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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bone mass is a major determinant of fracture, but there have been few comprehensive studies of the correlates of bone mineral density (BMD) in older men. The objective of the current cross-sectional analysis was to determine the factors associated with BMD of the lumbar spine and proximal femur in a large population-based sample of older men enrolled in The Osteoporotic Fractures in Men Study, "Mr.OS." We enrolled 5,995 men 65 years of age or older, 89% Caucasian, in Mr.OS at six US clinical centers. Demographic, medical and family history and lifestyle information was obtained by interview and physical function and anthropometric data by examination. Spine and hip BMD was measured using dual-energy X-ray absorptimetry. The multivariable linear regression models predicted 19 and 10% of the overall variance in BMD of the femoral neck and spine, respectively. African-American men had 6 to 11% higher BMD than Caucasian men independent of multiple factors. Hip BMD declined with advancing age, while spine BMD increased. Body weight (per 10 kg) and self report of diabetes were each associated with 2 to 4% higher BMD, while history of a non-trauma fracture and current use of selective serotonin reuptake inhibitors, but not other antidepressants, were associated with at least 4% lower BMD. Both maternal and paternal histories of fracture were associated with 1.4-1.7% lower BMD. Osteoarthritis, physical activity, grip strength, alcohol intake, and dietary calcium were positively related to BMD, while a history of chronic lung disease, prostate cancer, and kidney stones was associated with lower BMD. Smoking, caffeine intake, and thiazide diuretics were not related to BMD in older men. A number of lifestyle and behavioral characteristics and medical conditions were associated with BMD in older men. Identification of these correlates could improve methods to identify men at risk for fracture and improve our understanding of fracture etiology.
Osteoporos Int 2005 Dec
PMID:Factors associated with the lumbar spine and proximal femur bone mineral density in older men. 1588 16

We report our early experience of 20 cases of metal on metal articulation total hip arthroplasty in 19 young patients. Avascular necrosis of the femoral head (63%) was the commonest diagnosis for patients undergoing this procedure, followed by osteoarthritis (21%). In general, most of the patients were young and physically active with an average age of 43.1 years (range, 25 to 58 years). The average follow-up period was 18 months (range, 7 to 46 months). The mean total Harris Hip Score preoperatively and at final follow-up was 31 points and 89 points respectively. The mean total Pain Score improved from an average of 11.5 to 41.1 points at final follow-up. Sixteen (84%) of the patients had a good to excellent hip score. There was one dislocation, which stabilized after reduction and conservative management. One case of early infection underwent a two-staged revision.
Med J Malaysia 2004 Dec
PMID:Early results of metal on metal articulation total hip arthroplasty in young patients. 1594 Nov 53

Hip fractures are an important cause of morbidity and mortality in the elderly. Hip protectors are padded undergarments designed to decrease the impact of a fall on the hip. We systematically reviewed randomized controlled trials of hip protectors to determine if they reduce hip fractures in the elderly. Analyses were pooled according to participant residence--community or institutional (the latter, included nursing homes, residential group homes or seniors' hostels). We included individually randomized and statistically adjusted cluster randomized trials. Seven trials of 12- to 28-month duration were included. The Safehip brand of hip protector was used in most studies. Compliance rates in the treatment groups varied from 31 to 68%. In four trials including a total of 5,696 community-dwelling seniors, the hip fracture rates in control groups ranged from 1.1 to 7.4%, and the pooled risk difference with hip protector allocation was 0% [95% confidence intervals (CI), -1%, +1%), with a relative risk of 1.07 (0.81, 1.42). In three trials including 1,188 institutionalized elderly participants, hip fracture rates in the control groups varied from 8 to 19.4%, and the pooled risk difference for sustaining one or more hip fractures with hip protector allocation was -3.7% (95% CI, -7.4%, 0.1%), with a relative risk of 0.56 (0.31, 1.01) (with statistically significant heterogeneity of treatment effect). In a post-hoc subgroup analysis of two trials comprised of exclusively nursing home residents, the risk difference with hip protector allocation was -4.4% (-8.09, -0.76) with a relative risk of 0.50 (0.28, 0.91) (n=1,014). Thus, there is little evidence to support the use of hip protectors outside the nursing home setting. The potential benefit of hip protectors in reducing hip fractures in nursing home residents requires further confirmation.
Osteoporos Int 2005 Dec
PMID:Do hip protectors decrease the risk of hip fracture in institutional and community-dwelling elderly? A systematic review and meta-analysis of randomized controlled trials. 1599 Sep 49

