ABSTRACT
Hip fracture occurrences in nursing homes are associated with high morbidity, mortality, and high health care costs in elderly people. In the United States, approximately 340,000 hip fractures occur each year, while more then 90% are associated with falls. Osteoporosis is a skeletal disorder causing impaired bone strength that increases the risk of fracture. In the United States alone, osteoporosis affects < 10 million individuals aged > or =50. The American Association of Clinical Endocrinologists (AACE), North American Menopause Society (NAMS), and National Osteoporosis Foundation (NOF) have developed recommendations for the identification of patients with osteoporosis who need therapy. Good nutrition with adequate supplements of calcium and vitamin D3 is considered one of the most important lifestyle factors for maintaining adequate bone mineral density. Only a combination of calcium and vitamin D therapy has been shown to increase the bone mineral density as well as a reduction in the nonvertebral fractures.
Subject(s)
Accidental Falls , Hip Fractures/etiology , Homes for the Aged , Nursing Homes , Osteoporosis, Postmenopausal/complications , Aged , Aged, 80 and over , Bone Density/drug effects , Bone Density Conservation Agents/therapeutic use , Calcium/deficiency , Calcium/therapeutic use , Calcium, Dietary/administration & dosage , Cholecalciferol/therapeutic use , Dietary Supplements , Drug Therapy, Combination , Female , Health Care Costs , Hip Fractures/economics , Hip Fractures/prevention & control , Hospitalization/statistics & numerical data , Humans , Male , Osteoporosis, Postmenopausal/drug therapy , Osteoporosis, Postmenopausal/metabolism , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/prevention & controlABSTRACT
There are more than 5 million participants in 1 of 6 gymnastic disciplines that are prone to spinal cord injuries. Working with the gifted scholar and attorney, Jeffrey Beaton, the authors have participated in developing an injury prevention program for children and teenagers who participate in gymnastics. This program includes the following components: (1) a gymnastics center that complies with the e-Book design of gymnasticszone.com; (2) all teachers and students in gymnastics should be members of USA Gymnastics (USAG) and purchase a copy of the USA Gymnastics Safety Manual, the official manual of the United States Gymnastics Safety Association; (3) trampolines should be sunk in the ground with the bed level with the floor; and finally, (4) immediate emergency access of the injured gymnast to either a skilled orthopedic or neurosurgeon.
Subject(s)
Athletic Injuries/prevention & control , Gymnastics/injuries , Preventive Medicine/organization & administration , Program Development , Adolescent , Child , Equipment Safety , Female , Humans , Male , Physical Education and Training , Program Evaluation , Spinal Injuries/etiology , United StatesABSTRACT
Multiple Sclerosis (MS) is an inflammatory disease that demyelinates the central nervous system causing progressive disability. The urodynamics of MS patients is an important consideration because these patients are susceptible to acute urinary bladder retention associated with a high fever. Treatment should include irrigation using a Foley catheter and an irrigation syringe to remove residual urine and sediment from the neurogenic bladder, intravenous fluid resuscitation, bacteriological analysis of the residual urine, and admission to an Intensive Care Unit for further evaluation by a urologist. After discharge, suprapubic cystostomy should be a consideration for patients who have chronic urinary tract infections associated with acute urinary bladder retention, as well as limited mobility to perform self catheterization, or limited personal care assistants trained to perform a urethral clean intermittent catheterization.
