Browsing by Subject "Osteoporosis"
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Item An Analysis of Osteoporosis-Related Hip Fractures, Using Hospital Discharge Data(2001-12-01) Rubin, Bernard; Antonio A. Rene; Douglas Mains; Muriel MarshallThe purpose of this study is to assess whether a current physician practice may inadequately diagnose osteoporosis in a high risk population of postmenopausal women who have sustained a hip fracture. A review of all patients discharged from Texas hospitals during calendar year 1999 was analyzed, using the Public Use Data File provided through the Texas Health Care Information Council. A total of 13,628 women over the age of 55 were admitted to hospital with a fractured hip. Only 2,233, or 16.3%, of women were also coded with the diagnosis of osteoporosis (P [less than] 0.001). Forty to fifty percent of postmenopausal women have osteoporosis. Therefore, women presenting with a fragility fracture form an even more at-risk subset of the population, such that one would expect a majority of these women to carry a diagnosis of osteoporosis. Percentages of Caucasian, non-Hispanic women in each group were comparable. The age distribution in each group was comparable, implying that the coded diagnosis of osteoporosis was not related to the age of the women when admitted to the hospital. In conclusion, physicians practicing in Texas during calendar year 1999 inadequately diagnosed osteoporosis in a high risk population of postmenopausal women who were admitted to hospital with fractured hip. Future analysis of subsequent analysis databases will be able to identify whether or not continuing medical education efforts will cause physicians to diagnose osteoporosis in this high risk population more frequently.Item PSOAS AND SACROSPINALIS MUSCLE SIZE AND DENSITY: AN INDICATOR OF FALL RISK IN THE GERIATRIC POPULATION(2014-03) Icenogle, Kurt; Nana, ArvindPurpose (a): The sequlae of fragility fractures continue to be a major source of morbidity and mortality, as well as a contributing factor in the rising cost of healthcare. The risks of fragility fracture are multifactorial with the current screening paradigm focused on detecting and treating decreased bone mineral density. Physiologic aging is associated with sarcopenia, and decreasing muscle mass has also been described as an independent risk factor for fragility fracture. This study hypothesized that the observed cross sectional area of the psoas and sacrospinalis muscles would be smaller in patients who developed fragility fractures. Methods (b): To test this hypothesis we performed a retrospective chart review comparing the cross sectional area of Illiopsoas and Sacrospinalis muscles in 145 patients over 50 years of age with fragility fractures compared with 55 controls (patients over age 50 undergoing CT scan for cholelithiasis). Results (c): We found that the population of patients admitted with femoral neck fractures had significantly smaller illiopsoas and sacrospinalis cross sectional areas than controls (P < 0.05). Conclusions (d): The study identifies a quantifiable independent risk factor for fragility fracture that is not currently included in standard screening protocols. Future prospective work will seek to verify if psoas and sacrospinalis muscle morphology is predictive of fracture risk. Ultimately a more predictive multifactorial model of fragility factor risk may be developed that includes screening for both osteoporosis and sarcopenia.Item WOMEN'S HEALTH: OSTEOPOROSIS(2013-04-12) Chandrasekera, LalanicaPurpose: Osteoporosis is associated with changes in bone remodeling, characterized by decreased bone mass and structural deterioration. A major feature of osteoporosis, fractures, can have an enormous impact on a patient's morbidity and mortality, leading to increased need of social services and adding to the cost of health care. As there is no cure for osteoporosis, the importance of wellness and prevention becomes paramount. Here, we will review various osteoporosis resources available to the Terrant County community as well as on a national level. Methods: Daily calcium supplements along with Vitamin D improve bone density and maintain overall bone health, while weight bearing, strengthening, and balance exercises prevent further bone loss. Hormone replacement therapy is targeted to prevent rapid bone loss in post-menopausal women, and medications such as Actonel, Boniva, and Fosamax can be used to treat and prevent osteoporosis. Results: Locally, the Division of Chronic Disease Prevention at the Tarrant County Public Health Department offers free classes focusing on methods to delay the onset of osteoporosis. Services targeted to women's health and aging are the center of focus at "A Woman's View," a multidisciplinary clinic in Dallas, Texas. On a broader spectrum, the National Osteoporosis Foundation offers educational resources aimed at raising awareness of this disease and keeping physicians up-to-date with novel treatment options. Lastly, online services as well as consultation with Endocrinologists provide a rich resource to maintaining bone health and delaying age-associated osteoporosis. Conclusions: As it stands, the burden of osteoporosis lies mainly on elderly women, but remains underdiagnosed in men and those with risk factors predisposing to poor bone health. The Division of Chronic Disease Prevention at the Tarrant County Public Health Department, the National Osteoporosis Foundation, and other local multidisciplinary centers are resources discovered in this study whose purpose is to promote methods of prevention and wellness, including access to education. While these resources have proven to be a boon to the community, in order to alleviate the impact of osteoporosis on health care costs and improving overall public health, greater measures should be taken to target resources to more appropriate at-risk populations. For example, the adolescent female population is at risk for inadequate calcium intake and may be a beneficial group for osteoporosis awareness.