Blood alcohol was determined in 1012 injury victims. It was found that the alcohol involvement (AI) rate was 37% in the total number of patients, 19% in industrial, 38% in traffic, 36% in home, 45% in other freetime accidents, and 69% in the victims of fights, assaults, and suicide attempts. The most common external cause of injury was falling (447 cases) with an AI rate of 38%, while the 172 other nontraffic true accident cases had a rate of 24%. The road and stairs were the usual places of falls while intoxicated. Head injuries had a high (47%) and upper extremity injuries a low (25%) AI rate. Tibial and ankle fractures were also very often associated with alcohol intake. Contrarily to traffic and industrial accidents the slightly injured at home and in other freetime environments had been drinking more frequently than the severely injured. The data suggest that alcohol is a powerful contributing factor in leisure-time injuries. Head and low leg are especially vulnerable in drunken persons. Not only driving but even when walking while intoxicated means taking risks.
To assess the role of four biomarkers of neuroendocrine activation and endothelial dysfunction in the longitudinal prediction of fragility fractures.
We analysed a population-based prospective cohort of 5415 community-dwelling individuals (mean age, 68.9±6.2 years) enrolled in the Malmö Preventive Project followed during 8.1±2.9 years, and investigated the longitudinal association between C-terminal pro-arginine vasopressin (CT-proAVP), C-terminal endothelin-1 precursor fragment (CT-proET-1), the mid-regional fragments of pro-adrenomedullin (MR-proADM) and pro-atrial natriuretic peptide (MR-proANP), and incident vertebral, pelvic and extremity fractures.
Overall, 1030 (19.0%) individuals suffered vertebral, pelvic or extremity fracture. They were older (70.7±5.8 vs 68.4±6.3 years), more likely women (46.9% vs 26.3%), had lower body mass index and diastolic blood pressure, were more often on antihypertensive treatment (44.1% vs 38.4%) and had more frequently history of fracture (16.3% vs 8.1%). Higher levels of MR-proADM (adjusted HR (aHR) per 1 SD: 1.51, 95% CI 1.01 to 2.28, p
Serpin alpha-1-proteinase inhibitor have been studied in human subjects and in mice of different lines as acute phase reactant and during tumor development. In humans, there was no difference of serpin activity between men and women. Increased activity was noted in men with acute trauma (acute phase reaction). Comparatively to male, in female mice of different lines decreased activity of serum alpha-1-proteinase inhibitor, was shown. There was no increase of alpha-1-proteinase inhibitor activity during inflammation induced by zymosan administration in mice. alpha-1-proteinase inhibitor belongs to acute phase reactants in humans but not in mice; for mice alpha-2-macroglobulin is a more typical acute phase reactant as compared to alpha-1-proteinase inhibitor. Murine tumor development (hepatoma HA-1, lymphosarcoma LS, Lewis lung adenocarcinoma) was followed by a decreased activity of serum alpha-1-proteinase inhibitor both in successfully treated and untreated groups. According to data of literature, similar dated were obtained in humans with tumors. It was suggested that changes of expressiln of alpha-1-proteinase inhibitor by tumors and its secretion were involved in decreased activity of alpha-1-proteinase inhibitor.
To prospectively study the relation between TSH and risk of hip and forearm fractures.
A population-based cohort study.
In a substudy of the second survey of the Nord Trøndelag Health Study, Norway (HUNT2, 1995-97), linked with a hospital-based fracture registry, we investigated the relation between baseline TSH and risk of hip and/or forearm fractures.
A total of 16?610 women and 8595 men aged 40 years or more, without previous self-reported thyroid disease and hip or forearm fractures.
During 12.5 years follow-up, a total of 1870 women and 342 men experienced hip or forearm fractures. Overall, there was no relation between baseline TSH and fracture risk. However, there was weak evidence that women with TSH 3.5?mU/l had a slightly increased risk of hip fractures (hazard ratio (HR) 1.30, 95% CI 0.97-1.94 and HR 1.19, 95% CI 0.93-1.52) compared with the reference group with TSH of 1.5-2.4?mU/l. Supplementary analyses showed higher hip fracture risk in women with TSH >4.0?mU/l and negative thyroid peroxidase antibodies (TPOAb) compared with the reference group (HR 1.75, 95% CI 1.24-2.46).
We found no statistically significant relation between baseline TSH and subsequent fracture risk, but the data suggest a weak positive association with hip fracture risk among women with both low and high TSH. The latter association was confined to women with negative TPOAb status.
Optimal levels of intact parathyroid hormone (iPTH) in the post-transplant period are not known due to insufficient data. Therefore, we aimed to describe secondary hyperparathyroidism (SHPT) in Swedish renal transplant (RT) recipients and also report events of fractures and vascular events potentially related to levels of iPTH.
Medical charts from 132 RT recipients were retrospectively reviewed. Laboratory/clinical data were obtained at regular points up to 12 months post RT. Three groups were created based on pre-RT levels of iPTH based on KDOQI recommended levels of iPTH in CKD 5.
