The aim of this study was to analyze the association between the presence of actinic lesions (solar keratosis and non-melanoma skin cancer) and osteoporotic hip fractures in older patients. Both ...pathologies are common conditions in this age group. Since cumulative sun exposure is difficult to quantify, the presence of actinic lesions can be used to indirectly analyze the association between ultraviolet radiation and osteoporotic hip fractures. This was an observational case–control study. We reviewed the centralized medical records of patients with hip fracture (cases,
n
= 51) and patients with other diseases hospitalized in the same institution and period (controls,
n
= 59). The mean age of the patients was 80 ± 8.3 years (range 50–103 years). Differences in maternal hip fracture history were found between cases and controls (14.8 and 8 %, respectively;
p
= 0.047). Falls history in the past year was higher in cases than in controls (
p
< 0.0001). Actinic lesions were observed in 32.7 % of patients (prevalence rate 23.5 % in cases, 40.7 % in controls;
p
= 0.04). When considering patients with actinic lesions, controls have a higher FRAX score compared with cases. Although sun exposure is recommended for bone health, it represents a risk factor for actinic lesions. The presence of actinic lesions may indicate a lower osteoporotic hip fracture risk. A balance between adequate lifetime sun exposure and protection against its adverse effects is required for each patient, in the context of geographic location.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objectives: The purpose of this research was to explore the performance of anthropometric tools in the assessment of low muscle mass in a group of postmenopausal women.
Method: Fifty consecutive ...ambulatory postmenopausal women were studied. A complete clinical examination and an anthropometric evaluation following a standardized procedure were performed. Three indicators were devised: upper limb adjusted perimeter (ULAP), lower limb adjusted perimeter (LLAP), and appendicular adjusted perimeter (AAP).
Results: Sixteen sarcopenic patients (32%) were identified using the DXA appendicular lean mass/h
2
threshold. ULAP and AAP correctly classified 82% of the patients, while LLAP showed a lower performance (72%). The sensitivity and specificity values of ULAP and AAP were higher than those obtained using LLAP; their positive and negative predictive values were 65.2%, 96.3% and 68.4%, 90.3%, respectively. A highly significant concordance was observed for the three anthropometric indicators.
Conclusion: The availability of reliable and simple clinical instruments to identify low muscle mass is of great relevance. Anthropometric methods reported in this paper could represent an innovative resource for muscle mass assessment in daily practice. The contribution of these approaches in the detection and management of sarcopenia should allow the physician to make early interventions and thus prevent or modify its relevant health consequences.
Full text
Available for:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract Vertebral deformities are associated with a marked increase in morbidity, mortality, and burden in terms of sanitary expenditures. Patients with vertebral fractures have a negative impact in ...their health, less quality of life, and loss of functional capacity and independence. The purpose of this study was to explore the vulnerability of healthy vertebrae in patients who have sustained already a compression fracture and in patients who do not have prevalent fractures in the thoracic spine; and to explore the association of the deformity in healthy vertebrae with different variables, such as bone mineral density (BMD), body mass index, age, loss of height, presence of clinical kyphosis, history of other osteoporotic fractures, and falls occurring during the last year. Clinical data and complementary studies from 175 postmenopausal outpatients were analyzed. These women (age: 69.7 ± 11.1 years) had not received any treatment for osteoporosis. Anteroposterior and lateral radiographs of the thoracic spine and bone densitometry of the hip were obtained; morphometry was performed in 1575 thoracic vertebrae from T4 to T12. The angle of wedging of each vertebral body was calculated using a trigonometric formula. Then, the sum of wedge angles of vertebral bodies (SWA) was determined, and Cobb angle was measured. In patients with vertebral fractures, after excluding the angles of fractured vertebral bodies, the mean wedge angle of the remaining vertebrae (MWAhealthy) was calculated. The same procedure was followed in patients without vertebral fractures. MWAhealthy was considered as an indicator of the structural vulnerability of non-fractured vertebrae. Patients with prevalent fractures had lower BMD, wider Cobb angle, and higher sum of wedge angles than patients without vertebral fractures. The proportion of patients with accentuation of clinical kyphosis was higher in the group with prevalent vertebral fractures. A highly significant difference was found in the MWAhealthy, which was higher in patients with prevalent fractures (4.1 ± 1.3° vs. 3.0 ± 1.1°; p < 0.001). Patients showing vertebral fractures had 7.1 ± 4.2 cm height loss in average, significantly superior than that found among non-fractured women (3.6 ± 3.2 cm; p < 0.01). In multivariate analysis, the increase of MWAhealthy was associated with advancing age ( p < 0.02), lower femoral neck BMD ( p < 0.005), presence of clinical kyphosis ( p < 0.01) and vertebral fractures ( p < 0.02). This study presents evidence that a series of factors independently influence the increase in wedging deformity of vertebral bodies that are not fractured yet. These factors could contribute to an increased vulnerability of the vertebrae, making them more susceptible to fracture.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
PDF
