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Morimoto T, Kobayashi T, Fukuda M, Hirata H, Otani K, Sekiguchi M, Yamauchi K, Tsukamoto M, Nagamine S, Haro H. Comparison of Gender Diversity Among Spine Surgeons in the Japanese Society for Spine Surgery and Related Research and the Neurospinal Society of Japan: A Descriptive Study Through Secondary Analysis of Aggregated Data. Cureus 2024; 16:e61152. [PMID: 38803408 PMCID: PMC11129104 DOI: 10.7759/cureus.61152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
STUDY DESIGN This was a descriptive study through secondary analysis of aggregated data. PURPOSE This study aimed to describe changes in women's membership in the Japanese Society for Spine Surgery and Related Research (JSSR) for orthopedic surgery and the Neurospinal Society of Japan (NSJ) for neurosurgery over the past decade and make predictions for the future. OVERVIEW OF LITERATURE Although the ratio of women physicians in the field of spine surgery is known to be low worldwide, there is a lack of detailed surveys in Japan. METHODS We sent emails to the JSSR and NSJ secretariats to verify membership information (gender and age) from 2013 to 2022. Using ordinary least squares, we projected the years it would take for the JSSR and NSJ to achieve a gender diversity ratio of 30%. RESULTS In 2013, the percentage of women in JSSR and NSJ was 2.3% and 2.7%, respectively. However, after 2018, the percentage of women in NSJ will be higher than in JSSR, rising to 2.7% in JSSR and 4.7% in NSJ by 2022. It would require 101 years for the NSJ and more than 1,000 years for the JSSR to realize 30% gender diversity. CONCLUSIONS JSSR and NSJ have low percentages of women. Improving gender diversity is an important issue for both societies, and they may collaborate on finding a good solution. Both the JSSR and NSJ societies need to actively address gender diversity and become more attractively represented in society for the next generation of spine surgeons.
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Affiliation(s)
| | | | - Miyuki Fukuda
- Neurological Surgery, Shin-Aikai Spine Center, Katano Hospital, Katano, JPN
| | | | - Koji Otani
- Orthopedic Surgery, Fukushima Medical University, Fukushima, JPN
| | - Miho Sekiguchi
- Orthopedic Surgery, Fukushima Medical University, Fukushima, JPN
| | - Kazuyo Yamauchi
- Community-Oriented Medical Education, Graduate School of Medicine, Chiba University, Chiba, JPN
| | | | | | - Hirotaka Haro
- Orthopedic Surgery, University of Yamanashi, Chuo, JPN
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Asavamongkolkul A, Adulkasem N, Chotiyarnwong P, Vanitcharoenkul E, Chandhanayingyong C, Laohaprasitiporn P, Soparat K, Unnanuntana A. Prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults: a nationwide cross-sectional study. JBMR Plus 2024; 8:ziad020. [PMID: 38505534 PMCID: PMC10945715 DOI: 10.1093/jbmrpl/ziad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 03/21/2024] Open
Abstract
Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60-107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand's national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.
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Affiliation(s)
- Apichat Asavamongkolkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nath Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Panai Laohaprasitiporn
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Krabkaew Soparat
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Sato K, Kogawa M, Yamada Y, Yamashiro M, Kasama F, Matsuda M. Equivalent values between anterior vertebral height, wedge ratio, and wedge angle for evaluating vertebral mobility and deformity in osteoporotic vertebral fractures: a conventional observational study. J Orthop Surg Res 2023; 18:284. [PMID: 37031169 PMCID: PMC10082485 DOI: 10.1186/s13018-023-03758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/26/2023] [Indexed: 04/10/2023] Open
Abstract
BACKGROUND Vertebral mobility (V-mobility) has been used to diagnose fresh osteoporotic vertebral fractures (OVFs) and determine bone union by setting cutoff values for these purposes. V-mobility is the difference in vertebral height on dynamic radiographs taken in the sitting and lateral decubitus or supine positions. The dimensions for V-mobility were presented as anterior vertebral height (Ha; mm), wedge ratio (WR; %), and wedge angle (WA; °) in previous reports. This study was performed to obtain WR and WA values equivalent to V-mobility of 1.0 mm in Ha. METHODS Lateral radiographs of 284 OVFs (grade 1-3 deformed vertebrae) from T11 to L2 were obtained from 77 patients with OVF. V-mobility presented as Ha, posterior vertebral height, and WA was obtained by the difference in these dimensions on dynamic radiographs. The WR and WA values equivalent to 1.0 mm in Ha were obtained by dividing the V-mobility values for WR and WA by that for Ha. RESULTS The mean WR values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 3.2% ± 1.4%, 3.2% ± 0.9%, and 3.4% ± 1.0%, respectively, and the corresponding value for grade 1-3 vertebrae was 3.3% ± 1.0%. The mean WA values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 1.5° ± 0.8°, 1.5° ± 0.6°, and 1.5° ± 0.8°, respectively, and the corresponding value for grade 1-3 vertebrae was 1.5° ± 0.7°. CONCLUSIONS The WR and WA values equivalent to V-mobility of 1.0 mm in Ha were 3.3% and 1.5°, respectively, in grade 1-3 vertebrae. These findings may be useful to secure a reliable value of V-mobility of OVFs using simultaneous measurements in three dimensions (Ha, WR, and WA) in clinical practice and to establish cutoff values for V-mobility to determine bone union.
