RESUMO
Objectives@#To investigate trends of osteoporosis treatment rates, and factors affecting osteoporosis treatment after hip fracture admission within a single health care system in Hawaii. @*Methods@#A retrospective chart review was conducted of patients aged 50 years or older and hospitalized for hip fractures between January 1, 2011 and December 31, 2019 at Hawaii Pacific Health, a large health care system in Hawaii. We collected data on basic demographics and osteoporosis medication prescription from electronic medical records. We evaluated trends of osteoporosis treatment rates and performed logistic regression to determine factors associated with osteoporosis treatment. @*Results@#The mean for treatment rates for osteoporosis from 2011 to 2019 was 17.2% (range 8.8%-26.0%). From 2011 to 2019 there was a small increase in treatment rates from 16.3% in 2011 to 24.1% in 2019. Men were less likely to receive osteoporosis treatment after admission for hip fracture. Patients discharged to a facility were more likely to receive osteoporosis treatment. As compared to women, men who had a hip fracture were less likely to receive dual-energy X-ray absorptiometry scan, and osteoporosis medication before hip fracture admission. @*Conclusions@#The use of osteoporosis medication for secondary prevention after admission for hip fracture in Hawaii from 2011 to 2019 was low. However, there was a small increase in treatment rates from 2011 to 2019. Disparities in treatment of osteoporosis after hip fracture were noted in men. Significant work is needed to increase treatment rates further, and to address the disparity in osteoporosis treatment between men and women.
RESUMO
Objectives@#To investigate trends of osteoporosis treatment rates, and factors affecting osteoporosis treatment after hip fracture admission within a single health care system in Hawaii. @*Methods@#A retrospective chart review was conducted of patients aged 50 years or older and hospitalized for hip fractures between January 1, 2011 and December 31, 2019 at Hawaii Pacific Health, a large health care system in Hawaii. We collected data on basic demographics and osteoporosis medication prescription from electronic medical records. We evaluated trends of osteoporosis treatment rates and performed logistic regression to determine factors associated with osteoporosis treatment. @*Results@#The mean for treatment rates for osteoporosis from 2011 to 2019 was 17.2% (range 8.8%-26.0%). From 2011 to 2019 there was a small increase in treatment rates from 16.3% in 2011 to 24.1% in 2019. Men were less likely to receive osteoporosis treatment after admission for hip fracture. Patients discharged to a facility were more likely to receive osteoporosis treatment. As compared to women, men who had a hip fracture were less likely to receive dual-energy X-ray absorptiometry scan, and osteoporosis medication before hip fracture admission. @*Conclusions@#The use of osteoporosis medication for secondary prevention after admission for hip fracture in Hawaii from 2011 to 2019 was low. However, there was a small increase in treatment rates from 2011 to 2019. Disparities in treatment of osteoporosis after hip fracture were noted in men. Significant work is needed to increase treatment rates further, and to address the disparity in osteoporosis treatment between men and women.
RESUMO
Scrub typhus, caused by Orientia tsutsugamushi, is prevalent in the tropical areas like South-East and Far East Asia. A seven-year-old Indian boy who had recently returned from India, presented with fever, headache, vomiting and convulsions refractory to anticonvulsants and multiple antimicrobials. He was diagnosed as a case of Scrub Typhus by Weil-Felix test. He responded well to a ten day course of chloramphenicol. A huge population in Kuwait travels to and from the areas endemic for Scrub typhus. A clinical suspicion is prudent in all such cases presenting with a pyrexia of unknown origin. In cases with involvement of the central nervous system, chloramphenicol should be the first choice of treatment, as it penetrates the blood brain barrier well
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A 17-month-old vaccinated Kuwaiti boy presented with meningitis. The Haemophilus influenzae type b [Hib] capsular antigen was detected in his blood, CSF and urine. The microorganism failed to grow in culture. This case represents the first report of possible Hib vaccine failure from Kuwait. This report examines the possible reasons for this failure by reviewing the literature and emphasizes the need to broaden the definition of vaccine failure with the aim of optimizing the timing of the vaccine booster dose for prematurely born children and establishing continuous surveillance for Hib vaccine failure.