In estrogen target cells, estrogen receptor-alpha (ERalpha) protein levels are strictly regulated. Although receptor turnover is a continuous process, dynamic fluctuations in receptor levels, mediated primarily by the ubiquitin-proteasome pathway, occur in response to changing cellular conditions. In the absence of ligand, ERalpha is sequestered within a stable chaperone protein complex consisting of heat shock protein 90 (Hsp90) and cochaperones. However, the molecular mechanism(s) regulating ERalpha stability and turnover remain undefined. One potential mechanism involves CHIP, the carboxyl terminus of Hsc70-interacting protein, previously shown to target Hsp90-interacting proteins for ubiquitination and proteasomal degradation. In the present study, a role for CHIP in ERalpha protein degradation was investigated. In ER-negative HeLa cells transfected with ERalpha and CHIP, ERalpha proteasomal degradation increased, whereas ERalpha-mediated gene transcription decreased. In contrast, CHIP depletion by small interference RNA resulted in increased ERalpha accumulation and reporter gene transactivation. Transfection of mutant CHIP constructs demonstrated that both the U-box (containing ubiquitin ligase activity) and the tetratricopeptide repeat (TPR, essential for chaperone binding) domains within CHIP are required for CHIP-mediated ERalpha down-regulation. In addition, coimmunoprecipitation assays demonstrated that ERalpha and CHIP associate through the CHIP TPR domain. In ERalpha-positive breast cancer MCF7 cells, CHIP overexpression resulted in decreased levels of endogenous ERalpha protein and attenuation of ERalpha-mediated gene expression. Furthermore, the ERalpha-CHIP interaction was stimulated by the Hsp90 inhibitor geldanamycin (GA), resulting in enhanced ERalpha degradation; this GA effect was further augmented by CHIP overexpression but was abolished by CHIP depletion. Finally, ERalpha dissociation from CHIP by various ERalpha ligands, including 17beta-estradiol, 4-hydroxytamoxifen, and ICI 182,780, interrupted CHIP-mediated ERalpha degradation. These results demonstrate a role for CHIP in both basal and GA-induced ERalpha degradation. Furthermore, based on our observations that CHIP promotes ERalpha degradation and attenuates receptor-mediated gene transcription, we suggest that CHIP, by modulating ERalpha stability, contributes to the regulation of functional receptor levels, and thus hormone responsiveness, in estrogen target cells.
Mol Endocrinol 2005 Dec
PMID:CHIP (carboxyl terminus of Hsc70-interacting protein) promotes basal and geldanamycin-induced degradation of estrogen receptor-alpha. 1603 32

Some, but not all, studies report an association between decreased hip fracture risk and high parity despite similar bone mineral density (BMD). Our hypothesis was that bone size, a major determinant of bone strength, is greater in women with high parity compared with low parity or nulliparous women. A cross-sectional study of 168 Hutterite women aged 40-80 years was conducted. BMD, bone mineral content (BMC) and bone area of the total body (TB), hip, femoral neck (FN), and lumbar spine (LS) were measured, as well as bone geometry at the 4% and 20% distal radius and bending strength at 20% radius. Diet and activity recall and strength measurements were obtained. Of the 168 women, 42 (25%) were nulliparous while the remaining women reported 1 to 16 births (median=6). Of the 126 parous women, 122 (97%) breast-fed their infants (range 1.5-24 months). Hip, FN and LS BMD were not associated with either parity or months of breast-feeding. TB BMC and bone area (both, p<0.05) and FN bone area (p<0.01) were associated with parity. FN bone area was 4% greater in women with 7+ vs 1-4 children. Torsional bending strength, which includes structural and material bone properties, at the 20% distal radius was greater with higher parity (p=0.01). No bone measure was associated with average months of breast-feeding. High parity is associated with increased radial torsional bending strength and femoral neck size. The greater femoral neck size, without higher BMD, may explain the reduced hip fracture risk among women with high parity previously reported in some studies.
Osteoporos Int 2005 Dec
PMID:High parity is associated with increased bone size and strength. 1609 37

The objective of this study was to describe the hospital incidence rate and the in-patient costs of three peripheral "osteoporotic" fractures (proximal humerus and hip, distal radius and/or ulna) in women and men aged over 45 in France during 2001. Each stay for fracture was selected from the dataset of the French national hospital database in 2001. The incidence rate (CI 95%) was standardized by age and gender according to the last census of the French population (1999). The effect of age and existence of geographical difference in incidence rates has been studied. For each fracture, we described the number of stays, rate of surgical procedure and in-patient costs according to the 2004 French list of cost per diagnosis-related group (2004 Euros); 118,839 fractures were registered during 2001 (61% hip, 28% distal radius and 11% proximal humerus; sex ratio 0.26). The incidence rate for all fracture was 7,567 (7,519-7,615) and 2,312 (2,283-2,341) for 10(6) inhabitants in women and men aged over 45 years, respectively. The incidence increased significantly whatever type of fracture and gender. There were more fracture incidents in the east of France compared to the west and in the south compared to the north, whatever type of fracture in women and only for hip fracture in men. Surgical procedures were performed in 91% of proximal hip fractures, 83% of distal radius fractures and 53% of proximal humerus fractures. The median in-patient costs were 3,786 Euros for the humerus, from 2,363 to 2,574 Euros for the radius and from 8,048 to 8,727 Euros for the hip. The evaluation of the burden of peripheral fractures is possible using national hospital data in France. The incidence of fractures increased with age and is more common in women. Hip fracture with its higher occurrence, rate of procedure and in-patient costs could be used as a marker of osteoporosis for evaluating strategies of management.
Osteoporos Int 2005 Dec
PMID:Incidence and cost of osteoporotic fractures in France during 2001. A methodological approach by the national hospital database. 1621 87

