Abstract Introduction Hip fractures are a major cause of burden associated with osteoporosis in terms of mortality, disability, and costs. With the ageing of the population, a marked increase in the ...number of fractures is expected. Furthermore, many studies reveal an increase of the age-adjusted hip fracture incidence. We specifically examined secular changes in the incidence of hip fracture in women and men aged 50 years and over in the well-defined area of Geneva, Switzerland. Materials and methods All hip fractured patients were retrospectively identified from the computer medical records of the main hospital, which is receiving 95% of hip fractures occurring in a well-defined area. Results From 1991 to 2000, 4115 hip fractures were recorded in 2981 women and 822 men with a mean age (± S.D.) of 83.1 ± 8.9 and 78.3 ± 11.6 years, respectively. A second hip fracture occurred in 276 women (9.3%) and 36 men (4.4%), on average 2.1 ± 1.9 (median 1.44) years after the first event without gender difference. The overall incidence of hip fractures was 455 (95% CI: 439–471) per 100,000 person-years in women and 153 (95% CI: 143–163) in men. The number of hip fractures remained constant (412 (95% CI: 397–426)), but the mean age of these patients increased each year by 0.13 year in women ( p = 0.019) and by 0.04 year in men (NS). Furthermore, the age-adjusted incidence of hip fractures, standardized to the 2000 Geneva population, decreased significantly by 1.4% (95% CI: − 2.6 to − 0.1) per year in women ( p = 0.021), but remained stable in men (0.5% (95% CI: − 1.7 to + 2.8) per year, p = 0.66). The overall female/male ratio of hip fracture incidence was 2.99 (95% CI: 2.80–3.18, p < 0.001) and significantly decreased by 0.07 (95% CI: − 0.13 to − 0.01) per year ( p = 0.024). Conclusion Despite an increase in the population at risk and in the mean age of hip fractured women, there was a significant decrease in age-adjusted incidence in women but not in men. These results may suggest a reversal of the previously observed secular trend.
Summary
In this prospective, 10-year study in community-dwelling elderly aged 50 years and over, hip fracture incidence and accordingly age at hip fracture were inversely associated with the ...area-level income, independently of the geographical area. Age at hip fracture also depended of marital status but in a gender-specific way.
Purpose
The purpose of this study is to investigate the impact of socioeconomic and living conditions on hip fracture incidence and age occurrence among community-dwelling elderly.
Method
Between January 1991 and December 2000, 2,454 hip fractures were recorded in community-dwelling adults aged 50 years and over in the Geneva University Hospital, State of Geneva, Switzerland. Median annual household income by postal code of residence (referred to as area-level income) based on the 1990 Census was used as a measure of socioeconomic condition and was stratified into tertiles (<53,170; 53,170–58,678; and ≥58,678 CHF). Hip fracture incidence and age occurrence were calculated according to area-level income categories and adjusted for confounding factors among community-dwelling elderly.
Results
Independently of the geographical area (urban versus rural), community-dwelling persons residing in areas with the medium income category presented a lower hip fracture incidence OR 0.91 (0.82–0.99),
p
= 0.049 compared to those from the lowest income category. Those in the highest income category had a hip fracture at a significant older age +1.58 (0.55–2.61) year,
p
= 0.003 as compared to those in the lowest income category. Age at hip fracture also depended on marital status but in a gender-specific way, with married women fracturing earlier.
Conclusions
These results indicate that incidence and age occurrence of hip fracture are influenced by area-level income and living conditions among community-dwelling elderly. Prevention programs may be encouraged in priority in communities with low income.
The different constituents of an AZ91 alloy (α,β, and MnAl phases) were synthesized and their corrosion resistance was studied by electrochemistry in ASTM D1384 water, pH 8.3. The pure phases were ...characterised through the corrosion potential, the polarisation resistance, and polarisation curves, then systematically coupled to assess the galvanic corrosion occurring in the AZ91 alloy. The aluminium content of the oxide film was obtained by X-ray photoelectron spectroscopy measurements. The corrosion rate of the α solid solution alloys depends closely on their Al content. Aluminium enhances the corrosion resistance of the α-phase through the formation of an Al enriched superficial layer. The β-phase is 150 mV nobler than the α-phase, but their corrosion rates are similar. The galvanic currents are low (below 20 μA
cm
−2) whatever the implemented couples and close to the corrosion current previously measured for the AZ91 alloys.
This study describes the role of nickel oxide (NiO) in peraluminous glass. Peraluminous glass is defined by an excess of aluminium ions (Al3+) compared to modifier elements such as Na+, Li+ or Ca2+ ...ions. The study investigates the effect NiO incorporation on peraluminous glass homogeneity and process ability. Quenched NiO-containing glass showed an incorporation limit greater than 12 wt% NiO (13.8 mol%), while slowly cooled glass showed a limit of 5 wt% NiO (5.8 mol%). Nickel oxide is also found to have a fludifying effect on peraluminous glasses. When the nickel oxide content is above its incorporation limit, the resulting crystals were found to have a significant effect on glass rheological properties. Finally, hypotheses are proposed as to the structural role of Ni in peraluminous glass based on the experimental results obtained.