One year post RT 69% had iPTH above levels recommended by KDOQI. A multiple regression analysis showed a strong relation between pre-transplant iPTH levels and iPTH levels at 12 months (? coefficient = 0.323, p
Osteoporotic fractures are some of the major causes of morbidity and health care expenditure among the elderly. Identifying subjects at risk could be of major importance since several preventive treatments are now available. A large genetic component in the development of osteoporosis has been established. Previous studies concerning association of the common point mutation C677T in methylentetrahydrofolate reductase (MTHFR) and osteoporosis have revealed contradictory results. The aim of this study was to test the association between the MTHFR polymorphism, homocysteine, and fractures in a population-based sample of Danish twins aged 73+. In total, 689 subjects, with a mean age of 78 years, participated. Genotype and data of fractures are available from 687 subjects--144 with a previously diagnosed fracture. The genotype distribution is as follows: CC, CT, and TT genotypes, 317 (46.1%), 298 (43.3%), and 73 (10.6%), respectively. Using the proportional odds-ratio model adjusted for age, gender, and body mass Index, the odds-ratio of fracture was 1.5 per number of T alleles--meaning that fracture risk is 1.5 times higher in the CT group compared with the CC group and again 1.5 times higher in the TT group compared with the CT group. Homocysteine, smoking, and self-reported hormone use provided no significant contribution to fracture risk. Using biometrical modelling, the heritability of the liability to fractures was found to be approximately 0.10, when the effect of the MTHFR locus was included, and 0.07 when it was omitted. But both confidence intervals include zero and the estimates are therefore not significant. In conclusion, we here provide evidence for a significant impact of the MTHFR genotype on the occurrence of fractures in an elderly Danish population.
Parathyroid hormone (PTH) increases bone turnover and may thus increase fracture risk. As PTH secretion is increased in primary hyperparathyroidism, surgical cure may prevent fractures. We studied fracture risk before and after diagnosis in patients treated surgically and conservatively for primary hyperparathyroidism. All 1201 patients with newly diagnosed primary hyperparathyroidism (PHPT) between 1982 and 1996 in Denmark were identified through the Danish Hospital Discharge Register. Each patient was compared with three age- and gender-matched controls randomly drawn from the background population. Those who were treated surgically ( n = 841; mean age 58.6 +/- 14.6 years) were significantly younger than those who were not ( n = 360; 65.5 +/- 16.8 years; 2 p
Polymorphisms in the CYP2R1 gene encoding Vitamin D 25-hydroxylase have been reported to correlate with circulating levels of 25-OH vitamin D3 (25(OH)D). It is unknown whether these variations also affect overall bone metabolism. In order to elucidate the overall associations of polymorphisms in the CYP2R1, we studied haplotype tagging single nucleotide polymorphisms (SNPs) in the gene and serum levels of 25(OH)D, calcium, phosphate, parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23), as well as bone mineral density (BMD).
Baseline data on serum parameters and BMD from MrOS Sweden, a prospective population-based cohort study of elderly men (mean age 75 years, range 69-81), were analyzed. Genotyping was performed for eight SNPs covering the CYP2R1 gene in 2868 men with available samples of DNA. Subjects were followed up concerning incidence of fracture during five years.
There was a significant genetic association with circulating levels of 25(OH)D (4.6-18.5% difference in mean values between SNP alleles), but there were no correlations with levels of calcium, phosphate, PTH or FGF23 for any genetic variant. No differences were found in fracture incidence between the variants. There was an inverse relationship between lower BMD and concomitant higher 25(OH)D for three of the haplotypes (p
Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden (KM and LB); the Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (AW); the School of Health and Social Studies, Dalarna University, Falun, Sweden (JÄ); the Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden (JÄ); and the Department of Medical Sciences, Clinical Pharmacology, Uppsala University, Uppsala, Sweden (HM).
A reduction in the formation of free radicals and oxidative stress might reduce the rate of bone loss and muscle wasting.
The objective was to determine whether a-tocopherol intake or serum concentrations are associated with fracture risk in older women and men.
Two cohort studies, the Swedish Mammography Cohort (SMC; n = 61,433 women) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n = 1138 men), were used.
During 19 y of follow-up, 14,738 women in the SMC experienced a first fracture at any site (3871 hip fractures). A higher hip fracture rate was observed with lower intakes of a-tocopherol. Compared with the highest quintile of intake, the lowest quintile had a multivariable-adjusted HR of 1.86 (95% CI: 1.67, 2.06). The HR of any fracture was 1.20 (95% CI: 1.14, 1.28). a-Tocopherol-containing supplement use was associated with a reduced rate of hip fracture (HR: 0.78; 95% CI: 0.65, 0.93) and any fracture (HR: 0.86; 95% CI: 0.78, 0.94). Compared with the highest quintile of a-tocopherol intake in ULSAM (follow-up: 12 y), lower intakes (quintiles 1-4) were associated with a higher rate of hip fracture (HR: 3.33; 95% CI: 1.43, 7.76) and any fracture (HR: 1.84; 95% CI: 1.18, 2.88). The HR for hip fracture in men for each 1-SD decrease in serum a-tocopherol was 1.58 (95% CI: 1.13, 2.22) and for any fracture was 1.23 (95% CI: 1.02, 1.48).
Low intakes and low serum concentrations of a-tocopherol are associated with an increased rate of fracture in elderly women and men.
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