Although it is known that overall mortality is increased after hip fracture, the influence of hip fracture risk factors on the subsequent mortality and cause of death has not been well studied. The objective of this study was to establish the survival after hip fracture in women and to assess the impact of comorbidity on mortality. We identified a complete population-based set of 2,245 incident hip fracture cases and 4,035 randomly selected population-based controls among women 50-81 years old in Sweden and followed these subjects for an average of 5 years through the Swedish National Inpatient and Cause-of-Death Registers. Information on factors related to hip fracture was obtained through linkage to hospital discharge data and through a mailed questionnaire. We studied excess mortality of hip fracture patients compared to controls using survival curves and proportional hazard regression models. During follow-up, 896 hip fracture patients (40%) and 516 (13%) controls died. The relative risk (RR) of death, adjusted for age and previous hospitalization for serious disease, was 2.3 (95% CI 2.0-2.5). Although the highest mortality risks were in the 1st 6 months post-fracture, RRs for fractures versus controls were increased for at least 6 years. Increased mortality was apparent both in those with evidence of comorbidity and those without. Hip fracture patients have a substantially increased risk of death that persists for at least 6 years post-fracture. The relative excess mortality is independent of comorbidity and known hip fracture risk factors.
Osteoporos Int 2005 Dec
PMID:Survival after hip fracture. 1621 90

Osteoporosis is an important clinical and public health problem because of its association with fractures. Osteoporotic fractures result in significant morbidity, mortality and health and social care costs. Hip fracture is the major adverse health consequence associated with the disease, although other fractures are also linked with significant adverse outcomes. Because of current demographic trends, the number of men and women with osteoporosis and osteoporotic fractures is set to increase dramatically over the next 50 years unless effective preventive measures are adopted. Over and above this demographic trend there is evidence that the age-specific rates of fractures have increased during the last century. This chapter reviews the epidemiology of osteoporotic fractures, including their occurrence, descriptive epidemiology and impact.
Best Pract Res Clin Rheumatol 2005 Dec
PMID:How many people develop fractures with what outcome? 1630 Nov 85

The Swedish Hip Register was initiated in 1979. The mission of the register is to improve the outcome of THA. The hypothesis is that feedback of data stimulates participating clinics to reflect and improve. In addition to revision surgery, patient-based outcome measures and radiographic results are included to improve sensitivity. All patients who have a total hip arthroplasty answer a questionnaire preoperatively and again after 1, 6, and 10 years postoperatively. The questionnaire includes the Charnley classification, EQ-5D and visual analog scales concerning pain and overall satisfaction and is used by 31 of 81 units. Average costs for the procedure ($11,000) are obtained from a national database. The mean gain in the EQ-5D index after 1 year for 3900 patients was 0.37, giving a low cost of $3000 per quality adjusted life year. Patient satisfaction and pain amelioration generally was high. The national average 7-year survival (revision as endpoint), has improved from 93.5% (+/- 0.15) to 95.8 (+/- 0.15) between the two periods 1979 to 1991 and 1992 to 2003. National implant registers define the epidemiology of primary and revision surgery. In conjunction with individual subjective patient data and radiography they contribute to development of evidence-based THA surgery.
Clin Orthop Relat Res 2005 Dec
PMID:Presidential guest address: the Swedish Hip Registry: increasing the sensitivity by patient outcome data. 1633 Sep 81

We searched the Internet for Web sites related to 106 members of the Hip Society. Web sites (private and/or hospital affiliated) for each surgeon were evaluated for the term "minimally invasive total hip replacement" and its related names. One hundred two of the 106 Hip Society members (96%) had Web sites. Of the 102 Web sites, eight Web sites had links to multiple members of the Hip Society, resulting in 94 distinct sites. Nineteen percent (19 of 102 members) of Hip Society members made reference to minimally invasive hip surgery. 11% (10 of 94 sites) of Web sites included references to minimally invasive hip surgery. When the terms fast or quicker recovery were evaluated, 14% (14 of 102 members) of surgeons used these terms. There were references to these terms on 6% (six of 94 sites) of the members' Web sites. Two incision techniques were discussed by only 10% (10 of 102 members) of members, and reported on 4% (four of 94 sites) of Web sites. In contrast, only 26% (five of 19 members) of Hip Society members and 30% (three of 10 sites) of Web sites reported the risks. Although minimally invasive hip arthroplasty frequently is discussed and advertised by some surgeons, only a small percentage of Hip Society members actually promote or make claims to these techniques on their Web sites.
Clin Orthop Relat Res 2005 Dec
PMID:Minimally invasive total hip arthroplasty: internet claims made by members of the Hip Society. 1633 Sep 86


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