Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009
Directory of Open Access Journals (Sweden)
Ray Marks
2009-12-01
Full Text Available Ray MarksCity University of New York and Columbia University, New York, NY, USAAbstract: Hip fractures – which commonly lead to premature death, high rates of morbidity, or reduced life quality – have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather
Yoshihara, Hiroyuki; Yoneoka, Daisuke
2014-02-01
Unstable pelvic fracture is predominantly caused by high-energy blunt trauma and is associated with a high risk of mortality. The epidemiology in the United States is largely unknown. The purpose of this study was to examine the epidemiology of unstable pelvic fracture based on patient and hospital demographics in the United States during the last decade. The Nationwide Inpatient Sample was used to identify patients who were hospitalized with unstable pelvic fracture from 2000 to 2009, using the International Classification of Diseases--9th Rev.--Clinical Modification (ICD-9-CM) codes. The primary outcome parameter consisted of analyzing the temporal trends of in-hospital admissions for unstable pelvic fracture and the associated in-hospital mortality. The data were stratified by demographic variables, including age, sex, race, and hospital region in the United States. From 2000 to 2009, there were 24,059 patients in total; among these, 1,823 (7.6%) had open fractures, and 22,236 (92.4%) had closed fractures. The population growth-adjusted incidence was stable over time (p = 0.431). The incidence was the lowest in the northeastern region. The in-hospital mortality rate in patients with unstable pelvic fracture was 8.3% (21.3% for open fracture, 7.2% for closed fracture) and remained stable over time (p = 0.089). The in-hospital mortality rate was higher in several subgroups of patients, such as older patients, male patients, African-American patients, and patients in the northeastern region. During the last decade, the incidence of unstable pelvic fracture has remained stable over time in the United States. The in-hospital mortality rate in patients with unstable pelvic fracture was 8.3% and remained stable over time. The rate in patients with an open fracture was approximately three times higher than that in patients with a closed fracture. The incidence was the lowest, but the in-hospital mortality rate was the highest in the northeastern region compared with the
Secular trends in hip fractures worldwide: opposing trends East versus West.
Ballane, Ghada; Cauley, Jane A; Luckey, Marjorie M; Fuleihan, Ghada El-Hajj
2014-08-01
Despite wide variations in hip rates fractures worldwide, reasons for such differences are not clear. Furthermore, secular trends in the age-specific hip fracture rates are changing the world map of this devastating disease, with the highest rise projected to occur in developing countries. The aim of our investigation is to systematically characterize secular trends in hip fractures worldwide, examine new data for various ethnic groups in the United States, evidence for divergent temporal patterns, and investigate potential contributing factors for the observed change in their epidemiology. All studies retrieved through a complex Medline Ovid search between 1966 and 2013 were examined. For each selected study, we calculated the percent annual change in age-standardized hip fracture rates de-novo. Although occurring at different time points, trend breaks in hip fracture incidence occurred in most Western countries and Oceania. After a steep rise in age-adjusted rates in these regions, a decrease became evident sometimes between the mid-seventies and nineties, depending on the country. Conversely, the data is scarce in Asia and South America, with evidence for a continuous rise in hip fracture rates, with the exception of Hong-Kong and Taiwan that seem to follow Western trends. The etiologies of these secular patterns in both the developed and the developing countries have not been fully elucidated, but the impact of urbanization is at least one plausible explanation. Data presented here show close parallels between rising rates of urbanization and hip fractures across disparate geographic locations and cultures. Once the proportion of the urban population stabilized, hip fracture rates also stabilize or begin to decrease perhaps due to the influence of other factors such as birth cohort effects, changes in bone mineral density and BMI, osteoporosis medication use and/or lifestyle interventions such as smoking cessation, improvement in nutritional status and fall
Epidemiology of extremity fractures in the Netherlands
Beerekamp, M. S. H.; de Muinck Keizer, R. J. O.; Schep, N. W. L.; Ubbink, D. T.; Panneman, M. J. M.; Goslings, J. C.
2017-01-01
Insight in epidemiologic data of extremity fractures is relevant to identify people at risk. By analyzing age- and gender specific fracture incidence and treatment patterns we may adjust future policy, take preventive measures and optimize health care management. Current epidemiologic data on
Pediatric femur fractures, epidemiology and treatment
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Petković Lazar
2011-01-01
Full Text Available Background/Aim. Femur fractures in children most often occur as a consequence of traffic accidents, during play and sport activities, and due to different pathological states. Diagnosis is rather simple and it includes physical and radiographycal examination. Femur fractures treatment in children can be operative and unoperative, depending on several facts: age, localisation and type of fracture, joint injuries of soft tissues, the presence of other injuries (in polytrauma, economical and social aspects, ect. The aim of this study was to present epidemiological characteristics of pediatric femur fractures, that is in the stage of development, including a special analysis of the used treatment techniques, as well as the comparison of the obtained data with those from the literature. Methods. The evaluation included following parameters: age, gender, cause, localisation and type of femur fracture, applied treatment and hospitalisation duration. Results. Among the presented 143 patients with femur fracture, 109 were boys and 34 were girls (3.2 : 1 ratio; p = 0.0001. Average age for both genders was 8.6 years, and no difference between boys and girls were found for the age (p = 0.758. In total, the most common fracture was diaphyseal fracture of femur in 93 (65.03% patients. The second was proximal fracture in 30 (20.98% patients, and the last distal fracture of the femur in 20 (13.99% patients (p = 0.0001. Three main causes of femur fracture can be distinguished: during play and sport activities in 67 (46.8% children, in traffic accidents in 64 (44.8% children, and pathological fractures in 12 (8.4% children. Inoperative treatment was applied in 82 (57.3% patients, and operative one in 61 (42.7% patients. The most common tretament was traction, in 71 (49.6% patients, followed by immobilization by hip spica cast mostly in young children. Intramedullar elastic nailing was applied in 16 (11.2% cases, and intramedullar rigid nailing (Küntscher in 19
Epidemiology of hip fractures in Lebanon: a nationwide survey.
Maalouf, G; Bachour, F; Hlais, S; Maalouf, N M; Yazbeck, P; Yaghi, Y; Yaghi, K; El Hage, R; Issa, M
2013-10-01
Hip fractures are a reliable indicator of osteoporosis. Despite their importance, few studies have assessed their epidemiology in Lebanon and the Middle East. Hip fracture incidence rates in Lebanon approximate those of Northern countries, and show the same characteristics, particularly the exponential increase with age, higher incidence in women, and a recent trend of rate leveling in women but not in men. A national database of hip fracture cases admitted to hospitals in Lebanon in 2007 was created. Crude and age-adjusted incidence rates were calculated at 5-year intervals for individuals over age 50. These rates were also standardized to the 2000 United States population, and compared to those of other countries. Projected incidence rates in Lebanon in 2020 and 2050 were also calculated. A total of 1199 patients were included in the study. The crude annual incidence rate in individuals over 50 was 147 per 100,000 individuals, 132 per 100,000 males and 160 per 100,000 females, with a female-to-male ratio of 1.2. The age-standardized annual incidence rates (per 100,000) were 180 in males and 256 in females. Assuming unchanged healthcare parameters, the projected crude incidence rates for people over 50 are expected to reach 174 and 284 per 100,000 in 2020 and 2050 respectively. Lebanese hip fracture rates are lower than Northern countries, but show many similar characteristics such as an exponential increase with age, a higher incidence in women, and clues of a leveling of rates in women but not in men. Numbers are expected to increase substantially in the coming decades. Level IV. Epidemiological study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Incidence and epidemiology of tibial shaft fractures
DEFF Research Database (Denmark)
Larsen, Peter; Elsøe, Rasmus; Hansen, Sandra Hope
2015-01-01
Introduction: The literature lacks recent population-based epidemiology studies of the incidence, trauma mechanism and fracture classification of tibial shaft fractures. The purpose of this study was to provide up-to-date information on the incidence of tibial shaft fractures in a large....... The mean age at time of fracture was 38.5 (21.2SD) years. The incidence of tibial shaft fracture was 16.9/100,000/year. Males have the highest incidence of 21.5/100,000/year and present with the highest frequency between the age of 10 and 20, whereas women have a frequency of 12.3/100,000/year and have...... frequency of fractures while participating in sports activities and walking. Women present the highest frequency of fractures while walking and during indoor activities. Conclusion: This study shows an incidence of 16.9/100,000/year for tibial shaft fractures. AO-type 42-A1 was the most common fracture type...
The epidemiology of fractures in infants--Which accidents are preventable?
Wegmann, Helmut; Orendi, Ingrid; Singer, Georg; Eberl, Robert; Castellani, Christoph; Schalamon, Johannes; Till, Holger
2016-01-01
In children, fractures have a huge impact on the health care system. In order to develop effective prevention strategies exact knowledge about the epidemiology of fractures is mandatory. This study aims to describe clinical and epidemiological data of fractures diagnosed in infants. A retrospective analysis of all infants (childrenfractures in an 11 years period (2001-2011) was performed. Information was obtained regarding the location of the fractures, sites of the accident, circumstances and mechanisms of injury and post-injury care. 248 infants (54% male, 46% female) with a mean age of 7 months presented with 253 fractures. In more than half of the cases skull fractures were diagnosed (n=151, 61%). Most frequently the accidents causing fractures happened at home (67%). Falls from the changing table, from the arm of the care-giver and out of bed were most commonly encountered (n=92, 37%). While the majority of skull fractures was caused from falls out of different heights, external impacts tended to lead to fractures of the extremities. 6 patients (2%) were victims of maltreatment and sustained 10 fractures (2 skull fractures, 4 proximal humeral fractures, 2 rib fractures, and 2 tibial fractures). Falls from the changing table, the arms of the caregivers and out of bed caused the majority of fractures (especially skull fracture) in infants. Therefore, awareness campaigns and prevention strategies should focus on these mechanisms of accident in order to decrease the rate of fractures in infants. Copyright © 2015 Elsevier Ltd. All rights reserved.
Kim, Sunny H; Szabo, Robert M; Marder, Richard A
2012-03-01
To evaluate the occurrence of emergency department (ED) visits due to humerus fractures in the US. We analyzed the 2008 Nationwide Emergency Department Sample, which contained approximately 28 million ED records. We identified the cases of interest using diagnostic codes for proximal, shaft, and distal humerus fractures. In 2008, approximately 370,000 ED visits in the US resulted from humerus fractures. Proximal humerus fractures were the most common, accounting for 50% of humerus fractures. The incidence rate of proximal humerus fractures followed the shape of an exponential function in the age groups 40-84 years for women (R(2) = 97.9%) and 60-89 years for men (R(2) = 98.2%). After the exponential increase in these age intervals, the growth rate of proximal humerus fracture slowed and eventually decreased. The peak occurrence of distal humerus fractures was in children ages 5-9 years; however, elderly women had an increased risk. As the baby boomer generation ages, unless fracture prevention programs improve, more than 490,000 ED visits due to humerus fractures are expected in 2030 when the youngest of the baby boomers turn age 65 years. Compared to epidemiologic studies in Japan and European countries, the incidence rates of humerus fractures are substantially higher in the US. The high incidence rate of humerus fractures in the expanding elderly population may contribute to the recent trend of rapid increase in shoulder arthroplasty in the US. Rigorous safety measures to reduce falls and improved preventive treatments of osteoporosis are needed. Copyright © 2012 by the American College of Rheumatology.
Epidemiology of open tibia fractures in Nigeria | Ikem | Nigerian ...
African Journals Online (AJOL)
Epidemiology of open tibia fractures in Nigeria. ... DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access ... A total of 120 patients aged 4-80 years with open tibia fractures were studied. Majority were Gustilo and Anderson type II, 39.2% and type I, 30.8%. The treatment modality was ...
Incidence and epidemiology of tibial shaft fractures.
Larsen, Peter; Elsoe, Rasmus; Hansen, Sandra Hope; Graven-Nielsen, Thomas; Laessoe, Uffe; Rasmussen, Sten
2015-04-01
The literature lacks recent population-based epidemiology studies of the incidence, trauma mechanism and fracture classification of tibial shaft fractures. The purpose of this study was to provide up-to-date information on the incidence of tibial shaft fractures in a large and complete population and report the distribution of fracture classification, trauma mechanism and patient baseline demographics. Retrospective reviews of clinical and radiological records. A total of 196 patients were treated for 198 tibial shaft fractures in the years 2009 and 2010. The mean age at time of fracture was 38.5 (21.2SD) years. The incidence of tibial shaft fracture was 16.9/100,000/year. Males have the highest incidence of 21.5/100,000/year and present with the highest frequency between the age of 10 and 20, whereas women have a frequency of 12.3/100,000/year and have the highest frequency between the age of 30 and 40. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. The majority of tibial shaft fractures occur during walking, indoor activity and sports. The distribution among genders shows that males present a higher frequency of fractures while participating in sports activities and walking. Women present the highest frequency of fractures while walking and during indoor activities. This study shows an incidence of 16.9/100,000/year for tibial shaft fractures. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.
Trends in epidemiology and patho-anatomical pattern of proximal humeral fractures
DEFF Research Database (Denmark)
Bahrs, Christian; Stojicevic, Tanja; Tanja, Stojicevic
2014-01-01
PURPOSE: Proximal humeral fractures are common and frequently associated with osteoporosis. Little is known about the association between the patho-anatomical fracture pattern of proximal humeral fractures and patient characteristics. The purpose of this six year longitudinal registry analysis...... of proximal humeral fractures was to study overall numbers, certain predefined pathoanatomical patterns and distribution compared with specific patient characteristics. METHODS: Data of patients treated between 2006 and 2011 in a country hospital that provides care >95 % of the city's hospitalised patients...... with fractures was retrospectively reviewed. Data were analysed according to patient characteristics of age, gender, comorbidity, accompanying injuries and radiological analysis of pathoanatomical fracture patterns based on Neer and Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification. RESULTS: Eight...
Epidemiology of Osteoporosis and Osteoporotic Fractures in South Korea
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Young-Kyun Lee
2013-06-01
Full Text Available Several epidemiologic studies suggested that osteoporosis and osteoporotic fractures are not uncommon in South Korea. However, these previous cohort studies had limitations that may have influenced their results and the generalizability of the study conclusions, including small sample sizes, inclusion of only women, enrollment of participants from specific areas, and nonrandom selection of participants. Recently, epidemiologic studies using a nationwide claim register have been performed to overcome these limitations through collaboration between the Korean Society of Bone and Mineral Research and Health Insurance Review Assessments. Our review of the Korean Nationwide-database Osteoporosis Study could be helpful to obtain accurate incidence and prevalence estimations of osteoporosis and osteoporosis-related fractures in Korea.
2014 New Trends in Fatigue and Fracture Conference
Milovic, Ljubica
2017-01-01
This book is a compilation of selected papers from the 2014 New Trends in Fatigue and Fracture (NT2F14) Conference, which was held in Belgrade, Serbia. This prestigious conference brought together delegates from around the globe to discuss how to characterize, predict and analyze the fatigue and fracture of engineering materials, components, and structures using theoretical, experimental, numerical and practical approaches. It highlights some important new trends in fracture mechanics presented at the conference, such as: • two-parameter fracture mechanics, arising from the coupling of fracture toughness and stress constraints • high-performance steel for gas and oil transportation and production (pressure vessels and boilers) • safety and reliability of welded joints This book includes 12 contributions from well-known international scientists and a special tribute dedicated to the scientific contributions of Stojan Sedmark, who passed away in 2014.
Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study
Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.
2013-01-01
Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with comparison cohorts of nonsurvivors versus survivors and elderly versus nonelderly. Linear regression analysis was utilized to demonstrate trends with statistical significance. There were 965 patients with traumatic spine injuries with 2,333 spine trauma levels. The general cohort showed a trimodal age distribution, male-to-female ratio of 2:2, motor vehicle accidents as the primary spine trauma mechanism, 47.7% patients with severe polytrauma as graded using the Injury Severity Score (ISS), 17.3% with traumatic brain injury (TBI), the majority of patients with one spine injury level, 7% neurological deficit rate, 12.8% spine trauma operative rate, and 5.2% mortality rate. Variables with statistical significance trending toward mortality were the elderly, motor vehicle occupants, severe ISS, TBI, C1–2 dissociations, and American Spinal Injury Association (ASIA) A, B, and C neurological grades. Variables with statistical significance trending toward the elderly were females; low falls; one spine injury level; type 2 odontoid fractures; subaxial cervical spine distraction injuries; ASIA A, B, and C neurological grades; and patients without neurological deficits. Of the general cohort, 50.3% of spine trauma survivors were discharged home, and 48.1% were discharged to rehabilitation facilities. This study provides baseline spine trauma epidemiological data. The trimodal age distribution of patients with traumatic spine injuries calls for further studies and intervention targeted
Recent trends in fracture and damage mechanics
Zybell, Lutz
2016-01-01
This book covers a wide range of topics in fracture and damage mechanics. It presents historical perspectives as well as recent innovative developments, presented by peer reviewed contributions from internationally acknowledged authors. The volume deals with the modeling of fracture and damage in smart materials, current industrial applications of fracture mechanics, and it explores advances in fracture testing methods. In addition, readers will discover trends in the field of local approach to fracture and approaches using analytical mechanics. Scholars in the fields of materials science, engineering and computational science will value this volume which is dedicated to Meinhard Kuna on the occasion of his 65th birthday in 2015. This book incorporates the proceedings of an international symposium that was organized to honor Meinhard Kuna’s contributions to the field of theoretical and applied fracture and damage mechanics.
Winkler, Dennis; Goudie, Stuart T; Court-Brown, Charles M
2018-02-01
To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared. There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups. Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cervellin, Gianfranco; Comelli, Ivan; Lippi, Giuseppe
2017-09-01
Internet-derived information has been recently recognized as a valuable tool for epidemiological investigation. Google Trends, a Google Inc. portal, generates data on geographical and temporal patterns according to specified keywords. The aim of this study was to compare the reliability of Google Trends in different clinical settings, for both common diseases with lower media coverage, and for less common diseases attracting major media coverage. We carried out a search in Google Trends using the keywords "renal colic", "epistaxis", and "mushroom poisoning", selected on the basis of available and reliable epidemiological data. Besides this search, we carried out a second search for three clinical conditions (i.e., "meningitis", "Legionella Pneumophila pneumonia", and "Ebola fever"), which recently received major focus by the Italian media. In our analysis, no correlation was found between data captured from Google Trends and epidemiology of renal colics, epistaxis and mushroom poisoning. Only when searching for the term "mushroom" alone the Google Trends search generated a seasonal pattern which almost overlaps with the epidemiological profile, but this was probably mostly due to searches for harvesting and cooking rather than to for poisoning. The Google Trends data also failed to reflect the geographical and temporary patterns of disease for meningitis, Legionella Pneumophila pneumonia and Ebola fever. The results of our study confirm that Google Trends has modest reliability for defining the epidemiology of relatively common diseases with minor media coverage, or relatively rare diseases with higher audience. Overall, Google Trends seems to be more influenced by the media clamor than by true epidemiological burden. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Hip fractures. Epidemiology, risk factors, falls, energy absorption, hip protectors, and prevention
DEFF Research Database (Denmark)
Lauritzen, J B
1997-01-01
have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...
Incidence rates and trends of hip/femur fractures in five European countries
DEFF Research Database (Denmark)
Requena, G; Abbing-Karahagopian, V; Huerta, C
2014-01-01
Hip fractures represent a major public health challenge worldwide. Multinational studies using a common methodology are scarce. We aimed to estimate the incidence rates (IRs) and trends of hip/femur fractures over the period 2003-2009 in five European countries. The study was performed using seven......, P European countries. With the exception of Denmark, no decreasing trend was observed over the study period....
Trends in hip fracture-related mortality in Texas, 1990-2007.
Orces, Carlos H; Alamgir, Abul H
2011-07-01
There are limited data about trends in hip fracture-related mortality. In this study, we examined temporal trends in hip fracture mortality rates among persons aged 50 years or older in Texas between 1990 and 2007. Hip fracture-related mortality was defined as a death on the multiple cause of death record for which hip fracture was listed as a contributing cause. Population estimates for Texas were used as the denominator to calculate mortality rates per 100,000 persons. The joinpoint regression analysis was used to identify points where a statistically significant change occurred in the linear slope of the rates. A total of 14,350 death certificates listed hip fracture as a contributing cause of death. Hip fracture rates decreased predominantly among men by 0.8% (95% CI, -1.5 to -0.1) per year. Conversely, age-adjusted rates among women increased by 0.3% (95% CI, -0.4 to 1.0) per year. By race/ethnicity, hip fracture mortality rates increased annually 2.2% (95% CI, -0.1 to 4.4) among blacks, whereas the rates among whites and Hispanics remained steady. Moreover, the proportion of death records that listed nursing homes and residence as a place of death increased by 2.2% (95% CI, 1.6 to 2.9) and 8.7% (95% CI, 6.3 to 11.0) per year, respectively. Hip fracture mortality rates decreased predominantly among men in Texas during the study period. Increasing hip fracture mortality rates among blacks and nursing home residents merit further research.
Epidemiological Trends of Spine Trauma: An Australian Level 1 Trauma Centre Study
Tee, J. W.; Chan, C. H. P.; Fitzgerald, M. C. B.; Liew, S. M.; Rosenfeld, J. V.
2013-01-01
Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with...
Epidemiology of fractures in people with severe and profound developmental disabilities
Glick, N.R.; Fischer, M.H.; Heisey, D.M.; Leverson, G.E.; Mann, D.C.
2005-01-01
Fractures are more prevalent among people with severe and profound developmental disabilities than in the general population. In order to characterize the tendency of these people to fracture, and to identify features that may guide the development of preventive strategies, we analyzed fracture epidemiology in people with severe and profound developmental disabilities who lived in a stable environment. Data from a 23-year longitudinal cohort registry of 1434 people with severe and profound developmental disabilities were analyzed to determine the effects of age, gender, mobility, bone fractured, month of fracture, and fracture history upon fracture rates. Eighty-five percent of all fractures involved the extremities. The overall fracture rate increased as mobility increased. In contrast, femoral shaft fracture risk was substantially higher in the least mobile [relative risk (RR), 10.36; 95% confidence interval (CI), 3.29-32.66] compared with the most mobile group. Although the overall fracture rate was not associated with age, the femoral shaft fractures decreased but hand/foot fractures increased with age. Overall fracture risk declined in August and September (RR, 0.70; 95% CI, 0.55-0.89), being especially prominent for tibial/fibular fractures (RR, 0.31; 95% CI, 0.13-0.70). Gender was not a factor in fracture risk. Two primary fracture mechanisms are apparent: one, largely associated with lack of weight-bearing in people with the least mobility, is exemplified by femoral fractures during non-traumatic events as simple as diapering or transfers; the other, probably due to movement- or fall-related trauma, is exemplified by hand/foot fractures in people who ambulate. The fracture experience of people with severe and profound developmental disabilities is unique and, because it differs qualitatively from postmenopausal osteoporosis, may require population-specific methods for assessing risk, for improving bone integrity, and for reduction of falls and accidents
Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.
Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang
2017-12-01
Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
Dengue in Latin America: Systematic Review of Molecular Epidemiological Trends.
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José Ramos-Castañeda
2017-01-01
Full Text Available Dengue, the predominant arthropod-borne viral disease affecting humans, is caused by one of four distinct serotypes (DENV-1, -2, -3 or -4. A literature analysis and review was undertaken to describe the molecular epidemiological trends in dengue disease and the knowledge generated in specific molecular topics in Latin America, including the Caribbean islands, from 2000 to 2013 in the context of regional trends in order to identify gaps in molecular epidemiological knowledge and future research needs. Searches of literature published between 1 January 2000 and 30 November 2013 were conducted using specific search strategies for each electronic database that was reviewed. A total of 396 relevant citations were identified, 57 of which fulfilled the inclusion criteria. All four dengue virus serotypes were present and co-circulated in many countries over the review period (with the predominance of individual serotypes varying by country and year. The number of countries in which more than one serotype circulated steadily increased during the period under review. Molecular epidemiology data were found for Argentina, Bolivia, Brazil, the Caribbean region, Colombia, Ecuador, Mexico and Central America, Paraguay, Peru and Venezuela. Distinct lineages with different dynamics were found in each country, with co-existence, extinction and replacement of lineages occurring over the review period. Despite some gaps in the literature limiting the possibility for comparison, our review has described the molecular epidemiological trends of dengue infection. However, several gaps in molecular epidemiological information across Latin America and the Caribbean were identified that provide avenues for future research; in particular, sequence determination of the dengue virus genome is important for more precise phylogenetic classification and correlation with clinical outcome and disease severity.
EPIDEMIOLOGICAL STUDY OF LOW ENERGY FRACTURES IN REPUBLIC OF ARMENIA
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S. Saakyan
2017-01-01
Full Text Available Until present no data was available inArmeniain respect of incidence of low energy fractures that are typical of osteoporotic locations which consequently did not allow to evaluate the scope of this problem across the country.Purpose of the study – to identify the incidence of low energy fractures in proximal femur, in distal forearm, in proximal humerus and in distal tibia across population ofArmenia aged 50 years and older.Materials and methods. An observing population study was performed in two regions of Armenia during 2011-2013 where the frequency of selected locations in cases of moderate trauma was identified. During 2011-2012 the information was collected based on traumatology service records adding in 2013 other sources including primary level of healthcare due to observed infrequent applications for medical help in cases of trauma. Results. In 2013 the incidence of proximal femur fractures in men was reported as 136 cases per 100 000 of population aged 50 years and older, in women – 201 cases per 100 000. At the same time only 57.7% of patients with proximal femur fractures were admitted to hospital. Distal forearm fractures incidence in men and women was observed correspondingly 56/100 000 and 176/100 000 cases, proximal humerus fractures – 39/100 000 and 86/100 000 cases and distal tibia fractures – 39/100 000 and 86/100 000 cases. The predicted annual number of proximal femur fracture in Armenia amounts to 2067 cases, distal forearm fractures – 1205, proximal humerus fractures – 640.Conclusion. Epidemiological data that was collected for the first time on low energy fractures incidence confirmed the acute osteoporosis issue inArmenia and revealed the problems in organization of medical care for the group of senior patients with injuries.
EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH TRAUMATIC SPINAL FRACTURE
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MATEUS BERGAMO LOMAZ
Full Text Available ABSTRACT Objective: To analyze the epidemiological profile of patients with spinal fractures and the characteristics of the population at risk attended at a university hospital. Methods: The study population is composed of 202 patients diagnosed and treated for vertebral fracture due to trauma. The variables were correlated with each other and the correlations with p<0.05 were considered statistically significant. Results: The ratio of incidence of trauma between the sexes was 3:1 for males. The mean age was 37 years and the age group with the highest incidence was between 20 and 39 years. Traffic accidents were the most frequent mechanism (51.2% and secondly, falls (33.2%. There was a statistical correlation between trauma mechanisms to age group and region of the spine. The first lumbar vertebra (L1 fracture alone accounted for 21.5% of all cases studied associated with the fall mechanism. Spinal cord injury was recorded in 33.7% of the individuals in the sample. A total of 57.3% of the patients were submitted to surgical treatment and 41.7% to the conservative treatment. The mean hospitalization time was 15 days. Conclusions: Spinal fractures are important determinants of morbidity and mortality in the population with a major impact on economically active individuals, especially males. They are directly associated to traffic accidents in the young population and to falls in the higher age brackets. Primary prevention of trauma is the main mechanism for change in this scenario.
Epidemiology and risk factors of lower limb fractures (literature review
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N.V. Grygorieva
2017-08-01
Full Text Available The article presents current data about the risk factors of main lower limb fractures (LLFs of different localization (femur, tibia and foot. It has been shown that the most studies examine epidemiology and risk factors for hip fractures, but information about the risk factors for other LLFs is insufficient and controversial. It has been demonstrated that in addition to factors of age and sex, the road traffic accidents, sports, inadequate physical activity, injuries, falls and previous fractures play the important role in the development of LLFs. Also some diseases (systemic osteoporosis, large joints osteoarthritis, rheumatoid arthritis, dementia, epilepsy, alcoholism, parkinsonism, cancer, obesity and cataract can influence the LLFs risk. Administration of some drugs, in particular, hypnotic and sedative, as well as antidepressants, antipsychotic drugs and glucocorticoids, is the additional risk factor for LLFs. Almost all types of fractures in women are associated with low bone mineral density, which is more defined at femoral neck than at spine or peripheral skeleton, but part of fractures associated with osteoporosis is small and ranges from 10 to 44 %. The assessment of risk factors should necessarily be carried out in routine clinical practice in patients with LLFs, since it affects not only their incidence, but also the prognosis of treatment of these patients.
University student’s dental and maxillofacial fractures characteristics and epidemiology in sports
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Ivan Onone Gialain
2014-10-01
Full Text Available Current study analyzes the characteristics and epidemiology of oral and nasal fractures and knowledge degree regarding the use of a mouthguard by an amateur university handball team inBrazil. A cross-sectional study comprised 138 students who practiced the sport. They were interviewed on dental and nasal fractures and on the need of mouthguards in games such as amateur handball. Data were processed by descriptive analysis. Results showed that 19.6% had suffered some type of dental injury during the practice of sports, namely 40 fractured teeth; 12% had fractured nasal bones; 57% underwent head and neck injuries; 32% were unaware of the need to use a mouthguard during sports; 68% had heard of mouthguards, but only 4.5% of the interviewees made use of this protection device. There was a high prevalence of nasal and dental fractures in the group under analysis. The upper central incisors were most susceptible to fracture. Even though most athletes knew a mouthguard was needed during sports activities, only 4.5% actually used one.
Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping
2017-01-01
Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.
Epidemiological features and trends of Ebola virus disease in West Africa
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Ligui Wang
2015-09-01
Full Text Available According to a World Health Organization report, the epidemiological features of Ebola virus disease (EVD have changed significantly in West Africa. In this study, the new epidemiological features and prevalence trends for EVD in Guinea, Liberia, and Sierra Leone are described. It was predicted that the Ebola outbreak would end in June 2015.
Epidemiology of fractures of the proximal third of the femur in elderly patients ☆
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Daniel Daniachi
2015-08-01
Full Text Available ABSTRACTOBJECTIVE: This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo. METHODS: The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra-hospital mortality rate were evaluated. RESULTS: The 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low-energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was 7 days. The intra-hospital mortality rate was 7.1%. CONCLUSION: The patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra-hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented.
[Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)].
Agudelo-Suárez, Andrés A; Duque-Serna, Francisco Levi; Restrepo-Molina, Lucas; Martínez-Herrera, Eliana
2015-09-01
To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Emerging Trends in the Epidemiological Pattern of Head and Neck ...
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Emerging Trends in the Epidemiological Pattern of Head and Neck Cancers in Lagos, ... The oral cavity was the most affected anatomic site (21.2%, 230/1083) in the ... and squamous cell carcinoma accounted for 58% (421/726) of carcinomas ...
A decreasing trend in fall-related hip fracture incidence in Victoria, Australia.
Cassell, E; Clapperton, A
2013-01-01
In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999-2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people. The study aim was to investigate trends in the incidence of fall-related and hip fracture hospitalisations among Victorians aged 65 years and older overall and by age, gender, country of birth, socio-economic status (SES) and location of the event (home, residential care institution, etc.) over the 11-year period 1998/1999 to 2008/2009. Annual counts and age-standardised rates for fall-related hospitalisations among people aged 65 years and older were estimated using Victorian hospital admissions data. The statistical significance of changes in trends over time were analysed using a log-linear regression model of the rate data assuming a Poisson distribution of cases. Although the age-standardised incidence of fall-related hospitalisations increased significantly by 13% (95% confidence interval [CI], 9% to 18%) in Victoria, the age-standardised incidence of fall-related hip fracture hospitalisations decreased from 600/100,000 in 1998/1999 to 467/100,000 in 2008/2009 - an estimated overall reduction of 25% (95% CI, -29% to -22%). By contrast, the age-standardised incidence of fall-related hospitalisations for fractures at other body sites either increased significantly or showed no significant change. Significant decreases in fall-related hip fractures were observed in both males and females, across all 5-year age groups, in both Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people but not in people living in residential care facilities. Despite the downward trend in the age-standardised incidence of
Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects
DEFF Research Database (Denmark)
Rosengren, B E; Björk, J; Cooper, C
2017-01-01
This study used nationwide hip fracture data from Denmark and Sweden during 1987-2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in the not ...
Trends in the Fractures and Fatalities of Farmyard Injuries in Ireland: A 10 year analysis
LENUS (Irish Health Repository)
Lee, MJ
2017-01-01
The farming and agricultural sector remains one of Ireland’s primary industries. Fatality rates remain higher than the European average. The aim of this study was to analyze the national trend in hospital in-patient admissions for farmyard related fractures and related fatalities in Ireland from 2005 to 2014. Relevant socioeconomic trends were used for comparison. There were 2,064 farm-related fractures and 187 fatalities recorded over the same period. Despite a decrease in incidence of farmyard fractures over 2005-2014, fatality rates have increased indicating the alarming continued occupational hazards and severity of sustained injuries.
Selected trends in breast cancer epidemiology in Slovakia
International Nuclear Information System (INIS)
Ondrusova, M.; Psenkova, M.; Mardiak, J.
2015-01-01
Introduction: Breast cancer is one of the most prevalent forms of malignant tumors in women and so poses a serious social and economic problem. Aims: By analysing the trends of the basic indicators of breast cancer descriptive epidemiology in Slovakia, the prospective development was predicted, providing the missing information needed to assess the impact of intervention programmes. Results: The age-standardised incidence of breast cancer in Slovakia shows a strongly rising trend by an annual percentage change value of 2.2%, whereby in respect of mortality, after a previous significant decrease in values recorded in the period 2000-2009, stabilisation is registered once again with an annual percentage change of 3.4% (without statistical significance). Conclusion: Adverse trends in the development of breast cancer mortality in Slovakia underline the importance of establishing and monitoring the efficacy of intervention steps as part of organised screening. (author)
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HK Gupta
2015-06-01
Full Text Available Objective To study the epidemiology of fractures in the pediatric population. Methods All the cases of fractures of age 14 yrs or less presenting in emergency room or outdoor patient department of Orthopaedics during the time period of January 2013 to December 2013 were included in the study and prospectively studied. Demographic data were collected and analysed by descriptive methods. Results The incidence of fracture was more in male child. Most fractures occurred in age group of 6 to 14 years. Lower limb fractures (56.8% were more common than upper limb fractures. Incidence of injuries was more during summer most common mode of trauma being motor vehicle accidents (26%. Conclusion Proper supervision and guidance during outdoor activities, on the play ground and proper home safety measures with improved road conditions and proper traffic knowledge can markedly reduce the incidence of pediatric trauma. DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12760 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1; 1-4
Risk factors and epidemiological profile of hip fractures in Indian population: A case-control study
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Kaustubh Ahuja
2017-09-01
Conclusions: Hip fractures in the elderly population are on a rising trend especially in the Indian subcontinent due to a number of factors both hereditary and acquired. Simple measures like routine usage of bedside railing, wall-side railings at an appropriate height, high friction tiles inside rooms and washrooms, and adequate lighting indoors can play a significant role in reducing falls and hip fractures among the elderly.
AN EPIDEMIOLOGICAL SURVEY OF OSTEOPOROTIC FRACTURES IN OLDER RESIDENTS FROM THE MIDDLE URALS
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E. N. Gladkova
2014-01-01
Full Text Available The epidemiological characteristics of osteoporotic fractures in Russia have been inadequately studied.Objective: to estimate the incidence rate of osteoporotic fractures in the old age groups of an urban population in the Middle Urals.Subjects and methods. The survey was performed in Pervouralsk, a typical industrial town in the Middle Urals, with a total of 160,860 people, including 54,189 dwellers over 50 years of age (20,746 men and 33,443 women, which amounted to 33.7% of the general population of the town. The survey covered its residents aged 50 years and over who had fractures of the proximal hip (FPH, distal forearm (FDF, distal shin, ribs, or surgical neck of the humerusbetween 1 January 2008 and 31 December 2009. Statistical analysis was made applying the programs Biostatistics, Microsoft Excell 2007, and MedCalc (demo-version. The findings were processed using parametric and nonparametric statistical methods.Results. During two years, 1371 fractures, including FPH, FDF, fractures of the humerus, distal shin, and ribs, were registered in the examined sample of persons aged 50 years and over from Pervouralsk. 383 (27.9% of these fractures occurred in men and 988 (72.1% in women. The incidence rate of all fractures was 1265.0 per 100,000 inhabitants aged 50 years and over (1,477.1 for women and 923.1 for men. FDF were more common in women, the incidence was 787.9 cases per 100,000 population; costal fractures – in men (386.7 per 100,000. The investigation has shown that certain types of fractures are predominant in the oldest age groups. Thus, the incidence rate of FDF and fractures of the distal shin decreases while that of FPH and fractures of the humerus increaseswith age, which is likely to be due to several causes: an age-related decline in bone mass; an increase in the frequency of falls with age; muscle weakness and movement discoordination, which alter the mechanism of fall and increase the risk of femoral and
MAEDA, Yousuke; HANADA, Michiko; OIKAWA, Masa-aki
2016-01-01
ABSTRACT This report describes the descriptive epidemiology of racing fractures that occurred from the 1980s to 2000s on racetracks of the Japan Racing Association (JRA). The incidence of racehorse fractures during flat racing was approximately 1?2%. Fractures occurring during a race are more likely to occur in a forelimb. Fractures mostly occur at the third and fourth corners of oval tracks and on the home stretch. They also occur more frequently at the time of changing the leading limb. Com...
Extremity fractures associated with ATVs and dirt bikes: a 10-year national epidemiologic study.
Lombardo, D J; Jelsema, T; Gambone, A; Weisman, M; Petersen-Fitts, G; Whaley, J D; Sabesan, V J
2017-08-01
Morbidity and mortality of all-terrain vehicles and dirt bikes have been studied, as well as the association of helmet use and head injury. The purpose of this study is to compare and contrast the patterns of extremity fractures associated with ATVs and dirt bikes. We believe there will be unique and potentially preventable injury patterns associated with dirt bikes and three-wheeled ATVs due to the poor stability of these vehicles. Descriptive epidemiology study. The National Electronic Injury Surveillance System (NEISS) was used to acquire data for extremity fractures related to ATV (three wheels, four wheels, and number of wheels undefined) and dirt bike use from 2007 to 2012. Nationwide estimation of injury incidence was determined using NEISS weight calculations. The database yielded an estimate of 229,362 extremity fractures from 2007 to 2012. The incidence rates of extremity fractures associated with ATV and dirt bike use were 3.87 and 6.85 per 1000 participant-years. The largest proportion of all fractures occurred in the shoulder (27.2%), followed by the wrist and lower leg (13.8 and 12.4%, respectively). There were no differences in the distribution of the location of fractures among four-wheeled or unspecified ATVs. However, three-wheeled ATVs and dirt bikes had much larger proportion of lower leg, foot, and ankle fractures compared to the other vehicle types. While upper extremity fractures were the most commonly observed in this database, three-wheeled ATVs and dirt bikes showed increased proportions of lower extremity fractures. Several organizations have previously advocated for better regulation of the sale and use of these specific vehicles due to increased risks. These findings help illustrate some of the specific risks associated with these commonly used vehicles.
Incidence Trend and Epidemiology of Common Cancers in the Center of Iran.
Rafiemanesh, Hosein; Rajaei-Behbahani, Narjes; Khani, Yousef; Hosseini, Sayedehafagh; Pournamdar, Zahra; Mohammadian-Hafshejani, Abdollah; Soltani, Shahin; Hosseini, Seyedeh Akram; Khazaei, Salman; Salehiniya, Hamid
2015-07-13
Cancer is a major public health problem in Iran and many other parts of the world. The cancer incidence is different in various countries and in country provinces. Geographical differences in the cancer incidence lead to be important to conduct an epidemiological study of the disease. This study aimed to investigate cancer epidemiology and trend in the province of Qom, located in center of Iran. This is an analytical cross-sectional study carried out based on re-analysis cancer registry report and the disease management center of health ministry from 2004 to 2008 in the province of Qom. To describe incidence time trends, we carried out join point regression analysis using the software Join point Regression Program, Version 4.1.1.1. There were 3,029 registered cases of cancer during 5 years studied. Sex ratio was 1.32 (male to female). Considering the frequency and mean standardized incidence, the most common cancer in women were breast, skin, colorectal, stomach, and esophagus, respectively while in men the most common cancers included skin, stomach, colorectal, bladder, and prostate, respectively. There was an increasing and significant trend, according to the annual percentage change (APC) equal to 8.08% (CI: 5.1-11.1) for all site cancer in women. The incidence trend of all cancers was increasing in this area. Hence, planning for identifying risk factors and performing programs for dealing with the disease are essential.
Leslie, William D; Lix, Lisa M; Yogendran, Marina S; Morin, Suzanne N; Metge, Colleen J; Majumdar, Sumit R
2014-04-01
Diverging international trends in fracture rates have been observed, with most reports showing that fracture rates have stabilized or decreased in North American and many European populations. We studied two complementary population-based historical cohorts from the Province of Manitoba, Canada (1996-2006) to determine whether declining osteoporotic fracture rates in Canada are attributable to trends in obesity, osteoporosis treatment, or bone mineral density (BMD). The Population Fracture Registry included women aged 50 years and older with major osteoporotic fractures, and was used to assess impact of changes in osteoporosis treatment. The BMD Registry included all women aged 50 years and older undergoing BMD tests, and was used to assess impact of changes in obesity and BMD. Model-based estimates of temporal changes in fracture rates (Fracture Registry) were calculated. Temporal changes in obesity and BMD and their association with fracture rates (BMD Registry) were estimated. In the Fracture Registry (n=27,341), fracture rates declined 1.6% per year (95% confidence interval [CI], 1.3% to 2.0%). Although osteoporosis treatment increased from 5.6% to 17.4%, the decline in fractures was independent of osteoporosis treatment. In the BMD Registry (n=36,587), obesity increased from 12.7% to 27.4%. Femoral neck BMD increased 0.52% per year and lumbar spine BMD increased 0.32% per year after covariate adjustment (pobesity or osteoporosis treatment. © 2014 American Society for Bone and Mineral Research.
Operative Trends in the Treatment of Hip Fractures and the Role of Arthroplasty
Grau, Luis; Summers, Spencer; Rosas, Samuel; Ong, Alvin; Hernandez, Victor Hugo
2018-01-01
Introduction: There is a projected exponential increase in the number of hip fractures in the United States. Trends in patient demographics and the role of total hip arthroplasty (THA) and its associated outcomes following hip fractures surgery have not been well studied. Methods: Patients with proximal femur fractures between 1990 and 2007 were identified in the National Hospital Discharge Survey database. Demographics, comorbidities, perioperative complications, and discharge status for patients undergoing THA, hemiarthroplasty, or internal fixation were examined. Multivariable regression was performed to determine independent risk factors for perioperative complications. Results: Between 1990 and 2007, there was a statistically significant increase in patient age, adverse events, medical comorbidities, surgical complications, medical complications, and nonroutine discharge across all surgical treatment modalities. In the same time period, the utilization of THA for all fracture types decreased significantly. Discussion: Total hip arthroplasty was found to be an independent risk factor for perioperative complications. Orthopedic surgeons should be aware that the hip fracture population continues to get older, with more medical comorbidities and are at higher risk for perioperative complications. Conclusion: Total hip arthroplasty is associated with a higher rate of perioperative complications in the hip fracture population. PMID:29619275
Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid
2014-09-01
Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Epidemiological trends in electronic cigarette exposures reported to U.S. Poison Centers.
Vakkalanka, J P; Hardison, L S; Holstege, C P
2014-06-01
The Centers for Disease Control and Prevention (CDC) has reported an increase in electronic cigarette (e-cigarette) use in both adults and adolescents. Poison Center calls provide data on exposures pertaining to e-cigarette devices and components (including nicotine-refill cartridges), potentially identifying epidemiological trends in reported exposures over time. To characterize the trends in e-cigarette exposures reported to United States (U.S.) Poison Centers between 01 June 2010 and 30 September 2013. We obtained data from the American Association of Poison Control Centers (AAPCC) for all exposures involving e-cigarettes reported to the National Poison Data System (NPDS) by U.S. Poison Centers and described trends in exposures over time, demographics, geographical characteristics, clinical effects and outcomes, management site, and exposure route. A total of 1,700 exposures were reported to Poison Centers during this time. The most frequent age groups were children 5 years or below with 717 (42.2%) exposures and adults ages 20-39 years with 466 (27.4%) exposures. Temporal trends showed an increase of 1.36 exposures per month [95% CI: 1.16-1.56] from June 2010 through December 2012, after which exposures increased by 9.60 per month [95% CI: 8.64-10.55] from January through September 2013. The majority of patients who were followed reported that they had only minor effects. The majority of exposures to e-cigarette devices and components occurred in children of 5 years or below due to accidental exposure. Based on the available data, the reported exposures have resulted in minimal toxicity. Calls to Poison Centers regarding these products have rapidly increased since 2010, and continued surveillance may show changes in the epidemiological trends surrounding e-cigarette exposures.
