR), 4.9; 95% confidence interval (CI), 2.7-8.8), previous stroke (adjusted OR, 2.9; 95% CI, 1.3-6.3), sideways fall (adjusted OR, 2.5; 95% CI, 1.6-3.9), functional mobility (a decrease of 1 SD; adjusted OR, 2.0; 95% CI, 1.1-3.5), BMI (a decrease of 1 SD; adjusted OR, 1.8; 95% CI, 1.1-2.8) and femoral neck BMD (a decrease of 1 SD; adjusted OR, 1.7; 95% CI, 1.0-2.8). The effect of risk factors remained the same in different analysis sets, and adding or removing femoral neck BMD did not change other risk factors, though BMD was significantly correlated with functional mobility and BMI. Importantly, both sideways fall and direct hip impact are independent predictors of hip fracture. From these results, we suggest a preventive strategy of hip fracture in the elderly: besides the maintenance of BMD, keeping an appropriate body weight and maintaining a physically active lifestyle might be crucial.
Osteoporos Int 2001
Dec
PMID:Fall characteristics, functional mobility and bone mineral density as risk factors of hip fracture in the community-dwelling ambulatory elderly. 1184 32
Hip
fractures may be prevented by the use of external hip protectors, but compliance is often poor. Therefore, the objective of this study was to assess the determinants of compliance with hip protectors by systematically reviewing the literature. A literature search was performed in PubMed, Embase and the Cochrane Library. Primary acceptance with hip protectors ranged from 37% to 72% (median 68%); compliance varied between 20% and 92% (median 56%). However, in most studies it was not very clear how compliance was defined (e.g., average wearing time on active days and during waking hours, number of user-days per all available follow-up days, percentage falls with hip protector) and how it was measured. To provide more insight in the compliance percentages, the different methods of defining and measuring compliance were presented for the selected studies, when provided. Because of the heterogeneity in study design of the selected studies and the lack of quantitative data in most studies, results regarding the determinants of compliance could not be statistically pooled. Instead a qualitative summary of the determinants of compliance was given. The reasons most frequently mentioned for not wearing hip protectors, were: not being comfortable (too tight/poor fit); the extra effort (and time) needed to wear the device; urinary incontinence; and physical difficulties/illnesses. In conclusion, compliance is a very complex, but important issue in hip protector research and implementation. Based on the experiences of elderly people who wear the hip protectors, adjustments should be made to the protector and the underwear, while maintaining the force attenuation capacity. Furthermore, methods to improve the compliance should be developed, and their effectiveness tested.
Osteoporos Int 2002
Dec
PMID:Acceptance and compliance with external hip protectors: a systematic review of the literature. 1245 33
A retrospective study was carried out to evaluate prophylaxis for heterotopic ossification (HO) about the hip joint post total hip arthroplasty (THA). Between 1990 and 1996, 20 patients with known risk for developing HO were treated prophylactically to prevent this complication. Patients at risk were divided into 3 groups based on risk factors for HO formation (previous ipsilateral hip HO formation, previous contralateral hip HO formation and bilateral hypertrophic osteoarthritis) Single fraction radiotherapy of 600, 700 or 800 cGy was administered postoperatively to all patients. The aim was to irradiate all patients within 72 hours of THA. 12 (60%) patients received in addition a short course of postoperative indomethacin for less than 13 days. Patients in this study were investigated for the following treatment variables: relative risk for forming HO, radiotherapy doses administered, time delays between surgery and irradiation, combined radiotherapy and indomethacin treatment versus radiotherapy alone, and surgical approach used for THA. Heterotopic ossification in patients was measured radiographically by use of the Brooker grading sytem, and was assessed clinically by use of the Harris
Hip
Score (HHS). A significant difference was found between relative risk groups (p = 0.02). Patients with previous HO formation in the ipsilateral hip joint were at greater risk of developing HO than those with previous contralateral HO formation. Moreover both of these groups were at greater risk than those with advanced bilateral hypertrophic osteoarthritis. Other variables studied showed differences that were not significant due to small sample numbers. This study, though limited by sample number, addresses questions regarding effective radiotherapy dosage, time delays acceptable before irradiation postoperatively, usefulness of short course postoperative indomethacin, and preferred operative approaches to minimise HO.
