Volume 2, Issue 4, December 2017

Objectives

Determine the influence of muscle mass, muscle strength, physical performance, nutritional status and certain comorbidities on the four years mortality risk of hospitalized geriatric patients.

Design

Retrospective cohort study.

Setting

During hospitalization of the included geriatric patients, the determinants of sarcopenia and nutritional status were obtained.

Participants

A total of 302 patients hospitalized at the geriatric department of the Saint-Elisabeth hospital in Antwerp (Belgium) from 01/08/2012 until 31/01/2013.

Measurements

Muscle mass was measured using a CT scan. The muscle strength was obtained by measuring the handgrip strength using a Jamar dynamometer. The physical performance was measured by performing the SPPB. The nutritional status was surveyed by using the MNA-SF. Comorbidities were obtained through medical records.

Results

The variables gender (HR= 0.609; 95% CI 0.442-0.838), nutritional status (HR= 2.953; 95% CI 1.924-4.531), muscle mass (HR= 0.443; 95% CI 0.251-0.780), muscle strength (HR= 0.215; CI 95% 0.079-0.587), physical performance (HR= 0.407; 95% CI 0.237-0.702) and heart failure (HR= 1.440; 95% CI 1.022-2.029) have been shown to be significant.

Conclusion

The determinants gender, nutritional status and physical performance have the greatest prognostic value.

Objectives

The aim of this study was to examine whether the risk of falls could be reduced among patients in our ward using the standing test for imbalance and disequilibrium (SIDE).

Methods

The study participants were 97 inpatients (24 men, 73 women; mean age, 81.9±9.0 years) who had been diagnosed with spinal compression or hip or other fractures in a ward for community-based integrated care in Japan. The participants took part in six daily 40-min rehabilitation training sessions per week. We investigated patient data obtained from medical records, including duration of stay in the ward, discharge destination, and SIDE level at admission and discharge. We compared indices at admission and discharge using Fisher’s exact test (P<0.05).

Results

The mean duration of stay was 38.5±15.9 days, and 83.5% of the patients were discharged home. Significant increases in SIDE levels were observed at discharge compared with admission (P<0.001).

Conclusions

The results of the present study suggest that exercises in the ward reduce the risk of falls.

Objective

A study to retrospectively assess the decision to implement treatment for osteoporosis based on Greek version of FRAX tool.

Methods

The study population was 1000 postmenopausal women aged 45 or above, excluding those with medical conditions demanding specific osteoporosis management. Data were collected regarding their medical history and additionally, risk factors incorporated in FRAX questionnaire. FRAX score was estimated at the time of the anti-osteoporotic treatment initiation.

Results

The mean age of the study sample was 58.5±8.79 years. 46.8% of the participating osteopenic women had initiated treatment for osteoporosis at their first consultation while the 80.6% met the current national intervention threshold of FRAX tool.

Conclusion

Stemming from our results there is an indication that women who are borderline eligible for treatment and seek consultation for osteoporosis are likely to be given treatment regardless of the potential benefit. One cannot ignore the fact that a clinician’s good clinical judgment is of the utmost importance and under no circumstances can be replaced by any prognostic assessment tool.

The present article is an opinion paper referring to adult scoliosis, sarcopenia and their relation. There is a presentation of adult scoliosis and sarcopenia as a whole including their classifications, aetiopathogenesis, clinical picture and evaluation, therapy options and complications, risk factors and consequences. The most important part is how sarcopenia and adult scoliosis can coexist and how this relation can lead to secondary problems for the patient as falls. Treatment options, for the elimination of all the above pathological conditions, are introduced in order to improve patient’s life and his ADL.

Osteomyelitis is an inflammation process of bone caused by a pathogenic microorganism and associated by edema, thrombosis of small vessels and eventually bone necrosis. Infection of bone occurs as a consequence of hematogenous dissemination of bacteria, invasion from a contiguous focuw of infection and skin breakdown. We report a case of lower limbs osteomyelitis due to Nocardia spp in a 68 years old man with Granulomatosis with Polyangiitis (GPA) during his treatment of underlying vasculitis. This case indicates considering rare pathogens in immunosuppressed patients.

Falls among elderly are a common and major public health problem. Even though most falls do not lead to injury, they threaten the independence of older people causing functional decline in activities of daily living (ADLs) with substantial socioeconomic consequences. According to current literature several risk factors have been identified. Falls rarely have a single cause and the majority of them are due to a complex interaction of the age-related changes, the underlying medical condition and the medications. Some medications due to their side effects are usually called fall-risk-increasing drugs (FRIDs). We conducted a retrospective, multicentre, observational chart review study of elderly aged over 60, which aims to reveal any correlation between specific groups of medications given for the most common diseases, and falls in elderly. The sample consists of 827 participants. The data were collected by using a medication logbook which includes information about sex, age, residency, underlying diseases and the corresponding medications, incidents of fall during the last 2 years and possible fracture as a consequence of the fall.