Porta, Miquel; Vandenbroucke, Jan P; Ioannidis, John P A; Sanz, Sergio; Fernandez, Esteve; Bhopal, Raj; Morabia, Alfredo; Victora, Cesar; Lopez, Tomàs
2013-01-01
There are no analyses of citations to books on epidemiological and statistical methods in the biomedical literature. Such analyses may shed light on how concepts and methods changed while biomedical research evolved. Our aim was to analyze the number and time trends of citations received from biomedical articles by books on epidemiological and statistical methods, and related disciplines. The data source was the Web of Science. The study books were published between 1957 and 2010. The first year of publication of the citing articles was 1945. We identified 125 books that received at least 25 citations. Books first published in 1980-1989 had the highest total and median number of citations per year. Nine of the 10 most cited texts focused on statistical methods. Hosmer & Lemeshow's Applied logistic regression received the highest number of citations and highest average annual rate. It was followed by books by Fleiss, Armitage, et al., Rothman, et al., and Kalbfleisch and Prentice. Fifth in citations per year was Sackett, et al., Evidence-based medicine. The rise of multivariate methods, clinical epidemiology, or nutritional epidemiology was reflected in the citation trends. Educational textbooks, practice-oriented books, books on epidemiological substantive knowledge, and on theory and health policies were much less cited. None of the 25 top-cited books had the theoretical or sociopolitical scope of works by Cochrane, McKeown, Rose, or Morris. Books were mainly cited to reference methods. Books first published in the 1980s continue to be most influential. Older books on theory and policies were rooted in societal and general medical concerns, while the most modern books are almost purely on methods.
Directory of Open Access Journals (Sweden)
Miquel Porta
Full Text Available BACKGROUND: There are no analyses of citations to books on epidemiological and statistical methods in the biomedical literature. Such analyses may shed light on how concepts and methods changed while biomedical research evolved. Our aim was to analyze the number and time trends of citations received from biomedical articles by books on epidemiological and statistical methods, and related disciplines. METHODS AND FINDINGS: The data source was the Web of Science. The study books were published between 1957 and 2010. The first year of publication of the citing articles was 1945. We identified 125 books that received at least 25 citations. Books first published in 1980-1989 had the highest total and median number of citations per year. Nine of the 10 most cited texts focused on statistical methods. Hosmer & Lemeshow's Applied logistic regression received the highest number of citations and highest average annual rate. It was followed by books by Fleiss, Armitage, et al., Rothman, et al., and Kalbfleisch and Prentice. Fifth in citations per year was Sackett, et al., Evidence-based medicine. The rise of multivariate methods, clinical epidemiology, or nutritional epidemiology was reflected in the citation trends. Educational textbooks, practice-oriented books, books on epidemiological substantive knowledge, and on theory and health policies were much less cited. None of the 25 top-cited books had the theoretical or sociopolitical scope of works by Cochrane, McKeown, Rose, or Morris. CONCLUSIONS: Books were mainly cited to reference methods. Books first published in the 1980s continue to be most influential. Older books on theory and policies were rooted in societal and general medical concerns, while the most modern books are almost purely on methods.
Epidemiology of stress fracture injuries among US high school athletes, 2005-2006 through 2012-2013.
Changstrom, Bradley G; Brou, Lina; Khodaee, Morteza; Braund, Cortney; Comstock, R Dawn
2015-01-01
High school athletes in the United States sustain millions of injuries annually, approximately 10% of which are fractures. However, there is no clear estimate of the number of stress fractures sustained by high school athletes annually despite reports that stress fractures account for 0.7% to 20% of injuries seen in sports medicine clinics. This suggests a high utilization of resources for a potentially preventable injury. In addition, stress fractures have been associated with low energy availability and disordered eating in young athletes, highlighting the importance of early recognition and intervention. To investigate stress fracture rates and patterns in a large national sample of US high school athletes. Descriptive epidemiologic study. Data from High School RIO (Reporting Information Online), a national sports injury surveillance study, were analyzed to describe rates and patterns of stress fracture injury sustained from 2005-2006 through 2012-2013, across sports and by sex. From 2005-2006 through 2012-2013, a total of 51,773 injuries were sustained during 25,268,873 athlete-exposures, of which 389 (0.8%) were stress fractures, resulting in an overall stress fracture rate of 1.54 per 100,000 athlete-exposures. Rates per 100,000 athlete-exposures were highest in girls' cross country (10.62), girls' gymnastics (7.43), and boys' cross country (5.42). In sex-comparable sports, girls sustained more stress fractures (63.3%) than did boys (36.7%) and had higher rates of stress fracture (2.22 vs 1.27; rate ratio, 1.75; 95% CI, 1.38-2.23). The most commonly injured sites were the lower leg (40.3% of all stress fractures), foot (34.9%), and lower back/lumbar spine/pelvis (15.2%). Management was nonsurgical in 98.7% of the cases, and 65.3% of injuries resulted in ≥3 weeks of time loss, medical disqualification, or an end to the season before athletes could return to play. Although a rare injury, stress fractures cause considerable morbidity for high school athletes
Reinhold, M; Knop, C; Beisse, R; Audigé, L; Kandziora, F; Pizanis, A; Pranzl, R; Gercek, E; Schultheiss, M; Weckbach, A; Bühren, V; Blauth, M
2009-01-01
The Spine Study Group (AG WS) of the German Trauma Association (DGU) has now been in existence for more than a decade. Its main objective is the evaluation and optimization of the operative treatment for traumatic spinal injuries. The authors present the results of the second prospective internet-based multicenter study (MCS II) of the AG WS in three consecutive parts: epidemiology, surgical treatment and radiologic findings and follow-up results. The aim of the study was to update and review the state-of-the art for treatment of spinal fractures for thoracic and lumbar spine (T1-L5) injuries in German-speaking countries: which lesions will be treated with which procedure and what differences can be found in the course of treatment and the clinical and radiological outcome? This present first part of the study outlines the new study design and concept of an internet-based data collection system. The epidemiologic findings and characteristics of the three major treatment subgroups of the study collective will be presented: operative treatment (OP), non-operative treatment (KONS), and patients receiving a kyphoplasty and/or vertebroplasty without additional instrumentation (PLASTIE). A total of 865 patients (OP n=733, KONS n=52, PLASTIE n=69, other n=7) from 8 German and Austrian trauma centers were included. The main causes of accidents in the OP subgroup were motor vehicle accidents 27.1% and trivial falls 15.8% (KONS 55.8%, PLASTIE 66.7%). The Magerl/AO classification scheme was used and 548 (63.3%) compression fractures (type A), 181 (20.9%) distraction injuries (type B), and 136 (15.7%) rotational injuries (type C) were diagnosed. Of the fractures 68.8% were located at the thoracolumbar junction (T11-L2). Type B and type C injuries carried a higher risk for concomitant injuries, neurological deficits and additional vertebral fractures. The average initial VAS spine score, representing the status before the trauma, varied between treatment subgroups (OP 80, KONS
Epidemiology of hip fracture: Worldwide geographic variation
Directory of Open Access Journals (Sweden)
Dinesh K Dhanwal
2011-01-01
Full Text Available Osteoporosis is a major health problem, especially in elderly populations, and is associated with fragility fractures at the hip, spine, and wrist. Hip fracture contributes to both morbidity and mortality in the elderly. The demographics of world populations are set to change, with more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. This review conducted using the PubMed database describes the incidence of hip fracture in different regions of the world and discusses the possible causes of this wide geographic variation. The analysis of data from different studies show a wide geographic variation across the world, with higher hip fracture incidence reported from industrialized countries as compared to developing countries. The highest hip fracture rates are seen in North Europe and the US and lowest in Latin America and Africa. Asian countries such as Kuwait, Iran, China, and Hong Kong show intermediate hip fracture rates. There is also a north-south gradient seen in European studies, and more fractures are seen in the north of the US than in the south. The factors responsible of this variation are population demographics (with more elderly living in countries with higher incidence rates and the influence of ethnicity, latitude, and environmental factors. The understanding of this changing geographic variation will help policy makers to develop strategies to reduce the burden of hip fractures in developing countries such as India, which will face the brunt of this problem over the coming decades.
Mineral exploration and fracture trends in Utah and Nevada, by ERTS-1 imagery
Jensen, M. L. (Principal Investigator); Smith, M. R.
1973-01-01
The author has identified the following significant results. Major structural trends have been compiled on five separate maps, at a scale of 1:1,000,000, of Utah and Nevada from ERTS-1 imagery. An arbitrary length of ten kilometers has been chosen as a minimum length of the trends. The selection is based upon: (1) obvious displacement of structures; (2) continuity or persistence of trends across structures; (3) line-up of outcrop patterns, drainage, erosional features or vegetation; and (4) near-linear trends. Several recognizable trend directions have noted, viz., N 10-15 deg W, N 35 deg W, N 80 deg W, N 30 deg E, and E-W. More than 1500 structural trends have been identified, some of which are mineralized and extend into pediment or shallow alluvial cover. Those fracture trends that exhibit mineralization in exposed bedrock will be assayed for mercury content with a soil-gas analyzer and similar collection will be done over alluvial posture blankets by the same technique with the hope of discovering blind mineralized zones that are not exposed on the surface.
Parrett, Brian M; Matros, Evan; Pribaz, Julian J; Orgill, Dennis P
2006-04-01
Open lower leg fractures with exposed bone or tendon continue to be challenging for plastic surgeons. Microvascular free-tissue transfer increases the ability to close wounds, transfer vascularized bone, and prevent amputation, yet remains a complex, invasive procedure with significant complication rates, donor-site morbidity, and failure rates. This review documents the changing treatment protocol in the authors' institution for these injuries. Two hundred ninety consecutive open tibia-fibula fractures over a 12-year period (1992 to 2003) were retrospectively reviewed and methods and outcomes were compared by grouping the fractures into 4-year intervals. The number of open lower extremity fractures increased, whereas the distribution of Gustilo grade I to III fractures remained unchanged. Overall, free-tissue transfer was performed less frequently and constituted 20 percent of reconstructions in period 1 (1992 to 1995), 11 percent in period 2 (1996 to 1999), and 5 percent in period 3 (2000 to 2003). For the most severe fractures, Gustilo grade III, free-flap reconstruction has decreased significantly, constituting 42 percent, 26 percent, and 11 percent of procedures in periods 1, 2, and 3, respectively. Local flaps for grade III fractures have remained relatively constant throughout the study. In contrast, local wound care for grade III fractures, including skin grafts, delayed primary closures, and secondary intention closures has significantly increased from 22 percent to 49 percent of reconstructions from periods 1 through 3. In 1997, the authors began to use the vacuum-assisted closure device and now use it in nearly half of all open fractures. Despite this trend, there has been no change in infection, amputation, or malunion/nonunion rates and a decrease in reoperation rate with at least 1-year follow-up. These results demonstrate a change in practice, with a trend down the reconstructive ladder, currently using fewer free flaps and more delayed closures and
The incidence of associated fractures of the upper limb in fractures of the radial head
Kaas, Laurens; van Riet, Roger P.; Vroemen, Jos P. A. M.; Eygendaal, Denise
2008-01-01
Radial head fractures are common injuries. In American publications, one-third of the patients with these fractures have been shown to have associated injuries. The aim of this retrospective study is to describe the epidemiology of radial head fractures and associated fractures of the ipsilateral
[Hip Fracture--Epidemiology, Management and Liaison Service. Risk factor for hip fracture].
Fujiwara, Saeko
2015-04-01
Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.
[Latest trends in the surgical management of mandibular condyle fractures in France, 2005-2012].
Trost, O; Péron, J-M
2013-12-01
The surgical treatment of mandibular condylar fractures is commonly performed. We had for aim to present the latest trends in the surgical management of condylar fractures in France, between 2005 and 2012. A survey was performed among the 49 members of the French college of oral and maxillofacial surgeons between January and September 2012, with a questionnaire sent by email. We analyzed the therapeutic management, the surgical indications; the techniques used according to the fracture, and the postoperative treatment protocols. The data was compared to that of a similar study performed in 2005. The overall reply rate was 86%. Low subcondylar fractures were operated on in all institutions (100%), compared to 76% in 2005. The most popular technique was the high submandibular approach with intraoral miniplate fixation osteosynthesis. High subcondylar and diacapitular fractures were operated on in respectively 82% and 35% of the cases compared to 29% and 10% in 2005 with various surgical techniques and postoperative management. French maxillofacial surgeons operated on more mandibular condylar fractures in 2012 than in 2005. As observed in 2005, the lower and the more dislocated the fractures were, the more they were operated on. The high submandibular approach has become the most popular approach. The use of miniplates for bone fixation has become common. Diacapitular fractures were usually treated functionally. The postoperative management varied greatly from one team to the other. Copyright © 2013. Published by Elsevier Masson SAS.
Ackermann, Jakob; Fraser, Ethan J; Murawski, Christopher D; Desai, Payal; Vig, Khushdeep; Kennedy, John G
2016-04-01
The purpose of this study was to report trends associated with concurrent ankle arthroscopy at the time of operative treatment of ankle fracture. The current procedural terminology (CPT) billing codes were used to search the PearlDiver Patient Record Database and identify all patients who were treated for acute ankle fracture in the United States. The Medicare Standard Analytic Files were searchable between 2005 and 2011 and the United Healthcare Orthopedic Dataset from 2007 to 2011. Annual trends were expressed only between 2007 and 2011, as it was the common time period among both databases. Demographic factors were identified for all procedures as well as the cost aspect using the Medicare data set. In total, 32 307 patients underwent open reduction internal fixation (ORIF) of an ankle fracture, of whom 313 (1.0%) had an ankle arthroscopy performed simultaneously. Of those 313 cases, 70 (22.4%) patients received microfracture treatment. Between 2005 and 2011, 85 203 patients were treated for an ankle fracture whether via ORIF or closed treatment. Of these, a total of 566 patients underwent arthroscopic treatment within 7 years. The prevalence of arthroscopy after ankle fracture decreased significantly by 45% from 2007 to 2011 (Pankle fracture treatment, it appears that only a small proportion of surgeons in the United States perform these procedures concurrently. Therapeutic, Level IV: Retrospective. © 2015 The Author(s).
(Mal)nutrition and the new epidemiological trend in a context of development and inequalities.
Souza, Nathália Paula de; Lira, Pedro Israel Cabral de; Fontbonne, Annick; Pinto, Fernanda Cristina de Lima; Cesse, Eduarda Ângela Pessoa
2017-07-01
The current context of intense social, economic and political transformations has contributed to changes in the health profile of the population and generated discussions about the impact of these changes on the reorganization of society. At the present moment, the increase in non-communicable illnesses and diseases raises major concerns about the paradox of malnutrition and obesity. Based on an in-depth reading and interpretation of texts, documents and databases, this article discusses issues related to nutrition, considering the dimensions of shortages and excesses, the evolution of nutrition over time, and the connection with the new epidemiological trend. We begin with a conceptual characterization, the historical background and the anthropological connections with the guiding theme of the article. We then describe the prevalence, distribution and secular trend of malnutrition and obesity, as well as the temporal relationship with the new epidemiological trend in Brazil within a context of development and inequalities. Finally, we reflect on the issue of (mal)nutrition in post-modernity, the new interests at stake in the health-disease process, as well as international experiences and strategies of partnerships designed to overcome these problems. We conclude by discussing some current advances and challenges in relation to the complexity and speed of contemporary changes.
Zamboni, Rodrigo Andrighetti; Wagner, João Carlos Birnfeld; Volkweis, Maurício Roth; Gerhardt, Eduardo Luis; Buchmann, Elissa Muller; Bavaresco, Caren Serra
2017-01-01
ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 yea...
The emerging trend of non-operative treatment in paediatric type I open forearm fractures.
Zhang, H; Fanelli, M; Adams, C; Graham, J; Seeley, M
2017-08-01
Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention. A fixed-effect meta-analysis, weighting each study based on the number of patients, and a pooled estimate of infection risk (with 95% confidence interval (CI)) was performed. The search results yielded five studies that were eligible for inclusion. No included patients had operative debridement and all were treated with antibiotics. The number of patients in each study ranged from 3 to 45, with a total of 127 paediatric patients in the meta-analysis. The infection rate was 0% for all patients included. The meta-analysis estimated a pooled infection risk of 0% (95% CI 0 to 2.9). The five included studies had a total of 127 patients with no cases of infection after non-operative management of Type I open paediatric forearm fractures. The infection rate of Type I fractures among operatively managed patients is 1.9%. The trend in literature towards non-operative treatment of paediatric Type I open fractures holds true in this meta-analysis.
Epidemiology of distal forearm fractures in Oslo, Norway.
Lofthus, C M; Frihagen, F; Meyer, H E; Nordsletten, L; Melhuus, K; Falch, J A
2008-06-01
The population of Oslo has the highest incidence of hip fracture reported. The present study shows that the overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. The population of Oslo has the highest incidence of hip fracture reported. The present study reports the incidence of distal forearm fracture in Oslo and the fracture rates of immigrants. Patients aged > or = 20 years resident in Oslo sustaining a distal forearm fracture in a one-year period in 1998/99 were identified using electronic diagnosis registers, patient protocols, and/or X-ray registers of the clinics in Oslo. Medical records were obtained and the diagnosis verified. The age- and sex-specific incidence rates were calculated and compared with those for 1979. Data on immigrant category and country of origin of the patients were obtained. The age-adjusted fracture rates per 10,000 for the age group > or = 50 years were 109.8 and 25.4 in 1998/99 compared with 108.3 and 23.5 in 1979 for women and men, respectively (n.s.). The relative risk of fracture in Asians was 0.72 (95% CI 0.53-1.00) compared with ethnic Norwegians. The overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. Furthermore, the present data suggest that Asian immigrants in Oslo have a slightly lower fracture risk than ethnic Norwegians.
Finestone, Aharon; Milgrom, Charles; Wolf, Omer; Petrov, Kaloyan; Evans, Rachel; Moran, Daniel
2011-01-01
The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 (p=0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports (p=0.02) and greater tibial length (p=0.05) were protective factors for stress fracture. The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures
Weber, Christian David; Hildebrand, Frank; Kobbe, Philipp; Lefering, Rolf; Sellei, Richard M; Pape, Hans-Christoph
2018-02-02
Open tibia fractures usually occur in high-energy mechanisms and are commonly associated with multiple traumas. The purposes of this study were to define the epidemiology of open tibia fractures in severely injured patients and to evaluate risk factors for major complications. A cohort from a nationwide population-based prospective database was analyzed (TraumaRegister DGU ® ). Inclusion criteria were: (1) open or closed tibia fracture, (2) Injury Severity Score (ISS) ≥ 16 points, (3) age ≥ 16 years, and (4) survival until primary admission. According to the soft tissue status, patients were divided either in the closed (CTF) or into the open fracture (OTF) group. The OTF group was subdivided according to the Gustilo/Anderson classification. Demographic data, injury mechanisms, injury severity, surgical fracture management, hospital and ICU length of stay and systemic complications (e.g., multiple organ failure (MOF), sepsis, mortality) were collected and analyzed by SPSS (Version 23, IBM Inc., NY, USA). Out of 148.498 registered patients between 1/2002 and 12/2013; a total of 4.940 met the inclusion criteria (mean age 46.2 ± 19.4 years, ISS 30.4 ± 12.6 points). The CTF group included 2000 patients (40.5%), whereas 2940 patients (59.5%) sustained open tibia fractures (I°: 49.3%, II°: 27.5%, III°: 23.2%). High-energy trauma was the leading mechanism in case of open fractures. Despite comparable ISS and NISS values in patients with closed and open tibia fractures, open fractures were significantly associated with higher volume resuscitation (p Open tibia fractures are common in multiple trauma patients and are therefore associated with increased resuscitation requirements, more surgical procedures and increased in-hospital length of stay. However, increased systemic complications are not observed if a soft tissue adapted surgical protocol is applied.
Epidemiology of forearm fractures in adults in Denmark
DEFF Research Database (Denmark)
Abrahamsen, Bo; Jørgensen, N R; Schwarz, P
2015-01-01
with less detailed information. Rates were higher than previously estimated. INTRODUCTION: Despite a significant contribution to the overall burden of osteoporotic, nonvertebral fractures, relatively little information is available about age- and gender-specific incidence rates for many countries including...... Denmark. METHODS: We used national individual patient data on inpatient and outpatient treatment to calculate rates of forearm fractures, taking readmissions into account, with subtables for distal and proximal fractures. We also calculated ratios of forearm to hip fractures that may be useful when...
Trend and Demographic Characteristics of Maxillofacial Fractures in Level I Trauma Center.
Emodi, Omri; Wolff, Amir; Srouji, Hanna; Bahouth, Hany; Noy, Dani; Abu El Naaj, Imad; Rachmiel, Adi
2018-03-01
The aim of this study was to analyze the pattern and treatment of craniomaxillofacial injuries in the northern part of Israel, within a Jewish majority and large Arab minority population. A 5-year retrospective study evaluated patients treated for craniomaxillofacial fractures. Fracture cause, type, site, and patient demographics were evaluated. Patient age ranged from 1 to 94 years with an average age of 36.7 years; 52% of the victims were Jews and 48% Arabs. There was male predilection in both sectors (78.3% vs 21.7%). The main site of injury was the zygomatic bone (33.5%) followed by nasal bone, orbital, mandible, frontal sinus, and maxillary fractures. The main etiology of injuries was falls (45.4%) with significantly more falls reported by females (52.1% vs 43.2% in males). Motor vehicle accidents caused injuries more frequent in males. Arabs experienced CMF fractures at a younger age compared to Jews (27.8 and 44.8 average age, respectively). In the elderly, the trend reversed where Jews were more prone to craniomaxillofacial fractures. Compared to their weight in the population, the Arab sector experiences more craniomaxillofacial injuries. The Jewish elderly population tends to reside in nursing homes where they are more susceptible to accidental falls, whereas young Arab males are more exposed to motor vehicle accidents and interpersonal violence. Falls were the main cause of injuries particularly in women. This may reflect the women's fear of reporting domestic violence. We believe that increased government investments in infrastructures and education will lower the incidence of craniomaxillofacial trauma and balance the gap between both sectors and sexes.
Barrett-Connor, Elizabeth; Nielson, Carrie M; Orwoll, Eric; Bauer, Douglas C; Cauley, Jane A
2010-03-15
To study the causes and consequences of radiologically confirmed rib fractures (seldom considered in the context of osteoporosis) in community dwelling older men. Prospective cohort study (Osteoporotic Fractures in Men (MrOS) Study). 5995 men aged 65 or over recruited in 2000-2 from six US sites; 99% answered mailed questionnaires about falls and fractures every four months for a mean 6.2 (SD 1.3) year follow-up. New fractures validated by radiology reports; multivariate Cox proportional hazard ratios were used to evaluate factors independently associated with time to incident rib fracture; associations between baseline rib fracture and incident hip and wrist fracture were also evaluated. The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. Nearly half of new rib fractures (48%; n=61) followed falling from standing height or lower. Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. Men with a history of rib/chest fracture had at least a twofold increased risk of an incident rib fracture (adjusted hazard ratio 2.71, 95% confidence interval 1.86 to 3.95), hip fracture (2.05, 1.33 to 3.15), and wrist fracture (2.06, 1.14 to 3.70). Only 14/82 of men reported being treated with bone specific drugs after their incident rib fracture. Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.
Sheikh, Azfar; Patel, Nileshkumar J; Nalluri, Nikhil; Agnihotri, Kanishk; Spagnola, Jonathan; Patel, Aashay; Asti, Deepak; Kanotra, Ritesh; Khan, Hafiz; Savani, Chirag; Arora, Shilpkumar; Patel, Nilay; Thakkar, Badal; Patel, Neil; Pau, Dhaval; Badheka, Apurva O; Deshmukh, Abhishek; Kowalski, Marcin; Viles-Gonzalez, Juan; Paydak, Hakan
2015-01-01
Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide and the most common arrhythmia leading to hospitalization. Due to a substantial increase in incidence and prevalence of AF over the past few decades, it attributes to an extensive economic and public health burden. The increasing number of hospitalizations, aging population, anticoagulation management, and increasing trend for disposition to a skilled facility are drivers of the increasing cost associated with AF. There has been significant progress in AF management with the release of new oral anticoagulants, use of left atrial catheter ablation, and novel techniques for left atrial appendage closure. In this article, we aim to review the trends in epidemiology, hospitalization, and cost of AF along with its future implications on public health. Published by Elsevier Inc.
Sonderegger, J; Simmen, H-P
2003-02-01
The epidemiology, therapy and results of proximal humeral fractures in a touristic area were investigated and our concept for treatment presented. Between 1.1.1999 and 30.04.2000 adult patients with proximal humeral fractures were included, the fractures classified (Codman/Neer and AO) and results determined after an average of 9 months. 62 adults were treated. 59 (95 %) had an accident during leisure time, mainly skiing accidents (52 %). 7 patients (11 %) had an associated luxation of the shoulder. 51 (82 %) were treated conservatively, 11 (18 %) operatively with a T-plate. The conservatively treated had to wear a Gilchrist-cast for an average of 29 (operatively 13) days, started passive movement after 20 (operatively 9) days, and active movement after 44 (operatively 45) days. The 32 employed (52 %) were not able to work for 46 days on average. Overall, 52 patients (84 %) were totally or mostly satisfied with the result. 5 among the 13 patients (38.5 %) with 3- or 4-part-fractures, and 4 among the 11 operated patients (36.4 %) were not satisfied with the result. Proximal humeral fractures are common skiing injuries, they need a long and intensive treatment and are economically expensive. The Codman/Neer and AO-classifications are equal. The results for simple, mainly conservatively treated fractures (Codman/Neer 1, 2A, 2-part) are good. Complex, mainly operatively treated fractures (Codman/Neer 3- and 4-part) have a much poorer prognosis. Diagnostically the computed tomography with 3-D-reconstruction is recommended for a better representation of the fracture and a safer choice of the therapeutical strategy.
Orbital fractures due to domestic violence: an epidemiologic study.
Goldberg, Stuart H.; McRill, Connie M.; Bruno, Christopher R.; Ten Have, Tom; Lehman, Erik
2000-09-01
Domestic violence is an important cause of orbital fractures in women. Physicians who treat patients with orbital fractures may not suspect this mechanism of injury. The purpose of this study was to assess the association between domestic violence and orbital fractures. A medical center-based case-control study with matching on age and site of admission was done. Medical center databases were searched using ICD-9 codes to identify all cases of orbital fractures encountered during a three-year period. Medical records of female patients age 13 and older were reviewed along with those of age, gender and site of admission matched controls. A stratified exact test was employed to test the association between domestic violence and orbital fracture. Among 41 adult female cases with orbital fractures treated at our medical center, three (7.3%) reported domestic violence compared to zero among the matched controls (p = 0.037). We believe that domestic violence may be under-reported in both orbital fracture cases and controls. This may result in an underestimate of the orbital fracture versus domestic violence association. Domestic violence is a serious women's health and societal problem. Domestic violence may have a variety of presentations, including illnesses and injuries. Orbital fracture is an identifiable manifestation of domestic violence. Domestic violence is more likely to be detected in adult female hospital patients with orbital fracture than in matched controls with any other diagnosis. Physicians who treat patients with orbital fractures should be familiar with this mechanism of injury.
Fracture of nasal bones: an epidemiologic analysis
Directory of Open Access Journals (Sweden)
Fornazieri, Marco Aurélio
2008-12-01
Full Text Available Introduction: One of the most common diseases in the otorhinolaryngology emergency room is the nasal bones fracture. The peak of incidence is between 15 and 25 years of age. Generally men are more affected. Objective: To analyze the age, gender and the most frequent causes of nasal fractures evaluated in the otorhinolaryngology service of a tertiary hospital. Method: Retrospective study of records of the patients with nasal fracture diagnosis treated between July 1st, 2003 and July 1st, 2007. Results: 167 patients with nasal bones fracture were included in the study, including 134 men and 33 women. Violence was the most frequent cause, with 55 cases (32.9%, followed by fall from their own height, with 33 cases (19.7%, and motorcycle accident, 14 cases (8.4%. The most common age was between 21 and 39 years (46.1%. Conclusion: Male, age between 21 and 39 years and violence are the most common characteristics found in our service. Motorcycle accidents also play an important role in this affection.
Directory of Open Access Journals (Sweden)
Ana Claudia Ramalho
Full Text Available CONTEXT: It is believed that about 25% of menopausal women in the USA will exhibit some kind of fracture as a consequence of osteoporosis. Fractures of the proximal femur are associated with a greater number of deaths and disabilities and higher medical expenses than all the other osteoporotic fractures together. OBJECTIVE: To study the clinical and epidemiological features of patients with proximal femur fracture in hospitals in São Paulo. DESIGN: Transversal and retrospective study. LOCAL: Hospital São Paulo and Hospital Servidor Público Estadual "Francisco Morato Oliveira". PARTICIPANTS: Patients aged sixty-five years or more hospitalized because of proximal femur fracture, from March to November 1996 (N = 73. This group was compared to patients of the same age without fracture of the proximal femur. INTERVENTION: Evaluation of weight, height, body mass index; lifestyle habits (physical activity at home, ingestion of dairy calcium, drinking of coffee, smoking habit, gynecological history (ages at menarche and menopause, number of pregnancies and lactations, previous morbidity, use of medications, history of previous fractures, family history of osteoporosis. MEASUREMENT: The comparison of the different data regarding lifestyle habits between the two groups was made using the chi-squared test. Other data were analyzed using the Mann -- Whitney test. P £ 0.05 was considered significant. RESULTS: We noted a predominance of proximal femur fracture among females in relation to males (a female/male ratio of 3.3:1 with a progressive increase in the frequency of proximal femur fracture with age in both sexes. The group with proximal femur fracture, in comparison with the control group, showed a lower body mass index, less physical activity, and a greater number of pregnancies and lactations. Other data were not different. CONCLUSION: In accordance with the literature, we found a predomination of proximal femur fracture in women in relation to men
[Epidemiology of osteoporosis].
Grazio, Simeon
2006-01-01
Osteoporosis represents a major and increasing public health problem with the aging of population. Major clinical consequences and economic burden of the disease are fractures. Many risk factors are associated with the fractures including low bone mass, hormonal disorders, personal and family history of fractures, low body weight, use of certain drugs (e.g. glucocorticoids), cigarette smoking, elevated intake of alchohol, low physical activity, insufficient level of vitamin D and low intake of calcium. This epidemiological review describes frequency, importance of risk factors and impact of osteoporosis and osteoporotic fractures. Objective measures of bone mineral density along with clinical assessment of risk factors can help identify patients who will benefit from prevention and intervention efforts and eventually reduce the morbidity and mortality associated with osteoporosis-related fractures.
Osteoporotic Hip and Spine Fractures
Cannada, Lisa K.; Hill, Brian W.
2014-01-01
Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment...
Zamboni, Rodrigo Andrighetti; Wagner, João Carlos Birnfeld; Volkweis, Maurício Roth; Gerhardt, Eduardo Luis; Buchmann, Elissa Muller; Bavaresco, Caren Serra
2017-01-01
to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%), followed by motor vehicle accidents (14.2%), motorcycle accidents (13.4%), falls (9%), road accidents (6.7%), sports accidents (5.2%), work accidents (5.2%), firearm injuries (4.5%) and cycling accidents (3%). The most frequent fractures were those of the zygomatic complex (44.5%), followed by fractures of the mandible (42.5%), maxillary bone (5.2%), nasal bones (4.5%) and zygomatic arch (3.3%). the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.
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Rodrigo Andrighetti Zamboni
Full Text Available ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6% and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%, followed by motor vehicle accidents (14.2%, motorcycle accidents (13.4%, falls (9%, road accidents (6.7%, sports accidents (5.2%, work accidents (5.2%, firearm injuries (4.5% and cycling accidents (3%. The most frequent fractures were those of the zygomatic complex (44.5%, followed by fractures of the mandible (42.5%, maxillary bone (5.2%, nasal bones (4.5% and zygomatic arch (3.3%. Conclusion: the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.
Pedrazzoni, M; Abbate, B; Verzicco, I; Pedrazzini, A; Benatti, M; Cervellin, G
2015-01-01
This survey describes the epidemiology of approximately 1800 low-energy humeral fractures seen in a large emergency department in Northern Italy over 7 years (2007-2013), highlighting the differences from previous Italian studies. The purpose of this study was to determine the incidence of humeral fractures due to low-energy trauma in patients 40 years of age or older referred to a large Emergency Department (Parma, Northern Italy) in a 7-year period (2007-2013). All humeral fractures referred to the emergency department of the Academic Hospital of Parma (the main hospital in the province with a catchment area of approximately 345,000) were retrieved from the hospital database using both ICD-9CM codes and text strings. The diagnosis of humeral fracture due to low-energy trauma was confirmed by medical records and X-ray reports, after exclusion of injuries due to a clear-cut high-energy trauma or cancer. The query identified 1843 humeral fractures (1809 first fractures), with a clear predominance in women (78 %). Fractures of the proximal humerus represented the large majority of humeral fractures (more than 85 %), with an incidence progressively increasing with age (more than 60-fold in women and 20-fold in men). Simultaneous fractures (hip in particular) were frequent especially after 85 years of age (1 out of 8 cases). When compared to other Italian studies, the incidence of humeral fractures was significantly lower than that derived from discharge data corrected for hospitalization rate (standardized rate ratio 0.74; p energy humeral fractures in Italy. Our results partly differ from previous Italian studies based on indirect estimations.
Rizzone, Katherine H; Ackerman, Kathryn E; Roos, Karen G; Dompier, Thomas P; Kerr, Zachary Y
2017-10-01
Stress fractures are injuries caused by cumulative, repetitive stress that leads to abnormal bone remodeling. Specific populations, including female athletes and endurance athletes, are at higher risk than the general athletic population. Whereas more than 460 000 individuals participate in collegiate athletics in the United States, no large study has been conducted to determine the incidence of stress fractures in collegiate athletes. To assess the incidence of stress fractures in National Collegiate Athletic Association (NCAA) athletes and investigate rates and patterns overall and by sport. Descriptive epidemiology study. National Collegiate Athletic Association institutions. National Collegiate Athletic Association athletes. Data were analyzed from the NCAA Injury Surveillance Program for the academic years 2004-2005 through 2013-2014. We calculated rates and rate ratios (RRs) with 95% confidence intervals (CIs). A total of 671 stress fractures were reported over 11 778 145 athlete-exposures (AEs) for an overall injury rate of 5.70 per 100 000 AEs. The sports with the highest rates of stress fractures were women's cross-country ( 28.59/100 000 AEs), women's gymnastics ( 25.58/100 000 AEs), and women's outdoor track ( 22.26/100 000 AEs). Among sex-comparable sports (baseball/softball, basketball, cross-country, ice hockey, lacrosse, soccer, swimming and diving, tennis, indoor track, and outdoor track), stress fracture rates were higher in women (9.13/100 000 AEs) than in men (4.44/100 000 AEs; RR = 2.06; 95% CI = 1.71, 2.47). Overall, stress fracture rates for these NCAA athletes were higher in the preseason (7.30/100 000 AEs) than in the regular season (5.12/100 000 AEs; RR = 1.43; 95% CI = 1.22, 1.67). The metatarsals (n = 254, 37.9%), tibia (n = 147, 21.9%), and lower back/lumbar spine/pelvis (n = 81, 12.1%) were the most common locations of injury. Overall, 21.5% (n = 144) of stress fractures were
[Epidemiological trends 1992-2007 in a neonatal intensive care unit].
Feria-Kaiser, Carina; Vargas, Mario H; Furuya, María E Y
2013-01-01
progressive advances in neonatal care are expected to change the epidemiological profile of patients and conditions seen in neonatal intensive care units (NICU). Thus, the objective of this study was to identify such changes in a NICU in Mexico City. retrospectively, we analyzed age, gender, weight at admission, hospital stay,diagnoses at discharge and cause of death in 5,192 patients admitted from 1992-2007. in the study period,patients were admitted at a progressively older age (median of 3 days old in 1992 to 9 in 2007; rS = 0.87) and lower weight (2,800-2,343 g; rS = –0.56), while length of hospital stay was stable (approximately, 9 days). Over 90% patients had cardiological, digestive and/or pulmonary diseases, and most patients (71.4%) had conditions for which a surgical approach is the usual treatment. Cardiological and neurologic problems increased (rS = 0.86 and 0.85, respectively),while pulmonary diseases decreased (rS = –0.79). Mortality and autopsy rate diminished from 26 to 15% (rS = –0.80),and from 32.5 to 10.7% (rS = –0.53), respectively. Conditions more frequently associated with death were urologic/nephrologic and infectious diseases. epidemiological patterns in our NICU are clearly changing, and thus searching for similar time trends in other NICU is warranted.
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
Wright, N C; Hooker, E R; Nielson, C M; Ensrud, K E; Harrison, S L; Orwoll, E S; Barrett-Connor, E
2018-04-01
There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance. To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study. Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks. We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65-69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake. Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney
Falls: epidemiology, pathophysiology, and relationship to fracture.
Berry, Sarah D; Miller, Ram R
2008-12-01
Falls are common in the elderly, and frequently result in injury and disability. Most falls result from an interaction between individual characteristics that increase an individual's propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, comorbidities such as osteoarthritis, visual impairment and dementia, psychotropic medications, and certain types of footwear. Fewer studies have focused on acute precipitating factors, but environmental and situational factors are clearly important to fall risk. Approximately 30% of falls result in an injury that requires medical attention, with fractures occurring in approximately 10%. In addition to the risk factors for falls, the fall descent, fall impact, and bone strength are all important determinants of whether a fall will result in a fracture. In recent years, numerous studies have been directed toward the development of effective fall and fall-related fracture prevention interventions.
Maeda, Yousuke; Hanada, Michiko; Oikawa, Masa-Aki
2016-01-01
This report describes the descriptive epidemiology of racing fractures that occurred from the 1980s to 2000s on racetracks of the Japan Racing Association (JRA). The incidence of racehorse fractures during flat racing was approximately 1-2%. Fractures occurring during a race are more likely to occur in a forelimb. Fractures mostly occur at the third and fourth corners of oval tracks and on the home stretch. They also occur more frequently at the time of changing the leading limb. Comparison of the incidence of racing fracture between before and after reconstruction of the geometrical configuration of a racetrack revealed that there was an outstanding reduction in the number of serious fractures in the year before and after reconstruction. It was postulated that the improvement in racing time, possibly influenced by reconstructing the geometrical configuration of the racetrack, was connected to the reduction in the number of fractures. Of non-biological race- and course-related factors, type of course (dirt or turf), track surface condition, differences between racecourses, and racing distance significantly influence racing time. By using an instrumented shoe, vertical ground reaction forces (VGRFs) on the forelimb during galloping and the relationships between a rough dirt and woodchip track surface and a smooth dirt and woodchip surface were measured. Relating the incidence of racing fractures with track conditions in general showed that track surface has significant effects on the incidence of fracture, with the incidence of fractures increasing as track conditions on dirt worsen and a tendency for the incidence of fractures to decrease as track conditions on turf worsen. It seems probable that track condition in general may affect the incidence of fracture. The incidence of fracture in horses during both racing and training decreased as the years progressed.
MAEDA, Yousuke; HANADA, Michiko; OIKAWA, Masa-aki
2016-01-01
ABSTRACT This report describes the descriptive epidemiology of racing fractures that occurred from the 1980s to 2000s on racetracks of the Japan Racing Association (JRA). The incidence of racehorse fractures during flat racing was approximately 1–2%. Fractures occurring during a race are more likely to occur in a forelimb. Fractures mostly occur at the third and fourth corners of oval tracks and on the home stretch. They also occur more frequently at the time of changing the leading limb. Comparison of the incidence of racing fracture between before and after reconstruction of the geometrical configuration of a racetrack revealed that there was an outstanding reduction in the number of serious fractures in the year before and after reconstruction. It was postulated that the improvement in racing time, possibly influenced by reconstructing the geometrical configuration of the racetrack, was connected to the reduction in the number of fractures. Of non-biological race- and course-related factors, type of course (dirt or turf), track surface condition, differences between racecourses, and racing distance significantly influence racing time. By using an instrumented shoe, vertical ground reaction forces (VGRFs) on the forelimb during galloping and the relationships between a rough dirt and woodchip track surface and a smooth dirt and woodchip surface were measured. Relating the incidence of racing fractures with track conditions in general showed that track surface has significant effects on the incidence of fracture, with the incidence of fractures increasing as track conditions on dirt worsen and a tendency for the incidence of fractures to decrease as track conditions on turf worsen. It seems probable that track condition in general may affect the incidence of fracture. The incidence of fracture in horses during both racing and training decreased as the years progressed. PMID:27703403
Trends in the United States in the treatment of distal radial fractures in the elderly.
Chung, Kevin C; Shauver, Melissa J; Birkmeyer, John D
2009-08-01
Traditionally, distal radial fractures in the elderly have been treated nonoperatively with casting. However, since the introduction of the volar locking plating system in 2000, there has been an interest in the use of more aggressive treatment methods. The purpose of the present study was to assess changing trends in the treatment of distal radial fractures in elderly patients in the United States. We evaluated a 5% sample of Medicare data from 1996 to 1997 and a 20% sample from 1998 to 2005. Information on four treatment methods (closed treatment, percutaneous pin fixation, internal fixation, and external fixation) was extracted from the dataset. Other available data were diagnosis, physician specialty, and patient age, sex, and race. We calculated frequencies and rates to compare the utilization of different treatments over time. Over the ten-year time period examined, the rate of internal fixation of distal radial fractures in the elderly increased fivefold, from 3% in 1996 to 16% in 2005. Closed treatment, however, remained the predominant method (used for 82% of the fractures in 1996 and 70% in 2005). Fractures in patients with an age of eighty-five years or more were significantly more likely to be treated in a closed fashion (p < 0.0001). There was a large variation among physician specialties with regard to the fixation methods that were used. Orthopaedic surgeons were significantly more likely to use closed treatment than hand surgeons were, whereas hand surgeons were significantly more likely to use internal fixation than orthopaedic surgeons were. Since 2000, although the majority of distal radial fractures are still treated nonoperatively, there has been an increase in the use of internal fixation and a concurrent decrease in the rate of closed treatment of distal radial fractures in the elderly in the United States.
The epidemiology of hip fractures across western Victoria, Australia.
Holloway, Kara L; Sajjad, Muhammad A; Mohebbi, Mohammadreza; Kotowicz, Mark A; Livingston, Patricia M; Khasraw, Mustafa; Hakkennes, Sharon; Dunning, Trisha L; Brumby, Susan; Page, Richard S; Pedler, Daryl; Sutherland, Alasdair; Venkatesh, Svetha; Brennan-Olsen, Sharon L; Williams, Lana J; Pasco, Julie A
2018-03-01
Hip fractures are associated with considerable morbidity and mortality. Hip fracture incidence varies across different levels of accessibility/remoteness and socioeconomic status (SES). As part of the Ageing, Chronic Disease and Injury Study, we aimed to map the pattern of hip fractures across the western region of the Australian state of Victoria, which contains a range of remoteness levels and SES. Data on hip fractures resulting in hospital admission were extracted from the Victorian Admitted Episodes Dataset (VAED) for men and women aged 40+years during 2010-2013 inclusive. An age-adjusted incidence rate (per 10,000population/year) was calculated for the entire region. Crude incidence rates and length of acute care hospital stay (excluding rehabilitation) were calculated for each Local Government Area (LGA). The impact of aggregated age, accessibility/remoteness index of Australia (ARIA) and SES on hip fracture rates aggregated across LGAs was determined using Poisson regression. For men, the age-standardised rate of hospitalisations for hip fracture across the whole region was 19.2 per 10,000population/year (95%CI 18.0-20.4) and for women, 40.0 (95%CI 38.3-41.7). The highest incidence rates for both sexes occurred in the less accessible LGAs of Yarriambiack and Hindmarsh, as well as the LGA with the lowest SES, Central Goldfields. In both sexes, approximately two thirds of individuals were discharged from acute hospital care within 14days. Increasing age, higher remoteness and lower SES were all associated with higher hip fracture rates. Crude incidence rates varied by location. Given that a high proportion of patients had acute hospital care of ≤14days, and accessibility and SES were associated with hip fracture rates, these results can inform policy and provide a model for other groups to conduct similar research in their local environment. Copyright © 2017 Elsevier Inc. All rights reserved.