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Affiliation(s)
- Kozo Sato
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan
| | - Masakazu Kogawa
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan.
- Centre for Orthopaedic and Trauma Research, Discipline of Orthopaedics and Trauma, The University of Adelaide, North Terrace and George St., Adelaide, SA, 5005, Australia.
| | - Yuichiro Yamada
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan
| | - Masahiro Yamashiro
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan
| | - Fumio Kasama
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan
| | - Michimasa Matsuda
- Department of Orthopaedic Surgery, Matsuda Hospital, 17-1 Sanezawa Aza Tatsutayashiki, Izumi-Ku, Sendai, Miyagi, 981-3217, Japan
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Hagino H, Yoshinaga Y, Hamaya E, Lin TC, Ajmera M, Meyers J. A real-world study of treatment patterns among patients with osteoporotic fracture: analysis of a Japanese hospital database. Arch Osteoporos 2023; 18:23. [PMID: 36683098 PMCID: PMC9868038 DOI: 10.1007/s11657-022-01201-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/12/2022] [Indexed: 01/24/2023]
Abstract
Health records of patients hospitalized for osteoporotic fracture were analyzed. Prior to the index hospital admission, most patients were not receiving any antiosteoporotic treatment. During the index hospitalization visit, 25.5% of patients received antiosteoporotic treatment. The most common treatment regimens were active vitamin D3, bisphosphonates, and teriparatide. PURPOSE To examine the real-world treatment patterns and factors associated with receipt of treatment among Japanese patients with osteoporotic fracture. METHODS We retrospectively analyzed health records of patients who were hospitalized for osteoporotic fracture between February 2016 and February 2018 in Japan. The type and duration of treatment with antiosteoporotic medications prescribed during hospital stays and after discharge were examined using descriptive statistics. Demographic and clinical factors (e.g., age, previous diagnoses, Charlson Comorbidity Index scores) associated with osteoporotic treatment were explored using multivariable logistic regression. RESULTS A total of 112,275 patient medical records were evaluated, including 56,574 records from patients with hip fracture, 26,681 records from patients with vertebrae fracture, and 29,020 patients with non-vertebral non-hip fractures. Prior to the index hospital admission, most patients (91.7%, n = 102,919) were not receiving any antiosteoporotic treatment. For those receiving treatment, active vitamin D3 (51.1%, n = 4778) and bisphosphonates (47.5%, n = 4441) were the most common. During the index hospitalization visit, 25.5% (n = 28,678) of patients received treatment for their fracture, including active vitamin D3 (n = 17,074), bisphosphonates (n = 10,007), and teriparatide (n = 4561). Upon discharge, 41.5% (n = 46,536) of patients returned to their home and 34.3% (n = 38,542) of patients were transferred to a different hospital or medical care facility. Variables associated with receipt of treatment at follow-up included older age, previous diagnoses of osteoporosis and fracture, and higher Charlson Comorbidity Index scores. CONCLUSION Despite osteoporotic fracture being a major health concern within older Japanese populations, treatment with antiosteoporotic medication regimens remains generally low.