•The effect of NiO incorporation on peraluminous glass homogeneity and process ability is investigated•Quenched glass showed an incorporation limit greater than 12 wt% NiO (13.8 mol%)•Slowly cooled glass showed an incorporation limit of 5 wt% NiO (5.8 mol%)•NiO is found to have a fludifying effect•Ni-containing crystals were found to have a significant effect on the glass rheological properties•Hypotheses on the structural role of Ni in peraluminous glass are proposed
Summary
In this prospective 10-year study in elderly aged 60 years and over, there was a 1.3% per year reduction in the standardized incidence of hip fracture in women but not in men. This decrease ...was mainly due to changes in the standardized incidence of hip fracture in institution-dwelling women.
Introduction
A decrease in age-adjusted hip fracture incidence has been recently demonstrated in some countries. Since a large proportion of hip fractures occur in nursing homes, we analyzed whether this decreasing trend would be more detectable in institution-dwelling elderly compared with community-dwelling elderly.
Methods
All hip fracture patients aged 60 years and over were identified in a well-defined area. Incidence of hip fracture, age- and sex-adjusted to the 2000 Geneva population, was computed in community- and institution-dwelling elderly.
Results
From 1991 to 2000, 1,624 (41%) hip fractures were recorded in institutionalized-dwelling elderly and 2,327 (59%) in community-dwelling elderly. The standardized fracture incidence decreased by 1.3% per year in women (
p
= 0.039), but remained unchanged in men (+0.5%;
p
= 0.686). Among institution-dwelling women, hip fracture incidence fell by 1.9% per year (
p
= 0.044), whereas it remained stable among community-dwelling women (+0.0%,
p
= 0.978). In men, no significant change in hip fracture incidence occurred among institution- or community-dwelling elderly.
Conclusions
The decrease in the standardized hip fracture incidence in institution-dwelling women is responsible for the reversal in secular trend. Future research should include stratification according to the residential status to better identify the causes responsible for the trend in hip fracture incidence.
Résumé
Contexte
L’opiophobie de certains professionnels de santé n’est pas anodine: elle peut entraîner une prise en charge inappropriée des patients présentant des douleurs invalidantes.
Objectifs
...Cette étude avait pour objectifs de comparer l’opiophobie entre médecins et infirmières d’une part; et d’autre part de décrire les représentations que ces professionnels de santé ont de la morphine et leur attitude face à sa prescription et à son utilisation ainsi que les raisons évoquées.
Méthode
Enquête par questionnaire autoadministré auprès des médecins et infirmières des hôpitaux et centres médicosociaux à Beira Interior au Portugal.
Résultats
Le mot morphine évoque en premier lieu l’analgésie (médecins 32 % et infirmières 27 %) et en deuxième lieu le cancer (médecins 12 % et infirmières 27 %). L’attitude en ce qui concerne le recours à la morphine diffère entre médecins et infirmières, notamment en fonction de l’expérience professionnelle. Les raisons les plus fréquemment évoquées de non-administration de la morphine chez le patient algique sont les difficultés légales d’usage (médecins 79 % et infirmières 84 %), le risque de dépression respiratoire (médecins 70 % et infirmières 68 %) et le risque de dépendance (médecins 50 % et infirmières 69 %).
Conclusion
L’existence de fausses croyances quant à la prescription et l’utilisation de la morphine dans notre collectif. Une différence significative existe pour plusieurs fausses croyances relatives à la prescription et à l’utilisation de la morphine entre infirmières et médecins. Ces résultats suggèrent que l’on forme mieux les professionnels de santé dans la gestion de la douleur.
Background: Dyspnea represents a very frequent and distressing symptom in patients with advanced cancer. This study was undertaken to assess the efficacy of morphine on dyspnea and its safety for ...ventilatory function in elderly advanced cancer patients. Patients and methods: Nine elderly patients with dyspnea due to lung involvement were randomized to receive either morphine subcutaneously (5 mg in seven opioid-naïve patients and 3.75 mg in two patients on top of their regular oral dose of 7.5 mg q4h) or placebo on day 1. On day 2, they were crossed over to receive the alternate treatment. Dyspnea was assessed every fifteen minutes using a visual analogue scale (VAS: 0–100 mm) and the ordinal scale developed by Borg (0–10 points). Pain, somnolence and anxiety were assessed using VAS. Respiratory effort, respiratory rate and oxygen saturation were also measured repeatly. Results: Mean changes in dyspnea 45 minutes after injection were −25 ± 10 mm and −1.2 ± 1.2 points for morphine, versus 0.6 ± 7.7 mm (P < 0.01) and −0.1 ± 0.3 points (P = 0.03) for placebo on VAS and Borg scale, respectively. No relevant changes were observed in somnolence, pain, anxiety, respiratory effort and rate, and oxygen saturation. Conclusions: Morphine appears effective for cancer dyspnea, and it does not compromise respiratory function at the dose level used.