Kukreja, Sunil; Kalakoti, Piyush; Murray, Richard; Nixon, Menarvia; Missios, Symeon; Guthikonda, Bharat; Nanda, Anil
2015-04-01
Incidence of C-2 fracture is increasing in elderly patients. Patient age also influences decision making in the management of these fractures. There are very limited data on the national trends of incidence, treatment interventions, and resource utilization in patients in different age groups with isolated C-2 fractures. The aim of this study is to investigate the incidence, treatment, complications, length of stay, and hospital charges of isolated C-2 fracture in patients in 3 different age groups by using the Nationwide Inpatient Sample (NIS) database. The data were obtained from NIS from 2002 to 2011. Data on patients with closed fractures of C-2 without spinal cord injury were extracted using ICD-9-CM diagnosis code 805.02. Patients with isolated C-2 fractures were identified by excluding patients with other associated injuries. The cohort was divided into 3 age groups: 80 years. Incidence, treatment characteristics, inpatient/postoperative complications, and hospital charges (mean and total annual charges) were compared between the 3 age groups. A total of 10,336 patients with isolated C-2 fractures were identified. The majority of the patients were in the very elderly age group (> 80 years; 42.3%) followed by 29.7% in the 65- to 80-year age group and 28% in age group. From 2002 to 2011, the incidence of hospitalization significantly increased in the 65- to 80-year and > 80-year age groups (p age group (p = 0.287). Overall, 21% of the patients were treated surgically, and 12.2% of the patients underwent nonoperative interventions (halo and spinal traction). The rate of nonoperative interventions significantly decreased over time in all age groups (p age groups had a greater risk of inpatient/postoperative complications, nonroutine discharges, and longer hospitalization. The mean hospital charges were significantly higher in older age groups (p age groups. Simultaneously, there has been a steadily decreasing trend in the preference for nonoperative
Epidemiology and risk factors of humerus fractures among skiers and snowboarders.
Bissell, Benjamin T; Johnson, Robert J; Shafritz, Adam B; Chase, Derek C; Ettlinger, Carl F
2008-10-01
The incidence of humerus fractures while participating in snowboarding and skiing is undefined. Very little is known about the risk factors associated with these fractures. Snowboarders are at increased risk for sustaining humerus fractures when compared with skiers. In addition, the types of fractures, laterality, and risk factors differ between the 2 groups. Case-control study; Level of evidence, 3. At a major ski area clinic, 318 humerus fractures were evaluated over 34 seasons. Radiographs were classified according to the AO and Neer systems. Patient data were analyzed and compared with that of a control population of uninjured skiers and snowboarders to determine incidence and risk factors. The incidence of humerus fractures among snowboarders (0.062 per 1000 snowboarder days) was significantly higher than that of skiers (0.041 per 1000, P Jumping was involved in 28.3% of humerus fractures among snowboarders and in 5.4% among skiers. Skiers with humerus fractures were more skilled, older, and fell less frequently than controls. Snowboarders were less skilled, younger, and fell at a similar rate compared with controls. Snowboarders are at significantly higher risk of sustaining humerus fractures than skiers. In skiers, humerus fractures show no laterality and most often involve the proximal humerus. In contrast, snowboarders more often fracture the left humerus at the diaphysis.
Prevalence of osteoporosis and incidence of hip fracture in women - secular trends over 30 years
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Sernbo Ingemar
2010-03-01
Full Text Available Abstract Background The number of hip fractures during recent decades has been reported to be increasing, partly because of an increasing proportion of elderly women in the society. However, whether changes in hip fracture annual incidence in women are attributable to secular changes in the prevalence of osteoporosis is unclear. Methods Bone mineral density was evaluated by single-photon absorptiometry at the distal radius in 456 women aged 50 years or above and living in the same city. The measurements were obtained by the same densitometer during three separate time periods: 1970-74 (n = 106, 1987-93 (n = 175 and 1998-1999 (n = 178, and the age-adjusted prevalence of osteoporosis in these three cohorts was calculated. Additionally, all hip fractures sustained in the target population of women aged 50 years or above between 1967 and 2001 were registered, whereupon the crude and the age-adjusted annual incidence of hip fractures were calculated. Results There was no significant difference in the age-adjusted prevalence of osteoporosis when the three cohorts were compared (P = 1.00. The crude annual incidence (per 10,000 women of hip fracture in the target population increased by 110% from 40 in 1967 to 84 in 2001. The overall trend in the crude incidence between 1967 and 2001 was increasing (1.58 per 10,000 women per year; 95 percent confidence interval, 1.17 to 1.99, whereas the age-adjusted incidence was stable over the same period (0.22 per 10,000 women per year; 95 percent confidence interval, -0.16 to 0.60. Conclusions The increased number of hip fracture in elderly women is more likely to be attributable to demographic changes in the population than to secular increase in the prevalence of osteoporosis.
Vsemirnova, E. A.; Jones, R. R.; McCaffrey, K. J. W.
2012-04-01
We describe studies analysing terrestrial lidar datasets of fracture systems from a range of reservoir analogues in clastic and carbonate lithologies that represent geological analogues of offshore hydrocarbon reservoirs for the UK continental shelf. As fracture networks (observed here from centimetre to kilometre scale) can significantly affect the permeability of a fractured reservoir, the definition of fracture network geometry at various scales has become an important goal of structural analysis. The main aim of the study has been to extend the investigation of fracture networks in order to quantify spatial variations in fracture parameters in a variety of lithologies. The datasets were pre-processed using RiSCAN PRO software, and then re-sampled and filtered to derive characteristics which are traditionally measured from outcrops, including size distributions, fracture spacing and clustering statistics. This type of analysis can significantly reduce the uncertainty associated with some field fracture network measurements. The digitised fracture networks datasets are then used to investigate various aspects of spatial heterogeneity. A series of fracture maps (joints and faults) were generated at different scales, and fracture trends were studied to test scale dependency of fracture orientations. Multiscale trend analysis was then applied to describe the trend structure of the fracture networks.
Excess mortality following hip fracture: a systematic epidemiological review
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Abrahamsen, B; van Staa, T; Ariely, R
2009-01-01
This systematic literature review has shown that patients experiencing hip fracture after low-impact trauma are at considerable excess risk for death compared with nonhip fracture/community control populations. The increased mortality risk may persist for several years thereafter, highlighting th...
Comparison of tibial shaft ski fractures in children and adults.
Hamada, Tomo; Matsumoto, Kazu; Ishimaru, Daichi; Sumi, Hiroshi; Shimizu, Katsuji
2014-09-01
To examine whether child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures. Descriptive epidemiological study. Prospectively analyzed the epidemiologic factors, injury types, and injury mechanisms at Sumi Memorial Hospital. This study analyzed information obtained from 276 patients with tibial fractures sustained during skiing between 2004 and 2012. We focused on 174 ski-related tibial shaft fractures with respect to the following factors: age, gender, laterality of fracture, skill level, mechanism of fracture (fall vs collision), scene of injury (steepness of slope), snow condition, and weather. Fracture pattern was graded according to Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification and mechanical direction [external (ER) or internal rotation (IR)]. Tibial shaft fractures were the most common in both children (89.3%) and adults (47.4%). There were no significant differences in gender, side of fracture, mechanism of fracture, snow condition, or weather between children and adults. Skill levels were significantly lower in children than in adults (P differences in some of these parameters, suggesting that child and adult skiers have different risk factors or mechanisms of injury for tibial shaft fractures.
Lower limb fracture presentations at a regional hospital.
Holloway, K L; Yousif, D; Bucki-Smith, G; Hosking, S; Betson, A G; Williams, L J; Brennan-Olsen, S L; Kotowicz, M A; Sepetavc, A; Pasco, J A
2017-08-28
We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality. Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures. The study aimed to investigate the epidemiology and burden of these fractures. Incident fractures of the hip, femur, tibia/fibula, ankle and foot in women (≥ 20 years) managed through the University Hospital Geelong, Australia, were ascertained from 1 Jan. 2014 to 31 Dec. 2014 from radiology reports. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records. We identified 585 fractures of the lower limb (209 hip, 42 femur, 41 tibia/fibula, 162 ankle, 131 foot). Most fractures were sustained by women aged ≥ 50 years. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites. Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home. Fractures of the lower limb occurred frequently in older women. Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life.
Reflections on the Historiography of American Eugenics: Trends, Fractures, Tensions.
Paul, Diane B
2016-12-01
By the 1950s, eugenics had lost its scientific status; it now belonged to the context rather than to the content of science. Interest in the subject was also at low ebb. But that situation would soon change dramatically. Indeed, in an essay-review published in 1993, Philip Pauly commented that a "eugenics industry" had come to rival the "Darwin industry" in importance, although the former seemed less integrated than the latter. Since then, the pace of publication on eugenics, including American eugenics, has only accelerated, while the field has become even more fractured, moving in multiple and even contradictory directions. This essay explores the trajectory of work on the history of American eugenics since interest in the subject revived in the 1960s, noting trends and also fractures. The latter are seen to result partly from the fact that professional historians no longer own the subject, which has attracted the interest of scholars in several other disciplines as well as scientists, political activists, and journalists, and also from the fact that the history of eugenics has almost always been policy-oriented. Historians' desire to be policy-relevant and at the same time attentive to context, complexity, and contingency has generated tensions at several levels: within individuals, among historians, and between professional historians and others who also engage with the history of eugenics. That these tensions are resolved differently by different authors and even by the same authors at different times helps explain why the fragmentation that Pauly noted is not likely to be overcome anytime soon.
Green, Traci C; Grau, Lauretta E; Carver, H Wayne; Kinzly, Mark; Heimer, Robert
2011-06-01
The leading cause of injury death among adults in Connecticut (CT), USA is drug poisonings. We analyzed the epidemiology and geographic distribution of opioid-involved accidental drug-involved intoxication deaths ("overdoses") in CT over an 11-year period. We reviewed data from 1997 to 2007 on all adult accidental/undetermined drug intoxication deaths in CT that were referred to the Office of the Chief Medical Examiner (OCME). Regression analyses were conducted to uncover risk factors for fatal opioid-involved intoxications and to compare heroin- to prescription opioid- and methadone-involved deaths. Death locations were mapped to visualize differences in the geographic patterns of overdose by opioid type. Of the 2900 qualifying deaths, 2231 (77%) involved opioids. Trends over time revealed increases in total opioid-related deaths although heroin-related deaths remained constant. Methadone, oxycodone and fentanyl, the most frequently cited prescription opioids, exhibited significant increases in opioid deaths. Prescription opioid-only deaths were more likely to involve other medications (e.g., benzodiazepines) and to have occurred among residents of a suburban or small town location, compared to heroin-involved or methadone-involved deaths. Heroin-only deaths tended to occur among non-Whites, were more likely to involve alcohol or cocaine and to occur in public locations and large cities. The epidemiology of fatal opioid overdose in CT exhibits distinct longitudinal, risk factor, and geographic differences by opioid type. Each of these trends has implications for public health and prevention efforts. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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David S. Schechter
1998-04-30
The objective is to assess the economic feasibility of CO2 flooding of the naturally fractured Straberry Trend Area in west Texas. Research is being conducted in the extensive characterization of the reservoirs, the experimental studies of crude oil/brine/rock (COBR) interaction in the reservoirs, the analytical and numerical simulation of Spraberry reservoirs, and the experimental investigations on CO2 gravity drainage in Spraberry whole cores.
Green, Traci C.; Grau, Lauretta E.; Carver, H. Wayne; Kinzly, Mark; Heimer, Robert
2010-01-01
Background The leading cause of injury death among adults in Connecticut (CT), USA is drug poisonings. We analyzed the epidemiology and geographic distribution of opioid-involved accidental drug-involved intoxication deaths (“overdoses”) in CT over an 11-year period. Methods We reviewed data from 1997 to 2007 on all adult accidental/undetermined drug intoxication deaths in CT that were referred to the Office of the Chief Medical Examiner (OCME). Regression analyses were conducted to uncover risk factors for fatal opioid-involved intoxications and to compare heroin- to prescription opioid- and methadone-involved deaths. Death locations were mapped to visualize differences in the geographic patterns of overdose by opioid type. Results Of the 2900 qualifying deaths, 2231 (77%) involved opioids. Trends over time revealed increases in total opioid-related deaths although heroin-related deaths remained constant. Methadone, oxycodone and fentanyl, the most frequently cited prescription opioids, exhibited significant increases in opioid deaths. Prescription opioid-only deaths were more likely to involve other medications (e.g., benzodiazepines) and to have occurred among residents of a suburban or small town location, compared to heroin-involved or methadone-involved deaths. Heroin-only deaths tended to occur among non-Whites, were more likely to involve alcohol or cocaine and to occur in public locations and large cities. Conclusions The epidemiology of fatal opioid overdose in CT exhibits distinct longitudinal, risk factor, and geographic differences by opioid type. Each of these trends has implications for public health and prevention efforts. PMID:21131140
Gabriel, Abigail; Batey, Jason; Capogreco, Joseph; Kimball, David; Walters, Andy; Tubbs, R. Shane; Loukas, Marios
2014-01-01
Background Despite much epidemiological research on brain cancer in the United States, the etiology for the various subtypes remains elusive. The black population in the United States currently experiences lower incidence but higher survival rates when compared to other races. Thus, the aim of this study is to analyze the trends in incidence and survival for the 6 most common primary brain tumors in the black population of the United States. Material/Methods The Surveillance, Epidemiology, an...
Babu, Ranjith; Sharma, Richa; Bagley, Jacob H; Hatef, Jeffrey; Friedman, Allan H; Adamson, Cory
2013-07-01
There are a variety of treatment options for the management of vestibular schwannomas (VSs), including microsurgical resection, radiotherapy, and observation. Although the choice of treatment is dependent on various patient factors, physician bias has been shown to significantly affect treatment choice for VS. In this study the authors describe the current epidemiology of VS and treatment trends in the US in the modern era. They also illustrate patient and tumor characteristics and elucidate their effect on tumor management. Patients diagnosed with VS were identified through the Surveillance, Epidemiology, and End Results database, spanning the years 2004-2009. Age-adjusted incidence rates were calculated and adjusted using the 2000 US standard population. The chi-square and Student t-tests were used to evaluate differences between patient and tumor characteristics. Multivariate logistic regression was performed to determine the effects of various patient and tumor characteristics on the choice of tumor treatment. A total of 6225 patients with VSs treated between 2004 and 2009 were identified. The overall incidence rate was 1.2 per 100,000 population per year. The median age of patients with VS was 55 years, with the majority of patients being Caucasian (83.16%). Of all patients, 3053 (49.04%) received surgery only, with 1466 (23.55%) receiving radiotherapy alone. Both surgery and radiation were only used in 123 patients (1.98%), with 1504 patients not undergoing any treatment (24.16%). Increasing age correlated with decreased use of surgery (OR 0.95, 95% CI 0.95-0.96; pmanagement (OR 1.04, 95% CI 1.04-1.05; pmanaged conservatively despite presenting with larger tumors. Further studies are needed to elucidate the reasons for treatment disparities and investigate the nationwide trend of resection for the treatment of small VSs.
Papaioannou, A; Kennedy, C C; Ioannidis, G; Cameron, C; Croxford, R; Adachi, J D; Mursleen, S; Jaglal, S
2016-03-01
In this population-based study, we compared incident fracture rates in long-term care (LTC) versus community seniors between 2002 and 2012. Hip fracture rates declined more rapidly in LTC than in the community. An excess burden of fractures occurred in LTC for hip, pelvis, and humerus fractures in men and hip fractures only in women. This study compares trends in incident fracture rates between long-term care (LTC) and community-dwelling seniors ≥65 years, 2002-2012. This is a population-based cohort study using administrative data. Measurements were age/sex-adjusted incident fracture rates and rate ratios (RR) and annual percent change (APC). Over 11 years, hip fracture rates had a marked decline occurring more rapidly in LTC (APC, -3.49 (95% confidence interval (CI), -3.97, -3.01)) compared with the community (APC, -2.93 (95% CI, -3.28, -2.57); p community (RRs: women, 1.55 (95% CI, 1.45, 1.67); men, 2.18 (95% CI, 1.93, 2.47)). Higher rates of pelvis (RR, 1.48 (95% CI, 1.22, 1.80)) and humerus (RR, 1.40 (95% CI, 1.07, 1.84)) fractures were observed in LTC men, not women. In women, wrist (RR, 0.76 (95% CI, 0.71, 0.81)) and spine (RR, 0.52 (95% CI, 0.45, 0.61)) fracture rates were lower in LTC than the community; in men, spine (RR, 0.75 (95% CI, 0.57, 0.98) but not wrist fracture (RR, 0.91 (95% CI, 0.67, 1.23)) rates were significantly lower in LTC than the community. Previous studies in the community have shown declining hip fracture rates over time, also demonstrated in our study but at a more rapid rate in LTC. Rates of humerus and wrist fractures also declined. An excess burden of fractures in LTC occurred for hip fractures in women and for hip, pelvis, and humerus fractures in men.
Fractures of the growing mandible.
Kushner, George M; Tiwana, Paul S
2009-03-01
Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.
Fractures of the patella in children and adolescents
DEFF Research Database (Denmark)
Schmal, Hagen; Strohm, Peter C; Niemeyer, Philipp
2010-01-01
Fractures of the patella in children and adolescents are rare injuries with particular characteristics. The aim of this study was an analysis of epidemiology, treatment strategy and outcome of this injury. Between 1992 and 2006 all fractures of the patella in patients with an age 5 16 years were...
Epidemiology of hip fracture and the development of FRAX in Ukraine.
Povoroznyuk, V V; Grygorieva, N V; Kanis, J A; Ev, McCloskey; Johansson, H; Harvey, N C; Korzh, M O; Strafun, S S; Vaida, V M; Klymovytsky, F V; Vlasenko, R O; Forosenko, V S
2017-12-01
A country-specific FRAX model has been developed for the Ukraine to replace the Austrian model hitherto used. Comparison of the Austrian and Ukrainian models indicated that the former markedly overestimated fracture probability whilst correctly stratifying risk. FRAX has been used to estimate osteoporotic fracture risk since 2009. Rather than using a surrogate model, the Austrian version of FRAX was adopted for clinical practice. Since then, data have become available on hip fracture incidence in the Ukraine. The incidence of hip fracture was computed from three regional estimates and used to construct a country-specific FRAX model for the Ukraine. The model characteristics were compared with those of the Austrian FRAX model, previously used in Ukraine by using all combinations of six risk factors and eight values of BMD (total number of combinations =512). The relationship between the probabilities of a major fracture derived from the two versions of FRAX indicated a close correlation between the two estimates (r > 0.95). The Ukrainian version, however, gave markedly lower probabilities than the Austrian model at all ages. For a major osteoporotic fracture, the median probability was lower by 25% at age 50 years and the difference increased with age. At the age of 60, 70 and 80 years, the median value was lower by 30, 53 and 65%, respectively. Similar findings were observed for men and for hip fracture. The Ukrainian FRAX model should enhance accuracy of determining fracture probability among the Ukrainian population and help to guide decisions about treatment. The study also indicates that the use of surrogate FRAX models or models from other countries, whilst correctly stratifying risk, may markedly over or underestimate the absolute fracture probability.
Pediatric Ankle Fractures: Concepts and Treatment Principles
Su, Alvin W.; Larson, A. Noelle
2016-01-01
Synopsis Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate exam, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, CT. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity. PMID:26589088
Prospective study of ankle and foot fractures in elderly women
Directory of Open Access Journals (Sweden)
Yadagiri Surender Rao
2015-01-01
Full Text Available The epidemiology of ankle fractures in old people is changing as time passes on. The incidence of ankle fractures increases with advancing age. The study conducted was among a rural popula-tion which comprised of 68 women (32 women with ankle fractures & 36 women with foot fractures. Patients studied were in the age group more than 50 years. The study highlights the etiological & risk factors for fractures of ankle & foot. The commonest ankle fracture was the lateral malleolar fracture & the commonest foot fracture was the 5th Metatarsal fracture. Diabetes is a risk factor which increases the occurrence of ankle and foot injuries.
Gibson-Smith, D; Klop, C; Elders, P J M; Welsing, P M J; van Schoor, N; Leufkens, H G M; Harvey, N C; van Staa, T P; de Vries, F
2014-01-01
UNLABELLED: The risk of a subsequent major or any fracture after a hip fracture and secular trends herein were examined. Within 1 year, 2.7 and 8.4% of patients sustained a major or any (non-hip) fracture, which increased to 14.7 and 32.5% after 5 years. Subsequent fracture rates increased during
Evidence-based medicine: Mandible fractures.
Morrow, Brad T; Samson, Thomas D; Schubert, Warren; Mackay, Donald R
2014-12-01
After studying this article, the participant should be able to: 1. Describe the anatomy and subunits of the mandible. 2. Review the cause and epidemiology of mandible fractures. 3. Discuss the preoperative evaluation and diagnostic imaging. 4. Understand the principles and techniques of mandible fracture reduction and fixation. The management of mandibular fractures has undergone significant improvement because of advancements in plating technology, imaging, and instrumentation. As the techniques in management continue to evolve, it is imperative for the practicing physician to remain up-to-date with the growing body of scientific literature. The objective of this Maintenance of Certification article is to present a review of the literature so that the physician may make treatment recommendation based on the best evidence available. Pediatric fractures have been excluded from this article.
Energy Technology Data Exchange (ETDEWEB)
McDonald, P.
1998-06-01
The objective of the Spraberry CO{sub 2} pilot project is to determine the technical and economic feasibility of continuous CO{sub 2} injection in the naturally fractured reservoirs of the Spraberry Trend. In order to describe, understand, and model CO{sub 2} flooding in the naturally fractured Spraberry reservoirs, characterization of the fracture system is a must. Additional reservoir characterization was based on horizontal coring in the second year of the project. In addition to characterization of natural fractures, horizontal coring has confirmed a previously developed rock model for describing the Spraberry Trend shaly sands. A better method for identifying Spraberry pay zones has been verified. The authors have completed the reservoir characterization, which includes matrix description and detection (from core-log integration) and fracture characterization. This information is found in Section 1. The authors have completed extensive imbibition experiments that strongly indicate that the weakly water-wet behavior of the reservoir rock may be responsible for poor waterflood response observed in many Spraberry fields. The authors have also made significant progress in analytical and numerical simulation of performance in Spraberry reservoirs as seen in Section 3. They have completed several suites of CO{sub 2} gravity drainage in Spraberry and Berea whole cores at reservoir conditions and reported in Section 4. The results of these experiments have been useful in developing a model for free-fall gravity drainage and have validated the premise that CO{sub 2} will recover oil from tight, unconfined Spraberry matrix.
Epidemiological analysis of mandibular fractures treated in Sao Paulo, Brazil
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Kelly Marinho
2015-10-01
Conclusion: The treatment of mandibular fractures should be aimed at restoring the occlusion and mastication function, with surgery being the most indicated treatment, using reduction and internal fixation with the use of a plates and screws system based on the experience of the authors. Knowledge of surgical techniques and methods of reduction and fixation of fractures, and periodic monitoring allow these patients to receive the appropriate treatment.
McDonnell, Lisa K; Hume, Patria A; Nolte, Volker
2011-11-01
Rib stress fractures (RSFs) can have serious effects on rowing training and performance and accordingly represent an important topic for sports medicine practitioners. Therefore, the aim of this review is to outline the definition, epidemiology, mechanisms, intrinsic and extrinsic risk factors, injury management and injury prevention strategies for RSF in rowers. To this end, nine relevant books, 140 journal articles, the proceedings of five conferences and two unpublished presentations were reviewed after searches of electronic databases using the keywords 'rowing', 'rib', 'stress fracture', 'injury', 'mechanics' and 'kinetics'. The review showed that RSF is an incomplete fracture occurring from an imbalance between the rate of bone resorption and the rate of bone formation. RSF occurs in 8.1-16.4% of elite rowers, 2% of university rowers and 1% of junior elite rowers. Approximately 86% of rowing RSF cases with known locations occur in ribs four to eight, mostly along the anterolateral/lateral rib cage. Elite rowers are more likely to experience RSF than nonelite rowers. Injury occurrence is equal among sweep rowers and scullers, but the regional location of the injury differs. The mechanism of injury is multifactorial with numerous intrinsic and extrinsic risk factors contributing. Posterior-directed resultant forces arising from the forward directed force vector through the arms to the oar handle in combination with the force vector induced by the scapula retractors during mid-drive, or repetitive stress from the external obliques and rectus abdominis in the 'finish' position, may be responsible for RSF. Joint hypomobility, vertebral malalignment or low bone mineral density may be associated with RSF. Case studies have shown increased risk associated with amenorrhoea, low bone density or poor technique, in combination with increases in training volume. Training volume alone may have less effect on injury than other factors. Large differences in seat and handle
Naouali, Chokri; Jones, Meriem; Nabouli, Imen; Jerbi, Manel; Tounsi, Haifa; Ben Rekaya, Mariem; Ben Ahmed, Melika; Bouhaouala, Balkiss; Messaoud, Olfa; Khaled, Aida; Zghal, Mohamed; Abdelhak, Sonia; Boubaker, Samir; Yacoub-Youssef, Houda
2017-01-01
Epidemiological features and trends of cutaneous melanoma (CM) in North-African populations remain unclear. Those populations are of particular interest as they belong to a mosaic of various other origins (sub-Saharan, European Ancestry, and North-African Berbers). The aim of this study is to draw epidemiological profile and clinicopathological features of CM in the Tunisian population. Incidence analyses were based on data from regional cancer registries. Clinical data were collected from dermatological departments and xeroderma pigmentosum (XP) referral centers and provided CM clinicopathological characteristics and progression. Statistical analyses were achieved using R packages and SPSS 20.0. The incidence of CM in Tunisia is relatively low (0.5-0.7 per 100,000 inhabitants per year). Gender differences were observed regarding anatomical distribution (P = 0.004). Acral lentiginous melanoma (ALM) was the most frequent histological subtype (32.3%); however, nodular melanoma (NM) was the most aggressive and responsible for 54.8% of deaths. CM in XP patients develops at a median age that is 42 years earlier than sporadic cases, with preferential localization on the head and neck (P Xeroderma pigmentosum stands as the major predisposing host factor. © 2016 The International Society of Dermatology.
OSTEOPOROSIS IN RUSSIAN FEDERATION: EPIDEMIOLOGY, SOCIO-MEDICAL AND ECONOMICAL ASPECTS (REVIEW
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O. M. Lesnyak
2018-01-01
Full Text Available The authors performed an analysis of published stadies devoted to osteoporosis situation in Russian Federation including epidemiological, social, medical and economical aspects of this pathology. The analysis demonstrated that osteoporosis is reported in every third woman and every forth man of 50 years old and older. Seven vertebra fractures happen every minute and one fracture of proximal femur — every 5 minutes in Russia. An overall number of all key osteoporotic fractures will increase from 590 thousand up to 730 thousand cases by the year 2035. Osteoporosis is financially demanding for healthcare due to high treatment cost of fractures that are accompanied by life quality deterioration, high mortality and invalidization of patients. Epidemiological studies demonstrated that due to high fracture risk the osteoporosis therapy should be assigned to 31% of female and 4% of male patients over 50 years old. Such factors of osteoporosis risks are widespread in the society: smoking, low food calcium consumption, vitamin D deficit, low physical activity. The authors analyzed the problems in organization of medical care to patients with osteoporosis and osteoporotic fractures and possible solutions to existing issues. The organization of healthcare should be addressed at identification of high risk patient groups, early diagnosis and assignment of corresponding treatment aimed at decreasing potential fracture risk as well as at pathology prophylaxis.
Directory of Open Access Journals (Sweden)
Wang Yueying
2017-08-01
Full Text Available Isolated fractures usually exist in fractured media systems, where the capillary pressure in the fracture is lower than that of the matrix, causing the discrepancy in oil recoveries between fractured and non-fractured porous media. Experiments, analytical solutions and conventional simulation methods based on the continuum model approach are incompetent or insufficient in describing media containing isolated fractures. In this paper, the simulation of the counter-current imbibition in fractured media is based on the discrete-fracture model (DFM. The interlocking or arrangement of matrix and fracture system within the model resembles the traditional discrete fracture network model and the hybrid-mixed-finite-element method is employed to solve the associated equations. The Behbahani experimental data validates our simulation solution for consistency. The simulation results of the fractured media show that the isolated-fractures affect the imbibition in the matrix block. Moreover, the isolated fracture parameters such as fracture length and fracture location influence the trend of the recovery curves. Thus, the counter-current imbibition behavior of media with isolated fractures can be predicted using this method based on the discrete-fracture model.
Trends, prospects and challenges in quantifying flow and transport through fractured rocks
Neuman, Shlomo P.
2005-03-01
of these trends in light of recent experimental and theoretical findings, ending with a short list of prospects and challenges for the future. Parmis les problèmes aucquels font face les hydrogéologues, il y a celui de la caractérisation des roches fracturées (Faybishenko and Benson, 2000). Cet article discute des solutions associées aux quantifications des écoulements et des transports à travers les roches fracturées à l'échelles des essais de puits et des essais de traçage. Une part importante de la litérature traite des roches cristallines, des roches sédimentaires consolidées telles les grés, les calcaires (exeptés les karsts) et la craie. De fait, cet article traitera la même panoplie de roches. La quantification directe des écoulements et du transport dans de tels milieux est généralement abordée via la géométrie des fractures, les données de pression et de traçage, qui déslors sont les objets principaux de notre étude. La géologie, la géophysique et la géochimie (incluant la géochimie isotopique) sont criticables car elles donnent des informations qualitatives sur l'écoulement et le transport des aquifères fracturés, et son intégrées graduellement dans des modèles qualitatifs. La manière d'intégrer ces données dépasse malheureusement cet article. L'hydrogéologie des aquifères de fractures et les autres sciences de la terre s'intéressant aux roches fracturées méritent des traîtements différents. En toute évidence il est suggéré que rarement un modèle d'écoulement et de transport dans une roche fracturée puisse être traité comme un milieu isotropique continu, uniforme ou moyennement non-uniforme. Par ailleurs, il est admis la dépendance entre la forte hétérogénéité erratique et la variété de natures et de comportements des roches fracturées. Une manière de régler le problème est de considérer le milieu comme un réseau de fractures discrètes (avec une perméabilité de matrice ou de bloc). Une
Valderrábano, Rodrigo J; Linares, Maria I
2018-01-01
Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice.
OSTEOPOROSIS IN RUSSIAN FEDERATION: EPIDEMIOLOGY, SOCIO-MEDICAL AND ECONOMICAL ASPECTS (REVIEW)
O. M. Lesnyak; I. A. Baranova; K. Yu. Belova; E. N. Gladkova; L. P. Evstigneeva; O. B. Ershova; T. L. Karonova; A. Yu. Kochish; O. A. Nikitinskaya; I. A. Skripnikova; N. V. Toroptsova; R. M. Aramisova
2018-01-01
The authors performed an analysis of published stadies devoted to osteoporosis situation in Russian Federation including epidemiological, social, medical and economical aspects of this pathology. The analysis demonstrated that osteoporosis is reported in every third woman and every forth man of 50 years old and older. Seven vertebra fractures happen every minute and one fracture of proximal femur — every 5 minutes in Russia. An overall number of all key osteoporotic fractures will increase fr...
K.C. Mahabier (Kiran); D. den Hartog (Dennis); M.J.M. Panneman (Martien); J.R. van Veldhuizen (Joyce); S. Polinder (Suzanne); M.H.J. Verhofstad (Michiel); E.M.M. van Lieshout (Esther)
2015-01-01
textabstractIntroduction: This study aimed to examine long-term population-based trends in the incidence rate of patients with a humeral fracture admitted to a hospital in the Netherlands from 1986 to 2012 and to give a detailed overview of the health care consumption and productivity loss with
Epidemiology and natural history of vestibular schwannomas
DEFF Research Database (Denmark)
Stangerup, Sven-Eric; Caye-Thomasen, Per
2012-01-01
This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma. A treatm......This article describes various epidemiologic trends for vestibular schwannomas over the last 35 years, including a brief note on terminology. Additionally, it provides information on the natural history of tumor growth and hearing level following the diagnosis of a vestibular schwannoma...
Stress fractures of the foot and ankle.
Welck, M J; Hayes, T; Pastides, P; Khan, W; Rudge, B
2017-08-01
Stress fractures occur as a result of microscopic injuries sustained when bone is subjected to repeated submaximal stresses. Overtime, with repeated cycles of loading, accumulation of such injuries can lead to macro-structural failure and frank fracture. There are numerous stress fractures about the foot and ankle of which a trauma and orthopaedic surgeon should be aware. These include: metatarsal, tibia, calcaneus, navicular, fibula, talus, medial malleolus, sesamoid, cuneiform and cuboid. Awareness of these fractures is important as the diagnosis is frequently missed and appropriate treatment delayed. Late identification can be associated with protracted pain and disability, and may predispose to non-union and therefore necessitate operative intervention. This article outlines the epidemiology and risk factors, aetiology, presentation and management of the range of stress fractures in the foot and ankle. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Maïna L'Azou
Full Text Available Dengue is a public health concern across the globe, and an escalating problem in the Americas. As part of a wider programme (covering Latin America and South East Asia to characterize the epidemiology of dengue in dengue endemic areas, we undertook a systematic literature review to assess epidemiological trends (incidence, timing and duration of outbreaks/epidemics, age and sex distribution, serotype distribution, seroprevalence and disease severity for dengue across the French Territories of the Americas (FTA, in French Guiana, Guadeloupe, Martinique, Saint Martin and Saint Barthélemy between 2000 and 2012 (CRD42012002341: http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42012002341. Of 413 relevant data sources identified, 45 were eligible for inclusion. A large proportion of the available data were from national surveillance reports, and 12 publications were from peer-reviewed journals. During the review period, 3-5 epidemics were identified in each of the island territories and French Guiana, and epidemics were often associated with a shift in the predominant circulating dengue virus serotype. Substantial gaps in epidemiological knowledge were identified. In particular, information regarding dengue virus genotype distribution, seroprevalence and age distribution of dengue were lacking. Additionally, much of the available data were from epidemic years; data from inter-epidemic periods were sparse. Nevertheless, the available epidemiological data showed that dengue is endemic across the FTA and suggest an evolution towards hyperendemicity, highlighting the need to continue the efforts with the existing surveillance programmes to assist in planning an effective vaccination programme once a dengue vaccine is deployed.PROSPERO CRD42012002341.
Gallegos, Tanya J.; Varela, Brian A.
2015-01-01
Hydraulic fracturing is presently the primary stimulation technique for oil and gas production in low-permeability, unconventional reservoirs. Comprehensive, published, and publicly available information regarding the extent, location, and character of hydraulic fracturing in the United States is scarce. This national spatial and temporal analysis of data on nearly 1 million hydraulically fractured wells and 1.8 million fracturing treatment records from 1947 through 2010 (aggregated in Data Series 868) is used to identify hydraulic fracturing trends in drilling methods and use of proppants, treatment fluids, additives, and water in the United States. These trends are compared to the literature in an effort to establish a common understanding of the differences in drilling methods, treatment fluids, and chemical additives and of how the newer technology has affected the water use volumes and areal distribution of hydraulic fracturing. Historically, Texas has had the highest number of records of hydraulic fracturing treatments and associated wells in the United States documented in the datasets described herein. Water-intensive horizontal/directional drilling has also increased from 6 percent of new hydraulically fractured wells drilled in the United States in 2000 to 42 percent of new wells drilled in 2010. Increases in horizontal drilling also coincided with the emergence of water-based “slick water” fracturing fluids. As such, the most current hydraulic fracturing materials and methods are notably different from those used in previous decades and have contributed to the development of previously inaccessible unconventional oil and gas production target areas, namely in shale and tight-sand reservoirs. Publicly available derivative datasets and locations developed from these analyses are described.
The pediatric mandible: II. Management of traumatic injury or fracture.
Smartt, James M; Low, David W; Bartlett, Scott P
2005-08-01
After studying this article, the participant should be able to: 1. Describe the changing epidemiology of mandibular fractures in children and adolescents. 2. Discuss the appropriate use of internal fixation in the treatment of pediatric mandibular fractures. 3. Describe the difficulties posed by the deciduous dentition in the use of interdental wiring. 4. Understand reasons why techniques specific to adult fractures may not be applicable to the growing mandible. 5. Understand the etiology and epidemiology of pediatric mandibular fractures. 6. Understand the reasons for conservative (closed) versus aggressive (open) treatment of mandibular injury. Fractures of the pediatric mandible are complicated by the anatomic complexity of the developing mandible, particularly by the presence of tooth buds and the eruption of deciduous and permanent teeth. Traditional methods of fracture reduction and fixation employed in adults have little applicability in the pediatric population. The authors describe the surgical techniques that have been used at their institution and those that can be used safely in the pediatric setting. In most cases, "conservative" management is the preferred option, especially in the treatment of condylar fractures. In cases requiring surgical intervention, interdental wiring, drop wires in combination with circummandibular wires, and acrylic splints are suited well to specific phases of dental maturation. Open reduction and internal fixation using monocortical screws and microplates or resorbable plates and screws are acceptable techniques in the pediatric patient, but they require special safeguards. Algorithms are presented to simplify management of these complicated injuries.
Malaria and health in Africa: the present situation and epidemiological trends.
Brinkmann, U; Brinkmann, A
1991-09-01
The World Health Organization does not give any data on the malaria situation in Africa in its regular reports because of the "insufficiency and irregularity of reporting". Estimates on the total number of cases and the number of deaths vary considerably. They range from 35 million to 189 million per year depending on whose figures one uses. An intensive search of the literature using computer-based systems identified more than 1000 titles on the epidemiology of malaria. Out of them and from other sources finally 426 articles were used to describe the current malaria situation and observable trends in Africa. Major findings were that malaria is responsible for about 40% of fever cases, mortality is about 5 per 1000 per year, case fatality ranges from 2% to 24%. Admissions for malaria account for 20% to 50% of all admissions in African health services although only 8% to 25% of persons with malaria visit health services. Self-treatment is more common in urban areas (more than 60%) but an increasing number of people use some form of self protection in rural areas (2% to 25%). The resistance of malaria parasites to chloroquine and other drugs is widespread. Chloroquine resistance has reached a prevalence of about 30% at the RII level in most countries. Malaria incidence shows annual growth rates of 7.3% for Zambia, 10.4% for Togo, and 21.0% for Rwanda. The data for Burkina Faso show a downward trend of--14.7% during the years from 1973 to 1981. Since then malaria incidence is increasing at 11.0% per year. Hospital data reported from Zambia indicate that mortality is rising 5.2% per annum in children and 9.7% per annum in adults. Reasons for the increase of malaria and its role for development are discussed.
Extremity Fractures Associated With ATVs and Dirt Bikes: A 6 Year National Epidemiological Study
Gambone, Andrew; Lombardo, Daniel Joseph; Jelsema, Timothy; Sabesan, Vani
2015-01-01
Objectives: All-terrain vehicle (ATV) and dirt bike use is increasing in the US and is associated with risk of traumatic injury. Extremity fractures are common injures associated with these vehicles. The purpose of this study is to compare and contrast the patterns extremity fractures associated with ATVs and dirt bikes. Our hypothesis is that these different vehicles will result in similar rates of high impact injuries, but differences in vehicle stability will result in greater proportions of upper extremity fractures associated with ATV use. Methods: The National Electronic Injury Surveillance System (NEISS) was used to acquire data for extremity fractures related to ATV (3-wheels, 4-wheels, and number of wheels undefined) and dirt bike use from 2007-2012. Locations were coded as shoulder, upper arm, elbow, lower arm, wrist, hand, upper leg, knee, lower leg, ankle, foot, and toe. The data were stratified according to age and gender for each year. Incidence rates were calculated on a per vehicle basis using previous estimates of the number of ATVs and dirt bikes in the country. Results: The database yielded an estimate of 229,362.52 extremity fractures from 2007-2012. An estimated total of 130,319.20 fractures were associated with ATVs, while 99,043.37 were associated with dirt bikes. The incidence rates of extremity fractures associated with ATV and dirt bike use were 3.87 and 6.85 per 1000 vehicle-years. Most fractures were in patients 10-19 years of age, after which the number of fractures decreased with age. The largest proportion of all fractures occurred in the shoulder (27.19%), followed by the wrist and lower leg (13.77% and 12.36%, respectively). This distribution of fractures was consistent among ATV use for all age groups except in the 0-9 year olds, where the lower arm and wrist were the most commonly fractured locations. Fracture distribution associated with dirt bike use also followed this general pattern, with the exception of 0-9 and 10-19 year
[Epidemiology of the osteoporotic fracture of the hip in the province of Palencia].
Arboleya, L R; Castro, M A; Bartolomé, E; Gervás, L; Vega, R
1997-09-01
Hip fracture is the most severe consequence of osteoporosis. The aim of the present study was to know the incidence of osteoporotic hip fracture in the Palencia province, its direct economical consequences and characteristics associated with the origin episode. All patients aged over 49 years who had a nontraumatic hip fracture during the second semester of 1994 and the first semester of 1995 were included in the study. An analysis of costs was performed and each patient received a questionnaire to know the circumstances associated with the episode. During the study period the overall incidence of hip fracture was 83/100,000 inhabitants/year, which corresponds to an adjusted incidence of 240.9/100,000 inhabitants older than 49 years (336.8 women and 120.7 men). There was an exponential growth, with peak values starting at 80 years. The female/male ratio was 2.8 and the mean age 80.8 years. Twenty-four percent of fractures occurred in institutionalized persons, with an adjusted incidence of 1,107/100,000 inhabitants/year, which corresponds to a relative risk of 13.57 (95% CI: 10.06-18.28). No significant differences were observed between trochanteric and neck fractures. Ninety-seven percent of fractures occurred after a fall, usually in the morning or afternoon (86%), with lateral direction and impact on the greater trochanter (89%). The mortality rate during admission was 5.9%. The mean cost of care during admission was 1,170,000 pesetas. The incidence of hip fracture in Palencia is slightly higher than the national mean, probably due to populational ageing. The risk of fracture reaches alarming proportions in the institutionalized population. The implementation of efficient preventive measures, particularly among the exposed populations, is necessary.
Chun, Young Soo; Juh, Hyung Suk; Cho, Yoon Je; Rhyu, Kee Hyung
2015-09-01
Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.
Changing incidence and residual lifetime risk of common osteoporosis-related fractures
DEFF Research Database (Denmark)
Lauritzen, J B; Schwarz, Peter; Lund, B
1993-01-01
1735 fractures of the distal radius, 747 fractures of the proximal humerus, 878 cervical and 635 trochanteric hip fractures were included. In men 273 cervical and 232 trochanteric hip fractures were included. The fractures were registered during the period 1976 to 1984 and changes in age.......05) during the observation period, while no significant decrease was found in the incidence of trochanteric fractures. No significant changes in incidence were observed in women with radial or humeral fractures, or in men with hip fractures. A women 60 years old with a life expectancy of 81 years had......Changes in incidence and lifetime risk of fractures are of major importance in the epidemiology of osteoporosis. We focused on hip fractures in women and men and on radial and humeral fractures in women. The study subjects comprised 4500 women and men 20 years old or more with fractures. In women...
Energy Technology Data Exchange (ETDEWEB)
Knight, Bill; Schechter, David S.
2002-07-26
The goal of this project was to assess the economic feasibility of CO2 flooding the naturally fractured Spraberry Trend Area in west Texas. This objective was accomplished through research in four areas: (1) extensive characterization of the reservoirs, (2) experimental studies of crude oil/brine/rock (COBR) interactions in the reservoirs, (3) reservoir performance analysis, and (4) experimental investigations on CO2 gravity drainage in Spraberry whole cores. This provides results of the final year of the six-year project for each of the four areas.
Atypical subtrochanteric and diaphyseal femoral fractures
DEFF Research Database (Denmark)
Shane, Elizabeth; Burr, David; Abrahamsen, Bo
2014-01-01
Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis of the femur have been reported in patients taking BPs and in patients on denosumab, but they also occur in patients with no exp......Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis of the femur have been reported in patients taking BPs and in patients on denosumab, but they also occur in patients...... with no exposure to these drugs. In this report, we review studies on the epidemiology, pathogenesis, and medical management of AFFs, published since 2010. This newer evidence suggests that AFFs are stress or insufficiency fractures. The original case definition was revised to highlight radiographic features...... a minor to a major feature. The association with specific diseases and drug exposures was removed from the minor features, because it was considered that these associations should be sought rather than be included in the case definition. Studies with radiographic review consistently report significant...