J Orthop Surg (Hong Kong) 2000
Dec
PMID:Prevention of heterotopic bone formation in high risk patients post-total hip arthroplasty. 1246 61
The anatomy and functions of muscle-tendon complexes and their bony attachments in birds and their outgroups show how the major pelvic limb muscle groups evolved. Fossils reveal that most changes evolved after the divergence of archosaurs in the Triassic, particularly in the dinosaurian precursors to birds. Three-dimensional limb control became concentrated at the hip joint; more distal joints and muscles were restricted to flexion or extension early in dinosaur evolution.
Hip
extensors expanded even though the primary femoral retractor M. caudofemoralis longus was reduced.
Hip
flexors and two-joint "hamstring" muscles were simplified to a few large heads. Knee extensors increased their sizes and moment arms early in bipedal dinosaurs, but the patella and cranial cnemial crest evolved later in birds. Lower limb muscles expanded as ossifications such as the hypotarsus increased their moment arms. The ossification of lower limb tendons, particularly in extensors, is a recent novelty of birds. Muscles and tendons that develop large forces, stresses, and moments to stabilize or move the limbs became increasingly prominent on the line to birds. Locomotion evolved in a stepwise pattern that only recently produced the derived limb control mechanisms of crown-group birds, such as the strongly flexed hip and knee joints.
Comp Biochem Physiol A Mol Integr Physiol 2002
Dec
PMID:The evolution of hindlimb tendons and muscles on the line to crown-group birds. 1248 92
Hip
fracture, the most serious complication of osteoporosis, is associated with considerable morbidity and mortality. Knowledge of hip fracture-related mortality rates by age, sex, and ethnicity as well as temporal changes in mortality are important for health planners to implement programs aimed at awareness and prevention of hip fractures. This study determines adjusted death rates in Texas by age, sex, and ethnic group from 1990 through 1998 and describes trends in mortality during the 9-year period. Upward trends in mortality were observed for both sexes in whites and blacks. Hispanics showed trends toward decreasing mortality rates. The highest mortality rates were observed in whites, predominantly in persons 80 years and older. Furthermore, rates in men by ethnic group consistently exceeded those in women. As the population ages, hip fractures are becoming a major public health problem in Texas that will likely increase unless fall prevention strategies and treatment of osteoporosis in elderly people are improved.
Tex Med 2002
Dec
PMID:Sex and ethnic differences in hip fracture-related mortality in Texas, 1990 through 1998. 1251 49
Hip
involvement is uncommon in familial Mediterranean fever (FMF) and can result either from a process specific to this disease or from a coexisting chronic inflammatory joint disease, usually suggestive of ankylosing spondylitis (AS). We report ten cases of FMF with radiologically-documented inflammatory hip disease. Five patients had AS and one had juvenile idiopathic arthritis. There were six men and four women, with a mean age of 34.4 years +/- 17.6 (range, 15-70 years). Onset of the inflammatory hip disease occurred after bouts of acute hip symptoms in one of the patients with isolated FMF and after protracted hip arthritis in another; the two other patients had no history of hip symptoms. The HLA-B27 antigen was looked for in two of the five patients with FMF and AS, with negative results in both; another patient in this subgroup had severe ulcerative colitis. Total hip replacement or replacement of the acetabulum was required in six patients, including two with isolated FMF. Chronic joint disease has been estimated to contribute fewer than 5% of the joint manifestations in FMF. In previous studies, the hips and knees were affected in 75% of patients with chronic joint disease related to FMF. The association of FMF and AS (usually without the HLA-B27 antigen) has been well documented, although the pathogenic mechanisms that link these two conditions remain unknown.
Joint Bone Spine 2002
Dec
PMID:Hip involvement in patients with familial Mediterranean fever. A review of ten cases. 1253 63
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