The microstructure and the corrosion behaviour of high pressure die-cast and semi-solid cast AZ91D magnesium alloys have been investigated. Semi-solid processing leads to a structure with large ...rounded grains of a solid solution of magnesium (α phase) whereas die-cast alloys are more homogeneous. Electrochemical measurements, particularly with impedance spectroscopy, have shown that the semi-solid cast alloy possesses a corrosion rate at least 35% below that of the die-cast alloy. This can be explained with considering the differences between the composition of the primary α phase and the volume fraction of the β phase, in the two types of alloy.
As many as 40% of hip fractures occur in institutions for the elderly. Several studies have demonstrated a higher age-adjusted incidence of hip fractures in urban areas compared with rural areas. To ...assess whether this difference could be due to a preferential location of institutions for the elderly in urban areas, we compared the incidence of hip fractures over a 5-year period in urban versus rural areas, as defined according to the population density (urban > 15 inhabitants/ha2). We then determined the age-adjusted incidence of hip fractures in institutional-dwelling elderly and home-dwelling elderly. Hip fracture incidence was 100.0/100,000 (150.5 in women and 43.8 in men) in urban areas, and 71.0/100,000 (107.2 in women and 32.8 in men) in rural areas (p<0.001). When only those patients living in their own homes were analyzed, the incidence was 66.7/100000 (94.6 in women and 35.7 in men) in urban regions and 36.8/100,000 (49.6 in women and 23.4 in men) in rural areas (p<0.001), a difference of even greater magnitude than when both home-dwelling and institutional-dwelling residents were considered together. In a logistic regression model including age class, gender, urban or rural areas and institutionalization for inhabitants 65 years of age and older, urban residents have a 31% significantly (p<0.001) higher incidence of hip fracture compared with rural residents; women have a 79% significantly (p<0.001) higher incidence of hip fracture compared with men; and institutional-dwelling elderly have a 351% significantly (p<0.001) higher incidence of hip fracture compared with home-dwelling elderly. These results confirm the existence of a higher age-adjusted incidence of hip fractures in urban compared with rural areas. Since this difference is increased when patients living at home were analyzed separately, it indicates that the difference between urban and rural areas is not due to a preferential urban location of institutions for the elderly.
Na₂O solubility in CaO–MgO–SiO₂ melts Mathieu, R; Libourel, G; Deloule, E ...
Geochimica et cosmochimica acta,
01/2011, Letnik:
75, Številka:
2
Journal Article
Recenzirano
The sodium solubility in silicate melts in the CaO–MgO–SiO₂ (CMS) system at 1400°C has been measured by using a closed thermochemical reactor designed to control alkali metal activity. In this ...reactor, Na₍g₎ evaporation from a Na₂O–xSiO₂ melt imposes an alkali metal vapor pressure in equilibrium with the molten silicate samples. Because of equilibrium conditions in the reactor, the activity of sodium-metal oxide in the molten samples is the same as that of the source, i.e., aNa₂O₍ₛₐₘₚₗₑ₎=aNa₂O₍ₛₒᵤᵣcₑ₎. This design also allows to determine the sodium oxide activity coefficient in the samples. Thirty-three different CMS compositions were studied. The results show that the amount of sodium entering from the gas phase (i.e., Na₂O solubility) is strongly sensitive to silica content of the melt and, to a lesser extent, the relative amounts of CaO and MgO. Despite the large range of tested melt compositions (0<CaO and MgO<40; 40<SiO₂<100; in wt%), we found that Na₂O solubility is conveniently modeled as a linear function of the optical basicity (Λ) calculated on a Na-free basis melt composition. In our experiments, γNa₂O₍ₛₐₘₚₗₑ₎ ranges from 7×10⁻⁷ to 5×10⁻⁶, indicating a strongly non-ideal behavior of Na₂O solubility in the studied CMS melts (γNa₂O₍ₛₐₘₚₗₑ₎≪1). In addition to showing the effect of sodium on phase relationships in the CMS system, this Na₂O solubility study brings valuable new constraints on how melt structure controls the solubility of Na in the CMS silicate melts. Our results suggest that Na₂O addition causes depolymerization of the melt by preferential breaking of Si–O–Si bonds of the most polymerized tetrahedral sites, mainly Q⁴.
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