What accounts for rib fractures in older adults?
Wuermser, Lisa-Ann; Achenbach, Sara J; Amin, Shreyasee; Khosla, Sundeep; Melton, L Joseph
2011-01-01
To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21-93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.
What Accounts for Rib Fractures in Older Adults?
Directory of Open Access Journals (Sweden)
Lisa-Ann Wuermser
2011-01-01
Full Text Available To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years, 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.
What Accounts for Rib Fractures in Older Adults?
Wuermser, Lisa-Ann; Achenbach, Sara J.; Amin, Shreyasee; Khosla, Sundeep; Melton, L. Joseph
2011-01-01
To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes. PMID:22028986
Epidemiology of acute wrist trauma
DEFF Research Database (Denmark)
Larsen, C F; Lauritsen, Jens
1993-01-01
Epidemiological data on wrist injuries in a population can be used for planning by applying them to criteria for care and thus deriving estimates of provisions for care according to currently desirable standards. In a 1-year study all patients > or = 15 years with acute wrist trauma and treated...... in the emergency room were examined according to an algorithm until a diagnosis was established. The overall incidence of wrist trauma was 69 per 10,000 inhabitants per year. Incidence of wrist trauma requiring x-ray examination was 58 per 10,000 per year. The incidence of distal radius fractures was 27 per 10...... using data from a population-based study. A completeness rate of 0.56 (95% confidence interval: 0.31-0.78) was found. An x-ray had been taken for all patients reporting a fracture thus justifying the use of fractures as an incidence measure when comparing groups of patients with wrist trauma....
The Epidemiology of Pheochromocytoma
DEFF Research Database (Denmark)
Ladefoged Ebbehøj, Andreas
2017-01-01
Pheochromocytoma and catecholamine secreting paraganglioma (PPGL) are exceedingly rare endocrine tumours, but remain a frequent diagnostic dilemma due to their potential life-threatening nature. Reliable data on the epidemiology of PPGL is lacking and no time trends in incidence rates (IR) have...
Trends in the aetiology of facial fractures in the south of Ireland (1975-1993).
LENUS (Irish Health Repository)
Carroll, S M
2012-02-03
An aetiological review of 332 patients with facial fractures seen in a 1 year period (1993) was carried out and compared to a similar study of 266 patients, performed in this unit in 1975. Males predominated in both years. Two thirds of fractures occurred in the second and third decades. Road traffic accident (RTA) related facial fractures decreased from 27% of the total in 1975 to 17% in 1993. Assault related facial fractures increased from 18% of the total in 1975 to 27% in 1993. In both study periods nasal fractures were the most common facial fracture seen and sport was the most common cause of facial fracture. The number of patients undergoing surgery increased from 67% of the total to 79% over the same period.
Epidemiology of open tibial fractures in a teaching hospital ...
African Journals Online (AJOL)
Methods: This is a prospective observational study of all open tibial fractures seen at the Accident and Emergency department of the University of Port Harcourt Teaching Hospital (UPTH) over a twelve- month period (July 2002- June 2003). Data from a pre-designed proforma for the study was analyzed and descriptive ...
Epidemiological analysis of trauma patients following the Lushan earthquake.
Directory of Open Access Journals (Sweden)
Li Zhang
Full Text Available BACKGROUND: A 7.0-magnitude earthquake hit Lushan County in China's Sichuan province on April 20, 2013, resulting in 196 deaths and 11,470 injured. This study was designed to analyze the characteristics of the injuries and the treatment of the seismic victims. METHODS: After the earthquake, an epidemiological survey of injured patients was conducted by the Health Department of Sichuan Province. Epidemiological survey tools included paper-and-pencil questionnaires and a data management system based on the Access Database. Questionnaires were completed based on the medical records of inpatients with earthquake-related injuries. Outpatients or non-seismic injured inpatients were excluded. A total of 2010 patients from 140 hospitals were included. RESULTS: The most common type of injuries involved bone fractures (58.3%. Children younger than 10 years of age suffered fewer fractures and chest injuries, but more skin and soft -tissue injuries. Patients older than 80 years were more likely to suffer hip and thigh fractures, pelvis fractures, and chest injuries, whereas adult patients suffered more ankle and foot fractures. A total of 207 cases of calcaneal fracture were due to high falling injuries related to extreme panic. The most common type of infection in hospitalized patients was pulmonary infections. A total of 70.5% patients had limb dysfunction, and 60.1% of this group received rehabilitation. Most patients received rehabilitation within 1 week, and the median duration of rehabilitation was 3 weeks. The cause of death of all seven hospitalized patients who died was severe traumatic brain injuries; five of this group died within 24 h after the earthquake. CONCLUSIONS: Injuries varied as a function of the age of the victim. As more injuries were indirectly caused by the Lushan earthquake, disaster education is urgently needed to avoid secondary injuries.
Incidence of spinal fractures in the Netherlands 1997-2012
ten Brinke, J. G.; Saltzherr, T. P.; Panneman, M. J. M.; Hogervorst, M.; Goslings, J. C.
2017-01-01
: To determine time trends of emergency department (ED) visits, hospitalization rates, spinal cord lesions and characteristics of patients with spinal fractures in the Netherlands. In an observational database study we used the Dutch Injury Surveillance System to analyse spinal fracture-related ED
Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012).
Olorunfemi, Gbenga; Ndlovu, Ntombizodwa; Masukume, Gwinyai; Chikandiwa, Admire; Pisa, Pedro T; Singh, Elvira
2018-05-22
Cervical cancer (CC) is the leading cause of cancer death among female South Africans (SA). Improved access to reproductive health services following multi-ethnic democracy in 1994, HIV epidemic, and the initiation of CC population-based screening in early 2000's have influenced the epidemiology of CC in SA. We therefore evaluated the trends in CC age-standardized incidence (ASIR) (1994 - 2009) and mortality rates (ASMR) (2004 - 2012) using data from the South African National Cancer Registry and the Statistics South Africa, respectively. Five-year relative survival rates and average percent change (AAPC) stratified by ethnicity and age-groups was determined. The average annual CC cases and mortalities were 4,694 (75,099 cases/16years) and 2,789 (25,101 deaths/9years) respectively. The ASIR was 22.1/100,000 in 1994 and 23.3/100,000 in 2009, with an average annual decline in incidence of 0.9% per annum (AAPC = -0.9%, P-valueASMR decreased slightly by 0.6% per annum from 13.9/100,000 in 2004 to 13.1/100,000 in 2012 (AAPC = -0.6%, P-value ASMR was 5.8-fold higher in Blacks than in Whites. The 5-year survival rates were higher in Whites and Indians/Asians (60-80%) than in Blacks and Coloureds (40-50%). The incidence rate increased (AAPC range: 1.1% to 3.1%, P-value<0.001) among young women (25-34 years) from 2000 to 2009. Despite interventions, there were minimal changes in overall epidemiology of CC in SA but there were increased CC rates among young women and ethnic disparities in CC burden. A review of the CC national policy and directed CC prevention and treatment are required to positively impact the burden of CC in SA. This article is protected by copyright. All rights reserved. © 2018 UICC.
Marques, Andréa; Rodrigues, Ana M; Romeu, José Carlos; Ruano, Afonso; Barbosa, Ana Paula; Simões, Eugénia; Águas, Fernanda; Canhão, Helena; Alves, José Delgado; Lucas, Raquel; Branco, Jaime Cunha; Laíns, Jorge; Mascarenhas, Mário; Simões, Susete; Tavares, Viviana; Lourenço, Oscar; da Silva, José António Pereira
2016-01-01
To establish Portuguese recommendations regarding the indication to perform DXA and to initiate medication aimed at the prevention of fragility fractures. A multidisciplinary panel, representing the full spectrum of medical specialties and patient associations devoted to osteoporosis, as well as national experts in this field and in health economics, was gathered to developed recommendations based on available evidence and expert consensus. Recently obtained data on the Portuguese epidemiologic, economic and quality-of-life aspects of fragility fractures were used to support decisions. 10 recommendations were developed covering the issues of whom to investigate with DXA and whom to treat with antifracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of ten-year probability of osteoporotic fracture, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are now provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based and supported by a wide scope multidisciplinary panel of experts and scientific societies. Implementation of these recommendations holds great promise in assuring the most effective use of health resources in the prevention of osteoporotic fractures in Portugal.
Energy Technology Data Exchange (ETDEWEB)
Schechter, D.S.
1999-02-03
The overall goal of this project is to assess the economic feasibility of CO{sub 2} flooding the naturally fractured Spraberry Trend Area in West Texas. This objective is being accomplished by conducting research in four areas: (1) extensive characterization of the reservoirs, (2) experimental studies of crude oil/brine/rock (COBR) interactions in the reservoirs, (3) reservoir performance analysis, and, (4) experimental investigations on CO2 gravity drainage in Spraberry whole cores. This report provides results of the third year of the five-year project for each of the four areas including a status report of field activities leading up to injection of CO2.
Selected trends in lung cancer epidemiology in Slovakia
International Nuclear Information System (INIS)
Ondrusova, M.; Psenkova, M.; Berzinec, P.
2015-01-01
Introduction: The lung cancer is still among the dominant malignant tumors despite declining trend of incidence, especially in men, and also its adverse prognosis remains. Aim: The aim of the study was to analyse the development of long-term trends in incidence and mortality and to produce a prospective estimate of prevalence and overall burden of lung cancer in the population in the Slovak Republic. Results: A significant drop of incidence of the disease in men has been seen in Slovakia since 1988 by a mean annual percentage change of -2.16%, whereby mortality is declining a little faster (by an annual percentage change of -2.87%). Adverse trend has been registered in both indicators in case of lung cancer in women, with incidence rising since 2001 by 5.31% annually and mortality rising by 1.3% for the whole monitored period. Conclusion: The adverse rising trend in the incidence and mortality of lung cancer in women in the Slovak Republic, as well as the slower decline in incidence and mortality in men compared with some countries of Western Europe, will have an impact in future also on total costs for management of this disease. (author)
Stress fractures in the lower extremity
International Nuclear Information System (INIS)
Berger, Ferco H.; Jonge, Milko C. de; Maas, Mario
2007-01-01
Stress fractures are fatigue injuries of bone usually caused by changes in training regimen in the population of military recruits and both professional and recreational athletes. Raised levels of sporting activity in today's population and refined imaging technologies have caused a rise in reported incidence of stress fractures in the past decades, now making up more than 10% of cases in a typical sports medicine practice. Background information (including etiology, epidemiology, clinical presentation and treatment and prevention) as well as state of the art imaging of stress fractures will be discussed to increase awareness amongst radiologists, providing the tools to play an important role in diagnosis and prognosis of stress fractures. Specific fracture sites in the lower extremity will be addressed, covering the far majority of stress fracture incidence. Proper communication between treating physician, physical therapist and radiologist is needed to obtain a high index of suspicion for this easily overlooked entity. Radiographs are not reliable for detection of stress fractures and radiologist should not falsely be comforted by them, which could result in delayed diagnosis and possibly permanent consequences for the patient. Although radiographs are mandatory to rule out differentials, they should be followed through when negative, preferably by magnetic resonance imaging (MRI), as this technique has proven to be superior to bone scintigraphy. CT can be beneficial in a limited number of patients, but should not be used routinely
DesRoches, A. J.; Butler, K. E.; MacQuarrie, K. TB
2018-03-01
Variations in self-potential (SP) signals were recorded over an electrode array during a constant head injection test in a fractured bedrock aquifer. Water was injected into a 2.2 m interval isolated between two inflatable packers at 44 m depth in a vertical well. Negative SP responses were recorded on surface corresponding to the start of the injection period with strongest magnitudes recorded in electrodes nearest the well. SP response decreased in magnitude at electrodes further from the well. Deflation of the packer system resulted in a strong reversal in the SP signal. Anomalous SP patterns observed at surface at steady state were found to be aligned with dominant fracture strike orientations found within the test interval. Numerical modelling of fluid and current flow within a simplified fracture network showed that azimuthal patterns in SP are mainly controlled by transmissive fracture orientations. The strongest SP gradients occur parallel to hydraulic gradients associated with water flowing out of the transmissive fractures into the tighter matrix and other less permeable cross-cutting fractures. Sensitivity studies indicate that increasing fracture frequency near the well increases the SP magnitude and enhances the SP anomaly parallel to the transmissive set. Decreasing the length of the transmissive fractures leads to more fluid flow into the matrix and into cross-cutting fractures proximal to the well, resulting in a more circular and higher magnitude SP anomaly. Results from the field experiment and modelling provide evidence that surface-based SP monitoring during constant head injection tests has the ability to identify groundwater flow pathways within a fractured bedrock aquifer.
Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom.
Moon, Rebecca J; Harvey, Nicholas C; Curtis, Elizabeth M; de Vries, Frank; van Staa, Tjeerd; Cooper, Cyrus
2016-04-01
Fractures are common in childhood, and there is considerable variation in the reported incidence across European countries, but few data relating to ethnic and geographic differences within a single country. We therefore aimed to determine the incidence of childhood fractures in the United Kingdom (UK), and to describe age-, ethnicity- and region- specific variations. The Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records for approximately 7% of the UK population. The occurrence of a fracture between 1988 and 2012 was determined from the CPRD for all individuals ethnicity. Regional fracture incidence rates were also calculated based on general practitioner location within 14 Strategic Health Authorities (SHA) within the UK. The overall fracture incidence rate was 137 per 10,000 person-years (py). This was higher in boys (169 per 10,000 py) than girls (103 per 10,000 py) and white children (150 per 10,000 py) compared to those of black (64 per 10,000 py) and South Asian (81 per 10,000 py) ethnicity. Marked geographic variation in incidence was observed. The highest fracture rates were observed in Wales, where boys and girls had 1.82 and 1.97 times greater incidence, respectively, than those residing in Greater London. In the period 1988-2012, there was marked geographic and ethnic variation in childhood fracture incidence across the UK. These findings also implicate lifestyle and socio-economic differences associated with location and ethnicity, and are relevant to policy makers in the UK and internationally. Copyright © 2016 Elsevier Inc. All rights reserved.
Epidemiology, imaging, and treatment of Lisfranc fracture-dislocations revisited
International Nuclear Information System (INIS)
Kalia, Vivek; Fishman, Elliot K.; Carrino, John A.; Fayad, Laura M.
2012-01-01
The purpose of this article is to discuss the features of Lisfranc injuries and identify their typical imaging findings on radiographs, CT, and MR imaging. Lisfranc injuries are most often caused by hyperplantarflexion of the foot, often during a sporting injury or in high-speed motor vehicle collisions. The most common radiographic findings include diastasis of the base of the first and second metatarsals and the ''fleck'' sign, though neither is necessarily present in every Lisfranc fracture-dislocation. Owing to their often subtle radiographic presentation, clinically suspected Lisfranc injuries warrant imaging with a more sensitive test for the detection of osseous and ligamentous Lisfranc injuries. 3D CT imaging provides a comprehensive evaluation of the injury for optimal treatment planning, with resultant decreased long-term patient morbidity. Furthermore, 3D volume-rendered CT and CT multiplanar reconstructions (MPRs) provide osseous and neurovascular anatomic detail that may be a considerable help with surgical planning for operative cases of Lisfranc injuries. Also, with 3D CT and MPRs, other occult fractures, which are common in patients with high-energy injury and multiple trauma, may become evident. (orig.)
Risk factors for trochanteric and femoral neck fracture.
Díaz, A R; Navas, P Z
The differences between the two main types of fracture of proximal end of the femur, trochanteric and cervical fractures, are still a subject of study, and could be the key to a better understanding of its pathophysiology and prevention. The aim of this study is to determine whether epidemiological differences in the distribution of risk factors associated with hip fracture exist between these two entities. A descriptive cross-sectional study of 428 patients over the age of 65 admitted for trochanteric or cervical fractures in 2015, in which gender, age, previous diagnosis, external causes associated with fracture and place of the event were recorded. There were 220 patients with a cervical fracture (51.4%) and 208 patients with a trochanteric fracture (48.6%). The average age was higher in the trochanteric fracture, observing a constant increase with age only in women with trochanteric fractures. Cervical fracture showed a significant association with cerebrovascular disease (p=0.039) and trochanteric fracture with accidental falls (p=0.047) and presence of 5-9 previous diseases (p=0.014). A regression analysis maintained this association in the case of a cerebrovascular disease (OR 2.6, 95%CI 1.1-6.4) and the presence of 5-9 diseases (OR 1.5, 95%CI 1.1-2.3). Trochanteric fractures are associated with women patients of more advanced ages, 5-9 previous diseases and accidental falls. Cerebrovascular disease shows a higher prevalence in cervical fractures. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.
Fractal characteristics of fracture roughness and aperture data
International Nuclear Information System (INIS)
Kumar, S.; Boernge, J.
1991-05-01
In this study mathematical expressions are developed for the characteristics of apertures between rough surfaces. It has shown that the correlation between the opposite surfaces influences the aperture properties and different models are presented for these different surface correlations. Fracture and apertures profiles measured from intact fractures are evaluated and it is found that they qualitatively follow the mathematically predicted trends
Epidemiological Study of Heart Failure in China
Directory of Open Access Journals (Sweden)
Yang Guo
2015-10-01
Full Text Available Heart failure (HF is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. HF is one of the most important and severe end stages of many cardiovascular diseases. Epidemiological studies of HF have focused mainly on the prevalence, incidence, mortality, fatality, and distribution and temporal trends of these indicators among different populations. This review highlights important epidemiological studies of HF in China.
Epidemiological Trends of Dengue Disease in Colombia (2000-2011): A Systematic Review
Villar, Luis Angel; Rojas, Diana Patricia; Besada-Lombana, Sandra; Sarti, Elsa
2015-01-01
A systematic literature review was conducted to describe the epidemiology of dengue disease in Colombia. Searches of published literature in epidemiological studies of dengue disease encompassing the terms “dengue”, “epidemiology,” and “Colombia” were conducted. Studies in English or Spanish published between 1 January 2000 and 23 February 2012 were included. The searches identified 225 relevant citations, 30 of which fulfilled the inclusion criteria defined in the review protocol. The epidemiology of dengue disease in Colombia was characterized by a stable “baseline” annual number of dengue fever cases, with major outbreaks in 2001–2003 and 2010. The geographical spread of dengue disease cases showed a steady increase, with most of the country affected by the 2010 outbreak. The majority of dengue disease recorded during the review period was among those dengue disease in Colombia may provide several avenues for future research, namely studies of asymptomatic dengue virus infection, primary versus secondary infections, and under-reporting of the disease. Improved understanding of the factors that determine disease expression and enable improvement in disease control and management is also important. PMID:25790245
Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom
Moon, Rebecca J; Harvey, Nicholas C; Curtis, Elizabeth M; de Vries, Frank; van Staa, Tjeerd; Cooper, Cyrus
BACKGROUND: Fractures are common in childhood, and there is considerable variation in the reported incidence across European countries, but few data relating to ethnic and geographic differences within a single country. We therefore aimed to determine the incidence of childhood fractures in the
Prosthetic replacement for proximal humeral fractures.
Kontakis, George; Tosounidis, Theodoros; Galanakis, Ioannis; Megas, Panagiotis
2008-12-01
The ideal management of complex proximal humeral fractures continues to be debatable. Evolution of proximal humeral fracture management, during the past decade, led to the implementation of many innovations in surgical treatment. Even though the pendulum of treatment seems to swing towards new trends such as locked plating, hemiarthroplasty remains a valid and reliable option that serves the patient's needs well. Hemiarthroplasty is indicated for complex proximal humeral fractures in elderly patients with poor bone stock and when internal fixation is difficult or unreliable. Hemiarthroplasty provides a better result when it is performed early post-injury. Stem height, retroversion and tuberosity positioning are technical aspects of utmost importance. Additionally reverse total shoulder arthroplasty is an alternative new modality that can be used as a primary solution in selected patients with proximal humeral fracture treatment. Failed hemiarthroplasty and fracture sequelae can be successfully managed with reverse total shoulder arthroplasty. Individual decision-making and tailored treatment that takes into consideration the personality of the fracture and the patient's characteristics should be used.
International Nuclear Information System (INIS)
Sayab, M.
2005-01-01
Systematic relationships between the fracture orientation and fold geometry in sedimentary rocks have been used to explain the development of synfolding fractures. Based on field observations at the Khushalgarh syncline, located east of the Kohat Plateau, we proposed that the orientation of fractures was influenced dominantly by two tectonic fracture sets, that is, the NE-SW and NW-SE. The NE-SW fracture set dominantly formed as mode 1 (tensile), where as, the NW-SE fracture set developed as mode 11 (shear) conjugate fractures. The NE-SW trending fractures follow the axis of the syncline, whereas, the NW-SE fracture about crosscuts the fold axis. Most of the NE-SW fractures abut against the NW-SW fracture set. Based on the orientation and crosscutting relationship, their modes in response to stress, we conclude that the NE-SW trending fractures formed early than those of NW-SE fracture set. Though, both the fracture sets are formed during the folding, we suggest that they were not formed at the same time. Their crosscutting relationship suggests that they developed sequentially rather than synchronously. Our interpretations support the laboratory-based models where only one fracture orientation (or set of fractures with one orientation) form in response to single stress. However, as the stress distribution in folded strata changes over time new fractures of distinct orientations can form during or late in the folding history. We conclude that the sandstone units underwent bedding-parallel extension during folding, where bedding is stretched to accommodate extension. Parallel to the fold axis orientation. Bending of the limbs is a likely mechanism for the development of observed NE-SW trending fractures during folding, whereas the NW-SE fractures developed late in the folded history. (author)
Data Analytics of Hydraulic Fracturing Data
Energy Technology Data Exchange (ETDEWEB)
Zhang, Jovan Yang [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Viswanathan, Hari [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hyman, Jeffery [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Middleton, Richard [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
2016-08-11
These are a set of slides on the data analytics of hydraulic fracturing data. The conclusions from this research are the following: they proposed a permeability evolution as a new mechanism to explain hydraulic fracturing trends; they created a model to include this mechanism and it showed promising results; the paper from this research is ready for submission; they devised a way to identify and sort refractures in order to study their effects, and this paper is currently being written.
Growth Kinematics of Opening-Mode Fractures
Eichhubl, P.; Alzayer, Y.; Laubach, S.; Fall, A.
2014-12-01
Fracture aperture is a primary control on flow in fractured reservoirs of low matrix permeability including unconventional oil and gas reservoirs and most geothermal systems. Guided by principles of linear elastic fracture mechanics, fracture aperture is generally assumed to be a linear function of fracture length and elastic material properties. Natural opening-mode fractures with significant preserved aperture are observed in core and outcrop indicative of fracture opening strain accommodated by permanent solution-precipitation creep. Fracture opening may thus be decoupled from length growth if the material effectively weakens after initial elastic fracture growth by either non-elastic deformation processes or changes in elastic properties. To investigate the kinematics of fracture length and aperture growth, we reconstructed the opening history of three opening-mode fractures that are bridged by crack-seal quartz cement in Travis Peak Sandstone of the SFOT-1 well, East Texas. Similar crack-seal cement bridges had been interpreted to form by repeated incremental fracture opening and subsequent precipitation of quartz cement. We imaged crack-seal cement textures for bridges sampled at varying distance from the tips using scanning electron microscope cathodoluminescence, and determined the number and thickness of crack-seal cement increments as a function of position along the fracture length and height. Observed trends in increment number and thickness are consistent with an initial stage of fast fracture propagation relative to aperture growth, followed by a stage of slow propagation and pronounced aperture growth. Consistent with fluid inclusion observations indicative of fracture opening and propagation occurring over 30-40 m.y., we interpret the second phase of pronounced aperture growth to result from fracture opening strain accommodated by solution-precipitation creep and concurrent slow, possibly subcritical, fracture propagation. Similar deformation
The Kane fracture zone in the Central Atlantic Ocean
Purdy, G.M.; Rabinowitz, P.D.; Velterop, J.J.A.
1979-01-01
The Kane fracture zone has been traced as a distinct topographic trough from the Mid-Atlantic Ridge near 24°N to the 80-m.y. B.P. isochron (magnetic anomaly 34) on either side of the ridge axis for a total of approximately 2800 km. Major changes in trend of the fracture zone occur at approximately
Future trends in fracture mechanics: theory and applications
International Nuclear Information System (INIS)
Hosbons, R.R.
1978-05-01
A brief description of the current methods available for the analysis of fracture in ductile materials is given. Crack-opening displacement, R-curves and J-integrals are discussed and their future incorporation into structural codes assessed. The current areas of research which will probably influence code making bodies are also described. Emphasis is made on J-integral theory and a description of its limitations and extensions. Numerical techniques for calculating J for complicated structure are outlined. (author)
Notarnicola, A; Maccagnano, G; Tafuri, S; Moretti, L; Laviola, L; Moretti, B
2016-01-01
Increased risk of osteoporosis and its clinical significance in patients with diabetes is controversial. This study aims to increase the data which are available regarding the prevalence of diabetes mellitus in patients affected by fragility fracture in Italy. We retrospectively studied Hospital Discharge Data (HDD) in the Apulian database for the period 20062010 to identify a fragility fracture diagnosis in males over 65 years of age and in females over 50. The database was then checked for drug prescriptions to identify those persons who had taken at least one osteoporosis drug. Within this latter group, thanks to hospital admission and prescription records, the subjects affected with diabetes mellitus were identified. Between 2006 and 2010 in Apulia 177,639 patients were hospitalized and diagnosed as having fragility fracture. The greatest number of those fragility fractures were found to be in the 70 to 79 age range (64,917 total; females 56,994, males 7,923). The prevalence of diabetes subjects in Apulia in this period was estimated at 6.5%. In the same region and period 21.1% of subjects affected by diabetes experienced a fragility fracture; in particular, this number was 27% for males and for 20.5% females. This is the first study providing data on the prevalence of fragility fractures and diabetes in the Apulian population. The data confirm that diabetes is a risk factor which influences bone density and risk of fractures and therefore the need of osteoporosis screening and treatment in diabetic patients.
International Nuclear Information System (INIS)
Darcel, C.; Davy, P.; Le Goc, R.; Dreuzy, J.R. de; Bour, O.
2009-11-01
Investigations led for several years at Laxemar and Forsmark reveal the large heterogeneity of geological formations and associated fracturing. This project aims at reinforcing the statistical DFN modeling framework adapted to a site scale. This leads therefore to develop quantitative methods of characterization adapted to the nature of fracturing and data availability. We start with the hypothesis that the maximum likelihood DFN model is a power-law model with a density term depending on orientations. This is supported both by literature and specifically here by former analyses of the SKB data. This assumption is nevertheless thoroughly tested by analyzing the fracture trace and lineament maps. Fracture traces range roughly between 0.5 m and 10 m - i e the usual extension of the sample outcrops. Between the raw data and final data used to compute the fracture size distribution from which the size distribution model will arise, several steps are necessary, in order to correct data from finite-size, topographical and sampling effects. More precisely, a particular attention is paid to fracture segmentation status and fracture linkage consistent with the DFN model expected. The fracture scaling trend observed over both sites displays finally a shape parameter k t close to 1.2 with a density term (α 2d ) between 1.4 and 1.8. Only two outcrops clearly display a different trend with k t close to 3 and a density term (α 2d ) between 2 and 3.5. The fracture lineaments spread over the range between 100 meters and a few kilometers. When compared with fracture trace maps, these datasets are already interpreted and the linkage process developed previously has not to be done. Except for the subregional lineament map from Forsmark, lineaments display a clear power-law trend with a shape parameter k t equal to 3 and a density term between 2 and 4.5. The apparent variation in scaling exponent, from the outcrop scale (k t = 1.2) on one side, to the lineament scale (k t = 2) on
Salmonella epidemiology: A whirlwind of change.
Besser, John M
2018-05-01
The field of infectious disease epidemiology for Salmonella and other enteric pathogens is undergoing some of the most profound changes since the time of Kauffman and White. Rapid advances in "big data" technologies such as genomics and metagenomics are making it possible to monitor and control salmonellosis in new and exciting ways. Epidemiological methods are becoming increasingly robust through the routine use of standardized hypothesis-generating questionnaires, iterative open-ended interviewing, informational trace-backs and new modeling techniques for describing the attribution of disease to food sources. In addition, Salmonella epidemiology is facing important challenges and new opportunities due to the rapid adoption of culture independent diagnostic test panels by clinical laboratories. Where is this unprecedented wave of change taking us? This chapter will examine emerging trends in Salmonella epidemiology, and take a peek into the not-so-distant future. Published by Elsevier Ltd.
Outcome analysis of sports-related multiple facial fractures.
Hwang, Kun; You, Sun Hye; Lee, Hong Sik
2009-05-01
In this paper, we report a retrospective study of 236 patients with facial bone fractures from various sports who were treated at the Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, South Korea, between February 1996 and April 2007. The medical records of these patients were reviewed and analyzed to determine the clinical characteristics and treatment of the sports-related facial bone fractures. The highest frequency of sports-related facial bone fractures was in the age group 11 to 20 years (40.3%); there was a significant male predominance in all age groups (13.75:1). The most common causes of the injury were soccer (38.1%), baseball (16.1%), basketball (12.7%), martial arts (6.4%), and skiing or snowboarding (11%). Fractures of the nasal bone were the most common in all sports; mandible fractures were common in soccer and martial arts, orbital bone fractures were common in baseball, basketball, and ice sports, and fractures of the zygoma were frequently seen in soccer and martial arts. The main causes of the sports injuries were direct body contact (50.8%), and the most commonly associated soft tissue injuries were found in the head and neck regions (92.3%). Nasal bone fractures were the most common (54.2%), and tripod fractures were the most common type of complex injuries (4.2%). The complication rate was 3.0%. Long-term epidemiological data regarding the natural history of sports-related facial bone fractures are important for the evaluation of existing preventative measures and for the development of new methods of injury prevention and treatment.
Ramírez-Crescencio, M A; Velásquez-Pérez, L; Ramírez-Crescencio, María Antonieta; Velásquez-Pérez, Leora
2013-08-01
The aim of this study was to identify the main neurological conditions associated with HIV/AIDS in Mexican patients treated at the National Institute of Neurology and Neurosurgery (NINN) in Mexico city, the main referral center for patients with disorders of the central and peripheral nervous system. An observational, transversal and descriptive analysis was performed. We reviewed the databases from the Department of Epidemiology and the medical records of patients with AIDS seen during the period from January 1st, 1995 to December 31, 2009. 320 patients were detected, the main conditions related to HIV/AIDS were brain toxoplasmosis (42%), cerebral criptoccocosis (28%), tuberculous meningitis (8.7%), linfoma no Hodking (3.75%), acute HIV infection (3.4%) and AIDS dementia complex (3%). No specific trend on morbility and mortality were detected during the period of study. In Mexico the most common neurological complications of HIV/AIDS are opportunistic infections. Copyright © 2013 Elsevier B.V. All rights reserved.
Al Awaidy, Salah Thabit; Al Obeidani, Idris; Bawikar, Shyam; Al Mahrouqi, Salim; Al Busaidy, Suleiman Salim; Al Baqlani, Said; Patel, Prakash K
2014-10-01
Dengue fever has emerged as a major public health problem globally in the past three decades. A 13-year national surveillance data analysis was done to describe the epidemiology and its trend of dengue disease in Oman reported between 2001 and 2013. Laboratory-confirmed dengue virus infections reported were studied retrospectively during the study period. A total of 64 laboratory confirmed cases were reported. All the patients contracted the disease during their visit to South-East Asian countries, hence classified as imported cases. The majority of the cases were reported in the year 2012 (23.4%). The most important clinical characteristics were fever (90.6%), myalgia (35.9%) and rash/petechial rash (20.3%). Thrombocytopenia was seen in 31.2% of the study subjects. The mortality was nearly 4.6% and all other patients made a full recovery. The most effective measure for travellers is taking precautions to avoid mosquito bites. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Impaired Fracture Healing after Hemorrhagic Shock
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Philipp Lichte
2015-01-01
Full Text Available Impaired fracture healing can occur in severely injured patients with hemorrhagic shock due to decreased soft tissue perfusion after trauma. We investigated the effects of fracture healing in a standardized pressure controlled hemorrhagic shock model in mice, to test the hypothesis that bleeding is relevant in the bone healing response. Male C57/BL6 mice were subjected to a closed femoral shaft fracture stabilized by intramedullary nailing. One group was additionally subjected to pressure controlled hemorrhagic shock (HS, mean arterial pressure (MAP of 35 mmHg for 90 minutes. Serum cytokines (IL-6, KC, MCP-1, and TNF-α were analyzed 6 hours after shock. Fracture healing was assessed 21 days after fracture. Hemorrhagic shock is associated with a significant increase in serum inflammatory cytokines in the early phase. Histologic analysis demonstrated a significantly decreased number of osteoclasts, a decrease in bone quality, and more cartilage islands after hemorrhagic shock. μCT analysis showed a trend towards decreased bone tissue mineral density in the HS group. Mechanical testing revealed no difference in tensile failure. Our results suggest a delay in fracture healing after hemorrhagic shock. This may be due to significantly diminished osteoclast recruitment. The exact mechanisms should be studied further, particularly during earlier stages of fracture healing.
Gender differences in the clinical characteristics of traumatic spinal fractures among the elderly.
Wang, Hongwei; Xiang, Liangbi; Liu, Jun; Zhou, Yue; Ou, Lan
2014-01-01
In order to illustrate the epidemiology of traumatic spinal fractures among the elderly, with an emphasis on exploring gender differences in clinical characteristics, we retrospectively reviewed hospital records on all elderly patients with traumatic spinal fractures who were 60 years of age or older at two university-affiliated hospitals between January 2001 and December 2010. A total of 642 elderly patients with traumatic spinal fractures were identified, of whom 249 were male and 393 were female. Accidental falls from low heights were the most common cause of traumatic spinal fractures among the elderly (50.8%). Frequencies of falls from high heights and direct collisions with a blunt object were significantly higher in male than in female elderly patients (Pspinal fractures, spinal cord injuries, associated non-spinal injuries (ASOIs) and mean injury severity scores (ISSs) were significantly higher in males than in females (Pspinal fractures in females were significantly higher than in males (Pspinal fractures among the elderly. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Keng Yin Loh; King Hock Shong; Soo Nie Lan; Lo, Wan-Yi; Shu Yuen Woon
2008-01-01
Osteoporosis is a silent disease and becomes clinically significant in the presence of fragility fracture. Identifying risk factors that are associated with osteoporosis in the community is important in reducing the incidence of fragility fracture. The aim of this study is to identify risk factors associated with fragility fracture in the Seremban District of Malaysia. This is a population comparison study between orthopedic ward patients and outpatients attending a community health clinic for 6 months. Epidemiological data and the possible risk factors for osteoporosis were collected by direct interview. This study demonstrates that advancing age, low body weight, smoking, lack of regular exercise, low consumption of calcium containing foods, and using bone depleting drugs (steroids, thyroid hormone, and frusemides) are major risk factors for fragility fracture. Most of these risk factors are modifiable through effective lifestyle intervention.
The epidemic of hip fractures: are we on the right track?
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Klaas A Hartholt
Full Text Available BACKGROUND: Hip fractures are a public health problem, leading to hospitalization, long-term rehabilitation, reduced quality of life, large healthcare expenses, and a high 1-year mortality. Especially older adults are at greater risk of fractures than the general population, due to the combination of an increased fall risk and osteoporosis. The aim of this study was to determine time trends in numbers and incidence rates of hip fracture-related hospitalizations and admission duration in the older Dutch population. METHODS AND FINDINGS: Secular trend analysis of all hospitalizations in the older Dutch population (≥65 years from 1981 throughout 2008, using the National Hospital Discharge Registry. Numbers, age-specific and age-adjusted incidence rates (per 10,000 persons of hospital admissions and hospital days due to a hip fracture were used as outcome measures in each year of the study. Between 1981 and 2008, the absolute number of hip fractures doubled in the older Dutch population. Incidence rates of hip fracture-related hospital admissions increased with age, and were higher in women than in men. The age-adjusted incidence rate increased from 52.0 to 67.6 per 10,000 older persons. However, since 1994 the incidence rate decreased (percentage annual change -0.5%, 95% CI: -0.7; -0.3, compared with the period 1981-1993 (percentage annual change 2.3%, 95% CI: 2.0; 2.7. The total number of hospital days was reduced by a fifth, due to a reduced admission duration in all age groups. A possible limitation was that data were obtained from a linked administrative database, which did not include information on medication use or co-morbidities. CONCLUSIONS: A trend break in the incidence rates of hip fracture-related hospitalizations was observed in the Netherlands around 1994, possibly as a first result of efforts to prevent falls and fractures. However, the true cause of the observation is unknown.
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Esaú Samuel Feitosa
2015-06-01
Full Text Available Envenoming snakebites are thought to be a particularly important threat to public health worldwide, especially in rural areas of tropical and subtropical countries. The true magnitude of the public health threat posed by snakebites is unknown, making it difficult for public health officials to optimize prevention and treatment. The objective of this work was to conduct a systematic review of the literature to gather data on snakebite epidemiology in the Amazon region and describe a case series of snakebites from epidemiological surveillance in the State of Amazonas (1974-2012. Only 11 articles regarding snakebites were found. In the State of Amazonas, information regarding incidents involving snakes is scarce. Historical trends show an increasing number of cases after the second half of the 1980s. Snakebites predominated among adults (20-39 years old; 38%, in the male gender (78.9% and in those living in rural areas (85.6%. The predominant snake envenomation type was bothropic. The incidence reported by the epidemiological surveillance in the State of Amazonas, reaching up to 200 cases/100,000 inhabitants in some areas, is among the highest annual snakebite incidence rates of any region in the world. The majority of the cases were reported in the rainy season with a case-fatality rate of 0.6%. Snakebite envenomation is a great disease burden in the State of Amazonas, representing a challenge for future investigations, including approaches to estimating incidence under-notification and case-fatality rates as well as the factors related to severity and disabilities.
NATO Advanced Study Institute on Disorder and Fracture
Roux, S; Guyon, E
1990-01-01
Fracture, and particularly brittle fracture, is a good example of an instability. For a homogeneous solid, subjected to a uniform stress field, a crack may appear anywhere in the structure once the threshold stress is reached. However, once a crack has been nucleated in some place, further damage in the solid will in most cases propagate from the initial crack, and not somewhere else in the solid. In this sense fracture is an unstable process. This property makes the process extremely sensitive to any heterogeneity present in the medium, which selects the location of the first crack nucleated. In particular, fracture appears to be very sensitive to disorder, which can favor or impede local cracks. Therefore, in most realistic cases, a good description of fracture mechanics should include the effect of disorder. Recently this need has motivated work in this direction starting from the usual description of fracture mechanics. Parallel with this first trend, statistical physics underwent a very important develop...
Tendências no ensino da epidemiologia no Brasil Trends in the teaching of epidemiology in Brazil
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Rita Barradas Barata
1997-01-01
development of biostatistical techniques. Currently, the definition of guidelines for the teaching of epidemiology in Brazil depends on careful reflection regarding a number of issues, among which are the reformulation or elimination of medical residency programs in preventive medicine, social medicine, and collective health; the creation of masters and doctoral programs exclusively in epidemiology; the conflict between a theoretical emphasis and a technical emphasis; and the development of strategies to strengthen new instructional groups that are being created in teaching institutions in less developed regions of the country. A positive trend is that teaching institutions are working more closely with health services, both for training personnel and for providing technical support in planning, organizing, and evaluating health programs. Regarding the teaching of health service professionals, successful training depends on how well teachers can provide in-service training that ties students' learning to real work situations, where the application of theories can be understood in the natural context of real problems.
Pediatric mandibular fractures treated by rigid internal fixation.
Wong, G B
1993-09-01
Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.
Management of nonunion after an old - neglected ankle fracture in diabetic patient; case report
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Tudor M. Gavrilă
2016-11-01
Full Text Available Ankle fractures represent 9% of fractures. Even if it is a relatively usual fracture, the presence of diabetes makes treatment more difficult and rate of complications is higher than in the rest of population. The incidence of ankle fractures increased in the last half century. Many studies from SUA, England, Sweden and Finland suggest that the epidemiology of ankle fractures continues to change as populations age, up to the age 60 of years in men and above age of 50 years in women. Two-thirds of fractures are isolated malleolar fractures, bimalleolar fractures occur in one-fourth of patients and trimaleolar fractures occur in the rest of them. We present a case of 60 years old women with non-insulin dependent diabetes for 22 years who sustained a fracture of ankle. Her first presentation at doctor was after 4 months after injury and surgical treatment occurred after 8 months after the injury. She was operated using an external fixator. Despite the fact the treatment was delayed, the evolution of lesion was good and patient could regained normal gate.
Epidemiology of selected gynaecological malignancies in Slovakia
International Nuclear Information System (INIS)
Ondrusova, M.; Psenkova, M.; Sadovsky, O.
2015-01-01
The study analyses selected trends of descriptive epidemiology of ovarian cancer, endometrial cancer and cervical cancer in Slovakia point to time trends in their development, enabling a prediction of the development of the indicators in the years to come. Based on the results of analyses, it was discovered that the incidence of ovarian cancer and endometrial cancer in women in Slovakia is rising continually and significantly, while mortality in both diagnoses is declining. In respect of cervical cancer, a stabilised trend in incidence was registered, with an important, but very mild drop in mortality values. (author)
Self-potential observations during hydraulic fracturing
Energy Technology Data Exchange (ETDEWEB)
Moore, Jeffrey R.; Glaser, Steven D.
2007-09-13
The self-potential (SP) response during hydraulic fracturing of intact Sierra granite was investigated in the laboratory. Excellent correlation of pressure drop and SP suggests that the SP response is created primarily by electrokinetic coupling. For low pressures, the variation of SP with pressure drop is linear, indicating a constant coupling coefficient (Cc) of -200 mV/MPa. However for pressure drops >2 MPa, the magnitude of the Cc increases by 80% in an exponential trend. This increasing Cc is related to increasing permeability at high pore pressures caused by dilatancy of micro-cracks, and is explained by a decrease in the hydraulic tortuosity. Resistivity measurements reveal a decrease of 2% prior to hydraulic fracturing and a decrease of {approx}35% after fracturing. An asymmetric spatial SP response created by injectate diffusion into dilatant zones is observed prior to hydraulic fracturing, and in most cases this SP variation revealed the impending crack geometry seconds before failure. At rupture, injectate rushes into the new fracture area where the zeta potential is different than in the rock porosity, and an anomalous SP spike is observed. After fracturing, the spatial SP distribution reveals the direction of fracture propagation. Finally, during tensile cracking in a point load device with no water flow, a SP spike is observed that is caused by contact electrification. However, the time constant of this event is much less than that for transients observed during hydraulic fracturing, suggesting that SP created solely from material fracture does not contribute to the SP response during hydraulic fracturing.
Update on the epidemiology of the rheumatic diseases.
Gabriel, S E
1996-03-01
Epidemiologic studies continue to enhance our understanding of the rheumatic diseases. Such studies now indicate that 26 million American women are at risk for osteoporotic fractures. Contrary to previous recommendations, the identification and treatment of patients at risk for osteoporosis may be valuable even among very elderly people. Other epidemiologic studies suggest that the incidence of rheumatoid arthritis is decreasing and that it is a more benign disease than previously recognized. Osteoarthritis remains a leading cause of physical and work disability in North America. The roles of occupational physical activity, obesity, and highly competitive (though not low-impact) exercise as risk factors for osteoarthritis continue to be explored. Pharmacoepidemiologic research has recently demonstrated that a policy of prior authorization for prescription of nonsteroidal anti-inflammatory drugs may be highly cost effective. Finally, controlled epidemiologic studies have not confirmed an association between silicone breast implants and connective tissue diseases, a conclusion recently endorsed by the American College of Rheumatology.
