Volume 2, Issue 3, September 2017

Objective

Malnutrition is a common problem in hip fracture patients. The prevalence of malnutrition and available nutritional markers for use for nutritional assessment in this population group was investigated.

Methods

This is a case control study including 214 patients with a hip fracture from “KAT” Hospital in Athens, Greece, and 108 controls from three Elderly Open Protection Centers. Main outcome measures were anthropometric [Body Mass Index (BMI), triceps skinfold thickness (TST) and mid-arm muscle circumference (MAMC)] and biochemical parameters (serum albumin and serum cholesterol). Mini Nutritional Assessment (MNA) was used for malnutrition assessment.

Results

Based on MNA score only, we found 19.5 % vs. 0.9% malnourished, 54.6% vs. 32.4% at risk and 25.9% vs. 66.7% well-nourished, in hip fracture group and controls, respectively. All anthropometric parameters of malnutrition were significantly lower in the hip fracture patients compared to controls (p value<0.05). Serum albumin and serum-cholesterol levels correlated negatively significantly with s-CRP levels (R2=0.247, p<0.001 and R2=0.06, p<0.001, respectively) in the hip fracture group.

Conclusions

Hip fracture patients are often malnourished. MNA application may be helpful in identifying malnourished hip fracture patients. Moreover, serum cholesterol may be a useful marker of malnutrition in hip fracture patients.

Osteoarthritis is the most common, incurable joint disease. The rapid pace of the disease has adverse consequences in the quality of patient’s life, while affecting healthcare systems. The research interest is focused on cost-effective and without side-effects methods to reduce the symptoms and improve the quality of life. Several dietary factors have been linked to the health of cartilage tissue, inflammatory processes and the progress of osteoarthritis. Mediterranean diet (MD) is a dietary pattern that was adopted by people living around the Mediterranean sea. This term first appeared in 1950, by Ancel Keys. It’s characterized by high consumption of vegetables, unprocessed grains, fruits, legumes, seeds, modest consumption of fish and poultry and olive oil is the principal fat source. Emerged data emphasize the beneficial effects of MD against chronic inflammation, metabolic complications and chronic diseases. There are few studies investigating the effect of MD against osteoarthritis, but apparent evidence is encouraging, this highlights the need for further research of the relationship between MD and osteoarthritis. The purpose of this work is a literature review between the effect of MD and its components and the progress of osteoarthritis.

This article presents a review of the main causes of falls among hospitalized patients, a global, cost-effective phenomenon with many complications for patients and institutions alike, with the objective of looking into fall prevention. Reviewing articles from various databases we look into data from articles with positive outcomes, published in English. Following an analysis of the main factors of in-hospital falls -intrinsic, extrinsic and exposure to risk-, we present a concise analysis of the existing fall prevention studies, focusing on the most popular risk assessing tools which seem to lead to the best results when used in combination with an integral approach from and proper communication between the patient, the family, the institution and the health-care teams.

Sarcopenia is a combination of a progressive and generalized loss of skeletal muscle mass and muscle strength or physical performance, with high risk of adverse outcomes such as physical disability, poor quality of life and death. It mainly affects older people, aged 60-70 years. The development of sarcopenia is multifactor. The first step towards the management of sarcopenia is the proper and professional diagnosis. According to EWGSOP the diagnosis of sarcopenia depends on the presence of low muscle mass (LMM) plus low muscle strength (LMS) or low physical performance (LPP). Although it is difficult to establish its prevalence, the higher prevalence is observed in hospitalized elderly patients. It has direct and indirect impact on public health, which are difficult to be measured due to numerous negative outcomes of sarcopenia.

The loads on skeleton control bone turnover, rates of adapted remodeling and influence growth. Mechanical stimulus detected by osteocytes, is derived from muscle contraction or gravity forces. It is difficult to separate the effect of gravity from muscle contractions at bone mass. A great number of studies show that muscle contractions are present, significant and able to represent the large majority which causes the adaptive bone responses.