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Affiliation(s)
- Hiroshi Hagino
- School of Health Sciences, Tottori University, Tottori, Japan.
| | | | | | - Tzu-Chieh Lin
- Center for Observational Research, Amgen, Inc, Thousand Oaks, USA
| | - Mayank Ajmera
- Department of Health Economics and Outcomes Strategy, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Juliana Meyers
- Department of Health Economics and Outcomes Strategy, RTI Health Solutions, Research Triangle Park, NC, USA
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Yu S, Li C, Zhong Y, Zang J, Zhou Z, Wang S, Zhang Y. Risk factors for contralateral hip refractures in patients aged over 80 years with intertrochanteric femoral fractures. Front Surg 2022; 9:924585. [PMID: 36176341 PMCID: PMC9513157 DOI: 10.3389/fsurg.2022.924585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this study was to identify which of the risk factors would contribute to the contralateral fracture in very elderly patients after intramedullary nail fixation. Methods Clinical data of 227 intertrochanteric fracture patients aged 80 years or older were retrospectively reviewed. Intramedullary nails (IMNs) were used on all of the patients. Potential risk factors for contralateral hip refractures were determined using univariate and logistic regression analyses. Results Contralateral hip refractures occurred in 11 patients (4.84%). Univariate analysis revealed that age, gender, body mass index, fracture classification, hematocrit, D-dimer, and CRP level were not associated with contralateral fractures (P > 0.05). However, neurological diseases, cardiovascular disease, and visual impairments were significantly associated with contralateral fractures (P < 0.05). Multivariate analysis further revealed that neurological diseases (OR 4.25, P = 0.044) and visual impairments (OR 5.42, P = 0.015) were independent risk factors associated with contralateral refractures. Conclusion To prevent contralateral refractures, more attention should be paid to elderly intertrochanteric fracture patients with underlying neurological disease and visual impairments.
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Affiliation(s)
- Shujun Yu
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Chen Li
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Yuqiao Zhong
- Department of Radiology, Tianjin Hospital, Tianjin, China
| | - Jiacheng Zang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
| | - Zhanzhe Zhou
- Department of Orthopedics, Tianjin Xiqing Hospital, Tianjin, China
| | - Song Wang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
- Correspondence: Song Wang Yinguang Zhang
| | - Yinguang Zhang
- The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China
- Correspondence: Song Wang Yinguang Zhang
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Mitchell PJ, Ang SB, Mercado-Asis LB, Rey-Matias R, Chen WS, Flicker L, Leung E, Choon D, Chandrasekaran SK, Close JCT, Seymour H, Cooper C, Halbout P, Blank RD, Zhao Y, Lim JY, Tabu I, Tian M, Unnanuntana A, Wong RMY, Yamamoto N, Chan DC, Lee JK. Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region. Arch Osteoporos 2022; 17:115. [PMID: 35987919 PMCID: PMC9392505 DOI: 10.1007/s11657-022-01153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/01/2022] [Indexed: 02/03/2023]
Abstract
This narrative review summarises ongoing challenges and progress in the care and prevention of fragility fractures across the Asia Pacific region since mid-2019. The approaches taken could inform development of national bone health improvement Road Maps to be implemented at scale during the United Nations 'Decade of Healthy Ageing'. PURPOSE This narrative review summarises recent studies that characterise the burden of fragility fractures, current care gaps and quality improvement initiatives intended to improve the care and prevention of fragility fractures across the Asia Pacific region. METHODS The review focuses on published studies, reports and quality improvement initiatives undertaken during the period July 2019 to May 2022. RESULTS Epidemiological studies conducted in countries and regions throughout Asia Pacific highlight the current and projected increasing burden of fragility fractures. Recent studies and reports document a persistent and pervasive post-fracture care gap among people who have sustained fragility fractures. Global initiatives developed by the Fragility Fracture Network and International Osteoporosis Foundation have gained significant momentum in the Asia Pacific region, despite the disruption caused by the COVID-pandemic. The Asia Pacific Fragility Fracture Alliance has developed educational resources including a Hip Fracture Registry Toolbox and a Primary Care Physician Education Toolkit. The Asia Pacific Osteoporosis and Fragility Fractures Society-a new section of the Asia Pacific Orthopaedic Association-is working to engage orthopaedic surgeons across the region in the care and prevention of fragility fractures. The Asia Pacific Consortium on Osteoporosis developed a framework to support national clinical guidelines development groups. Considerable activity at the national level is evident in many countries across the region. CONCLUSION Development and implementation of national Road Maps informed by the findings of this review are urgently required to respond to the epidemiological emergency posed by fragility fractures during the United Nations 'Decade of Healthy Ageing'.