Energy Technology Data Exchange (ETDEWEB)
Darcel, C. (Itasca Consultants SAS (France)); Davy, P.; Le Goc, R.; Dreuzy, J.R. de; Bour, O. (Geosciences Rennes, UMR 6118 CNRS, Univ. def Rennes, Rennes (France))
2009-11-15
Investigations led for several years at Laxemar and Forsmark reveal the large heterogeneity of geological formations and associated fracturing. This project aims at reinforcing the statistical DFN modeling framework adapted to a site scale. This leads therefore to develop quantitative methods of characterization adapted to the nature of fracturing and data availability. We start with the hypothesis that the maximum likelihood DFN model is a power-law model with a density term depending on orientations. This is supported both by literature and specifically here by former analyses of the SKB data. This assumption is nevertheless thoroughly tested by analyzing the fracture trace and lineament maps. Fracture traces range roughly between 0.5 m and 10 m - i e the usual extension of the sample outcrops. Between the raw data and final data used to compute the fracture size distribution from which the size distribution model will arise, several steps are necessary, in order to correct data from finite-size, topographical and sampling effects. More precisely, a particular attention is paid to fracture segmentation status and fracture linkage consistent with the DFN model expected. The fracture scaling trend observed over both sites displays finally a shape parameter k{sub t} close to 1.2 with a density term (alpha{sub 2d}) between 1.4 and 1.8. Only two outcrops clearly display a different trend with k{sub t} close to 3 and a density term (alpha{sub 2d}) between 2 and 3.5. The fracture lineaments spread over the range between 100 meters and a few kilometers. When compared with fracture trace maps, these datasets are already interpreted and the linkage process developed previously has not to be done. Except for the subregional lineament map from Forsmark, lineaments display a clear power-law trend with a shape parameter k{sub t} equal to 3 and a density term between 2 and 4.5. The apparent variation in scaling exponent, from the outcrop scale (k{sub t} = 1.2) on one side, to
Reddy, N Viveka V; Reddy, P Bhaskar; Rajan, Ritesh; Ganti, Srinivas; Jhawar, D K; Potturi, Abhinand; Pradeep
2013-09-01
This study aims to evaluate incidence, patterns and epidemiology of mandibular condylar fractures (MCF) to propose a treatment strategy for managing MCF and analyze the factors which influence the outcome. One hundred and seventy-five MCF's were evaluated over a four year period and their pattern was recorded in terms of displacement, level of fracture, age of incidence and dental occlusion. Of the 2,718 facial bone fractures, MCF incidence was the third most common at 18.39 %. Of 175 MCF 58.8 % were unilateral and 41.12 % were bilateral. 67 % of bilateral fractures and 43.8 % of unilateral fractures were associated with midline symphysis and contralateral parasymphysis fractures respectively. Most of the MCF was seen in the age group of above 16 years and 50 % of them were at subcondylar level (below the neck of the condyle). Majority of MCF sustained due to inter personal violence were undisplaced (72.7 %) and contrary to this majority of MCF sustained during road traffic accident were displaced. 62.9 % of total fractures required open reduction and rigid fixation and 37.1 % were managed with closed reduction. 80 % of MCF managed with closed reduction were in the age group of below 16 years. From this study it can be concluded that the treatment algorithm proposed for managing MCF is reliable and easy to adopt. We observed that absolute indication for open reduction of MCF is inability to achieve satisfactory occlusion by closed method and absolute contraindication for open reduction is condylar head fracture irrespective of the age of the patient.
"Epidemiological criminology": coming full circle.
Akers, Timothy A; Lanier, Mark M
2009-03-01
Members of the public health and criminal justice disciplines often work with marginalized populations: people at high risk of drug use, health problems, incarceration, and other difficulties. As these fields increasingly overlap, distinctions between them are blurred, as numerous research reports and funding trends document. However, explicit theoretical and methodological linkages between the 2 disciplines remain rare. A new paradigm that links methods and statistical models of public health with those of their criminal justice counterparts is needed, as are increased linkages between epidemiological analogies, theories, and models and the corresponding tools of criminology. We outline disciplinary commonalities and distinctions, present policy examples that integrate similarities, and propose "epidemiological criminology" as a bridging framework.
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Mauricélia da Silveira Lima
Full Text Available Abstract: Co-infection of tuberculosis (TB-HIV/AIDS is a persistent public health problem in Brazil. This study describes epidemiological patterns and time trends of mortality related to TB-HIV/AIDS co-infection. Based on mortality data from 2000-2011 (almost 12.5 million deaths, 19,815 deaths related to co-infection were analyzed. The average age-adjusted mortality rate was 0.97 deaths/100,000 inhabitants. The highest mortality rates were found among males, those in economically productive age groups, black race/color and residents of the South region. There was a significant reduction in the mortality coefficient at the national level (annual average percent change: -1.7%; 95%CI: -2.4; -1.0, with different patterns among regions: increases in the North, Northeast and Central regions, a reduction in the Southeast and a stabilization in the South. The strategic integration of TB-HIV/AIDS control programmes is fundamental to reduce the burden of mortality related to co-infection in Brazil.
Effect of Birth Cohort on Risk of Hip Fracture: Age-Specific Incidence Rates in the Framingham Study
Samelson, Elizabeth J.; Zhang, Yuqing; Kiel, Douglas P.; Hannan, Marian T.; Felson, David T.
2002-01-01
Objectives. This study examined the effect of birth cohort on incidence rates of hip fracture among women and men in the Framingham Study. Methods. Age-specific incidence rates of first hip fracture were presented according to tertile of year of birth for 5209 participants of the Framingham Study, a population-based cohort followed since 1948. Sex-specific incidence rate ratios were calculated by Cox regression to assess the relation between birth cohort and hip fracture incidence. Results. An increasing trend in hip fracture incidence rates was observed with year of birth for women (trend, P = .05) and men (trend, P = .03). Relative to those born from 1887 to 1900 (incidence rate ratio [IRR] = 1.0), age-specific incidence rates were greatest in the most recent birth cohort, born from 1911 to 1921 (IRR = 1.4 for women, IRR = 2.0 for men), and intermediate in those born from 1901 to 1910 (IRR = 1.2 for women, IRR = 1.5 for men). Conclusions. Results suggest risk of hip fracture is increasing for successive birth cohorts. Projections that fail to account for the increase in rates associated with birth cohort underestimate the future public health impact of hip fracture in the United States. PMID:11988460
Alvaro-Meca, Alejandro; Ryan, Pablo; Martínez-Larrull, Esther; Micheloud, Dariela; Berenguer, Juan; Resino, Salvador
2018-02-01
Chronic infections may be a triggering factor as well as a risk factor of deep venous thrombosis (DVT). The purpose of this study was to analyze the epidemiological trends of hospital admissions related to DVT in human immunodeficiency virus (HIV)-infected patients during the combination antiretroviral therapy (cART) era, in relation to hepatitis C virus (HCV) serological status. We performed a retrospective study using the Spanish Minimum Basic Data Set. We selected HIV-infected subjects over 15years old with a hospital admission and DVT diagnosis (ICD-9-CM codes: 453.4x and 453.8x) between 1997 and 2013. Patients were classified according to HCV serology. We estimated the incidence (events per 100,000 patient-years) in four calendar periods (1997-1999, 2000-2003, 2004-2007, and 2008-2013). Overall, the incidence of DVT-related hospitalizations had a significant upward trend in all HIV-infected patients (PHIV-monoinfected patients than in HIV/HCV-coinfected patients during the entire follow-up (PHIV-monoinfected patients (P=0.002) and a significant upward trend in HIV/HCV-coinfected patients (PHIV-monoinfected patients significantly decreased from 1997-1999 to 2008-2013 [142.7 vs. 103.1 (P=0.006)], whereas in HIV/HCV-coinfected patients, the incidence increased from 8.4 (1997-1999) to 70.7 (2008-2013) (PHIV-infected patients, with increasing incidence during the first 17years after the introduction of cART, particularly in HIV/HCV-coinfected patients. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Sliding contact fracture of dental ceramics: Principles and validation
Ren, Linlin; Zhang, Yu
2014-01-01
Ceramic prostheses are subject to sliding contact under normal and tangential loads. Accurate prediction of the onset of fracture at two contacting surfaces holds the key to greater long-term performance of these prostheses. In this study, building on stress analysis of Hertzian contact and considering fracture criteria for linear elastic materials, a constitutive fracture mechanics relation was developed to incorporate the critical fracture load with the contact geometry, coefficient of friction and material fracture toughness. Critical loads necessary to cause fracture under a sliding indenter were calculated from the constitutive equation, and compared with the loads predicted from elastic stress analysis in conjunction with measured critical load for frictionless normal contact—a semi-empirical approach. The major predictions of the models were calibrated with experimentally determined critical loads of current and future dental ceramics after contact with a rigid spherical slider. Experimental results conform with the trends predicted by the models. PMID:24632538
INCIDENCE AND CHARACTERIZATION OF ELDERLY IN THE ORTHOPEDIC CLINIC FOR FEMUR FRACTURE, CACERES MT
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Andréia Costa Ferreira
2013-05-01
Full Text Available Introduction:The elderly population is growing gradually in recent years, it increases theincidence of elderly people at risk of falls and hip fractures develop.Objective:To identifythe incidence and characterize elderly patients hospitalized with hip fractures in theOrthopedic Clinic of the Hospital Regional Dr º Antonio Cáceres sources.Methodology:Thisis an epidemiological, descriptive, quantitative and retrospective data collection documentbasis. The study population comprised 105.Results:It was found that the fracture of thefemur showed predominance in females, comprising 40.90% of the cases and the right lowerlimb most affected. As for location, the trochanteric fractures showed 39.04%, followed byfractures of the femoral shaftwith 27.61% of the cases. The treatment applied in 62.85% ofpatients went to surgery.Conclusion:It is concluded that the femur fracture may preclude theelderly in their daily activities.
Anchorage strategies in geriatric hip fracture management
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Knobe Matthias
2016-12-01
Full Text Available There is an enormous humanitarian and socioeconomic need to improve the quality and effectiveness of care for patients with hip fracture. To reduce mechanical complications in the osteosynthesis of proximal femoral fractures, improved fixation techniques have been developed including blade or screw-anchor devices, locked minimally invasive or cement augmentation strategies. However, despite numerous innovations and advances regarding implant design and surgical techniques, systemic and mechanical complication rates remain high. Treatment success depends on secure implant fixation in often-osteoporotic bone as well as on patient-specific factors (fracture stability, bone quality, comorbidity, and gender and surgeon-related factors (experience, correct reduction, and optimal screw placement in the head/neck fragment. For fracture fixation, the anchorage of the lag screw within the femoral head plays a crucial role depending on the implant’s design. Meta-analyses and randomized controlled studies demonstrate that there is a strong trend towards arthroplasty treating geriatric femoral neck fractures. However, for young adults as well as older patients with less compromised bone quality, or in undisplaced fractures, head-preserving therapy is preferred as it is less invasive and associated with good functional results. This review summarizes the evidence for the internal fixation of femoral neck fractures and trochanteric femoral fractures in elderly patients. In addition, biomechanical considerations regarding implant anchorage in the femoral head including rotation, migration, and femoral neck shortening are made. Finally, cement augmentation strategies for hip fracture implants are evaluated critically.
Google Trends terms reporting rhinitis and related topics differ in European countries
DEFF Research Database (Denmark)
Bousquet, J.; Agache, I; Anto, J M
2017-01-01
Google Trends (GT) searches trends of specific queries in Google and reflects the real-life epidemiology of allergic rhinitis. We compared Google Trends terms related to allergy and rhinitis in all European Union countries, Norway and Switzerland from 1 January 2011 to 20 December 2016. The aim w...
A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.
Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E
2016-06-01
Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.
The incidence of hip fractures in Norway -accuracy of the national Norwegian patient registry
DEFF Research Database (Denmark)
Høiberg, Mikkel; Gram, Jeppe; Hermann, Pernille
2014-01-01
% C.I. 8,934-9,249), excluding only 6.5% of all hip fractures defined by wider definitions. Conclusions: Based on current coding practice in Norway, a reliable national estimate of hip fracture incidences is found by a combination of relevant ICD-10 and NOMESCO codes in the NPR. This method may......Background: Hip fractures incur the greatest medical costs of any fracture. Valid epidemiological data are important to monitor for time-dependent changes. In Norway, hip fractures are registered in the Norwegian Patient Registry (NPR), but no published national validation exists. The aim...... of the present study was a national validation of NPR as a register for hip fractures using diagnostic codes (ICD-10 S 72.0-2) and/or procedure codes (NOMESCO version 1.14 NFBxy (x = 0-9, y = 0-2) or NFJxy (x = 0-9, y = 0-2). Method: A nationwide, population-based cohort comprising a random sub-sample of 1...
Surgical Management of Rib Fractures: Strategies and Literature Review.
de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H
2014-06-01
Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.
International Nuclear Information System (INIS)
Siggeirsdottir, Kristin; Aspelund, Thor; Sigurdsson, Gunnar; Mogensen, Brynjolfur; Chang, Milan; Jonsdottir, Birna; Eiriksdottir, Gudny; Launer, Lenore J.; Harris, Tamara B.; Jonsson, Brynjolfur Y.; Gudnason, Vilmundur
2007-01-01
Introduction and objective Misreporting fractures in questionnaires is known. However, the effect of misreporting on the association of fractures with subsequent health outcomes has not been examined. Methods Data from a fracture registry (FR) developed from an extensive review of radiographic and medical records were related to self-report of fracture for 2,255 participants from the AGES Reykjavik Study. This data was used to determine false negative and false positive rates of self-reported fractures, correlates of misreporting, and the potential effect of the misreporting on estimates of health outcomes following fractures. Results In women, the false positive rate decreased with age as the false negative rate increased with no clear trend with age in men. Kappa values for agreement between FR and self-report were generally higher in women than men with the best agreement for forearm fracture (men 0.64 and women 0.82) and the least for rib (men 0.28 and women 0.25). Impaired cognition was a major factor associated with discordant answers between FR and self-report, OR 1.7 (95% CI: 1.3-2.1) (P < 0.0001). We estimated the effect of misreporting on health after fracture by comparison of the association of the self-report of fracture and fracture from the FR, adjusting for those factors associated with discordance. The weighted attenuation factor measured by mobility and muscle strength was 11% (95% CI: 0-24%) when adjusted for age and sex but reduced to 6% (95% CI: -10-22%) when adjusted for cognitive impairment. Conclusion Studies of hip fractures should include an independent ascertainment of fracture but for other fractures this study supports the use of self-report
The changing epidemiology of Staphylococcus aureus bloodstream infection
DEFF Research Database (Denmark)
Laupland, K.B.; Lyytikäinen, O.; Søgaard, Mette
2013-01-01
Clin Microbiol Infect ABSTRACT: Although the epidemiology of Staphylococcus aureus bloodstream infection (BSI) has been changing, international comparisons are lacking. We sought to determine the incidence of S. aureus BSI and assess trends over time and by region. Population-based surveillance w...
International Nuclear Information System (INIS)
Cheverton, R.D.; Canonico, D.A.; Iskander, S.K.; Bolt, S.E.; Holz, P.P.; Nanstad, R.K.; Stelzman, W.J.
1982-01-01
Pressurized water reactors (PWRs) are susceptible to certain types of hypothetical accidents that can subject the reactor pressure vessel to severe thermal shock, that is, a rapid cooling of the inner surface of the vessel wall. The thermal-shock loading, coupled with the radiation-induced reduction in the material fracture toughness, introduces the possibility of propagation of preexistent flaws and what at one time were regarded as somewhat unique fracture-oriented conditions. Several postulated reactor accidents have been analyzed to discover flaw behavior trends; seven intermediate-scale thermal-shock experiments with steel cylinders have been conducted; and corresponding materials characterization studies have been performed. Flaw behavior trends and related fracture-mechanics data deduced from these studies are discussed
Current Trends in the Management of Lateral Ankle Sprain in the United States.
Feger, Mark A; Glaviano, Neal R; Donovan, Luke; Hart, Joseph M; Saliba, Susan A; Park, Joseph S; Hertel, Jay
2017-03-01
To characterize trends in the acute management (within 30 days) after lateral ankle sprain (LAS) in the United States. Descriptive epidemiology study. Of note, 825 718 ankle sprain patients were identified; 96.2% were patients with LAS. Seven percent had an associated fracture and were excluded from the remaining analysis. Primary and tertiary care settings. We queried a database of national health insurance records for 2007 to 2011 by ICD-9 codes for patients with LAS while excluding medial and syndesmotic sprains and any LAS with an associated foot or ankle fracture. The percentage of patients to receive specific diagnostic imaging, orthopedic devices, or physical therapy treatments within 30 days of the LAS diagnosis and the associated costs. Over two-thirds of patients with LAS without an associated fracture received radiographs, 9% received an ankle brace, 8.1% received a walking boot, 6.5% were splinted, and 4.8% were prescribed crutches. Only 6.8% received physical therapy within 30 days of their LAS diagnosis, 94.1% of which performed therapeutic exercise, 52.3% received manual therapy, and 50.2% received modalities. The annual cost associated with physician visits, diagnostic imaging, orthopedic devices, and physical therapy was 152 million USD, 81.5% was from physician evaluations, 7.9% from physical therapy, 7.2% from diagnostic imaging, and 3.4% from orthopedic devices. Most patients with LAS do not receive supervised rehabilitation. The small proportion of patients with LAS to receive physical therapy get rehabilitation prescribed in accordance with clinical practice guidelines. The majority (>80%) of the LAS financial burden is associated with physician evaluations.
Six paths for the future of social epidemiology.
Galea, Sandro; Link, Bruce G
2013-09-15
Social epidemiology is now an accepted part of the academic intellectual landscape. However, in many ways, social epidemiology also runs the risk of losing the identity that distinguished it as a field during its emergence. In the present article, we scan the strengths of social epidemiology to imagine paths forward that will make the field distinct and useful to the understanding of population health in future. We suggest 6 paths to such a future, each emerging from promising research trends in the field in which social epidemiologists can, and should, lead in coming years. Each of these paths contributes to the formation of distinct capacities that social epidemiologists can claim and use to elaborate or fill in gaps in the already strong history of social epidemiology. They present an opportunity for the field to build on its strengths and move forward while leading in new and critical areas in population health.
Trends in Invasive Infection with MRSA
Centers for Disease Control (CDC) Podcasts
2012-07-17
Dr. James Hadler, Associate Professor of Epidemiology and Public Health at the Yale School of Public Health, discusses recent trends in MRSA. Created: 7/17/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 7/19/2012.
Ferree, Steven; van der Vliet, Quirine M J; Nawijn, Femke; Bhashyam, Abhiram R; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco
2018-03-01
For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included. Patients with an Injury Severity Score of 16 or higher were classified as polytrauma patients. Injuries were defined as high or low energy. All DRFs were classified using the AO/OTA fracture classification system. A total of 830 patients with a DRF were included, 12% were polytrauma. The incidence rate of DRF in polytrauma patients was 3.5%. Ipsilateral upper extremity injury was found in >30% of polytrauma and high-energy monotrauma patients, compared to 5% in low-energy monotrauma patients. More type C DRF were found in polytrauma and high-energy monotrauma patients versus low-energy monotrauma patients. Operative intervention rates for all types of DRF were similar for polytrauma and high-energy monotrauma patients. Non-union rates were higher in polytrauma patients. Higher energy mechanisms of injury, in polytrauma and high-energy monotrauma patients, were associated with more severe complex articular distal radius fractures and more ipsilateral upper extremity injuries. Polytrauma and high-energy monotrauma patient have a similar fracture morphology. However, polytrauma patients have in addition to more injured body regions also more non-union related interventions than high-energy monotrauma patients. Copyright © 2018 Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Moayeri A
2017-04-01
Full Text Available Ardeshir Moayeri,1 Mahmoud Mohamadpour,2 Seyedeh Fatemeh Mousavi,3 Ehsan Shirzadpour,2 Safoura Mohamadpour,3 Mansour Amraei4 1Department of Anatomy, 2Department of Biochemistry, Faculty of Medicine, 3Department of Epidemiology, Prevention of Psychosocial Injuries Research Center, 4Department of Physiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Aim: Patients with type 2 diabetes mellitus (T2DM have an increased risk of bone fractures. A variable increase in fracture risk has been reported depending on skeletal site, diabetes duration, study design, insulin use, and so on. The present meta-analysis aimed to investigate the association between T2DM with fracture risk and possible risk factors.Methods: Different databases including PubMed, Institute for Scientific Information, and Scopus were searched up to May 2016. All epidemiologic studies on the association between T2DM and fracture risk were included. The relevant data obtained from these papers were analyzed by a random effects model and publication bias was assessed by funnel plot. All analyses were done by R software (version 3.2.1 and STATA (version 11.1.Results: Thirty eligible studies were selected for the meta-analysis. We found a statistically significant positive association between T2DM and hip, vertebral, or foot fractures and no association between T2DM and wrist, proximal humerus, or ankle fractures. Overall, T2DM was associated with an increased risk of any fracture (summary relative risk =1.05, 95% confidence interval: 1.04, 1.06 and increased with age, duration of diabetes, and insulin therapy.Conclusion: Our findings strongly support an association between T2DM and increased risk of overall fracture. These findings emphasize the need for fracture prevention strategies in patients with diabetes. Keywords: diabetes mellitus, fractures, bone, osteoporosis, risk factors, meta-analysis
Hand Fractures: Indications, the Tried and True and New Innovations.
Cheah, Andre Eu-Jin; Yao, Jeffrey
2016-06-01
Hand fractures are the second most common fracture of the upper extremity, and management of patients with these injuries is common for most hand surgery practices. In this article, we outline the principles of management of these injuries with a special focus on those that are common or complex. We also highlight recent innovations in the context of these injuries. From this cross-section of contemporary evidence on phalangeal and metacarpal fracture treatment, we have noted a trend toward minimally invasive surgery with immediate postoperative mobilization, the use of wide-awake anesthesia, as well as sustained investigation and innovation in the biomechanics and treatment of proximal interphalangeal joint fracture dislocations. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
“Epidemiological Criminology”: Coming Full Circle
Lanier, Mark M.
2009-01-01
Members of the public health and criminal justice disciplines often work with marginalized populations: people at high risk of drug use, health problems, incarceration, and other difficulties. As these fields increasingly overlap, distinctions between them are blurred, as numerous research reports and funding trends document. However, explicit theoretical and methodological linkages between the 2 disciplines remain rare. A new paradigm that links methods and statistical models of public health with those of their criminal justice counterparts is needed, as are increased linkages between epidemiological analogies, theories, and models and the corresponding tools of criminology. We outline disciplinary commonalities and distinctions, present policy examples that integrate similarities, and propose “epidemiological criminology” as a bridging framework. PMID:19150901
VoPham, Trang; Hart, Jaime E; Laden, Francine; Chiang, Yao-Yi
2018-04-17
Geospatial artificial intelligence (geoAI) is an emerging scientific discipline that combines innovations in spatial science, artificial intelligence methods in machine learning (e.g., deep learning), data mining, and high-performance computing to extract knowledge from spatial big data. In environmental epidemiology, exposure modeling is a commonly used approach to conduct exposure assessment to determine the distribution of exposures in study populations. geoAI technologies provide important advantages for exposure modeling in environmental epidemiology, including the ability to incorporate large amounts of big spatial and temporal data in a variety of formats; computational efficiency; flexibility in algorithms and workflows to accommodate relevant characteristics of spatial (environmental) processes including spatial nonstationarity; and scalability to model other environmental exposures across different geographic areas. The objectives of this commentary are to provide an overview of key concepts surrounding the evolving and interdisciplinary field of geoAI including spatial data science, machine learning, deep learning, and data mining; recent geoAI applications in research; and potential future directions for geoAI in environmental epidemiology.
Energy Technology Data Exchange (ETDEWEB)
Knight, Bill; Schechter, David S.
2001-11-19
The goal of this project was to assess the economic feasibility of CO{sub 2} flooding the naturally fractured Spraberry Trend Area in west Texas. This objective was accomplished through research in four areas: (1) extensive characterization of the reservoirs, (2) experimental studies of crude oil/brine/rock (COBR) interactions in the reservoirs, (3) reservoir performance analysis, and (4) experimental investigations on CO{sub 2} gravity drainage in Spraberry whole cores. The four areas have been completed and reported in the previous annual reports. This report provides the results of the final year of the project including two SPE papers (SPE 71605 and SPE 71635) presented in the 2001 SPE Annual Meeting in New Orleans, two simulation works, analysis of logging observation wells (LOW) and progress of CO{sub 2} injection.
Fracture patterns in the Zagros fold-and-thrust belt, Kurdistan Region of Iraq
Reif, Daniel; Decker, Kurt; Grasemann, Bernhard; Peresson, Herwig
2012-11-01
Fracture data have been collected in the Kurdistan Region of Iraq, which is a poorly accessible and unexplored area of the Zagros. Pre to early folding NE-SW striking extensional fractures and NW-SE striking contractive elements represent the older set affecting the exposed multilayer of the area. These latter structures are early syn-folding and followed by folding-related mesostructural assemblages, which include elements striking parallel to the axial trend of major folds (longitudinal fractures). Bedding perpendicular joints and veins, and extensional faults belonging to this second fracture set are located in the outer arc of exposed anticlines, whilst longitudinal reverse faults locate in the inner arcs. Consistently, these elements are associated with syn-folding tangential longitudinal strain. The younger two sets are related to E-W extension and NNE-SSW to N-S shortening, frequently displaying reactivation of the older sets. The last shortening event, which is described along the entire Zagros Belt, probably relates with the onset of N-S compression induced by the northward movement of the Arabian plate relative to the Eurasian Plate. In comparison between the inferred palaeostrain directions and the kinematics of recent GPS measurements, we conclude that the N-S compression and the partitioning into NW-SE trending folds and NW to N trending strike-slip faults likely remained unchanged throughout the Neogene tectonic history of the investigated area.
2D Geoelectric Imaging of the Uneme-Nekhua Fracture Zone
Directory of Open Access Journals (Sweden)
Muslim B. Aminu
2014-01-01
Full Text Available We have employed 2D geoelectric imaging to reveal the geometry and nature of a fracture zone in Uneme-Nekhua, southwestern Nigeria. The fracture zone is discernable from an outcropping rock scarp and appears to define the course of a seasonal stream. Data were acquired using the dipole-dipole survey array configuration with electrode separation of 6 m and a maximum dipole length of 60 m. Three traverses with lengths varying between 72 m and 120 m were laid orthogonal to the course of the seasonal stream. 2D geoelectric images of the subsurface along the profiles imaged a north-south trending fracture zone. This fracture zone appears to consist of two vertical fractures with more intense definition downstream. The eastern fracture is buried by recent sediment, while the western fracture appears to have experienced more recent tectonic activity as it appears to penetrate through the near surface. Perhaps at some point, deformation ceased on the eastern fracture and further strain was transferred to the western fracture. The fracture zone generally defines the course of the north-south seasonal stream with the exception of the downstream end where the fracture appears to have died out entirely. Two associated basement trenches lying parallel to and east of the fracture zone are also imaged.
The fluid mechanics of channel fracturing flows: experiment
Rashedi, Ahmadreza; Tucker, Zachery; Ovarlez, Guillaume; Hormozi, Sarah
2017-11-01
We show our preliminary experimental results on the role of fluid mechanics in channel fracturing flows, particularly yield stress fracturing fluids. Recent trends in the oil industry have included the use of cyclic pumping of a proppant slurry interspersed with a yield stress fracturing fluid, which is found to increase wells productivity, if particles disperse in a certain fashion. Our experimental study aims to investigate the physical mechanisms responsible for dispersing the particles (proppant) within a yield stress carrier fluid, and to measure the dispersion of proppant slugs in various fracturing regimes. To this end we have designed and built a unique experimental setup that resembles a fracture configuration coupled with a particle image/tracking velocimetry setup operating at micro to macro dimensions. Moreover, we have designed optically engineered suspensions of complex fluids with tunable yield stress and consistency, well controlled density match-mismatch properties and refractive indices for both X-rays and visible lights. We present our experimental system and preliminary results. NSF (Grant No. CBET-1554044- CAREER), ACS PRF (Grant No. 55661-DNI9).
Wang, D Z; Wang, C; Shen, C F; Zhang, Y; Zhang, H; Song, G D; Xue, X D; Xu, Z L; Zhang, S; Jiang, G H
2017-05-10
We described the time trend of acute myocardial infarction (AMI) from 1999 to 2013 in Tianjin incidence rate with Cochran-Armitage trend (CAT) test and linear regression analysis, and the results were compared. Based on actual population, CAT test had much stronger statistical power than linear regression analysis for both overall incidence trend and age specific incidence trend (Cochran-Armitage trend P valuelinear regression P value). The statistical power of CAT test decreased, while the result of linear regression analysis remained the same when population size was reduced by 100 times and AMI incidence rate remained unchanged. The two statistical methods have their advantages and disadvantages. It is necessary to choose statistical method according the fitting degree of data, or comprehensively analyze the results of two methods.
Epidemiological and demographic HIV/AIDS projections: South Africa
African Journals Online (AJOL)
Epidemiological and demographic HIV/AIDS projections: South Africa. ... African Journal of AIDS Research ... Projections and the Spectrum model program developed by the Futures Group were used to model the South African HIV epidemic, project future trends in HIV/AIDS and estimate the demographic impact of AIDS.
Fragility fractures at Auckland City Hospital: we can do better.
Braatvedt, Geoffrey; Wilkinson, Susan; Scott, Marilyn; Mitchell, Paul; Harris, Roger
2017-12-01
This study describes in detail the burden of caring for patients aged ≥ 50 years seen in one year with a fragility fracture in a large urban environment and shows that these fractures result in a long length of stay and significant mortality. Intervention to prevent further fracture was poorly done. To examine the epidemiology of fragility fracture in patients over age 50 years and record the number who received appropriate secondary prevention treatment. All patients aged ≥ 50 years presenting with a fracture during the 12 months following July 1 st 2011, to Auckland City Hospital or residing in central Auckland at the time of their fracture, were identified from hospital and Accident Compensation Corporation records. A random sample of 55% of these patient's records were reviewed to establish the type of fracture, prior fracture and falls history, and use of bisphosphonates in the 12 months before presentation. Their length of stay (LOS) by type of fracture was recorded. The use of bisphosphonate drugs in the following 12 months was obtained from centralised national records of prescriptions. 2729 patients aged ≥ 50 years presented with a fragility fracture in the central Auckland region in one year. Fifty-six percent of these patients were seen at Auckland Hospital and of these, 82% patients required admission with a mean LOS of 20 days (SD ± 24 days).The remaining 44% of patients were looked after in the private outpatient sector. Approximately 30% of the admissions were for hip fracture. Sixty-four percent of patients with a fragility fracture did not receive a potent bisphosphonate, 12% were considered not appropriate for treatment, and 24% received a potent bisphosphonate during their admission or in the next 12 months. Approximately 1 in 18 people aged ≥ 50 years presented in one year with a fragility fracture.Secondary prevention strategies were poorly implemented. Additional resources for identifying and initiating secondary fracture prevention
Saddoughi, Sahar A; Abdelsattar, Zaid M; Blackmon, Shanda H
2018-02-01
Malignant pleural mesothelioma (MPM) remains an aggressive malignancy that is difficult to cure. However, the treatment paradigm of MPM has evolved, and the national practice patterns are unknown. This study examined the national trends in the epidemiology, national treatment patterns, and survival of patients with this disease. We identified all patients (n = 19,134) with MPM from the National Cancer Data Base from 2004 to 2013. We analyzed patient, tumor characteristics, and treatment patterns using descriptive statistics and used Kaplan-Meier and Cox proportional hazards models to estimate survival stratified by the type of therapy administered. Four histologic subtypes were represented in the National Cancer Data Base, these included sarcomatoid (n = 2,355 [12.3%]), epithelioid (n = 6,858 [35.8%]), biphasic (n = 13,617 [11%]), and not otherwise specified (n = 8,560 [44.7%]). Across all subtypes, the prevalence of mesothelioma was highest among white men. Sarcomatoid had the worst survival (adjusted hazard ratio, 2.2; p Data Base. Although survival remains poor, multimodality therapy with surgical resection is associated with the best survival for MPM. Further research is needed to improve survival and overall patient outcomes. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Social epidemiology and political economy: ICU as point of convergence
Directory of Open Access Journals (Sweden)
Segura, Omar
2016-10-01
Full Text Available Questions around epidemiology, economics and critical care are often in the mind of almost any healthcare professional. However, it is seldom realized that epidemiology and economy may converge -in spite of being apparently separated fields of study- in order to explain the present situation or future trends of a hospital or public health service. This essay briefly depicts how social epidemiology and political economy have developed and how both academic activities may find a common ground about the Intensive Care Unit (ICU, particularly to pose questions, to create possible research lines and feasible alternatives towards more efficient, effective and humane health services.
The epidemiology of contact allergy. Allergen exposure and recent trends
DEFF Research Database (Denmark)
Thyssen, J P
2009-01-01
that the prevalence of nickel allergy is decreasing among young women whereas the prevalence of cobalt allergy remains stable. The prevalence of chromium allergy is currently increasing significantly in both sexes, mainly as a result of leather exposure. The epidemiology of fragrance allergy is changing...... high whereas the prevalence of methyldibromo glutaronitrile allergy has decreased following regulatory intervention. Finally, the prevalence of thiuram allergy is decreasing as a result of improved rubber glove production....
Energy Technology Data Exchange (ETDEWEB)
Gao, Dengliang
2013-03-01
In 3D seismic interpretation, curvature is a popular attribute that depicts the geometry of seismic reflectors and has been widely used to detect faults in the subsurface; however, it provides only part of the solutions to subsurface structure analysis. This study extends the curvature algorithm to a new curvature gradient algorithm, and integrates both algorithms for fracture detection using a 3D seismic test data set over Teapot Dome (Wyoming). In fractured reservoirs at Teapot Dome known to be formed by tectonic folding and faulting, curvature helps define the crestal portion of the reservoirs that is associated with strong seismic amplitude and high oil productivity. In contrast, curvature gradient helps better define the regional northwest-trending and the cross-regional northeast-trending lineaments that are associated with weak seismic amplitude and low oil productivity. In concert with previous reports from image logs, cores, and outcrops, the current study based on an integrated seismic curvature and curvature gradient analysis suggests that curvature might help define areas of enhanced potential to form tensile fractures, whereas curvature gradient might help define zones of enhanced potential to develop shear fractures. In certain fractured reservoirs such as at Teapot Dome where faulting and fault-related folding contribute dominantly to the formation and evolution of fractures, curvature and curvature gradient attributes can be potentially applied to differentiate fracture mode, to predict fracture intensity and orientation, to detect fracture volume and connectivity, and to model fracture networks.
Energy Technology Data Exchange (ETDEWEB)
Alaoui, H. El; Moujahid, El; Ibouh, H.; Bachnou, A.; Babram, M. Ait; Harti, A. EI
2016-07-01
The use of remote sensing, in this research, can be summarized in mapping and statistical studies of lineaments on the satellites images of the Jurassic outcrops in the Imilchil-Tounfite area, Central High Atlas of Morocco. This is to apply various manual techniques for extracting lineaments from Landsat TM image. Analytical techniques used in this work are: the principal component analysis (PCA) applied to selective bands of the visible and infrared, which allows creating new images with better visual interpretation. Directional filters N0°, N45°, N90°, and N135° with a 5×5 matrix were used to enhance lineaments in the corresponding perpendicular directions, and therefore to obtain a good discrimination of those structures. Preliminary results highlight a dominant geological fracturing trending ENE/WSW with 52% of the total lineaments, a second fracture trending is WNW/ESE at 23%, a third fracture series trending NE/SW with 20% and finally, a minor series of fractures trending NW/SE with 5% of the total lineaments. Distribution and statistical relationship, between fractures and the affected surface on the one hand and the fracture length on the other hand, shows a network of well-structured fractures. The final lineament map constitutes a contribution to complete the geology and assisting the mining and hydrogeological prospection, in the Imilchil-Tounfite area. (Author)
Incidence and Time to Return to Training for Stress Fractures during Military Basic Training
Directory of Open Access Journals (Sweden)
Alexander M. Wood
2014-01-01
Full Text Available Currently, little is known about the length of time required to rehabilitate patients from stress fractures and their return to preinjury level of physical activity. Previous studies have looked at the return to sport in athletes, in a general population, where rehabilitation is not as controlled as within a captive military population. In this study, a longitudinal prospective epidemiological database was assessed to determine the incidence of stress fractures and the time taken to rehabilitate recruits to preinjury stage of training. Findings demonstrated a background prevalence of 5% stress fractures in Royal Marine training; femoral and tibial stress fractures take 21.1 weeks to return to training with metatarsal stress fractures being the most common injury taking 12.2 weeks. Rehabilitation from stress fractures accounts for 814 weeks of recruit rehabilitation time per annum. Stress fracture incidence is still common in military training; despite this stress fracture recovery times remain constant and represent a significant interruption in training. It takes on average 5 weeks after exercise specific training has restarted to reenter training at a preinjury level, regardless of which bone has a stress fracture. Further research into their prevention, treatment, and rehabilitation is required to help reduce these burdens.
Harris, Dominic A; Cherian, Jacob; LoPresti, Melissa; Jea, Andrew; Lam, Sandi
2016-07-01
Although the incidence of myelomeningocele (MMC) has declined over the past decades with folic acid supplementation and prenatal screening, neural tube defects remain the most common birth defect in the USA. A majority of affected neonates require surgical repair. To characterize US trends in the epidemiology and hospital utilization of MMC repair over the past decade, we analyzed a nationally representative database. We queried the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Database (KID) for all discharges with procedure code for MMC repair for the years 2000, 2003, 2006, and 2009. The cohorts from these time points were compared for their demographic and in-hospital variables. Results are reported as estimated frequencies and means with 95 % confidence intervals (CI). Sex, race, insurance status, family income level, and mortality of affected infants have not changed significantly over the decade. A majority of neonatal MMC repairs occur in larger hospital bed size and more specialized children's hospital centers. Of patients, 52.3 to 60 % receive VPS placement during the same admission as the primary MMC repair. Total hospital costs for the MMC hospitalizations have remained relatively stable from 42,843 dollars in 2003 to 46,749 dollars in 2009 (adjusted to 2009 dollars). Demographics of children having MMC repair have not changed significantly over the past decade, while these surgeries have become more concentrated in pediatric-specialized centers. There appears to be a plateau in public health and access advances with relatively stable cost of MMC hospital care.
International Nuclear Information System (INIS)
Joutsen, A.
2012-02-01
Posiva Oy is responsible for preparation of final disposal of spent nuclear fuel in Olkiluoto. The knowledge about existing network of fractures is important for the safety and feasibility of the final repository. The bedrock properties essential for safety case are analyzed in investigations of Rock Suitability Criteria (RSC). One subtask in RSC is avoidance of large (long) fractures adjacent to disposal holes. The long fractures have been defined in tunnel mapping to indicate tunnel cross-cutting fractures (TCF) or full perimeter intersections (FPI). The purpose for this study was to evaluate the possibility of recognizing FPIs from drill cores by their geological properties. The study was carried out by correlating FPIs mapped from the ONKALO tunnel to the pilot holes logging data with a view of finding out which fracture in the pilot hole corresponds to the FPI in the tunnel. It was also estimated what kind of geological properties does FPIs commonly have in the tunnel and how does these properties differ from the FPI correlated pilot hole fractures. The data sources for this study are the pilot holes from ONK-PH8 to ONK-PH14 and the systematic geological mapping data. The FPIs used in this study usually follow the general trends of the fracturing in the Olkiluoto bedrock. The fracture surface profiles are principally undulating and a striation can be often seen on the fracture surfaces. The FPIs are frequently moderately to intensely altered with diverse filling mineralogy and thick fracture fillings in comparison to the regular fractures. The FPI correlated pilot hole fractures have slightly different properties in comparison to the FPIs. These fractures have wider range of different fracture surface profiles and are slightly less altered than the FPIs. Filling mineralogy follows the trends of the FPIs but filling thicknesses are thinner. These differences probably occur because of the variable uncertainties related to the correlation and to the fact that the
Energy Technology Data Exchange (ETDEWEB)
Joutsen, A.
2012-02-15
Posiva Oy is responsible for preparation of final disposal of spent nuclear fuel in Olkiluoto. The knowledge about existing network of fractures is important for the safety and feasibility of the final repository. The bedrock properties essential for safety case are analyzed in investigations of Rock Suitability Criteria (RSC). One subtask in RSC is avoidance of large (long) fractures adjacent to disposal holes. The long fractures have been defined in tunnel mapping to indicate tunnel cross-cutting fractures (TCF) or full perimeter intersections (FPI). The purpose for this study was to evaluate the possibility of recognizing FPIs from drill cores by their geological properties. The study was carried out by correlating FPIs mapped from the ONKALO tunnel to the pilot holes logging data with a view of finding out which fracture in the pilot hole corresponds to the FPI in the tunnel. It was also estimated what kind of geological properties does FPIs commonly have in the tunnel and how does these properties differ from the FPI correlated pilot hole fractures. The data sources for this study are the pilot holes from ONK-PH8 to ONK-PH14 and the systematic geological mapping data. The FPIs used in this study usually follow the general trends of the fracturing in the Olkiluoto bedrock. The fracture surface profiles are principally undulating and a striation can be often seen on the fracture surfaces. The FPIs are frequently moderately to intensely altered with diverse filling mineralogy and thick fracture fillings in comparison to the regular fractures. The FPI correlated pilot hole fractures have slightly different properties in comparison to the FPIs. These fractures have wider range of different fracture surface profiles and are slightly less altered than the FPIs. Filling mineralogy follows the trends of the FPIs but filling thicknesses are thinner. These differences probably occur because of the variable uncertainties related to the correlation and to the fact that the
Weibull analysis of fracture test data on bovine cortical bone: influence of orientation.
Khandaker, Morshed; Ekwaro-Osire, Stephen
2013-01-01
The fracture toughness, K IC, of a cortical bone has been experimentally determined by several researchers. The variation of K IC values occurs from the variation of specimen orientation, shape, and size during the experiment. The fracture toughness of a cortical bone is governed by the severest flaw and, hence, may be analyzed using Weibull statistics. To the best of the authors' knowledge, however, no studies of this aspect have been published. The motivation of the study is the evaluation of Weibull parameters at the circumferential-longitudinal (CL) and longitudinal-circumferential (LC) directions. We hypothesized that Weibull parameters vary depending on the bone microstructure. In the present work, a two-parameter Weibull statistical model was applied to calculate the plane-strain fracture toughness of bovine femoral cortical bone obtained using specimens extracted from CL and LC directions of the bone. It was found that the Weibull modulus of fracture toughness was larger for CL specimens compared to LC specimens, but the opposite trend was seen for the characteristic fracture toughness. The reason for these trends is the microstructural and extrinsic toughening mechanism differences between CL and LC directions bone. The Weibull parameters found in this study can be applied to develop a damage-mechanics model for bone.
Season of birth and the risk of hip fracture in danish men and women aged 65+
DEFF Research Database (Denmark)
Abrahamsen, Bo; Heitmann, Berit L; Eiken, Pia Agnete
2012-01-01
calculated fracture rates and relative risks. The analysis covered 541,109 men and 691,522 women. In women, we observed a small but statistically significant difference between fracture rates by season of birth for all age intervals expect the youngest (age 65-69). A similar pattern was seen in men...... an epidemiological analysis of hip fracture rates as a function of season of birth, age, and sex. We retrieved information on all hip fractures in the 9-year period between 1997 and 2005 in all men and women aged 65-95, excluded hip fractures that occurred in current and recent prednisolone users, and subsequently......, but this was only statistically significant in the two oldest age groups (age 85-89 and 90-95). These findings suggest that vitamin D availability in the first and second trimester of intrauterine life could have a small but lasting impact on bone health and the risk of osteoporotic fractures. Further studies...
Bragazzi, Nicola Luigi; Bacigaluppi, Susanna; Robba, Chiara; Nardone, Raffaele; Trinka, Eugen; Brigo, Francesco
2016-02-01
People increasingly use Google looking for health-related information. We previously demonstrated that in English-speaking countries most people use this search engine to obtain information on status epilepticus (SE) definition, types/subtypes, and treatment. Now, we aimed at providing a quantitative analysis of SE-related web queries. This analysis represents an advancement, with respect to what was already previously discussed, in that the Google Trends (GT) algorithm has been further refined and correlational analyses have been carried out to validate the GT-based query volumes. Google Trends-based SE-related query volumes were well correlated with information concerning causes and pharmacological and nonpharmacological treatments. Google Trends can provide both researchers and clinicians with data on realities and contexts that are generally overlooked and underexplored by classic epidemiology. In this way, GT can foster new epidemiological studies in the field and can complement traditional epidemiological tools. Copyright © 2015 Elsevier Inc. All rights reserved.
Origin of the Louisville Ridge and its relationship to the Eltanin Fracture Zone System
Watts, A. B.; Weissel, J. K.; Duncan, R. A.; Larson, R. L.
1988-04-01
We have combined shipboard and Seasat altimeter derived data in an intergrated geological and geophysical study of the Louisville Ridge; a 3500-km-long seamount chain extending from the Tonga trench to the Eltanin Fracture Zone. A break in the smooth trend of the ridge at latitude 37.5°S has been recognized in both bathymetric and altimetric data. The 40Ar-39Ar dating of rocks dredged either side of the break suggest that it is analogous to the bend in the Hawaiian-Emperor seamount chain. Although the general trend of the ridge can be fit by small circles about Pacific absolute motion poles determined from other seamount chains, the new bathymetric and age data allow us to refine Pacific absolute motion poles. The continuity in smooth trend of the ridge and the Eltanin Fracture Zone suggests some relationship between them. However, a major offset developed on this transform between 60 and 80 Ma, prior to the oldest dated rocks from the ridge. Although magmatism was more or less continuous on the ridge during 28-60 Ma, it probably occurred on crust with little or no offset. Thus magmatism appears to have been little influenced by the developing fracture zone. By 28 Ma, the distance between the magmatic source and the fracture zone had decreased sufficiently for a portion of the ridge to have been emplaced on crust with an offset. After about 12 Ma, however, volcanic activity on the Louisville Ridge apparently waned, despite a possible influence on the magmatism of the fracture zone.
Directory of Open Access Journals (Sweden)
A.E. Kattan
2017-01-01
Conclusion: We report a case series of a fracture pattern resulting from the improper/unsafe use of a hoverboard. This type of fracture occurs with a tremendous load of energy. Although improper use was a factor, design fault also plays a role in causing the injury. Parent awareness and supervision are important to prevent such injuries.
Increasing incidence of hip fracture in Chiang Mai, Thailand.
Wongtriratanachai, Prasit; Luevitoonvechkij, Sirichai; Songpatanasilp, Thawee; Sribunditkul, Siripoj; Leerapun, Taninnit; Phadungkiat, Sompant; Rojanasthien, Sattaya
2013-01-01
Hip fracture is a major health problem in Thailand. This study attempted to examine the incidence, related factors, and trends of hip fracture in Chiang Mai, Thailand. All hip fracture data among patients aged 50 yr or older were collected from hospitals in Chiang Mai, Thailand from August 1, 2006 to July 3, 2007. Data from the 1997 Chiang Mai hip fracture study were used for comparison. In the study period, 690 hip fractures were reported: 203 males and 487 females (male to female ratio was 1 to 2.4), with a mean age of 76.7 yr. The estimated cumulative incidence was 181.0 per 100,000, and the adjusted incidence was 253.3 (males: 135.9; females: 367.9). A simple fall was the most common mechanism (79%) of fracture, and 80% of the hip fractures occurred in patients aged 70 yr or older. The highest incidence of hip fracture was observed in patients older than 85 yr (1239). At 6 mo postfracture, most patients (61%) used a walking aid. Compared with the 1997 data, hip fracture incidence had increased by an average of 2% per yr, and the incidence of hip fracture had increased significantly from August 1, 2006 to July 31, 2007, especially in patients older than 75 yr. In patients older than 84 yr, the incidence increased by a factor of 2. Urgent strategies for the prevention and treatment of osteoporosis, and hence hip fracture, are needed. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.
You, Qiuting; Chen, Kai; Li, Yudong; Lai, Jianguo; Fang, Yichao; Shen, Shiyu; Liu, Yicheng; Su, Fengxi; Yu, Fengyan
2018-05-22
Our study aimed to investigate the factors influencing trends of contralateral prophylactic mastectomy (CPM) among patients with unilateral ductal carcinoma in situ (DCIS). We used the Surveillance, Epidemiology, and End Results (SEER) data to identify patients with unilateral DCIS diagnosed from 1998 to 2013. Patients were categorized as breast-conserving surgery (BCS), Unilateral Mastectomy and CPM group. Univariate and multivariate logistic regressions were applied to assess the factors associated with undergoing CPM among mastectomy patients. The trends of CPM among mastectomy patients through year were presented by different subgroups of sociodemographic and pathological characteristics. Of those, 105326 patients with DCIS were identified, and 6370 patients underwent CPM. The proportion of CPM was 6.05% for all surgically-treated patients and 21.09% for mastectomy patients, and it increased more than six-fold between 1998 and 2013 (from 1.74% to 10.89% for all surgically-treated patients and from 5.44% to 37.47% for mastectomy patients). Younger age, white race, married status, smaller tumor size, positive ER and PR status were significantly associated with higher CPM proportion among mastectomy patients. The proportion of CPM was increasing through year, and the increasing trends were obvious in the subgroups of younger, white, married, metropolitan, with higher bachelor degree and higher median family income patients, while there were no apparent differences in the trends between subgroups of pathological characteristics. The trends of CPM among mastectomy patients were increasing through years and influenced by patients' sociodemographic characteristics, but not pathological characteristics. Copyright © 2018 Elsevier Ltd. All rights reserved.
Food allergy trends at the crossing among socio-economics, history and geography.
Fiocchi, Alessandro; Dahdah, Lamia; Fierro, Vincenzo; Artesani, Maria C; Valluzzi, Rocco
2018-06-01
The epidemiology of food allergy did inspire theories on the reasons for the recent surge of the disease. We offer here a reasoned review on the relationships between the trajectories of human development and the trend of the food allergy epidemics. The exponential trend of the frequency of food allergy paralleled the explosive acceleration of the human development over the last few decades. Dietary factors have been indicated as responsible for these trends and targeted for potential preventive strategies. Other socio-economic factors have been related to this evolution: solar exposure, climate changes, structure of societies, reproductive choices and societal inequalities. The epidemiologic associations of food allergy suggest different causal theories. Future prevention strategies may be predicated not only on dietary interventions, but on wider programmes aimed to restore a human ecology promoting food tolerance.
Martinez-Laguna, Daniel; Soria-Castro, Alberto; Carbonell-Abella, Cristina; Orozco-López, Pilar; Estrada-Laza, Pilar; Nogues, Xavier; Díez-Perez, Adolfo; Prieto-Alhambra, Daniel
2017-11-28
Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Forefoot Adduction Is a Risk Factor for Jones Fracture.
Fleischer, Adam E; Stack, Rebecca; Klein, Erin E; Baker, Jeffrey R; Weil, Lowell; Weil, Lowell Scott
Jones fractures are among the most common fractures of the foot; however, much remains unknown about their etiology. The purpose of the present study was to further examine the risk factors of forefoot and hindfoot alignment on Jones fractures using an epidemiologic study design. We used a retrospective, matched, case-control study design. Cases consisted of patients with acute, isolated Jones fractures confirmed on plain film radiographs seen at our institute from January 2009 to December 2013. Patients presenting with pain unrelated to metatarsal fractures served as controls. Controls were matched to cases by age (±2 years), gender, and year of presentation. Weightbearing foot radiographs were assessed for 13 angular relationships by a single rater. Conditional multivariable logistic regression was used to identify important risk factors. Fifty patients with acute Jones fractures and 200 controls were included. The only significant variables in the final multivariable model were the metatarsus adductus angle (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08 to 1.25) and fourth/fifth intermetatarsal angle (OR 0.69, 95% CI 0.57 to 0.83)-both measures of static forefoot adduction. The presence of metatarsus adductus (defined as >15°) on foot radiographs was associated with a 2.4 times greater risk of a Jones fracture (adjusted OR 2.4, 95% CI 1.2 to 4.8). We have concluded that the risk of Jones fracture increases with an adducted forefoot posture. In our population, which consisted primarily of patients presenting after a fall (10 of 50; 20%) or misstep/inversion injury (19 of 50; 38%), the hindfoot alignment appeared to be a less important factor. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
REVIEW OF 40 CASES OF ISOLATED FRACTURE MANDIBLE
Directory of Open Access Journals (Sweden)
Shashikant Kondiram Mhashal
2016-10-01
Full Text Available BACKGROUND Mandible fractures are a frequent injury because of the mandible's prominence and relative lack of support. The purpose of this study is to clinically determine the most common sites and the prevalence of isolated fracture mandible in our scenario and determine most common traumatic aetiology factor responsible for fracture mandible. Numerous investigators have reported studies on populations on all continents; fractures of the mandible have been reported to account for 36-70% of all maxillofacial fractures. All reports apparently show a higher frequency in males aged 21-30 yrs. There is an emerging trend towards an increase in the frequency of violent mechanisms of fracture and in the proportion of adolescents and young adults sustaining such injuries. MATERIALS AND METHODS Patients treated at the Otorhinolaryngology Head and Neck Surgery Department of B.D.B.A. Hospital from a period between January 2014 to January2016 were (retrospectively evaluated with respect to age groups, gender, aetiology, localisation, type of fractures and treatment. RESULTS Total number of patients 38, 2 patients had bilateral fracture, males 27 (71.05%, females 11 (28.95%. Anatomical location symphysis and parasymphysis 14 (35%, condylar 12 (30%, body 7 (17.5%, angle 6 (15%, coronoid 1 (2.5%. Aetiological factors road traffic accidents 19 (50%, assault 13 (34.24%, fall 3 (7.89%, work-related trauma 2 (5.26%, sports trauma 1 (2.6%. CONCLUSION This study indicates that most common fracture in adult patient were symphysis and parasymphysis, second most common were condylar followed by body fracture and angle fracture. The most common cause of the injury maybe road traffic accidents, second most common assault followed by work related injuries, fall and sports injuries.
Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia
2015-02-01
Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.
Selected trends in colorectal cancer epidemiology in Slovakia
International Nuclear Information System (INIS)
Ondrusova, M.; Psenkova, M.; Spanik, S.
2015-01-01
Introduction: In worldwide estimates for the year 2012, the Slovak Republic had the highest value of age-standardised incidence, but real data on a national level have only been available up to 2008. Aims: Colorectal cancer is one of the more preventable malignant tumors, whereby organised screening with adequate participation of the population in risk leads to a significant drop in both incidence and mortality. The aim of the submitted paper is to predict the development of selected indicators of descriptive epidemiology of this disease prospectively. Results: In recent years, a significant growth in the incidence of the disease has been witnessed in Slovakia, rising by 2.3% annually in men and 1.4% in women. Mortality in men is falling substantially by -1% annually, and in women it is -1.6%. Conclusion: The drop in mortality is manifesting later and to a lesser degree in Slovakia than in those countries with long-term organised screening in place. (author)
In situ grain fracture mechanics during uniaxial compaction of granular solids
Hurley, R. C.; Lind, J.; Pagan, D. C.; Akin, M. C.; Herbold, E. B.
2018-03-01
Grain fracture and crushing are known to influence the macroscopic mechanical behavior of granular materials and be influenced by factors such as grain composition, morphology, and microstructure. In this paper, we investigate grain fracture and crushing by combining synchrotron x-ray computed tomography and three-dimensional x-ray diffraction to study two granular samples undergoing uniaxial compaction. Our measurements provide details of grain kinematics, contacts, average intra-granular stresses, inter-particle forces, and intra-grain crystal and fracture plane orientations. Our analyses elucidate the complex nature of fracture and crushing, showing that: (1) the average stress states of grains prior to fracture vary widely in their relation to global and local trends; (2) fractured grains experience inter-particle forces and stored energies that are statistically higher than intact grains prior to fracture; (3) fracture plane orientations are primarily controlled by average intra-granular stress and contact fabric rather than the orientation of the crystal lattice; (4) the creation of new surfaces during fracture accounts for a very small portion of the energy dissipated during compaction; (5) mixing brittle and ductile grain materials alters the grain-scale fracture response. The results highlight an application of combined x-ray measurements for non-destructive in situ analysis of granular solids and provide details about grain fracture that have important implications for theory and modeling.
A new system for severity scoring of facial fractures: development and validation.
Catapano, Joseph; Fialkov, Jeffrey A; Binhammer, Paul A; McMillan, Catherine; Antonyshyn, Oleh M
2010-07-01
Facial fractures are often the result of high-velocity trauma, causing skeletal disruption affecting multiple anatomic sites to varying degrees. Although several widely accepted classification systems exist, these are mostly region-specific and differ in the classification criteria used, making it impossible to uniformly and comprehensively document facial fracture patterns. Furthermore, a widely accepted system that is able to provide a final summary measure of fracture severity does not exist, making it difficult to investigate the epidemiologic data surrounding facial fracture severity. In this study, a comprehensive method for panfacial fracture documentation and severity measurement is proposed and validated through a retrospective analysis of 63 patients operated on for acute facial fracture. The severity scale was validated through statistical analysis of correlation with surrogate markers of severity (operating room procedure time and number of implants). Spearman correlation coefficients were calculated, and a statistically significant correlation was found between severity score and both number of implants and operating room procedure time (R = 0.92790 and R = 0.68157, respectively). Intraclass correlation coefficients were calculated to assess intrarater and interrater reliabilities of the severity scale and were found to be high (0.97 and 0.99, respectively). This severity scale provides a valuable, validated research tool for the investigation of facial fracture severity across patient populations, allowing for systematic evaluation of facial fracture outcomes, cost-benefit analysis, and objective analysis of the effect of specific interventions.
Directory of Open Access Journals (Sweden)
Daniel Falbo Martins de Souza
2010-01-01
Full Text Available OBJETIVO: Realizar um estudo epidemiológico das fraturas de face em crianças em um serviço de urgência. MÉTODOS: Estudo retrospectivo de quarenta e dois pacientes com idades variando entre zero a 17 anos, portadores de fraturas de face, tratados no Setor de Cirurgia Buco-Maxilo-Facial da Santa Casa de São Paulo, no período de janeiro de 2000 a dezembro de 2003. Os dados foram tabulados através das informações colhidas dos prontuários dos pacientes, tais como: idade, gênero, tipo de fratura, etiologia e sazonalidade. RESULTADOS: Entre os resultados encontrados, houve predominância do gênero masculino com 81% da casuística, a fratura de mandíbula foi a mais prevalente, com mais de 70% dos casos, os acidentes de trânsito e as quedas foram os agentes etiológicos que mais causaram fraturas. O verão foi a época do ano com mais casos de fratura e mais de 80% destas necessitaram de intervenção cirúrgica para o seu tratamento. CONCLUSÃO: É necessária uma política de prevenção com uma atenção especial aos acidentes de trânsito e às quedas, que foram os agentes etiológicos que mais causaram fraturas faciais.OBJECTIVE: To conduct an epidemiological study of facial fractures in children in an emergency room. METHODS: A retrospective study of forty-two patients, aged zero to 17 years, with facial fractures treated at the Department of Oral and Maxillofacial Surgery, Santa Casa de São Paulo, from January 2000 to December 2003. The data were tabulated from information retrieved from patient files, such as age, gender, type of fracture, etiology and season of occurrence. RESULTS: Among the results were a predominance of males, accounting for 81% of all cases; jaw fracture was the most prevalent, constituting more than 70% of cases; and traffic accidents and falls were the etiologic agents that caused the most fractures. Summer was the season with the greatest number of cases of fracture and more than 80% required surgical
Osteoporosis-related fracture case definitions for population-based administrative data
Directory of Open Access Journals (Sweden)
Lix Lisa M
2012-05-01
Full Text Available Abstract Background Population-based administrative data have been used to study osteoporosis-related fracture risk factors and outcomes, but there has been limited research about the validity of these data for ascertaining fracture cases. The objectives of this study were to: (a compare fracture incidence estimates from administrative data with estimates from population-based clinically-validated data, and (b test for differences in incidence estimates from multiple administrative data case definitions. Methods Thirty-five case definitions for incident fractures of the hip, wrist, humerus, and clinical vertebrae were constructed using diagnosis codes in hospital data and diagnosis and service codes in physician billing data from Manitoba, Canada. Clinically-validated fractures were identified from the Canadian Multicentre Osteoporosis Study (CaMos. Generalized linear models were used to test for differences in incidence estimates. Results For hip fracture, sex-specific differences were observed in the magnitude of under- and over-ascertainment of administrative data case definitions when compared with CaMos data. The length of the fracture-free period to ascertain incident cases had a variable effect on over-ascertainment across fracture sites, as did the use of imaging, fixation, or repair service codes. Case definitions based on hospital data resulted in under-ascertainment of incident clinical vertebral fractures. There were no significant differences in trend estimates for wrist, humerus, and clinical vertebral case definitions. Conclusions The validity of administrative data for estimating fracture incidence depends on the site and features of the case definition.
Epidemiology, public health, and health surveillance around point sources of pollution
International Nuclear Information System (INIS)
Stebbings, J.H. Jr.
1981-01-01
In industrial society a large number of point sources of pollution exist, such as chemical plants, smelters, and nuclear power plants. Public concern has forced the practising epidemiologist to undertake health surveillance of the usually small populations living around point sources. Although not justifiable as research, such epidemiologic surveillance activities are becoming a routine part of public health practice, and this trend will continue. This introduction reviews concepts of epidemiologic surveillance, and institutional problems relating to the quality of such applied research
Hydraulic properties of 3D rough-walled fractures during shearing: An experimental study
Yin, Qian; Ma, Guowei; Jing, Hongwen; Wang, Huidong; Su, Haijian; Wang, Yingchao; Liu, Richeng
2017-12-01
This study experimentally analyzed the influence of shear processes on nonlinear flow behavior through 3D rough-walled rock fractures. A high-precision apparatus was developed to perform stress-dependent fluid flow tests of fractured rocks. Then, water flow tests on rough-walled fractures with different mechanical displacements were conducted. At each shear level, the hydraulic pressure ranged from 0 to 0.6 MPa, and the normal load varied from 7 to 35 kN. The results show that (i) the relationship between the volumetric flow rate and hydraulic gradient of rough-walled fractures can be well fit using Forchheimer's law. Notably, both the linear and nonlinear coefficients in Forchheimer's law decrease during shearing; (ii) a sixth-order polynomial function is used to evaluate the transmissivity based on the Reynolds number of fractures during shearing. The transmissivity exhibits a decreasing trend as the Reynolds number increases and an increasing trend as the shear displacement increases; (iii) the critical hydraulic gradient, critical Reynolds number and equivalent hydraulic aperture of the rock fractures all increase as the shear displacement increases. When the shear displacement varies from 0 to 15 mm, the critical hydraulic gradient ranges from 0.3 to 2.2 for a normal load of 7 kN and increases to 1.8-8.6 for a normal load of 35 kN; and (iv) the Forchheimer law results are evaluated by plotting the normalized transmissivity of the fractures during shearing against the Reynolds number. An increase in the normal load shifts the fitted curves downward. Additionally, the Forchheimer coefficient β decreases with the shear displacement but increases with the applied normal load.
Energy Technology Data Exchange (ETDEWEB)
Schechter, D.S.
1997-12-01
The overall goal of this project is to assess the economic feasibility of CO{sub 2} flooding in the naturally fractured Spraberry Trend Area in West Texas. This objective is being accomplished by conducting research in four areas: (1) extensive characterization of the reservoirs, (2) experimental studies of crude oil/brine/rock (COBR) interaction in the reservoirs, (3) analytical and numerical simulation of Spraberry reservoirs, and, (4) experimental investigations on CO{sub 2} gravity drainage in Spraberry whole cores. This report provides results of the first year of the five-year project for each of the four areas.
Rehabilitation in peripheral non femoral fractures: a review.
Mangone, Giuseppe; Postiglione, Marco; Pasquetti, Pietro
2010-01-01
This paper is a short review of the available information on peripheral non femoral fractures (PNFF) which are strictly related to osteoporosis. Particular attention is focused on wrist fractures in view of their frequent occurrence as indicated by world wide statistics. Of special interest is the definition of risk groups (old age), risk areas (developed countries) and risk factors. Reference is made to 2008 WHO guidelines for fracture risk assessment. PNFF are a serious concern to health authorities because their high incidence in constant growth, causes a serious burden on the health budget. The pathway of patient care is described, from initial evaluation (including bone fragility, multi-morbidity and risk factors) to specific diagnosis and treatment. The multiplicity of etiological factors involved requires multidisciplinary approach. This aspect justifies the importance given to rehabilitation, which is the longest part of patient care and is strictly connected to preventive measures. There is ample reference to falls, to exercises, to appropriate sports, to complications and to active and passive mobilization. The paper suggests research in areas related to PNFF, to health economics, epidemiology, prevention, health education, training and multidisciplinary coordination.
Adawi, Mohammad; Bragazzi, Nicola Luigi; Watad, Abdulla; Sharif, Kassem; Amital, Howard; Mahroum, Naim
2017-12-01
Mayaro virus (MAYV), first discovered in Trinidad in 1954, is spread by the Haemagogus mosquito. Small outbreaks have been described in the past in the Amazon jungles of Brazil and other parts of South America. Recently, a case was reported in rural Haiti. Given the emerging importance of MAYV, we aimed to explore the feasibility of exploiting a Web-based tool for monitoring and tracking MAYV cases. Google Trends is an online tracking system. A Google-based approach is particularly useful to monitor especially infectious diseases epidemics. We searched Google Trends from its inception (from January 2004 through to May 2017) for MAYV-related Web searches worldwide. We noted a burst in search volumes in the period from July 2016 (relative search volume [RSV]=13%) to December 2016 (RSV=18%), with a peak in September 2016 (RSV=100%). Before this burst, the average search activity related to MAYV was very low (median 1%). MAYV-related queries were concentrated in the Caribbean. Scientific interest from the research community and media coverage affected digital seeking behavior. MAYV has always circulated in South America. Its recent appearance in the Caribbean has been a source of concern, which resulted in a burst of Internet queries. While Google Trends cannot be used to perform real-time epidemiological surveillance of MAYV, it can be exploited to capture the public's reaction to outbreaks. Public health workers should be aware of this, in that information and communication technologies could be used to communicate with users, reassure them about their concerns, and to empower them in making decisions affecting their health. ©Mohammad Adawi, Nicola Luigi Bragazzi, Abdulla Watad, Kassem Sharif, Howard Amital, Naim Mahroum. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 01.12.2017.
Liu, Zhiyuan; Wang, Shijie; Zhao, Haiyang; Wang, Lei; Li, Wei; Geng, Yudi; Tao, Shan; Zhang, Guangqing; Chen, Mian
2018-02-01
Natural fractures have a significant influence on the propagation geometry of hydraulic fractures in fractured reservoirs. True triaxial volumetric fracturing experiments, in which random natural fractures are created by placing cement blocks of different dimensions in a cuboid mold and filling the mold with additional cement to create the final test specimen, were used to study the factors that influence the hydraulic fracture propagation geometry. These factors include the presence of natural fractures around the wellbore, the dimension and volumetric density of random natural fractures and the horizontal differential stress. The results show that volumetric fractures preferentially formed when natural fractures occurred around the wellbore, the natural fractures are medium to long and have a volumetric density of 6-9%, and the stress difference is less than 11 MPa. The volumetric fracture geometries are mainly major multi-branch fractures with fracture networks or major multi-branch fractures (2-4 fractures). The angles between the major fractures and the maximum horizontal in situ stress are 30°-45°, and fracture networks are located at the intersections of major multi-branch fractures. Short natural fractures rarely led to the formation of fracture networks. Thus, the interaction between hydraulic fractures and short natural fractures has little engineering significance. The conclusions are important for field applications and for gaining a deeper understanding of the formation process of volumetric fractures.
Modeling biogechemical reactive transport in a fracture zone
Energy Technology Data Exchange (ETDEWEB)
Molinero, Jorge; Samper, Javier; Yang, Chan Bing, and Zhang, Guoxiang; Guoxiang, Zhang
2005-01-14
A coupled model of groundwater flow, reactive solute transport and microbial processes for a fracture zone of the Aspo site at Sweden is presented. This is the model of the so-called Redox Zone Experiment aimed at evaluating the effects of tunnel construction on the geochemical conditions prevailing in a fracture granite. It is found that a model accounting for microbially-mediated geochemical processes is able to reproduce the unexpected measured increasing trends of dissolved sulfate and bicarbonate. The model is also useful for testing hypotheses regarding the role of microbial processes and evaluating the sensitivity of model results to changes in biochemical parameters.
Modeling biogeochemical reactive transport in a fracture zone
International Nuclear Information System (INIS)
Molinero, Jorge; Samper, Javier; Yang, Chan Bing; Zhang, Guoxiang; Guoxiang, Zhang
2005-01-01
A coupled model of groundwater flow, reactive solute transport and microbial processes for a fracture zone of the Aspo site at Sweden is presented. This is the model of the so-called Redox Zone Experiment aimed at evaluating the effects of tunnel construction on the geochemical conditions prevailing in a fracture granite. It is found that a model accounting for microbially-mediated geochemical processes is able to reproduce the unexpected measured increasing trends of dissolved sulfate and bicarbonate. The model is also useful for testing hypotheses regarding the role of microbial processes and evaluating the sensitivity of model results to changes in biochemical parameters
Leprosy and the eye a review of epidemiology, pathogenesis, ocular ...
African Journals Online (AJOL)
Objectives: 1. To update knowledge on the current trends in the epidemiology, pathogenesis, and treatment of leprosy 2. To highlight the ocular complications associated with leprosy. Methodology:Current literature on various aspects of leprosy research obtained from the Internet and supplemented by available journals ...
Incidence and socioeconomic burden of hip fractures in Italy
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A. Angeli
2011-09-01
Full Text Available Objectives: The aim of this study was to evaluate the trend of the incidence and costs of hip fractures in Italy. Methods: The incidence of hip fractures after 45 years of age in both females and males during the years 1999-2002 was obtained by analyzing the Italian Ministry of Health national hospitalization database, according to the diagnosis codes of International Classification of Diseases, Clinical Modification, 9° edition (IDC-9-CM that indicate femoral fracture. We have computed all direct costs sustained by the National Health Service for hospitalization and treatment of hip fractures on the basis of the value of the Diagnosis Related Groups (DRG referring to hip fractures. The expenses of rehabilitation and indirect expenses were based on estimates. Results: In 2002, more than 86,000 hip fractures were registered in Italy in male and female patients over 45 years old, with 9% progression compared to 1999; 77% were female and 80% were over 75 years of age. In 2002 the direct costs of hospitalization, in the patients over 65 years alone, were almost 400 milion euros, with an increase of 15% as compared to 1999. Considering also estimated rehabilitation costs, social aid and indirect costs, we estimate that hip fractures due to age-related osteoporosis created over a billion euros in expenses in 2002. Conclusions: Preventive intervention regarding the risk of hip fracture in elderly patients is urgent.
Collinge, Cory A; Beltran, Michael J; Dollahite, Henry A; Huber, Florian G
2015-06-01
The reduction of tibial shaft fractures during intramedullary nailing is important if limb alignment is to be restored and successful clinical outcomes are expected. We have used a percutaneously applied (or open) clamp or clamps to achieve and maintain reduction during nailing of all amendable tibial shaft fractures. In this article, we describe the technique and preliminary results comparing closed, simple spiral and oblique tibial shaft fractures (OTA 42-A1 and A2) managed with percutaneous clamp-assisted nailing (CAN) versus nailing using manual reduction (MRN) held by the surgical team. In the MRN group, there were an increased fracture gap (P = 0.04) and trends toward malalignment (P = 0.07) and healing time (P = 0.06) compared with the CAN group. There were also trends in clinical; no wound complications occurred in either group. We have found that percutaneous CAN of closed, simple spiral and oblique tibial shaft fractures seems safe and allows for early predictable union with reproducible alignment compared with nailing using MRN.
Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures
International Nuclear Information System (INIS)
Nachtrab, O.; Cassar-Pullicino, V.N.; Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J.
2012-01-01
MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits.
Paratrooper's ankle fracture: posterior malleolar fracture.
Young, Ki Won; Kim, Jin-su; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai
2015-03-01
We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to
HIV in Japan: Epidemiologic puzzles and ethnographic explanations
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Anthony S. DiStefano
2016-12-01
Full Text Available Japan is widely perceived to have a low level of HIV occurrence; however, its HIV epidemics also have been the subject of considerable misunderstanding globally. I used a ground truthing conceptual framework to meet two aims: first, to determine how accurately official surveillance data represented Japan's two largest epidemics (urban Kansai and Tokyo as understood and experienced on the ground; and second, to identify explanations for why the HIV epidemics were unfolding as officially reported. I used primarily ethnographic methods while drawing upon epidemiology, and compared government surveillance data to observations at community and institutional sites (459 pages of field notes; 175 persons observed, qualitative interviews with stakeholders in local HIV epidemics (n = 32, and document research (n = 116. This revealed seven epidemiologic puzzles involving officially reported trends and conspicuously missing information. Ethnographically grounded explanations are presented for each. These included factors driving the epidemics, which ranged from waning government and public attention to HIV, to gaps in sex education and disruptive leadership changes in public institutions approximately every two years. Factors constraining the epidemics also contributed to explanations. These ranged from subsidized medical treatment for most people living with HIV, to strong partnerships between government and a well-developed, non-governmental sector of HIV interventionists, and protective norms and built environments in the sex industry. Local and regional HIV epidemics were experienced and understood as worse than government reports indicated, and ground-level data often contradicted official knowledge. Results thus call into question epidemiologic trends, including recent stabilization of the national epidemic, and suggest the need for revisions to the surveillance system and strategies that address factors driving and constraining the epidemics. Based
Kuate Defo, Barthélémy
2014-01-01
Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains in life expectancy from the
New sidescan sonar and gravity evidence that the Nova-Canton Trough is a fracture zone
Joseph, Devorah; Taylor, Brian; Shor, Alexander N.
1992-05-01
A 1990 sidescan sonar survey in the eastern region of the Nova-Canton Trough mapped 138°-striking abyssal-hill fabric trending into 70°-striking trough structures. The location and angle of intersection of the abyssal hills with the eastern Nova-Canton Trough effectively disprove a spreading-center origin of this feature. Free-air gravity anomalies derived from satellite altimetry data show continuity, across the Line Islands, of the Nova-Canton Trough with the Clipperton Fracture Zone. The Canton-Clipperton trend is copolar, about a pole at 30°S, 152°W, with other coeval Pacific-Farallon fracture-zone segments, from the Pau to Marquesas fracture zones. This copolarity leads us to postulate a Pacific-Farallon spreading pattern for the magnetic quiet zone region north and east of the Manihiki Plateau, with the Nova-Canton Trough originating as a transform fault in this system.
Epidemiological trends of dengue in mainland China, 2005–2015
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Jimin Sun
2017-04-01
Conclusions: Although the number of dengue cases has increased and the affected areas have expanded in recent years, dengue is still an imported disease and does not present an endemic trend in mainland China.
Trends in post osteoporotic hip fracture care from 2010 to 2014 in a private hospital in Malaysia
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Swan Sim Yeap
2017-06-01
Conclusions: Following a low-trauma hip fracture, approximately 72% of patients were not started on active antiosteoporosis therapy. Of those who were, the median duration of treatment was 1 month. This represents a missed opportunity for the prevention of future fractures.
Age-specific incidence of hip fracture in the elderly: a healthy decline.
LENUS (Irish Health Repository)
Green, C
2012-02-01
Hip fractures in the elderly are an important source of morbidity and mortality. The predicted increase in the number of hip fractures due to the increasing elderly population has not been universally observed. The purpose of this study was to examine the incidence of hip fractures over a twenty year period to determine if this rise is occurring in our region. All hip fractures from the unit over 20 years were identified. Population data for those over 65 in the catchment area of our hospital was acquired. The rate of fractures occurring each year relative to the population was determined. The results were split into age groups. There was a strong correlation between the population rise and number of fractures (p = 0.77). But there was no significant difference in the rate of fracture over time (p = 0.41). However, the average age at which fracture occurred increased by two years. In addition we show the overall trend in the rate of fractures decreases in the younger age groups and increases in the older age groups. Therefore, the predicted rapid increase in rate is not occurring. This probably reflects the strengthening of the economy in Ireland from the 1930\\'s onwards, leading to a healthier population.
Zusman, Natalie L; Ching, Alexander C; Hart, Robert A; Yoo, Jung U
2013-04-20
Nationwide epidemiological cohort study. To characterize the incidence of second cervical vertebral (C2) fractures by age and geographical region among the elderly Medicare population and to elucidate if the rate changed in the years 2005 to 2008. Recent publications hypothesized that the rate of cervical vertebral fractures may be increasing. To date, there are no published nationwide reports describing the incidence and demographics of these injuries in the elderly US population. Incidence of C2 fracture in the years 2005 to 2008 was determined by querying PearlDiver Technologies, Inc. (Warsaw, IN), a commercially available database, using International Classification of Diseases code 805.02. Rates were calculated using the PearlDiver reported person-counts as the numerator and the Center for Medicare and Medicare Services midyear population file as the denominator, and reported per 10,000 person-years (10,000 p-y). The age and geographical distributions of fractures were examined. Variability in rates was analyzed using the mean, standard deviation, 95% confidence intervals, χ tests, and Pearson correlation coefficients. Although the elderly population increased by 6% between 2005 and 2008, the annual incidence of C2 fracture rose by 21%, from 1.58 to 1.91 per 10,000 p-y, trending upward in a straight-line function (r = 0.999, P = 0.0006). The incidence of fracture varied between age groups; however, an increase was observed in all age groups. Persons aged 65 to 74 years (the youngest age group) experienced the lowest incidence (0.63 in 2005 to 0.71 in 2008), and the rate of increase was the smallest among the age groups examined (13%). Persons aged 85 and older demonstrated the highest incidence (4.36-5.67) and the greatest increase (30%). From 2005 to 2008, the overall incidence of C2 fracture rose at a rate that was 3.5 times faster than the elderly population growth.
International Nuclear Information System (INIS)
Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu
1992-08-01
This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.
MONOLATERAL LOW-INVASIVE TREATMENT OF HUMERAL SHAFT FRACTURE IN CHILDREN
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V. P. Kuzmin
2012-01-01
Full Text Available Humeral fractures in children are from 4 up to 10% of the general number of child fractures. Recently the trend is marked to expansion of indications to operative treatment despite of mainly conservative treatment of humeral shaft fractures. The experience of humeral shaft fractures operative treatment with use of Ender nails was analyzed. 8 humeral bones were treated with use of 2 nails, 15 humeral bones - with use of 1 nail only. The good and excellent results were received in both groups of patients. At the same time group with monolateral osteosynthesis (with 1 nail had statistically significant (p<0,01 decreasing of surgery time (average difference 16 min, and also it had statistically significant (p <0,001 decreasing of X-ray exposition time (average difference 23 sec in comparison with group where the osteosynthesis was done with use of 2 nails. The results received in study show necessity of the further work for this direction.
Theoretical and laboratory investigations of flow through fractures in crystalline rock
International Nuclear Information System (INIS)
Witherspoon, P.A.; Watkins, D.J.; Tsang, Y.W.
1981-01-01
A theoretical model developed for flow through a deformable fracture subject to stresses was successfully tested against laboratory experiments. The model contains no arbitrary parameters and can be used to predict flow rates through a single fracture if the fractional fracture contact area can be estimated and if stress-deformation data are available. These data can be obtained from laboratory or in situ tests. The model has considerable potential for practical application. The permeability of ultralarge samples of fractured crystalline rock as a function of stresses was measured. Results from tests on a pervasively fractured 1-m-diameter specimen of granitic rock showed that drastically simplifying assumptions must be used to apply theoretical models to this type of rock mass. Simple models successfully reproduce the trend of reduced permeability as stress is applied in a direction normal to the fracture plane. The tests also demonstrated how fracture conductivity increases as a result of dilatancy associated with shear displacements. The effect of specimen size on the hydraulic properties of fractured rock was also investigated. Permeability tests were performed on specimens of charcoal black granite containing a single fracture subjected to normal stress. Results are presented for tests performed on a 0.914-m-diameter specimen and on the same specimen after it had been reduced to 0.764 m in diameter. The data show that fracture conductivity is sensitive to stress history and sample disturbance
Elastic-plastic fracture mechanics of compact bone
Yan, Jiahau
Bone is a composite composed mainly of organics, minerals and water. Most studies on the fracture toughness of bone have been conducted at room temperature. Considering that the body temperature of animals is higher than room temperature, and that bone has a high volumetric percentage of organics (generally, 35--50%), the effect of temperature on fracture toughness of bone should be studied. Single-edged V-shaped notched (SEVN) specimens were prepared to measure the fracture toughness of bovine femur and manatee rib in water at 0, 10, 23, 37 and 50°C. The fracture toughness of bovine femur and manatee rib were found to decrease from 7.0 to 4.3 MPa·m1/2 and from 5.5 to 4.1 MPa·m1/2, respectively, over a temperature range of 50°C. The decreases were attributed to inability of the organics to sustain greater stresses at higher temperatures. We studied the effects of water and organics on fracture toughness of bone using water-free and organics-free SEVN specimens at 23°C. Water-free and organics-free specimens were obtained by placing fresh bone specimen in a furnace at different temperatures. Water and organics significantly affected the fracture toughness of bone. Fracture toughness of the water-free specimens was 44.7% (bovine femur) and 32.4% (manatee rib) less than that of fresh-bone specimens. Fracture toughness of the organics-free specimens was 92.7% (bovine femur) and 91.5% (manatee rib) less than that of fresh bone specimens. Linear Elastic Fracture Mechanics (LEFM) is widely used to study bone. However, bone often has small to moderate scale yielding during testing. We used J integral, an elastic-plastic fracture-mechanics parameter, to study the fracture process of bone. The J integral of bovine femur increased from 6.3 KJ/mm2 at 23°C to 6.7 KJ/mm2 at 37°C. Although the fracture toughness of bovine bone decreases as the temperature increases, the J integral results show a contrary trend. The energy spent in advancing the crack beyond the linear
Savannah River Site 1996 epidemiologic surveillance report
International Nuclear Information System (INIS)
2000-01-01
This report provides a summary of epidemiologic surveillance data collected from Savannah River Site from January 1, 1996 through December 31, 1996. The data were collected by a coordinator at Savannah River Site and submitted to the Epidemiologic Surveillance Data Center located at Oak Ridge Institute for Science and Education, where quality control procedures and preliminary data analyses were carried out. The analyses were interpreted and the final report prepared by the DOE Office of Epidemiologic Studies. The information in this report provides highlights of the data analyses conducted on the 1996 data collected from Savannah River Site. The main sections of the report include: work force characteristics; absences due to injury or illness lasting 5 or more consecutive workdays; workplace illnesses, injuries, and deaths that were reportable to the Occupational Safety and Health Administration (''OSHA-recordable'' events); and disabilities and deaths among current workers. The 1996 report includes a new section on time trends that provides comparative information on the health of the work force from 1994 through 1996
Savannah River Site 1997 epidemiologic surveillance report
International Nuclear Information System (INIS)
2000-01-01
This report provides a summary of epidemiologic surveillance data collected from Savannah River Site from January 1, 1997 through December 31, 1997. The data were collected by a coordinator at Savannah River Site and submitted to the Epidemiologic Surveillance Data Center located at Oak Ridge Institute for Science and Education, where quality control procedures and preliminary data analyses were carried out. The analyses were interpreted and the final report prepared by the DOE Office of Epidemiologic Studies. The information in this report provides highlights of the data analyses conducted on the 1997 data collected from Savannah River Site. The main sections of the report include: work force characteristics; absences due to injury or illness lasting 5 or more consecutive workdays; workplace illnesses, injuries, and deaths that were reportable to the Occupational Safety and Health Administration (''OSHA-recordable'' events); and disabilities and deaths among current workers. The 199 7 report includes a section on time trends that provides comparative information on the health of the work force from 1994 through 1997
Book citations: influence of epidemiologic thought in the academic community
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Porta Miquel
2006-01-01
Full Text Available Whilst their 'death' has often been certified, books remain highly important to most professions and academic disciplines. Analyses of citations received by epidemiologic texts may complement other views on epidemiology. The objective was to assess the number of citations received by some books of epidemiology and public health, as a first step towards studying the influence of epidemiological thought and thinking in academia. For this purpose, Institute for Scientific Information/ Thomson Scientific - Web of Science/ Web of Knowledgedatabase was consulted, in May 2006. The book by Rothman & Greenland appeared to have received the highest number of citations overall (over 8,000 and per year. The books by Kleinbaum et al, and by Breslow & Day received around 5,000 citations. In terms of citations per year the book by Sackett et al ranks 3rd, and the one by Rose, 4th of those included in this preliminary study. Other books which were influential in the classrooms collected comparatively less citations. Results offer a rich picture of the academic influences and trends of epidemiologic methods and reasoning on public health, clinical medicine and the other health, life and social sciences. They may contribute to assess epidemiologists' efforts to demarcate epidemiology and to assert epistemic authority, and to analyze some historical influences of economic, social and political forces on epidemiological research.
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Miskelyemen Abdelatti Elmekki
2017-01-01
Full Text Available Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012–2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%. Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively. Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively. Considering geographical distribution, the highest percentage of the cases (40.5% were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%. Few cases (2.5% were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed.
International Nuclear Information System (INIS)
Kang, Sung Sik; Chi, Se Hwan; Hong, Jun Hwa
1998-01-01
The statistical analysis method was applied to the evaluation of fracture toughness in the ductile-brittle transition temperature region. Because cleavage fracture in steel is of a statistical nature, fracture toughness data or values show a similar statistical trend. Using the three-parameter Weibull distribution, a fracture toughness vs. temperature curve (K-curve) was directly generated from a set of fracture toughness data at a selected temperature. Charpy V-notch impact energy was also used to obtain the K-curve by a K IC -CVN (Charpy V-notch energy) correlation. Furthermore, this method was applied to evaluate the neutron irradiation embrittlement of reactor pressure vessel(RPV) steel. Most of the fracture toughness data were within the 95 percent confidence limits. The prediction of a transition temperature shift by statistical analysis was compared with that from the experimental data. (author)
Optimizing fracture and completion design in the Westerose field
Energy Technology Data Exchange (ETDEWEB)
Dunn-Norman, S. [Missouri Univ., Rolla, MO (United States); Griffiths, E.; Barnhart, W. [Pan-Canadian Petroleum Ltd., Calgary, AB (Canada); Aunger, D.; Kenny, L.; Halvaci, M.
1998-12-31
An experimental study was conducted to determine the feasibility of developing additional gas reserves in the tight sands located between the main bar trends in the Westerose gas field, located 75 km south of Edmonton, Alberta. As part of the study, fracturing and completion alternatives in the Glauconitic `bar` and `interbar` sands were analyzed and compared. Optimal fracture designs for vertical wells were determined for each type of sand. Vertical well performance was compared to stimulated and unstimulated horizontal wells drilled either parallel or perpendicular to the minimum in-situ stress. Results indicated that in-situ permeabilities in the interbar sands were lower than anticipated. It was also shown that over the permeability ranges studied, predicted rates matched actual rates for both vertical fractured and multifractured horizontal wells, suggesting that analytical models can be used to assess anticipated well performance. A further conclusion drawn from the study was that by stimulating a wide variety of permeability ranges, well orientations, anisotropy, fracture orientations and completion options can be determined. 12 refs., 7 tabs., 4 figs.
Rubin, Guy; Peleg, Kobi; Givon, Adi; Rozen, Nimrod
2017-10-24
Fractures in pediatrics show epidemiological characteristics which are different from fractures in adults. The objective of this study was to examine the injury profiles of open upper extremity fractures (UEFs) in all modes of injury related to road traffic accidents (RTAs) in adult and pediatric hospitalized patients. Data on 103,465 RTA patients between 1997 and 2013 whose records were entered in a centralized country trauma database were reviewed. Data on open UEFs related to mode of injury (car, motorcycle, bicycle, and pedestrian) was compared between adult (18+ years) and pediatric (0-17 years) RTA patients. Of 103,465 RTA cases, 17,263 (16.7%) had UEFs. Of 73,087 adults, 13,237 (18.1%) included UEFs and of 30,378 pediatric cases, 4026 (13.2%) included UEFs (p open fractures. Adults had a greater risk for open fractures (2221, 13%) than the pediatric cases (522, 10.3%) (p open UEFs than the pediatric group (11 vs 8%, p = 0.0012). This study demonstrates the difference between adult and pediatric open fractures in hospitalized RTAs. We showed that adults had a greater risk for open UEFs compared to children, and the adult pedestrian group particularly had a significantly higher risk for open UEFs than the pediatric group.