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Affiliation(s)
- Paul James Mitchell
- School of Medicine, University of Notre Dame Australia, Sydney, Australia
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Synthesis Medical NZ Limited, Pukekohe, Auckland, New Zealand
| | - Seng Bin Ang
- Asian Federation of Osteoporosis Societies, c/o KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore
- Menopause Unit and Family Medicine Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Leilani Basa Mercado-Asis
- Asian Federation of Osteoporosis Societies, c/o KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore
- Department of Endocrinology, Metabolism and Diabetes, Public Health, University of the Philippines, Manila, Philippines
| | - Reynaldo Rey-Matias
- Asia-Oceanian Society of Physical and Rehabilitation Medicine, Kowloon, Hong Kong SAR, China
- Department of Physical and Rehabilitation Medicine, St Luke's Medical Center, Quezon City, Philippines
- College of Medicine, Philippine Academy of Rehabilitation Medicine, Manila, Philippines
| | - Wen-Shiang Chen
- Asia-Oceanian Society of Physical and Rehabilitation Medicine, Kowloon, Hong Kong SAR, China
- Department of Physical Medicine and Rehabilitation (University Hospital), National Taiwan University, Taipei, Taiwan
| | - Leon Flicker
- Asia Pacific Geriatric Network, Virtual Network, Perth, Australia
- Internal Medicine, University of Western Australia, Perth, WA, Australia
| | - Edward Leung
- Asia Pacific Geriatric Network, Virtual Network, Perth, Australia
- Geriatric Medicine Centre, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong SAR, China
| | - David Choon
- Asia Pacific Orthopaedic Association, Bukit Jalil, Kuala Lumpur, Wilayah Persekutuan, Malaysia
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Wilayah Persekutuan, Kuala LumpurKuala Lumpur, Malaysia
| | - Sankara Kumar Chandrasekaran
- Asia Pacific Orthopaedic Association, Bukit Jalil, Kuala Lumpur, Wilayah Persekutuan, Malaysia
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Wilayah Persekutuan, Kuala LumpurKuala Lumpur, Malaysia
| | - Jacqueline Clare Therese Close
- Fragility Fracture Network, c/o MCI Schweiz AG, Zurich, Switzerland
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Hannah Seymour
- Fragility Fracture Network, c/o MCI Schweiz AG, Zurich, Switzerland
- Department of Geriatrics and Aged Care, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Cyrus Cooper
- International Osteoporosis Foundation, Nyons, Switzerland
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | | | - Robert Daniel Blank
- International Society for Clinical Densitometry, Middletown, CT, USA
- Osteoporosis and Translational Research Laboratory, Garvan Institute of Medical Research, Sydney, Australia
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Yanling Zhao
- International Society for Clinical Densitometry, Middletown, CT, USA
- Beijing United Family Hospital (Department of Obstetrics and Gynecology), Beijing, China
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Irewin Tabu
- Department of Orthopedics, University of the Philippines - Philippine General Hospital, Manila, Philippines
- Institute On Aging, National Institutes of Health, UP Manila, Manila, Philippines
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, Harbin Medical University, Harbin, China
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Noriaki Yamamoto
- Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology and Department of Internal Medicine, National Taiwan University Hospital, No. 1, Changde St, Taipei, Taiwan.
| | - Joon Kiong Lee
- Department of Orthopaedics, Beacon Hospital, 1, Jalan 215, Section 51, Off Jalan Templer, 46050, Petaling Jaya, Selangor, Malaysia.