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Tamulaitiene Marija
2012-07-01
Full Text Available Abstract Background Few epidemiological data on hip fractures were previously available in Lithuania. The aim of this study was to estimate the incidence and hospital costs of hip fractures in Vilnius in 2010. Methods Data were collected from the medical charts of all patients admitted to hospitals in Vilnius (population, 548,835 due to new low-energy trauma hip fracture, during 2010. The estimated costs included ambulance transportation and continuous hospitalisation immediately after a fracture, which are covered by the Lithuanian healthcare system. Results The incidence of new low-energy trauma hip fractures was 252 (308 women and 160 men per 100,000 inhabitants of Vilnius aged 50-years or more. There was an exponential increase in the incidence with increasing age. The overall estimated cost of hip fractures in Vilnius was 1,114,292 EUR for the year 2010. The greatest part of the expenditure was accounted for by fractures in individuals aged 65-years and over. The mean cost per case was 2,526.74 EUR, and cost varied depending on the treatment type. Hip replacement did not affect the overall mean costs of hip fracture. The majority of costs were incurred for acute (53% and long-term care (35% hospital stays, while medical rehabilitation accounted for only 12% of the overall cost. The costs of hip fracture were somewhat lower than those found in other European countries. Conclusion The data on incidence and costs of hip fractures will help to assess the importance of interventions to reduce the number of fractures and associated costs.
[Eco-epidemiology: towards epidemiology of complexity].
Bizouarn, Philippe
2016-05-01
In order to solve public health problems posed by the epidemiology of risk factors centered on the individual and neglecting the causal processes linking the risk factors with the health outcomes, Mervyn Susser proposed a multilevel epidemiology called eco-epidemiology, addressing the interdependence of individuals and their connection with molecular, individual, societal, environmental levels of organization participating in the causal disease processes. The aim of this epidemiology is to integrate more than a level of organization in design, analysis and interpretation of health problems. After presenting the main criticisms of risk-factor epidemiology focused on the individual, we will try to show how eco-epidemiology and its development could help to understand the need for a broader and integrative epidemiology, in which studies designed to identify risk factors would be balanced by studies designed to answer other questions equally vital to public health. © 2016 médecine/sciences – Inserm.
Morbidity and mortality of hospitalized hip fractures in chronic hemodialysis
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Georgios Vlachopanos
2018-01-01
Full Text Available Abnormal bone architecture contributes to high incidence of hip fractures in chronichemodialysis (HD patients. Their clinical epidemiology is incompletely described. We conducted a retrospective cohort study to assess the implications ofhospitalization with hip fracture in HD patients compared to the nonchronic kidney disease population. Thirty-three chronic HD patients admitted with hip fracture overfiveyears were age- and sex-matched on a 1:1 ratio with controls that had hip fracture and normal renal function. Demographic characteristics, deaths, and readmissions atsixmonths,hospitalization length, time to operation, and laboratory resultswere recorded from electronic health files. Datawere compared betweenthe two groups usingpairedt-test for continuous variables and McNemar's test for categoricalvariables. The compositeendpoint of deathand/or readmission at6 months was higher in HD patients (12.1% vs. 6.2%, P<0.001. Furthermore, mean time tooperationwas more delayed due to comorbidities (4.7 vs. 2.9 days, p = 0.04. HD patients had anemia more frequently at presentation (hemoglobin below 10 mg/dL, 32.1% vs. 12.5%, P = 0.003. Finally, they were more likely to be considered toofrail for surgery and not be operated (21.2% vs. 6.2%, P<0.001. Hip fractures are associated with increased morbidity and mortality and represent an important health-care burden for chronic HD patients. Future research is needed to identify definite predictors of adverse outcomes and to implement prevention strategies.
Elderly patients with maxillofacial trauma: study of mandibular condyle fractures.
Nogami, Shinnosuke; Yamauchi, Kensuke; Yamashita, Toshio; Kataoka, Yoshihiro; Hirayama, Bunichi; Tanaka, Kenko; Takahashi, Tetsu
2015-02-01
The aim of this study was to investigate the trends and characteristic features of mandibular condyle fractures in elderly patients in terms of etiology, patterns, and treatment modalities. Records of 201 patients aged 65 years and older, who were treated for maxillofacial fractures at the Department of Oral and Maxillofacial Surgery, Kyushu Dental University, and Tohoku University from January 2002 to December 2013, were retrospectively analyzed. Patient records and radiographs were examined, with the following information: relevant medical history, cause of fracture, the presence and state of premolars and molars in the maxilla and mandible, number and location of mandible fracture, and method of treatment. As for the state of premolars and molars, premolars or molars in the mandible in contact with the maxilla were regarded as contacted. A fall was responsible for the majority of the fractures (173/201). With condyle fractures, there was a significant difference between the contacted and non-contacted group in regard to incidence. Furthermore, there was a significantly greater number of cases with symphysis and condyle combination fractures in the non-contacted group (70.9%) than in the contacted group (51.9%). As for the method of treatment, arthrocentesis was the most commonly employed. The present findings suggest that contacted molars in the maxilla and mandible have an influence on condyle fractures in elderly individuals. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Recent trends in coronary heart disease epidemiology in India.
Gupta, Rajeev
2008-01-01
Coronary heart disease (CHD) is epidemic in India and one of the major causes of disease-burden and deaths. Mortality data from the Registrar General of India shows that cardiovascular diseases are a major cause of death in India now. Studies to determine the precise causes of death in urban Chennai and rural areas of Andhra Pradesh have revealed that cardiovascular diseases cause about 40% of the deaths in urban areas and 30% in rural areas. Analysis of cross-sectional CHD epidemiological studies performed over the past 50 years reveals that this condition is increasing in both urban and rural areas. The adult prevalence has increased in urban areas from about 2% in 1960 to 6.5% in 1970, 7.0% in 1980, 9.7% in 1990 and 10.5% in 2000; while in rural areas, it increased from 2% in 1970, to 2.5% in 1980, 4% in 1990, and 4.5% in 2000. In terms of absolute numbers this translates into 30 million CHD patients in the country. The disease occurs at a much younger age in Indians as compared to those in North America and Western Europe. Rural-urban differences reveal that risk factors like obesity, truncal obesity, hypertension, high cholesterol, low HDL cholesterol and diabetes are more in urban areas. Case-control studies also confirm the importance of these risk factors. The INTERHEART-South Asia study identified that eight established coronary risk factors--abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable consumption, and lack of physical activity--accounted for 89% of the cases of acute myocardial infarction in Indians. There is epidemiological evidence that all these risk factors are increasing. Over the past fifty years prevalence of obesity, hypertension, hypercholesterolemia, and diabetes have increased significantly in urban (R2 0.45-0.74) and slowly in rural areas (R2 0.19-0.29). There is an urgent need for development and implementation of suitable primordial, primary, and secondary prevention
Lane, J.W.; Williams, J.H.; Johnson, C.D.; Savino, D.M.; Haeni, F.P.
2002-01-01
The U.S. Geological Survey conducted an integrated geophysical and hydraulic investigation at the Norden Systems, Inc. site in Norwalk, Connecticut, where chlorinated solvents have contaminated a fractured-rock aquifer. Borehole, borehole-to-borehole, surface-geophysical, and hydraulic methods were used to characterize the site bedrock lithology and structure, fractures, and transmissive zone hydraulic properties. The geophysical and hydraulic methods included conventional logs, borehole imagery, borehole radar, flowmeter under ambient and stressed hydraulic conditions, and azimuthal square-array direct-current resistivity soundings. Integrated interpretation of geophysical logs at borehole and borehole-to-borehole scales indicates that the bedrock foliation strikes northwest and dips northeast, and strikes north-northeast to northeast and dips both southeast and northwest. Although steeply dipping fractures that cross-cut foliation are observed, most fractures are parallel or sub-parallel to foliation. Steeply dipping reflectors observed in the radar reflection data from three boreholes near the main building delineate a north-northeast trending feature interpreted as a fracture zone. Results of radar tomography conducted close to a suspected contaminant source area indicate that a zone of low electromagnetic (EM) velocity and high EM attenuation is present above 50 ft in depth - the region containing the highest density of fractures. Flowmeter logging was used to estimate hydraulic properties in the boreholes. Thirty-three transmissive fracture zones were identified in 11 of the boreholes. The vertical separation between transmissive zones typically is 10 to 20 ft. Open-hole and discrete-zone transmissivity was estimated from heat-pulse flowmeter data acquired under ambient and stressed conditions. The open-hole transmissivity ranges from 2 to 86 ft2/d. The estimated transmissivity of individual transmissive zones ranges from 0.4 to 68 ft2/d. Drawdown monitoring
Study of Fatigue and Fracture Behavior of Cr-Based Alloys and Intermetallic Materials
Energy Technology Data Exchange (ETDEWEB)
He, YH
2001-01-31
The microhardness, and tensile and fracture-toughness properties of drop-cast and directionally-solidified Cr-9.25 at.% (atomic percent) Ta alloys have been investigated. Directional solidification was found to soften the alloy, which could be related to the development of equilibrium and aligned microstructures. It was observed that the tensile properties of the Cr-Ta alloys at room and elevated temperatures could be improved by obtaining aligned microstructures. The directionally-solidified alloy also showed increased fracture toughness at room temperature. This trend is mainly associated with crack deflection and the formation of shear ribs in the samples with aligned microstructures. The sample with better-aligned lamellar exhibits greater fracture toughness.
The epidemiological and histological trend of bladder cancer in Iran
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Hosein Rafiemanesh
2018-01-01
Conclusion: According to this study the trend of ASIR of bladder cancer in Iran is rising, so it is necessary to conduct further researches in future to provide accurate information on the cancer and investigate related risk factors and implement prevention programs in Iran.
Orchard, Tonya S; Larson, Joseph C; Alghothani, Nora; Bout-Tabaku, Sharon; Cauley, Jane A; Chen, Zhao; LaCroix, Andrea Z; Wactawski-Wende, Jean; Jackson, Rebecca D
2014-01-01
Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P 422.5 compared with magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611. PMID:24500155
International Nuclear Information System (INIS)
Milnes, A.G.; Gee, D.G.
1992-09-01
The stability of the bedrock in SE Sweden with regard to radioactive waste disposal has recently been the subject of some controversy. In order to better assess the age and significance of fracturing in the Precambrian basement at the site of the Aespoe Hard Rock Laboratory (HRL), near Oskarshamn, a detailed analysis of fracturing in the lower Ordovician limestones exposed along the west coast of the neighbouring island of Oeland has been carried out. The limestones form continuously exposed shore platforms, in segments up to 30 m broad and several kilometres long. These, and numerous quarries, provide ideal objects for quantitative analysis (ground and air photo mapping, scanline logging), and unique opportunities for investigating the amount of movement on the fractures, because of well-developed bedding and abundant rod-shaped fossils on the bedding surfaces. The fracture patterns are dominated by two sets of subvertical fractures, a NW trending closely spaced and strongly orientated set and a NNE-ENE trending widely spaced and variably orientated set. Only about 10% of the fractures in both sets show lateral fossil displacement, with maximum movement of 5 cm, and only 3% of the fractures show vertical displacement of bedding (maximum 8 cm). All in all, the lower Ordovician limestones along the exposed shoreline have suffered remarkably little deformation since deposition, i.e. over the last 500 million years. Appreciable bedrock instability, if it occurred, must have been concentrated offshore, or in the unexposed segments of the coastline, where some weak indications of slight movement (changes of a few metres in stratigraphic level) have been observed. Among other recommendations for further work, geophysical investigations to test these indications are suggested. (54 refs.)
The effect of stress fracture interventions in a single elite infantry training unit (1983-2015).
Milgrom, Charles; Finestone, Aharon S
2017-10-01
Stress fractures can be seen as an undesired byproduct of demanding physical training. The threshold value of stress that places an individual bone at high risk for stress fracture has not been identified. In a prospective study of stress fractures in 1983, a 31% incidence was found during demanding Israeli infantry basic training by bone scan criteria. Within a subgroup of these recruits, an elite infantry unit was found to have a 40% incidence. Since then and until 2015, eight additional induction companies of the same elite infantry unit were prospectively monitored for stress fractures during their basic training. In all of the studies, stress fracture surveillance and the examining orthopedist were the same. A retrospective review of all nine studies and of eight training changes was performed to look for a temporal trend in stress fracture incidence and to see if these might be related to training changes. There was a statistically significant trend for lower radiological proven stress fractures (p=0.0001) and radiological proven stress fractures plus clinical stress fractures (p=0.0013), as well as lower stress fracture severity by radiological criteria (p=0.0001) between 1983 and 2015. The only training change that was associated, by multivariate logistic regression, with a decreased incidence of stress fracture was restricting training to the authorized training protocol (odds ratio, 3874; 95% CI, 1.526 to 9.931; p=0.004). Increased recruit weight was found by multivariate analysis to be associated with lower stress fracture incidence (odds ratio 1.034; 95% CI, 1.00 to 1.070; p=0.051). Moving the training to a base with flatter terrain and reducing the formal marching distance by 1/3 was associated with a decrease in high grade stress fractures (odds ratio, 10.03; 95% CI, 3.5 to 28.4; p=0.0001). Neither the combined changes of enforcing a seven hour a night sleep regimen, training in more comfortable boots and adding a physical therapist to the unit nor
Model of T-Type Fracture in Coal Fracturing and Analysis of Influence Factors of Fracture Morphology
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Yuwei Li
2018-05-01
Full Text Available Special T-type fractures can be formed when coal is hydraulically fractured and there is currently no relevant theoretical model to calculate and describe them. This paper first establishes the height calculation model of vertical fractures in multi-layered formations and deduces the stress intensity factor (SIF at the upper and lower sides of the fracture in the process of vertical fracture extension. Combined with the fracture tip stress analysis method of fracture mechanics theory, the horizontal bedding is taken into account for tensile and shear failure, and the critical mechanical conditions for the formation of horizontal fracture in coal are obtained. Finally, the model of T-type fracture in coal fracturing is established, and it is verified by fracturing simulation experiments. The model calculation result shows that the increase of vertical fracture height facilitates the increase of horizontal fracture length. The fracture toughness of coal has a significant influence on the length of horizontal fracture and there is a threshold. When the fracture toughness is less than the threshold, the length of horizontal fracture remains unchanged, otherwise, the length of horizontal fracture increases rapidly with the increase of fracture toughness. When the shear strength of the interface between the coalbed and the interlayer increases, the length of the horizontal fracture of the T-type fracture rapidly decreases.
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Barthélémy Kuate Defo
2014-05-01
Full Text Available Background: Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective: The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results: Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1 theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2 simple summary indicators that can be used to evaluate their descriptive and predictive features; 3 marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4 the rapid decline in infant
Kuate Defo, Barthélémy
2014-01-01
Background Studies of trends in population changes and epidemiological profiles in the developing world have overwhelmingly relied upon the concepts of demographic, epidemiological, and health transitions, even though their usefulness in describing and understanding population and health trends in developing countries has been repeatedly called into question. The issue is particularly relevant for the study of population health patterns in Africa and sub-Saharan Africa, as the history and experience there differs substantially from that of Western Europe and North America, for which these concepts were originally developed. Objective The aim of this study is two-fold: to review and clarify any distinction between the concepts of demographic transition, epidemiological transition and health transition and to identify summary indicators of population health to test how well these concepts apply in Africa. Results Notwithstanding the characteristically diverse African context, Africa is a continent of uncertainties and emergencies where discontinuities and interruptions of health, disease, and mortality trends reflect the enduring fragility and instability of countries and the vulnerabilities of individuals and populations in the continent. Africa as a whole remains the furthest behind the world's regions in terms of health improvements and longevity, as do its sub-Saharan African regions and societies specifically. This study documents: 1) theoretically and empirically the similarities and differences between the demographic transition, epidemiological transition, and health transition; 2) simple summary indicators that can be used to evaluate their descriptive and predictive features; 3) marked disparities in the onset and pace of variations and divergent trends in health, disease, and mortality patterns as well as fertility and life expectancy trajectories among African countries and regions over the past 60 years; 4) the rapid decline in infant mortality and gains
A retrospective review of trends and clinical characteristics of ...
African Journals Online (AJOL)
Objective: Epidemiological studies indicate that methamphetamine (MA) abuse poses a major challenge to health in the Western Cape. The objectives of this study were to retrospectively assess the trends, clinical characteristics and treatment demand of MArelated admissions to a psychiatric ward in this region. Method: ...
EPIDEMIOLOGY OF SPINE FRACTURES IN MOTORCYCLE ACCIDENT VICTIMS
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Tiago Argolo Bittencourt de Oliveira
2016-03-01
Full Text Available ABSTRACT Objective: To analyze the incidence of spinal injuries between 2000-2010 due to motorcycle accidents and the relation to the increase in motorcycle sales in the same period, as well as the anatomical distribution of these spinal injuries. Methods: Data were collected from 1,295 records of patients who have suffered spinal injury resulting from motorcycle accidents admitted to the ward TRM (Spinal Cord Trauma of the Hospital Geral do Estado da Bahia from 2000 to 2010 in this retrospective study. We selected 110 medical records and collected information on sex, age, neurological deficit on admission (according to Frankel scale, diagnosis, and level of injury. Results: Between 2000 and 2010 there was an increase of almost five times in the incidence of patients who have suffered spinal injury due to motorcycle accidents. More than half (51.4% had cervical spine injury, 37.2% thoracic spine injury and 11.34% had lumbar spine injury. Only 34.3% of patients had no neurological deficit on admission and patients with thoracic spine fracture had a higher incidence and severity of lesion. The average age of patients was 30 years. Conclusions: The increased incidence of spinal injuries due motorcycle accidents occurred in the same period in which there was an increase in motorcycle sales in the country. Patients who have suffered those injuries were young, with higher incidence in the cervical and thoracic spinal levels and high rates of neurological deficit.
Vopat, Bryan; Beaulieu-Jones, Brendin R; Waryasz, Gregory; McHale, Kevin J; Sanchez, George; Logan, Catherine A; Whalen, James M; DiGiovanni, Christopher W; Provencher, Matthew T
2017-08-01
Navicular injuries can result in persistent pain, posttraumatic osteoarthritis, and diminished performance and function. To determine the epidemiology of navicular fracture in players participating in the National Football League (NFL) Scouting Combine and evaluate the impact of a navicular injury on the NFL draft position and NFL game play compared with matched controls. Cohort study; Level of evidence, 3. Data were collected on players who previously sustained a navicular injury and participated in the NFL Combine between 2009 and 2015. The epidemiology of navicular injury was determined through an evaluation of the number of injuries, surgeries, and collegiate games missed as well as the position played, a physical examination, the surgical technique, and imaging findings. Players with a previous navicular injury (2009-2013) were compared with a set of matched controls. NFL performance outcomes included the draft position, career length ≥2 years, and number of games played and started within the first 2 years. Between 2009 and 2015, 14 of 2285 (0.6%) players were identified as having sustained a navicular injury. A total of 11 of 14 (79%) athletes had sustained an overt navicular fracture, while 3 of 14 (21%) were diagnosed with stress reactions on magnetic resonance imaging. Eight patients who sustained a navicular fracture underwent surgery. There was evidence of ipsilateral talonavicular arthritis in 75% of players with a navicular fracture versus only 60% in the uninjured foot (odds ratio, 1.3; P = .04). Fifty-seven percent of players with navicular injury (72.7% of fractures) were undrafted versus 30.9% in the control group ( P = .001). Overall, 28.6% of players with navicular fracture played ≥2 years in the NFL compared with 69.6% in the control group ( P = .02). A previous navicular fracture results in a greater risk of developing posttraumatic osteoarthritis. Although only a low prevalence of navicular injury in prospective NFL players was noted
Epidemiology Characteristics and Trends of Lung Cancer Incidence in Iran.
Almasi, Zeinab; Salehiniya, Hamid; Amoori, Neda; Enayatrad, Mostafa
2016-01-01
Lung cancer is one of the most common cancers in the world and a major cause of death from cancer. One of the important indicators to compare the prevalence and incidence of the disease is a change in the trend. The aim of this study was to investigate the changes in the incidence of lung cancer in Iran. This study was conducted based on existing data obtained from a national registry of cancer cases and the Disease Management Center of Ministry of Health in Iran. All cases registered in the country were included during 2003-2008. Incidence rates were reported based on the direct method and standard population of World Health Organization. The study also examined the morphology of common lung cancers. Trends in incidence underwent joinpoint regression analysis. Based on the results of this study, 14,403 cases of lung cancer have been recorded of which 10,582 cases were in men and 3,821 in women. Highest incidence rates were observed in the 80-84 age group. Considerable variation across provinces was evident. In females squamous cell carcinoma (SCC) demonstrated a reduction from 24% to 16% of lesions over the period of study, while adenocarcinoma rose from 21% to 29%. In males a similar reduction in SCC was apparent (42% to 29%, again with increase in AC (13 % to 18%). The results show that the increase in the incidence of lung cancer the trend is that more men than women and in men and may be caused by changes in smoking pattern. The incidence of lung cancer in the North West and West provinces was higher than in other regions.
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Nadim Tarazi
2017-01-01
Conclusion: We noticed a clear epidemiological drift in the cervical spine pathologies requiring OCF during the first and second decade of study period with an increase in prevalence of pathological fractures secondary to metastatic disease. In addition, a drop in rheumatoid cervical disease requiring OCF has been noted.
Moayyeri, Alireza
2008-11-01
Physical activity helps maintain mobility, physical functioning, bone mineral density (BMD), muscle strength, balance and, therefore, may help prevent falls and fractures among the elderly. Meanwhile, it is theoretically possible that physical activity increases risk of fractures as it may increase risk of falls and has only a modest effect on BMD. This review aims to assess the potential causal association between physical activity and osteoporotic fractures from an epidemiological viewpoint. As the medical literature lacks direct evidence from randomized controlled trials (RCTs) with fracture end points, a meta-analysis of 13 prospective cohort studies with hip fracture end point is presented. The current evidence base regarding the link between exercise and fracture risk determinants (namely, falls, BMD, and bone quality) are also summarized. Moderate-to-vigorous physical activity is associated with a hip fracture risk reduction of 45% (95% CI, 31-56%) and 38% (95% CI, 31-44%), respectively, among men and women. Risk of falling is suggested to be generally reduced among physically active people with a potential increased risk in the most active and inactive people. Positive effects of physical activity on BMD and bone quality are of a questionable magnitude for reduction of fracture risk. The complexity of relationship between physical activity and osteoporotic fractures points out to the need for RCTs to be conducted with fractures as the primary end point.
Poverty is a risk factor for osteoporotic fractures.
Navarro, M C; Sosa, M; Saavedra, P; Lainez, P; Marrero, M; Torres, M; Medina, C D
2009-03-01
This study assesses the possible association between poverty and osteoporosis and/or fragility fractures in a population of postmenopausal women. We found that postmenopausal women with low socioeconomic status had lower values of BMD at the lumbar spine, a higher prevalence of densitometric osteoporosis, and a higher prevalence of total and vertebral fractures. Some lifestyles are related to the presence of osteoporosis and/or fragility fractures, whereas poverty is related to some lifestyles. Because of this, we studied the possible association of poverty with osteoporosis and fractures. This was an observational, cross-sectional study performed in the Canary Islands, Spain. Participants consisted of a total of 1,139 ambulatory postmenopausal women aged 50 years or older with no previous osteoporosis diagnosis and who were enrolled in some epidemiological studies. The prevalence of fractures (vertebral and non-vertebral) and the prevalence of osteoporosis (T-score poverty (annual family income lower than 6,346.80 Euros, in a one-member family, n = 474), were older and heavier and had lower height, lower prevalence of tobacco and alcohol consumption, lower use of HRT and higher use of thiazides. After correcting for age and body mass index (BMI), women in poverty had lower spine BMD values than women with a medium and high socioeconomic status (0.840 g/cm(2) vs. 0.867 g/cm(2), p = 0.005), but there were no statistical differences in femoral neck BMD between groups. The prevalence of osteoporosis was also higher in women in poverty [40.6% vs. 35.6%, (OR 1.35, CI 95%: 1.03; 1.76)] after adjusting by age and BMI. Moreover, 37.8% of women in poverty had a history of at least one fragility fracture compared to 27.7% of women not in poverty (OR: 1.45, CI 95%: 1.11; 1.90). The prevalence of vertebral fractures was also higher in women in poverty 24.7% vs. 13.4%, (OR 2.01, CI 95%: 1.44; 2.81). Postmenopausal women with low socioeconomic status had lower values of BMD at
Data on education: from population statistics to epidemiological research
DEFF Research Database (Denmark)
Pallesen, Palle Bo; Tverborgvik, Torill; Rasmussen, Hanna Barbara
2010-01-01
BACKGROUND: Level of education is in many fields of research used as an indicator of social status. METHODS: Using Statistics Denmark's register for education and employment of the population, we examined highest completed education with a birth-cohort perspective focusing on people born between...... of population trends by use of extrapolated values, solutions are less obvious in epidemiological research using individual level data....
Takakubo, Yuya; Ohta, Daichi; Ishi, Masaji; Ito, Juji; Oki, Hiroharu; Naganuma, Yasushi; Uno, Tomohiro; Sasaki, Akiko; Akabane, Takeru; Dairaku, Katsuyuki; Goto, Shinichi; Goto, Yasuo; Kanauchi, Yumiko; Kobayashi, Shinji; Nakajima, Taku; Masuda, Keiji; Matsuda, Michiharu; Mura, Nariyuki; Takenouchi, Kenji; Tsuchida, Hiroyuki; Onuma, Yasushi; Shibuya, Junichirou; Seino, Mitsuyoshi; Yamaguchi, Osamu; Hiragami, Ken; Urayama, Yasuhiro; Furukawa, Takashi; Okuda, Shouta; Ogura, Ken; Nakamura, Takeshi; Sasaki, Kan; Konta, Tsuneo; Takagi, Michiaki
2017-08-01
Atypical femoral fractures (AFFs) have been reported to occur with minimal or spontaneous subtrochanteric and femoral shaft fractures with a characteristic transverse pattern, compared with typical femoral fractures in young patients with high-energy trauma. AFFs are related to long-term use of bisphosphonates (BPs), glucocorticoids and rheumatic diseases. We have estimated a blind analysis of AFFs in rheumatic patients receiving BPs and glucocorticoids ordinary over a long time in all Yamagata prefectural area through radiographic examination. The 123 AFFs including suspected cases over six years were collected and reviewed by two independent orthopedic surgeons. We found 86 patients with a total of 99 AFFs between 2009 and 2014 (1.43 cases/100,000 person/year). Of these 99 AFFs, 11 were in 8 rheumatic patients including three patients with bilateral AFFs. The incidence of AFFs in rheumatic patients had trend to increase from 2012. The mean age of all 8 patients was 54.9 years. All 8 patients received BPs and 7/8 received prednisolone (PSL). The mean dose of PSL was 14 mg/day. Compared to patients with unilateral AFFs, those with bilateral AFFs in rheumatic patients were on a higher dose of PSL (20 mg/day vs. 7 mg/day) and had less femoral neck-shaft angle (129° vs. 136°, p rheumatic patients showed a trend to increase from 2012 to 2014 in Yamagata prefecture. Careful management of AFFs is of particular importance in rheumatic patients who have taken high doses of PSL and have small femoral neck-shaft angle.
Vital capacity helps predict pulmonary complications after rib fractures.
Carver, Thomas W; Milia, David J; Somberg, Chloe; Brasel, Karen; Paul, Jasmeet
2015-09-01
identify those at risk for complications after rib fractures, but a prospective study is necessary to confirm these findings. Prognostic/epidemiologic study, level IV.
Fractures of the mandible and maxilla: A 10-year analysis
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Estie Kruger
2016-01-01
Full Text Available Background Previous analysis of jaw fracture hospitalisations in Western Australia (WA indicated disproportionately high rates of hospitalisations for Aboriginal people. This study was to follow-up on the earlier analysis to determine if inequalities in terms of jaw fracture hospitalisation rates between Aboriginal and non-Aboriginal people have changed. Aims This study, done over a 10-year period from 1999/2000 to 2008/2009, aimed to determine rates of hospitalisations for jaw fractures in WA, trends over the 10–year period, and direct costs associated with these hospital admissions. Methods Hospitalisation data were obtained from the Western Australian Hospital Morbidity Data System (HMDS. Episodes were selected on the basis of an ICD10-AM code being S02.4 (Fracture of the malar and maxillary bones and S02.6 (Fracture of the mandible. Self-reported Aboriginality were used to compare Aboriginal to non-Aboriginal populations. Estimated cost of care was determined for each episode using the national standard diagnostic-related group (DRG average price. Results Our findings indicate that inequalities between Aboriginal and non-Aboriginal people in terms of hospital admissions for jaw fractures exist in WA, and continued over a decade-long period. Higher fracture rates occurred amongst males, Aboriginal people, younger adult age-groups, those from low socioeconomic areas, and those from remote and very remote areas. The DRG cost per person for jaw fractures ranged between AUD $842 and $109,002, with a median cost of $4,965. Conclusion Hospital admission rates for the treatment of maxillary and mandibular fractures is very strongly divided along racial and socioeconomic lines in WA.
Remote Sensing Applications for Antrim Shale Fracture Characterization, Michigan Basin
Kuuskraa, Vello
1997-01-01
Advanced Research International (ARI) sent seven staff members to the 1997 International Coalbed Methane Symposium, held in Tuscaloosa, Alabama from May 12-17. ARI gave a short course on risk reduction strategies, including remote fracture detection, for coalbed methane exploration and development that was attended by about 25 coalbed methane industry professionals; and presented a paper entitled 'Optimizing coalbed methane cavity completion operations with the application of a new discrete element model.' We met with many potential clients and discussed our fracture detection services. China has vast coalbed methane resources, but is still highly dependent on coal-and wood-burning. This workshop, sponsored by the United Nations, was intended to help China develop its less-polluting energy reserves. ARI is successfully finding new applications for its fracture detection services. Coalbed methane exploration became an important market in this quarter, with the inception of a joint industry/government collaboration between ARI, Texaco and DOE to use remote fracture detection to identify areas with good potential for coalbed methane production in the Ferron Coal Trend of central Utah. Geothermal energy exploration is another emerging market for ARI, where fracture detection is applied to identify pathways for groundwater recharge, movement, and the locations of potential geothermal reservoirs. Ari continued work on two industry/government collaborations to demonstrate fracture detection to potential clients. Also completed the technical content layout for multimedia CD-ROM that describes our remote fracture detection services.
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Buchari Lapau
2011-01-01
Full Text Available Makalah ini pertama kali menjelaskan perlu adanya profesi kesehatan masyarakat dalam rangka pembangunan kesehatan. Lalu dijelaskan apa profesi itu dan standar keberadaan profesi, atas dasar mana dapat ditetapkan bahwa pelayanan epidemiologi merupakan salah satu profesi. Dalam rangka pembinaan profesi kesehatan masyarakat, IAKMI dan APTKMI telah membentuk Majelis Kolegium Kesehatan Masyarakat Indonesia (MKKMI yang terdiri atas 8 kolegium antara lain Kolegium Epidemiologi, yang telah menyusun Standar Profesi Epidemiologi yang terdiri atas beberapa standar. Masing-masing standar dijelaskan mulai dari kurikulum, standar pelayanan epidmiologi, profil epidemiolog kesehatan, peran epidemiolog kesehatan, fungsi epidemiolog kesehatan, standar kompetensi epidemiologi, dan standar pendidikan profesi epidemiologi.
1996 Savannah River Site annual epidemiologic surveillance report
Energy Technology Data Exchange (ETDEWEB)
None
2000-03-01
This report provides a summary of epidemiologic surveillance data collected from Savannah River Site from January 1, 1996 through December 31, 1996. The data were collected by a coordinator at Savannah River Site and submitted to the Epidemiologic Surveillance Data Center located at Oak Ridge Institute for Science and Education, where quality control procedures and preliminary data analyses were carried out. The analyses were interpreted and the final report prepared by the DOE Office of Epidemiologic Studies. The information in this report provides highlights of the data analyses conducted on the 1996 data collected from Savannah River Site. The main sections of the report include: work force characteristics; absences due to injury or illness lasting 5 or more consecutive workdays; workplace illnesses, injuries, and deaths that were reportable to the Occupational Safety and Health Administration (''OSHA-recordable'' events); and disabilities and deaths among current workers. The 1996 report includes a new section on time trends that provides comparative information on the health of the work force from 1994 through 1996.
1997 Savannah River Site annual epidemiologic surveillance report
Energy Technology Data Exchange (ETDEWEB)
None
2000-06-01
This report provides a summary of epidemiologic surveillance data collected from Savannah River Site from January 1, 1997 through December 31, 1997. The data were collected by a coordinator at Savannah River Site and submitted to the Epidemiologic Surveillance Data Center located at Oak Ridge Institute for Science and Education, where quality control procedures and preliminary data analyses were carried out. The analyses were interpreted and the final report prepared by the DOE Office of Epidemiologic Studies. The information in this report provides highlights of the data analyses conducted on the 1997 data collected from Savannah River Site. The main sections of the report include: work force characteristics; absences due to injury or illness lasting 5 or more consecutive workdays; workplace illnesses, injuries, and deaths that were reportable to the Occupational Safety and Health Administration (''OSHA-recordable'' events); and disabilities and deaths among current workers. The 199 7 report includes a section on time trends that provides comparative information on the health of the work force from 1994 through 1997.
Directory of Open Access Journals (Sweden)
Pardhasaradhi
2015-10-01
Full Text Available INTRODUCTION : High - energy tibial plateau fractures are infrequent and technically demanding to treat especially if those are shearing type, coronal plane, displaced fractures. The most widely used the Schatzker system of classification , [1] ( B ased on the AP radiograph is more than likely to miss postero - medial and postero - lateral shear fractures, best visible on the lateral, than the AP radiograph. These fractures have recently been characterised by two studies, highlighti ng their clinical relevance [ 2,3] and showing that less invasive surgery and indirect reduction techniques are often inadequate. Hohl described unicondylar c oronal plane splitting fractures of the medial tibial plateau, noted that these injuries be considered as fracture - dislocations. Connolly and others have suggested that the mechanism involved in this fracture pattern is one of knee flexion, varus, and inter nal rotation of the medial femoral condyle . [4,5,6 ] Consistent among these and other authors is that the occurrence of this fragment is relatively unusual and that the use of a posteriorly based exposure with direct fracture visualization, anatomic reductio n and absolute stability appears to result in satisfactory outcomes. Though variations of a postero - medial approach been previously described ( by Trickey et al and also by Burks et al.,, more recently, Lobenhoffer et al described direct posterior exposure , Wang et al described postero - medial approach and Luo et al. described the approach for the management of posterior bicondylar tibial plateau fractures . [7,8] These approaches have been used in isolation or as a dual - incision approach for treating tibial plateau fractures . [9,10,11,12,13,14, 15] PURPOSE : The purpose of this study is to describe this unfamiliar direct posterior surgical (Medial Gastrocnemius approach to a general orthopod, highlighting the relevant anatomy and presenting our experience using this approach in treating a
Sirenomelia in Argentina: Prevalence, geographic clusters and temporal trends analysis.
Groisman, Boris; Liascovich, Rosa; Gili, Juan Antonio; Barbero, Pablo; Bidondo, María Paz
2016-07-01
Sirenomelia is a severe malformation of the lower body characterized by a single medial lower limb and a variable combination of visceral abnormalities. Given that Sirenomelia is a very rare birth defect, epidemiological studies are scarce. The aim of this study is to evaluate prevalence, geographic clusters and time trends of sirenomelia in Argentina, using data from the National Network of Congenital Anomalies of Argentina (RENAC) from November 2009 until December 2014. This is a descriptive study using data from the RENAC, a hospital-based surveillance system for newborns affected with major morphological congenital anomalies. We calculated sirenomelia prevalence throughout the period, searched for geographical clusters, and evaluated time trends. The prevalence of confirmed cases of sirenomelia throughout the period was 2.35 per 100,000 births. Cluster analysis showed no statistically significant geographical aggregates. Time-trends analysis showed that the prevalence was higher in years 2009 to 2010. The observed prevalence was higher than the observed in previous epidemiological studies in other geographic regions. We observed a likely real increase in the initial period of our study. We used strict diagnostic criteria, excluding cases that only had clinical diagnosis of sirenomelia. Therefore, real prevalence could be even higher. This study did not show any geographic clusters. Because etiology of sirenomelia has not yet been established, studies of epidemiological features of this defect may contribute to define its causes. Birth Defects Research (Part A) 106:604-611, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Bimalleolar ankle fracture with proximal fibular fracture
Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.
2005-01-01
A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular
Kutina, J.; Carter, William D.; Lopez, F.X.
1978-01-01
The role of east-west fracture zones in South America is discussed with regard to global fracturing and the motion of lithospheric plates. A set of major NW-trending lineaments has been derived which show a tendency to be spaced equidistantly and may correspond to a set of east-west fractures in the "pre-drift" position of the South American plate. Statistical analysis of linears in the ERTS-mosaics shows that NW-fractures are also among the most important ones in the Andes region, suggesting that the above major lineaments extend into the basement of the Andes. Some of the old major fractures, trending east-west in the present orientation of South America, are discussed and their NE orientation in the pre-drift position of the plate is considered. An example of structural control of ore deposition in the Brazilian Shield is presented, using the maps of the RADAM Project. It is concluded that the small tin-bearing granitic bodies concentrated in the region of Sao Felix do Xingu in the state of Para represent upper parts of an unexposed granitoid massif which is controlled by the intersection of a major east-west fracture zone probably represents westward extension of the Patos Lineament of the easternmost part of Brazil, connected with the east-west fracture zone of the Para state through the basement of the Maranhao Basin (Sineclise do Maranhao-Piaui). It is expected that the proposed "Patos-Para Lineament" extends further westward and may similarly control, at intersections with fractures of other trends, some mineralization centers in the western part of the state of Para and in the state of Amazonas.
Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.
2016-01-01
Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123
Epidemiology of Isolated Acromioclavicular Joint Dislocation
Directory of Open Access Journals (Sweden)
Claudio Chillemi
2013-01-01
Full Text Available Background. Acromioclavicular (AC joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood’s criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2% had an isolated AC dislocation, and 3 (2.8% were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5 : 1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation.
Statistical significance of epidemiological data. Seminar: Evaluation of epidemiological studies
International Nuclear Information System (INIS)
Weber, K.H.
1993-01-01
In stochastic damages, the numbers of events, e.g. the persons who are affected by or have died of cancer, and thus the relative frequencies (incidence or mortality) are binomially distributed random variables. Their statistical fluctuations can be characterized by confidence intervals. For epidemiologic questions, especially for the analysis of stochastic damages in the low dose range, the following issues are interesting: - Is a sample (a group of persons) with a definite observed damage frequency part of the whole population? - Is an observed frequency difference between two groups of persons random or statistically significant? - Is an observed increase or decrease of the frequencies with increasing dose random or statistically significant and how large is the regression coefficient (= risk coefficient) in this case? These problems can be solved by sttistical tests. So-called distribution-free tests and tests which are not bound to the supposition of normal distribution are of particular interest, such as: - χ 2 -independence test (test in contingency tables); - Fisher-Yates-test; - trend test according to Cochran; - rank correlation test given by Spearman. These tests are explained in terms of selected epidemiologic data, e.g. of leukaemia clusters, of the cancer mortality of the Japanese A-bomb survivors especially in the low dose range as well as on the sample of the cancer mortality in the high background area in Yangjiang (China). (orig.) [de
Energy Technology Data Exchange (ETDEWEB)
Schechter, D.S.
1996-12-17
The overall goal of this project is to assess the economic feasibility of CO{sub 2} flooding the naturally fractured Spraberry Trend Area in West Texas. This objective is being accomplished by conducting research in four areas: (1) extensive characterization of the reservoirs, (2) experimental studies of crude oil/brine/rock (COBR) interaction in the reservoirs, (3) analytical and numerical simulation of Spraberry reservoirs, and, (4) experimental investigations on CO{sub 2} gravity drainage in Spraberry whole cores. This report provides results of the first year of the five-year project for each of the four areas.
Impact of Maternal Diet on Offspring Bone Fracture Risk During Childhood
DEFF Research Database (Denmark)
Petersen, Sesilje Elise Bondo
, including maternal diet and vitamin D status. However, few studies have investigated whether these factors during pregnancy impact offspring bone health in short as well as in the long term. The overall objective of this thesis was to investigate epidemiologically whether maternal vitamin D status...... and dietary patterns in two prospective pregnancy cohorts, were associated with offspring risk of bone fractures in childhood. Overall, our studies provided limited support to the hypothesis that fetal bone health is programmed by the maternal vitamin D status and overall diet during pregnancy. However......, there were some indications of an increased risk for fractures when the mother consumed a Western diet and had high consumption of artificially sweetened soft drinks. Further, our results indicated that mid-pregnancy use of dietary supplements with high doses of vitamin D increased the risk for offspring...
Trends in puberty timing in humans and environmental modifiers
DEFF Research Database (Denmark)
Toppari, Jorma; Juul, Anders
2010-01-01
Secular trends in timing of puberty appear to continue although under-nutrition has not been any longer a limiting factor for pubertal development. Now obesity and other environmental reasons have been suspected to cause this trend, and endocrine disrupting chemicals have become into focus...... as possible contributors. Epidemiological studies on endocrine disrupters are still scarce and show only weak associations between exposures and timing of puberty. Since genetic background explains 50-80% of variability in the timing of puberty, it is not surprising that the observed environmental effects...
Clinical and epidemiological features of extrapulmonary tuberculosis in a high incidence region.
Pérez-Guzmán, Carlos; Vargas, Mario H; Arellano-Macías, María del Rosario; Hernández-Cobos, Silvia; García-Ituarte, Aurea Zelindabeth; Serna-Vela, Francisco Javier
2014-04-01
To describe the clinical features of extrapulmonary tuberculosis (EXPTB) and to evaluate epidemiological data to search for potential explanations for its high frequency in the state of Aguascalientes, Mexico. Clinical records of all patients with tuberculosis seen in Aguascalientes in 2008 were reviewed, and official databases were analyzed. EXPTB comprised 60.5% of the 86 cases evaluated, being lymph nodes the main site affected. Patients with EXPTB were younger and more obese than subjects with pulmonary tuberculosis (PTB). One third of cases in either group had diabetes, a frequency much higher than expected. Epidemiological analysis showed that PTB incidence, but not EXPTB incidence, decreases as geographical altitude increases, and had a descendent trend from 1997 to 2011. The lower frequency of PTB (due to its inverse relationship with altitude and its descendent trend in last years) might explain the high frequency of EXPTB. Obesity appeared to protect against developing pulmonary involvement, and diabetes was more frequent than expected among PTB and EXPTB cases.
Reesink, Heidi L
2017-08-01
Foals are susceptible to many of the same types of fractures as adult horses, often secondary to external sources of trauma. In addition, some types of fractures are specific to foals and occur routinely in horses under 1 year of age. These foal-specific fractures may be due to the unique musculoskeletal properties of the developing animal and may present with distinct clinical signs. Treatment plans and prognoses are tailored specifically to young animals. Common fractures not affecting the long bones in foals are discussed in this article, including osteochondral fragmentation, proximal sesamoid bone fractures/sesamoiditis, and distal phalanx fractures. Copyright © 2017 Elsevier Inc. All rights reserved.
Epidemiologic contributions to recent cancer trends among HIV-infected people in the United States.
Robbins, Hilary A; Shiels, Meredith S; Pfeiffer, Ruth M; Engels, Eric A
2014-03-27
HIV-infected people have elevated risk for some cancers. Changing incidence of these cancers over time may reflect changes in three factors: HIV population demographic structure (e.g. age distribution), general population (background) cancer rates, and HIV-associated relative risks. We assessed the contributions of these factors to time trends for 10 cancers during 1996-2010. Population-based registry linkage study. We applied Poisson models to data from the U.S. HIV/AIDS Cancer Match Study to estimate annual percentage changes (APCs) in incidence rates of AIDS-defining cancers [ADCs: Kaposi sarcoma, non-Hodgkin lymphoma (NHL), and cervical cancer] and seven non-AIDS-defining cancers (NADCs). We evaluated HIV-infected cancer trends with and without adjustment for demographics, trends in background rates, and trends in standardized incidence ratios (SIRs, to capture relative risk). Cancer rates among HIV-infected people rose over time for anal (APC 3.8%), liver (8.5%), and prostate (9.8%) cancers, but declined for Kaposi sarcoma (1996-2000: -29.3%; 2000-2010: -7.8%), NHL (1996-2003: -15.7%; 2003-2010: -5.5%), cervical cancer (-11.1%), Hodgkin lymphoma (-4.0%), and lung cancer (-2.8%). Breast and colorectal cancer incidence did not change over time. Based on comparison to adjusted models, changing demographics contributed to trends for Kaposi sarcoma and breast, colorectal, liver, lung, and prostate cancers (all P cancers. SIRs declined for ADCs, Hodgkin lymphoma (APC -3.2%), and lung cancer (-4.4%). Demographic shifts influenced several cancer trends among HIV-infected individuals. Falling relative risks largely explained ADC declines, while background incidence contributed to some NADC trends.