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Okuda R, Osaki M, Saeki Y, Okano T, Tsuda K, Nakamura T, Morio Y, Nagashima H, Hagino H. Effect of coordinator-based osteoporosis intervention on quality of life in patients with fragility fractures: a prospective randomized trial. Osteoporos Int 2022; 33:1445-1455. [PMID: 35195752 DOI: 10.1007/s00198-021-06279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED We examined the effects of the coordinator-based intervention on quality of life (QOL) in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL. The coordinator-based interventions mitigated the decrease in QOL. Secondary fracture after primary fracture, however, was a significant predictor of lower QOL. PURPOSE This study aimed to determine the effects of the coordinator-based intervention on QOL in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL, in an Asian population. METHODS Patients with new fractures in the intervention group received the coordinator-based intervention by a designated nurse certified as a coordinator, within 3 months of injury. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) scale before the fracture (through patient recollections) and at 0.5, 1, and 2 years after the primary fracture. RESULTS Data for 141 patients were analyzed: 70 in the liaison intervention (LI) group and 71 in the non-LI group. Significant intervention effects on QOL were observed at 6 months after the fracture; the QOL score was 0.079 points higher in the LI group than in the non-LI group (p=0.019). Further, the LI group reported significantly less pain/discomfort at 2 years after the fracture, compared to the non-LI group (p=0.037). In addition, secondary fractures were found to significantly prevent improvement and maintenance of QOL during the recovery period (p=0.015). CONCLUSION Short-term intervention effects were observable 6 months after the primary fracture, with the LI group mitigated the decrease in QOL. Few patients in the LI group reported pain/discomfort 2 years after the fracture, but there is uncertainty regarding its clinical significance. Secondary fracture after initial injury was a significant predictor of lower QOL after a fracture.
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Affiliation(s)
- R Okuda
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan.
| | - M Osaki
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
| | - Y Saeki
- Orthopedic Surgery Hospital Ward, Tottori University Hospital, Yonago, Tottori, Japan
| | - T Okano
- Department of Orthopedic Surgery, San-in Rosai Hospital, Yonago, Tottori, Japan
| | - K Tsuda
- Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Sakaiminato, Tottori, Japan
| | - T Nakamura
- Department of Orthopedic Surgery, Hakuai Hospital, Yonago, Tottori, Japan
| | - Y Morio
- Department of Orthopedic Surgery, Misasa Onsen Hospital, Misasa, Tottori, Japan
| | - H Nagashima
- Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
| | - H Hagino
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
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Xing B, Feng N, Zhang J, Li Y, Hou X, Wu H, Liu W, Han G. Pinocembrin relieves hip fracture-induced pain by repressing spinal substance P signaling in aged rats. J Neurophysiol 2022; 127:397-404. [PMID: 34986062 DOI: 10.1152/jn.00517.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Whether pinocembrin (PCN) could be utilized to alleviate hip fracture-induced pain is investigated in this research. Aged rats with hip fractures were treated with vehicle or 80 mg/kg/day PCN from week 3 to week 4. Then hind paw mechanical allodynia, unweighting, warmth, and thickness were measured. The microglia and astrocytes activation and proliferation markers in the spinal dorsal horn were detected with real-time PCR and immunofluorescence staining. The relative expression of substance P and its receptor, tachykinin receptor 1 (Tacr1), were detected with enzyme-linked immunosorbent assay (ELISA) and Western blots. The antinociceptive effect of Tacr1 inhibitor LY303870 was also testified. PCN alleviated hip fracture-induced hind paw nociceptive (allodynia and unweighting) and vascular changes (warmth and thickness) in aged rats with diminished microglia and astrocytes activation and proliferation in the spinal dorsal horn. Up-regulated substance P and Tacr1 were induced after hip fracture, which could be reversed by PCN treatment. Furthermore, LY303870 treatment partially reversed both spinal nociceptive sensitization and vascular changes after hip fracture. Substance P signaling contributes to the nociceptive and vascular changes observed in the hip fracture, which could be alleviated by PCN.
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Affiliation(s)
- Baorui Xing
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Nana Feng
- Science and Education Department, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Juan Zhang
- Department of Western Pharmaceutical Sciences, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Yunmei Li
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Xiuxiu Hou
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Hao Wu
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Wendong Liu
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
| | - Guangpu Han
- Department of Traumatology and Orthopedics, Cangzhou Hospital of integrated traditional Chinese medicine and Western medicine, Cangzhou, China
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