When and where do hip fractures occur? A population-based study.
Leavy, B; Åberg, A C; Melhus, H; Mallmin, H; Michaëlsson, K; Byberg, L
2013-09-01
We investigated the effects of socio-demographic and health factors on timing and location of hip fracture among 484 subjects. Time of fracture varied between community dwellers and residential care facility dwellers, and in relation to subjects' psychotropic drug status. Indoor hip fracture incidence increased on snow-covered days. This paper aims to describe the timing and whereabouts of hip fracture cases in a population-based setting and to relate these factors with residential and health status, seasonal variation, and snow-covered ground. We consecutively included 484 incident hip fracture events (age ≥50 years) admitted to a Swedish orthopedic department during a 1-year period. Data concerning socio-demographic details, fall location, time of fracture, comorbidity, and medications were collected from in-patient medical records and through patient or caregiver interviews. The expected peak in fracture occurrence during daytime was observed among community dwellers but not among subjects living in residential care. Hip fracture was twice as likely to occur during nighttime hours among psychotropic drug users (adjusted odds ratio (Adj. OR), 2.20; 95% confidence interval (CI), 1.12-4.30) compared to those not receiving these medications. Subjects without dementia, taking psychotropic drugs, were also more likely to fracture during nighttime hours (Adj. OR, 2.91; 95% CI, 1.40-6.0). We observed an increase in indoor hip fracture incidence on snow-covered days among community dwellers (incidence rate ratio, 1.34; 95% CI, 1.02-1.74). We observed only a weak seasonal trend in hip fracture incidence, based on month, among community dwellers who fractured indoors. Special attention and possibly fall-preventive efforts should be directed not only toward those living in residential care facilities but also toward community-dwelling subjects taking psychotropic drugs since these groups have a higher incidence of nighttime hip fracture. Further research aiming to explain
Fracture patterns in the maxillofacial region: a four-year retrospective study
2015-01-01
Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557
Farr, Joshua N; Melton, L Joseph; Achenbach, Sara J; Atkinson, Elizabeth J; Khosla, Sundeep; Amin, Shreyasee
2017-12-01
Although fractures in both the pediatric and, especially, the elderly populations have been extensively investigated, comparatively little attention has been given to the age group in between. Thus, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to determine incidence rates for all fractures among young adult (age range, 18 to 49 years) residents of Olmsted County, Minnesota, in 2009 to 2011, and compared the distribution of fracture sites and causes in this young adult cohort with those for older residents aged 50 years or older. During the 3-year study period, 2482 Olmsted County residents aged 18 to 49 years experienced 1 or more fractures. There were 1730 fractures among 1447 men compared with 1164 among 1035 women, and the age-adjusted incidence of all fractures was 66% greater among the men (1882 [95% confidence interval 1793-1971] versus 1135 [95% CI 1069-1201] per 100,000 person-years; p age ≥50 years who sustained a fracture in 2009 to 2011. Younger residents (aged 18 to 49 years), when compared with older residents (aged ≥50 years), had a greater proportion of fractures of the hands and feet (40% versus 18%) with relatively few fractures observed at traditional osteoporotic fracture sites (14% versus 43%). Vertebral fractures were still more likely to be the result of moderate trauma than at other sites, especially in younger women. In conclusion, whereas pediatric and elderly populations often fracture from no more than moderate trauma, young adults, and more commonly men, suffer fractures primarily at non-osteoporotic sites due to more significant trauma. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.
Descriptive Epidemiology of Female Breast Cancer in Tianjin, China
Institute of Scientific and Technical Information of China (English)
KexinChen; MinHe; ShufenDong; JifangWang
2004-01-01
OBJECTIVE To observe trends in the changes of incidence and mortality of female breast cancer patients in Tianjin, and evaluate the effect of these trends on prevention. METHODS A method of descriptive epidemiology was used to comprehensively study the status of female breast cancer in Tianjin. RESULTS From 1981 to 2000, the incidence rate of breast cancer in Tianjin had been increasing at the speed of 1.8 % annually, whereas the peak of the age-adjusted incidence and mortality rate expressed a mild declining trend. Follow-up study indicated that 3 and 5-year survival rates improved in various degrees. CONCLUSION Early detection and diagnosis of breast cancer are very important to both increasing survival and lowering mortality from breast cancer. Preventive efforts should be promoted for women who are at high risk for breast cancer.
Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg
2014-01-01
Background Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. Methods We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. Results In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change – APC: 9.4%; 95% confidence interval – CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. Conclusions Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality of VL in Brazil. PMID:24699517
Why is the age-standardized incidence of low-trauma fractures rising in many elderly populations?
Kannus, Pekka; Niemi, Seppo; Parkkari, Jari; Palvanen, Mika; Heinonen, Ari; Sievänen, Harri; Järvinen, Teppo; Khan, Karim; Järvinen, Markku
2002-08-01
Low-trauma fractures of elderly people are a major public health burden worldwide, and as the number and mean age of older adults in the population continue to increase, the number of fractures is also likely to increase. Epidemiologically, however, an additional concern is that, for unknown reasons, the age-standardized incidence (average individual risk) of fracture has also risen in many populations during the recent decades. Possible reasons for this rise include a birth cohort effect, deterioration in the average bone strength by time, and increased average risk of (serious) falls. Literature provides evidence that the rise is not due to a birth cohort effect, whereas no study shows whether bone fragility has increased during this relatively short period of time. This osteoporosis hypothesis could, however, be tested if researchers would now repeat the population measurements of bone mass and density that were made in the late 1980s and the 1990s. If such studies proved that women's and men's age-standardized mean values of bone mass and density have declined over time, the osteoporosis hypothesis would receive scientific support. The third explanation is based on the hypothesis that the number and/or severity of falls has risen in elderly populations during the recent decades. Although no study has directly tested this hypothesis, a great deal of indirect epidemiologic evidence supports this contention. For example, the age-standardized incidence of fall-induced severe head injuries, bruises and contusions, and joint distortions and dislocations has increased among elderly people similarly to the low-trauma fractures. The fall hypothesis could also be tested in the coming years because the 1990s saw many research teams reporting age- and sex-specific incidences of falling for elderly populations, and the same could be done now to provide data comparing the current incidence rates of falls with the earlier ones.
LENUS (Irish Health Repository)
O'Sullivan, S T
2012-02-03
With the introduction of low-profile mini-plating systems, a trend has developed towards open reduction and rigid internal fixation (ORIF) of fractures of the cranio-facial skeleton. The current policy for management of zygomatic fractures in our unit is to attempt primary reduction by traditional methods, and proceed to ORIF in the event of unsatisfactory fracture stability or alignment. Over a one-year period, 109 patients underwent surgical correction of fractures of the zygomatic complex. Standard Gilles\\' elevation was performed in 71 cases, percutaneous elevation in three cases, and ORIF was performed in 35 cases. Mean follow-up was 190 days. One case of persistent infraorbital step and three cases of residual malar flattening were documented in patients who underwent Gilles or percutaneous elevation. Morbidity associated with ORIF was minimal. We conclude that while ORIF of zygomatic fractures may offer better results than traditional methods in the management of complex fractures, traditional methods still have a role to play in less complex fractures.
Analysis of facial bone fractures: An 11-year study of 2,094 patients
Directory of Open Access Journals (Sweden)
Hwang Kun
2010-01-01
Full Text Available Purpose: The medical records of these patients were reviewed and analysed to determine the clinical characteristics and treatment of facial bone fractures. Patients and Methods: This is a retrospective study of 2,094 patients with facial bone fractures from various accidents that were treated at the Inha University Hospital from 1996 to 2007. Results: The most common age group was the third decade of life (29%. Males were more common than females (3.98:1. The most common aetiology was violent assault or nonviolent traumatic injury (49.4%. The most common isolated fracture site was the nasal bone (37.7%, followed by the mandible (30%, orbital bones (7.6%, zygoma (5.7%, maxilla (1.3% and the frontal bone (0.3%. The largest group with complex fractures included the inferior region of the orbital floor and zygomaticomaxilla (14%. Closed reduction was performed in 46.3% of the cases while 39.7% of the cases required open reduction. For open reductions, the most commonly used soft-tissue approach was the intraoral approach (32.3%. The complication rate was 6.4% and the most common complication was hypoesthesia (68.4% followed by diplopia (25.6%. Conclusion: Long-term collection of epidemiological data regarding facial fractures and concomitant injuries is important for the evaluation of existing preventive measures and useful in the development of new methods of injury prevention and treatment.
Lumbosacral plexopathies associated with acetabular fracture
Directory of Open Access Journals (Sweden)
Patpiya Sirasaporn
2017-01-01
Full Text Available Lumbosacral plexopathies are of considerably less epidemiologic common prevalence than brachial plexus. The most common form of trauma resulting in lesions affecting the lumbosacral plexus is injuries to sacroiliac region. The symptoms which are caused by compressing lumbosacral plexus are sensory disturbance and weakness in an affected leg. The author reports a case of a 65-year-old male with a history of right acetabular fracture status post open reduction and internal fixation by plate and screw who complained weakness and numbness in the right leg. Four months later, he still had difficulty in walking and felt paresthesia at the right lateral thigh and entire of the right foot. His further investigation which was electrodiagnostic study was diagnosed as right lumbosacral plexopathies.
Directory of Open Access Journals (Sweden)
Chad Correa
2017-09-01
Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior
Comparing two intramedullary devices for treating trochanteric fractures: A prospective study
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Kontogeorgakos Vasileios
2010-02-01
Full Text Available Abstract Background Intertrochanteric fractures are surgically treated by using different methods and implants. The optional type of surgical stabilization is still under debate. However, between devices with the same philosophy, different design characteristics may substantially influence fracture healing. This is a prospective study comparing the complication and final functional outcome of two intramedullary devices, the intramedullary hip screw (IMHS and the ENDOVIS nail. Materials and methods Two hundred fifteen patients were randomized on admission in two treatment groups. Epidemiology features and functional status was similar between two treatment groups. Fracture stability was assessed according to the Evan's classification. One hundred ten patients were treated with IMHS and 105 with ENDOVIS nail. Results There were no significant statistical differences between the two groups regarding blood loss, transfusion requirements and mortality rate. In contrast, the number of total complications was significantly higher in the ENDOVIS nail group. Moreover, the overall functional and walking competence was superior in the patients treated with the IMHS nail. Conclusions These results indicate that the choice of the proper implant plays probably an important role in the final outcome of surgical treatment of intertrochanteric fractures. IMHS nail allows for accurate surgical technique, for both static and dynamic compression and high rotational stability. IMHS nail proved more reliable in our study regarding nail insertion and overall uncomplicated outcome.
Dissolution-Enlarged Fractures Imaging Using Electrical Resistivity Tomography (ERT)
Siami-Irdemoosa, Elnaz
In recent years the electrical imaging techniques have been largely applied to geotechnical and environmental investigations. These techniques have proven to be the best geophysical methods for site investigations in karst terrain, particularly when the overburden soil is clay-dominated. Karst is terrain with a special landscape and distinctive hydrological system developed by dissolution of rocks, particularly carbonate rocks such as limestone and dolomite, made by enlarging fractures into underground conduits that can enlarge into caverns, and in some cases collapse to form sinkholes. Bedding planes, joints, and faults are the principal structural guides for underground flow and dissolution in almost all karstified rocks. Despite the important role of fractures in karst development, the geometry of dissolution-enlarged fractures remain poorly unknown. These features are characterized by an strong contrast with the surrounding formations in terms of physical properties, such as electrical resistivity. Electrical resistivity tomography (ERT) was used as the primary geophysical tool to image the subsurface in a karst terrain in Greene County, Missouri. Pattern, orientation and density of the joint sets were interpreted from ERT data in the investigation site. The Multi-channel Analysis of Surface Wave (MASW) method and coring were employed to validate the interpretation results. Two sets of orthogonal visually prominent joints have been identified in the investigation site: north-south trending joint sets and west-east trending joint sets. However, most of the visually prominent joint sets are associated with either cultural features that concentrate runoff, natural surface drainage features or natural surface drainage.
Application of Local Vibrations in Delayed and Non-Union Fractures: a Case Study
Trombetta, Chiara; Abundo, Paolo; Foti, Calogero; Rosato, Nicola
2011-02-01
The aim of the study was to assess the efficacy of local vibration treatments (LV) in delayed-union and non-union fractures, through therapeutic exercise vibration (TEV) practice, analysing the radiological trend. The Medical Engineering Service of the Fondazione Policlinico Tor Vergata in collaboration with the Chair-Department of Rehabilitation Medicine of the University of Rome Tor Vergata and the Boscosystem company, is developing a device dedicated to LV application, to favour bone regeneration and muscle strengthening. This case report analyses the bone activity of a male patient presenting a right tibial fracture, treated with TEV. At the end of the TEV program, clinical results confirmed independent ambulation with disappearance of perimalleolar edema, while radiographic images revealed the presence of bone repair activity around the fracture line.
Application of Local Vibrations in Delayed and Non-Union Fractures: a Case Study
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Trombetta, Chiara; Abundo, Paolo; Foti, Calogero; Rosato, Nicola
2011-01-01
The aim of the study was to assess the efficacy of local vibration treatments (LV) in delayed-union and non-union fractures, through therapeutic exercise vibration (TEV) practice, analysing the radiological trend. The Medical Engineering Service of the Fondazione Policlinico Tor Vergata in collaboration with the Chair-Department of Rehabilitation Medicine of the University of Rome Tor Vergata and the Boscosystem company, is developing a device dedicated to LV application, to favour bone regeneration and muscle strengthening. This case report analyses the bone activity of a male patient presenting a right tibial fracture, treated with TEV. At the end of the TEV program, clinical results confirmed independent ambulation with disappearance of perimalleolar edema, while radiographic images revealed the presence of bone repair activity around the fracture line.
Honkanen, R; Tuppurainen, M; Kroger, H; Alhava, E; Puntila, E
1997-04-01
In a retrospective population-based study we assessed whether and how self-reported former fractures sustained at the ages of 20-34 are associated with subsequent fractures sustained at the ages of 35-57. The 12,162 women who responded to fracture questions of the baseline postal enquiry (in 1989) of the Kuopio Osteoporosis Study, Finland formed the study population. They reported 589 former and 2092 subsequent fractures. The hazard ratio (HR), with 95% confidence interval (CI), of a subsequent fracture was 1.9 (1.6-2.3) in women with the history of a former fracture compared with women without such a history. A former low-energy wrist fracture was related to subsequent low-energy wrist [HR = 3.7 (2.0-6.8)] and high-energy nonwrist [HR = 2.4 (1.3-4.4)] fractures, whereas former high-energy nonwrist fractures were related only to subsequent high-energy nonwrist [HR = 2.8 (1.9-4.1)] but not to low-energy wrist [HR = 0.7 (0.3-1.8)] fractures. The analysis of bone mineral density (BMD) data of a subsample of premenopausal women who underwent dual x-ray absorptiometry (DXA) during 1989-91 revealed that those with a wrist fracture due to a fall on the same level at the age of 20-34 recorded 6.5% lower spinal (P = 0.140) and 10.5% lower femoral (P = 0.026) BMD than nonfractured women, whereas the corresponding differences for women with a former nonwrist fracture due to high-energy trauma were -1.8% (P = 0.721) and -2.4% (P = 0. 616), respectively. Our results suggest that an early premenopausal, low-energy wrist fracture is an indicator of low peak BMD which predisposes to subsequent fractures in general, whereas early high-energy fractures are mainly indicators of other and more specific extraskeletal factors which mainly predispose to same types of subsequent fractures only.
Analysis of 213 currently used rehabilitation protocols in foot and ankle fractures.
Pfeifer, Christian G; Grechenig, Stephan; Frankewycz, Borys; Ernstberger, Antonio; Nerlich, Michael; Krutsch, Werner
2015-10-01
Fractures of the ankle, hind- and midfoot are amongst the five most common fractures. Besides initial operative or non-operative treatment, rehabilitation of the patients plays a crucial role for fracture union and long term functional outcome. Limited evidence is available with regard to what a rehabilitation regimen should include and what guidelines should be in place for the initial clinical course of these patients. This study therefore investigated the current rehabilitation concepts after fractures of the ankle, hind- and midfoot. Written rehabilitation protocols provided by orthopedic and trauma surgery institutions in terms of recommendations for weight bearing, range of motion (ROM), physiotherapy and choice of orthosis were screened and analysed. All protocols for lateral ankle fractures type AO 44A1, AO 44B1 and AO 44C1, for calcaneal fractures and fractures of the metatarsal as well as other not specific were included. Descriptive analysis was carried out and statistical analysis applied where appropriate. 209 rehabilitation protocols for ankle fractures type AO 44B1 and AO 44C1, 98 for AO 44A1, 193 for metatarsal fractures, 142 for calcaneal fractures, 107 for 5(th) metatarsal base fractures and 70 for 5(th) metatarsal Jones fractures were evaluated. The mean time recommended for orthosis treatment was 6.04 (SD 0.04) weeks. While the majority of protocols showed a trend towards increased weight bearing and increased ROM over time, the best consensus was noted for weight bearing recommendations. Our study shows that there exists a huge variability in rehabilitation of fractures of the ankle-, hind- and midfoot. This may be contributed to a lack of consensus (e.g. missing publication of guidelines), individualized patient care (e.g. in fragility fractures) or lack of specialization. This study might serve as basis for prospective randomized controlled trials in order to optimize rehabilitation for these common fractures. Copyright © 2015 Elsevier Ltd
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Mehrdad Mahdian
2017-05-01
Full Text Available Background: Apart from the mortality, road traffic injuries are associated with significant morbidities. This study has aimed to examine the pattern of traffic accident-related extremity fractures/dislocations and their related disabilities. Methods: A retrospective hospital-based study was conducted to assess the characteristics of limb fractures/dislocations among road traffic accident victims registered in Trauma Research Center registry of Kashan University of Medical Sciences, Kashan, Iran, during 2012-2013. Age and sex distribution, cause of injury, and site of fractures/dislocations were recorded. Years lived with disability (YLD was calculated as a scale to measure the disability. One-way ANOVA and chi-square tests were used for data analysis. Results: From a total of 962 subjects, 812 (84.4% were males (the male/female sex ratio: 5.4:1. The mean age of victims was 32.7±17.9. Leg (37% and forearm (19% fractures were the most frequent fractures. Shoulder dislocations were among the most affected joints accounting for 36.6% of the cases. The total calculated YLD was 135.6 (34.4 for temporal and 101.2 for lifelong disabilities, and totally 117.3 and 18.3 for males and females, respectively. The highest YLD was for motorcyclists (104 and while the most YLD was for 15-29 years (68.2. Conclusion: Young men motorcyclist accidents are a major problem in Kashan region. Generally, they have been accounted for the highest YLD due to fractures/dislocations, especially in lower extremity. Although the calculated YLD will be decreased with increasing age, the elder people also had the high rate of traffic-related limb injuries.
Mechanical properties of highly defective graphene: from brittle rupture to ductile fracture.
Xu, Lanqing; Wei, Ning; Zheng, Yongping
2013-12-20
Defects are generally believed to deteriorate the superlative performance of graphene-based devices but may also be useful when carefully engineered to tailor the local properties and achieve new functionalities. Central to most defect-associated applications is the defect coverage and arrangement. In this work, we investigate, by molecular dynamics simulations, the mechanical properties and fracture dynamics of graphene sheets with randomly distributed vacancies or Stone-Wales defects under tensile deformations over a wide defect coverage range. With defects presented, an sp-sp(2) bonding network and an sp-sp(2)-sp(3) bonding network are observed in vacancy-defected and Stone-Wales-defected graphene, respectively. The ultimate strength degrades gradually with increasing defect coverage and saturates in the high-ratio regime, whereas the fracture strain presents an unusual descending-saturating-improving trend. In the dense vacancy defect situation, the fracture becomes more plastic and super-ductility is observed. Further fracture dynamics analysis reveals that the crack trapping by sp-sp(2) and sp-sp(2)-sp(3) rings and the crack-tip blunting account for the ductile fracture, whereas geometric rearrangement on the entire sheet for vacancy defects and geometric rearrangement on the specific defect sites for Stone-Wales defects account for their distinctive rules of the evolution of the fracture strain.
Fracture Risk and Risk Factors for Osteoporosis.
Schürer, Christian; Wallaschofski, Henri; Nauck, Matthias; Völzke, Henry; Schober, Hans-Christof; Hannemann, Anke
2015-05-25
As the population ages, diseases of the elderly are becoming more common, including osteoporosis. Ways to assess the risk of fracture and the distribution and effects of known risk factors for osteoporosis will be important in planning for future healthcare needs, as well as in the development of preventive strategies. The study population included 6029 men and women aged 20-90 who underwent examination in the second follow-up wave of the Study of Health in Pomerania (SHIP-2) or in the basal SHIP-Trend Study. The risk of fracture was estimated on the basis of quantitative ultrasonography of the calcaneus. Prior fractures and risk factors for osteoporosis were ascertained in standardized interviews. 4.6% of the male subjects and 10.6% of the female subjects were judged to have an elevated risk of fracture. The corresponding percentages among subjects over age 65 were 8.8% for men and 28.2% for women. Even among subjects under age 55, risk factors for osteoporosis were associated with lower bone stiffness: the mean stiffness index was 103/98 (men/women) without risk factors, 99/96 with one risk factor, and 93/95 with more than one risk factor. Logistic regression analysis yielded an odds ratio of 1.89 (95% confidence interval: 1.44-2.50; p<0.01) for prevalent fractures among subjects aged 75 and older compared to subjects under age 55. The data indicate a high prevalence of osteoporosis from age 65 onward. These findings are consistent with those of other studies from Germany and across Europe. Younger men and women should already begin taking steps to counteract modifiable risk factors.
Robinson, Philip C; Kempe, Sarina; Tebbutt, Ian; Roberts, Lynden
2017-06-01
To assess the epidemiology of inpatient gout in Australia and New Zealand during the years 2009-2014. Using the Health Roundtable Limited (HRT) dataset, all patients with a coded ICD10 primary or secondary discharge diagnosis of gout from a HRT participating Australian or New Zealand hospital between the years 2009 and 2014 were identified. The number of inpatient gout admissions, length of stay, body site of gout flare, temporal trends and comorbidities were assessed. During 2009-2014, the number of gout admissions increased significantly in Australia and New Zealand. The rate of inpatient gout admissions relative to the population and total HRT admissions rose in Australia and stayed static in New Zealand. Lower limb presentations were the commonest anatomical site of gout in admitted patients. Length of stay over the course of the study decreased both in patients admitted for gout and in those in the entire HRT dataset. Patients admitted for gout have longer length of stay compared to patients admitted for other reasons. Cardiovascular disease, infection and stroke were the commonest conditions that were complicated by an episode of inpatient gout. There was no influence of month or season on the pattern of gout admissions. The number of gout admissions rose in Australia numerically and as a proportion of the total population and total admissions. Gout is an increasing problem affecting individuals and the community as a whole in Australia. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
Kim, Kyong-Chol; Shin, Dong-Hyuk; Lee, Sei-Young; Im, Jee-Aee; Lee, Duk-Chul
2010-11-01
The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p related to BMD of all sites (p related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.
Translating Big Data into Smart Data for Veterinary Epidemiology.
VanderWaal, Kimberly; Morrison, Robert B; Neuhauser, Claudia; Vilalta, Carles; Perez, Andres M
2017-01-01
The increasing availability and complexity of data has led to new opportunities and challenges in veterinary epidemiology around how to translate abundant, diverse, and rapidly growing "big" data into meaningful insights for animal health. Big data analytics are used to understand health risks and minimize the impact of adverse animal health issues through identifying high-risk populations, combining data or processes acting at multiple scales through epidemiological modeling approaches, and harnessing high velocity data to monitor animal health trends and detect emerging health threats. The advent of big data requires the incorporation of new skills into veterinary epidemiology training, including, for example, machine learning and coding, to prepare a new generation of scientists and practitioners to engage with big data. Establishing pipelines to analyze big data in near real-time is the next step for progressing from simply having "big data" to create "smart data," with the objective of improving understanding of health risks, effectiveness of management and policy decisions, and ultimately preventing or at least minimizing the impact of adverse animal health issues.
Translating Big Data into Smart Data for Veterinary Epidemiology
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Kimberly VanderWaal
2017-07-01
Full Text Available The increasing availability and complexity of data has led to new opportunities and challenges in veterinary epidemiology around how to translate abundant, diverse, and rapidly growing “big” data into meaningful insights for animal health. Big data analytics are used to understand health risks and minimize the impact of adverse animal health issues through identifying high-risk populations, combining data or processes acting at multiple scales through epidemiological modeling approaches, and harnessing high velocity data to monitor animal health trends and detect emerging health threats. The advent of big data requires the incorporation of new skills into veterinary epidemiology training, including, for example, machine learning and coding, to prepare a new generation of scientists and practitioners to engage with big data. Establishing pipelines to analyze big data in near real-time is the next step for progressing from simply having “big data” to create “smart data,” with the objective of improving understanding of health risks, effectiveness of management and policy decisions, and ultimately preventing or at least minimizing the impact of adverse animal health issues.
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Yuji Nishi
2012-01-01
Full Text Available In order to appraise the utility of self-potential (SP measurements to characterize fractured reservoirs, we carried out continuous SP monitoring using multi Ag-AgCl electrodes installed within two open holes at the Kamaishi Mine, Japan. The observed ratio of SP change to pressure change associated with fluid flow showed different behaviors between intact host rock and fractured rock regions. Characteristic behavior peculiar to fractured reservoirs, which is predicted from numerical simulations of electrokinetic phenomena in MINC (multiple interacting continua double-porosity media, was observed near the fractures. Semilog plots of the ratio of SP change to pressure change observed in one of the two wells show obvious transition from intermediate time increasing to late time stable trends, which indicate that the time required for pressure equilibration between the fracture and matrix regions is about 800 seconds. Fracture spacing was estimated to be a few meters assuming several micro-darcies (10-18 m2 of the matrix region permeability, which is consistent with geological and hydrological observations.
Gastric cancer: epidemiology, prevention, classification, and treatment
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Sitarz R
2018-02-01
Full Text Available Robert Sitarz,1–3 Małgorzata Skierucha,1,2 Jerzy Mielko,1 G Johan A Offerhaus,3 Ryszard Maciejewski,2 Wojciech P Polkowski1 1Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland; 2Department of Human Anatomy, Medical University of Lublin, Lublin, Poland; 3Department of Pathology, University Medical Centre, Utrecht, The Netherlands Abstract: Gastric cancer is the second most common cause of cancer-related deaths in the world, the epidemiology of which has changed within last decades. A trend of steady decline in gastric cancer incidence rates is the effect of the increased standards of hygiene, conscious nutrition, and Helicobacter pylori eradication, which together constitute primary prevention. Avoidance of gastric cancer remains a priority. However, patients with higher risk should be screened for early detection and chemoprevention. Surgical resection enhanced by standardized lymphadenectomy remains the gold standard in gastric cancer therapy. This review briefly summarizes the most important aspects of gastric cancers, which include epidemiology, risk factors, classification, diagnosis, prevention, and treatment. The paper is mostly addressed to physicians who are interested in updating the state of art concerning gastric carcinoma from easily accessible and credible source. Keywords: gastric cancer, epidemiology, classification, risk factors, treatment
Ballistic fractures: indirect fracture to bone.
Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia
2011-11-01
Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.
Hydraulic fracture propagation modeling and data-based fracture identification
Zhou, Jing
Successful shale gas and tight oil production is enabled by the engineering innovation of horizontal drilling and hydraulic fracturing. Hydraulically induced fractures will most likely deviate from the bi-wing planar pattern and generate complex fracture networks due to mechanical interactions and reservoir heterogeneity, both of which render the conventional fracture simulators insufficient to characterize the fractured reservoir. Moreover, in reservoirs with ultra-low permeability, the natural fractures are widely distributed, which will result in hydraulic fractures branching and merging at the interface and consequently lead to the creation of more complex fracture networks. Thus, developing a reliable hydraulic fracturing simulator, including both mechanical interaction and fluid flow, is critical in maximizing hydrocarbon recovery and optimizing fracture/well design and completion strategy in multistage horizontal wells. A novel fully coupled reservoir flow and geomechanics model based on the dual-lattice system is developed to simulate multiple nonplanar fractures' propagation in both homogeneous and heterogeneous reservoirs with or without pre-existing natural fractures. Initiation, growth, and coalescence of the microcracks will lead to the generation of macroscopic fractures, which is explicitly mimicked by failure and removal of bonds between particles from the discrete element network. This physics-based modeling approach leads to realistic fracture patterns without using the empirical rock failure and fracture propagation criteria required in conventional continuum methods. Based on this model, a sensitivity study is performed to investigate the effects of perforation spacing, in-situ stress anisotropy, rock properties (Young's modulus, Poisson's ratio, and compressive strength), fluid properties, and natural fracture properties on hydraulic fracture propagation. In addition, since reservoirs are buried thousands of feet below the surface, the
Vitamin D and nutritional status are related to bone fractures in alcoholics.
González-Reimers, Emilio; Alvisa-Negrín, Julio; Santolaria-Fernández, Francisco; Candelaria Martín-González, M; Hernández-Betancor, Iván; Fernández-Rodríguez, Camino M; Viña-Rodríguez, J; González-Díaz, Antonieta
2011-01-01
, nutritional status is more impaired and there is a trend to more altered eating habits among patients with rib fractures, whereas multiple fractures depend more heavily on advanced liver disease.
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Frederico Barra de Moraes
2009-06-01
Full Text Available OBJETIVO: avaliar as características epidemiológicas e radiológicas dos casos de fratura diafisárias de fêmur, ocorridos de 1990 a 2005, tratados cirurgicamente no Hospital de Acidentados - Clínica Santa Isabel - de Goiânia, Goiás, com o propósito de contribuir para o melhor planejamento de medidas preventivas e terapêuticas a adotar em relação a essas fraturas. MÉTODOS: Foram avaliados retrospectivamente 200 prontuários e radiografias seriadas de pacientes com fraturas diafisárias do fêmur. Não foram incluídos os pacientes com menos de 10 anos de idade, pois o tratamento para esse grupo foi conservador. Foram descartados 25 prontuários por não fornecer todos os dados necessários ao estudo. Os pacientes foram analisados quanto ao sexo, idade, lado da fratura, exposição óssea, mecanismos de trauma, classificação das fraturas, traumas associados, tempo de consolidação e tipos de fixação cirúrgica. A análise estatística foi feita pelos testes do qui-quadrado, exato de Fisher" e t de Student, considerando significância quando p OBJECTIVE: to evaluate epidemiological and radiological characteristics of the femoral shaft fractures, surgically treated from 1990 to 2005 at Hospital de Acidentados - Clínica Santa Isabel - in Goiânia, Goiás, aiming to contribute to better preventive and therapeutic measures planning to adopt on those fractures. METHODS: 200 patients' files and x-rays with femoral shaft fractures have been retrospectively evaluated. Patients below the age of 10 years were not included because the treatment for this group was conservative. 25 files have been discarded for not supplying all the necessary data to the study. The patients were assessed for sex, age, side of the fracture, bone exposure, mechanisms of trauma, classification of the fractures, associated trauma, time for bone healing and types of surgical devices. Statistic analyses were made by chi-squared, Fisher and Student's-t tests
Fracture Patterns within the Shale Hills Critical Zone Observatory
Singha, K.; White, T.; Perron, J.; Chattopadhyay, P. B.; Duffy, C.
2012-12-01
Rock fractures are known to exist within the deep Critical Zone and are expected to influence groundwater flow, but there are limited data on their orientation and spatial arrangement and no general framework for systematically predicting their effects. Here, we explore fracture patterns within the Susquehanna-Shale Hills Critical Zone Observatory, and consider how they may be influenced by weathering, rock structure, and stress via field observations of variable fracture orientation within the site, with implications for the spatial variability of structural control on hydrologic processes. Based on field observations from 16-m deep boreholes and surface outcrop, we suggest that the appropriate structural model for the watershed is steeply dipping strata with meter- to decimeter-scale folds superimposed, including a superimposed fold at the mouth of the watershed that creates a short fold limb with gently dipping strata. These settings would produce an anisotropy in the hydraulic conductivity and perhaps also flow, especially within the context of the imposed stress field. Recently conducted 2-D numerical stress modeling indicates that the proxy for shear fracture declines more rapidly with depth beneath valleys than beneath ridgelines, which may produce or enhance the spatial variability in permeability. Even if topographic stresses do not cause new fractures, they could activate and cause displacement on old fractures, making the rocks easier to erode and increasing the permeability, and potentially driving a positive feedback that enhances the growth of valley relief. Calculated stress fields are consistent with field observations, which show a rapid decline in fracture abundance with increasing depth below the valley floor, and predict a more gradual trend beneath ridgetops, leading to a more consistent (and lower) hydraulic conductivity with depth on the ridgetops when compared to the valley, where values are higher but more variable with depth. Hydraulic
Epidemiología de campo y epidemiología social Field epidemiology and social epidemiology
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Javier Segura del Pozo
2006-03-01
Full Text Available Mediante la comparación de la epidemiología de campo y la epidemiología social, se pretende reflexionar sobre los imaginarios no explícitos que operan en ambos ámbitos, necesariamente convergentes, sobre los obstáculos de la práctica epidemiológica actual para alcanzar su función social y sobre la necesidad de cambiar las bases epistemológicas, metodológicas y prácticas que operan en la epidemiología, empezando por la formación del epidemiólogo de campo. La epidemiología de campo tiende a la acción sin marco teórico. La epidemiología social, por el contrario, tiende a los desarrollos teóricos (reflexión e investigación sobre los determinantes sociales alejados de la acción, debido a los limitantes para cambiar las políticas públicas. Otras diferencias se sitúan en el nivel de intervención (micro/macroespacios, el objeto de intervención (control del brote frente a control de las desigualdades y en la forma de articular la comunicación con la sociedad. Se asemejan en la preocupación por el método, la predominancia de una orientación positivista y condicionada por la estadística, aunque en proceso de cierta apertura epistemológica, la tensión experimentada entre relacionarse con un mundo virtual de bases de datos o con la sociedad real, su situación en la periferia del sistema político-social-institucional-profesional y por estar abocadas a la frustración profesional. Finalmente, se formulan 10 interrogantes a los epidemiólogos de campo sobre su práctica actual, a través de los cuales se podría evaluar si están realizando una epidemiología social, y se sugieren cambios para introducir en la formación y práctica del epidemiólogo.Comparing field epidemiology and social epidemiology, we pretend to think about the no explicit images and meanings operating in both necessary convergent fields, about the obstacles present in epidemiological practice to fulfil its social function and about the necessity of
Distinguishing stress fractures from pathologic fractures: a multimodality approach
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Fayad, Laura M.; Kamel, Ihab R.; Kawamoto, Satomi; Bluemke, David A.; Fishman, Elliot K.; Frassica, Frank J.
2005-01-01
Whereas stress fractures occur in normal or metabolically weakened bones, pathologic fractures occur at the site of a bone tumor. Unfortunately, stress fractures may share imaging features with pathologic fractures on plain radiography, and therefore other modalities are commonly utilized to distinguish these entities. Additional cross-sectional imaging with CT or MRI as well as scintigraphy and PET scanning is often performed for further evaluation. For the detailed assessment of a fracture site, CT offers a high-resolution view of the bone cortex and periosteum which aids the diagnosis of a pathologic fracture. The character of underlying bone marrow patterns of destruction can also be ascertained along with evidence of a soft tissue mass. MRI, however, is a more sensitive technique for the detection of underlying bone marrow lesions at a fracture site. In addition, the surrounding soft tissues, including possible involvement of adjacent muscle, can be well evaluated with MRI. While bone scintigraphy and FDG-PET are not specific, they offer a whole-body screen for metastases in the case of a suspected malignant pathologic fracture. In this review, we present select examples of fractures that underscore imaging features that help distinguish stress fractures from pathologic fractures, since accurate differentiation of these entities is paramount. (orig.)
Double segmental tibial fractures - an unusual fracture pattern
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Bali Kamal
2012-02-01
Full Text Available 【Abstract】A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis tech- nique with a pleasing outcome. Key words: Fracture, bone; Tibia; Fibula; Nails
Epidemiology of Pediatric Traumatic Spinal Cord Injury in a Population-Based Cohort, 1998-2012.
Saunders, Lee L; Selassie, Anbesaw; Cao, Yue; Zebracki, Kathy; Vogel, Lawrence C
2015-01-01
Traumatic spinal cord injury (SCI) that occurs in children and adolescents who are still developing represents a different challenge than SCI in adults. However, information on the epidemiology and incidence of SCI in a population-based cohort is lacking. To describe the epidemiology of pediatric SCI in a population-based cohort in the United States and to assess trend in incidence over a 15-year period (1998-2012). Children and adolescents (0-21 years) with SCI were identified through the South Carolina SCI Surveillance Registry using hospital discharge records from 1998 to 2012. Overall age-adjusted incidence rates were calculated for each year, and incidence rates were stratified by age, gender, and race. The overall age-adjusted incidence rate was 26.9 per million population, and there was a trend (P = .0583) toward decreasing incidence of pediatric SCI. When stratified by race, there was a significant decrease in incidence among Whites(P = .0052) but not among non-Whites. Younger participants were more likely to be female, to be injured through sports, and to be more likely to have concomitant traumatic brain injury. Since 1998, the proportion of older pediatric patients (16-22 years) with SCI has increased, as has the proportion of non-White patients. Although there was an overall trend toward decreasing incidence in this population-based cohort, when stratified by race, this trend only occurred in the White population.
Ankle fracture spur sign is pathognomonic for a variant ankle fracture.
Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G
2015-02-01
The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.
Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.
Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael
2017-04-01
To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Rossi, Meredith M.; Charvat, Jacqueline; Sibonga, Jean; Sieker, Jeremy
2017-01-01
-selection fractures experienced those fractures following their first mission (mean 12.7 +/- 11.1 years following first mission; range 14.0 days - 50.6 years). Additional analyses are ongoing and include examination of fracture history, skeletal site, mechanism, and type of fracture, age at time of fracture, time from spaceflight to fracture, as well as multivariable analysis comparing fracture events to non-events. The results of such analyses may reveal trends in risk factors for fracture among the astronaut corps that have yet to be systematically described through a corps-wide approach.
Deng, C.; Pan, H.; Zhao, P.; Qin, R.; Peng, L.
2017-12-01
After suffering from the disaster of Wenchuan earthquake on May 12th, 2008, scientists are eager to figure out the structure of formation, the geodynamic processes of faults and the mechanism of earthquake in Wenchuan by drilling five holes into the Yingxiu-Beichuan fault zone and Anxian-Guanxian fault zone. Fractures identification and in-situ stress determination can provide abundant information for formation evaluation and earthquake study. This study describe all the fracture modes in the five boreholes on the basis of cores and image logs, and summarize the response characteristics of fractures in conventional logs. The results indicate that the WFSD boreholes encounter enormous fractures, including natural fractures and induced fractures, and high dip-angle conductive fractures are the most common fractures. The maximum horizontal stress trends along the borehole are deduced as NWW-SEE according to orientations of borehole breakouts and drilling-induced fractures, which is nearly parallel to the strikes of the younger natural fracture sets. Minor positive deviations of AC (acoustic log) and negative deviation of DEN (density log) demonstrate their responses to fracture, followed by CNL (neutron log), resistivity logs and GR (gamma ray log) at different extent of intensity. Besides, considering the fact that the reliable methods for identifying fracture zone, like seismic, core recovery and image logs, can often be hampered by their high cost and limited application, this study propose a method by using conventional logs, which are low-cost and available in even old wells. We employ wavelet decomposition to extract the high frequency information of conventional logs and reconstruction a new log in special format of enhance fracture responses and eliminate nonfracture influence. Results reveal that the new log shows obvious deviations in fault zones, which confirm the potential of conventional logs in fracture zone identification.
[Milk, Daily products and Bone health.Milk or dairy products and bone:Epidemiology.
Tamaki, Junko
2018-01-01
An assessment of the association between the intake of milk or dairy products and bone density or the risk of fractures on the basis of epidemiological studies revealed the following findings:(1)a sufficient prepubertal intake of milk or dairy products could contribute to the increased bone growth and maximized peal bone mass because the intake of calcium in the corresponding stage in Japan is inadequate;(2)adequate milk intake could contribute to the maintenance of peal bone mass among menstruating adult females and the decrease of bone loss in postmenopausal females. Adequate milk intake could contribute to the decrease of aging-induced bone loss in elderly males, though there is no sufficient scientific evidence;and(3)a meta-analysis indicated no correlation between the increased milk intake and decreased risks of hip fractures in the elderly. As the intake of milk or dairy products in the Japanese elderly is rather less than that reported by the meta-analysis, the minimal intake of milk or dairy products is anticipated to elevate the risk of fractures in middle-aged or elderly males and females although the scientific evidence is inadequate.
Clinical and epidemiological features of extrapulmonary tuberculosis in a high incidence region.
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Carlos Pérez-Guzmán
2014-03-01
Full Text Available Objective. To describe the clinical features of extrapulmonary tuberculosis (EXPTB and to evaluate epidemiological data to search for potential explanations for its high frequency in the state of Aguascalientes, Mexico. Materials and methods. Clinical records of all patients with tuberculosis seen in Aguascalientes in 2008 were reviewed, and official databases were analyzed. Results. EXPTB comprised 60.5% of the 86 cases evaluated, being lymph nodes the main site affected. Patients with EXPTB were younger and more obese than subjects with pulmonary tuberculosis (PTB. One third of cases in either group had diabetes, a frequency much higher than expected. Epidemiological analysis showed that PTB incidence, but not EXPTB incidence, decreases as geographical altitude increases, and had a descendent trend from 1997 to 2011. Conclusions. The lower frequency of PTB (due to its inverse relationship with altitude and its descendent trend in last years might explain the high frequency of EXPTB. Obesity appeared to protect against developing pulmonary involvement, and diabetes was more frequent than expected among PTB and EXPTB cases.
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Hassan BOUSSAKRI
2015-12-01
Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.
Flow characteristics through a single fracture of artificial fracture system
International Nuclear Information System (INIS)
Park, Byoung Yoon; Bae, Dae Seok; Kim, Chun Soo; Kim, Kyung Su; Koh, Young Kwon; Jeon, Seok Won
2001-04-01
Fracture flow in rock masses is one of the most important issues in petroleum engineering, geology, and hydrogeology. Especially, in case of the HLW disposal, groundwater flow in fractures is an important factor in the performance assessment of the repository because the radionuclides move along the flowing groundwater through fractures. Recently, the characterization of fractures and the modeling of fluid flow in fractures are studied by a great number of researchers. Among those studies, the hydraulic behavior in a single fracture is one of the basic issues for understanding of fracture flow in rockmass. In this study, a fluid flow test in the single fracture made of transparent epoxy replica was carried out to obtain the practical exponent values proposed from the Cubic law and to estimate the flow rates through a single fracture. Not only the relationship between flow rates and the geometry of fracture was studied, but also the various statistical parameters of fracture geometry were compared to the effective transmissivity data obtained from computer simulation.
A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP
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Chandra Sekharam Naidu
2015-05-01
Full Text Available INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures were deemed not amenable for surgical reconstruction . 2 Conservative treatment by POP cast l ead to prolonged immobilization, leading to ankle and knee stiffness affecting quality of life of the patient . 3 Operative treatment is indicated for most tibial fractures caused by high energy trauma. Operative treatment allows early motion, and avoids sho rtening and other complications associated with prolonged immobilization . 4 The fundamental goal of treatment of distal tibial fractures is restoration of normal or near normal alignment and articular congruity and finally to obtain a well healed fracture; pain free weight bearing ; and functional ROM of ankle joint. For the past decade, plating has been successful in treating complex fractures of the lower extremity especially distal tibia . 5 Conventional ORIF have been associated with complications like infe ction and delayed or non - union due to devitalisation of bony fragments and additional damage to the soft tissues . 6 To improve fracture healing, more “biological” methods have been developed in the last decade to lessen the surgical dissection, preserving b lood supply to bony fragments and containing at least partially the fracture haematoma . 7 Recently, the trend is towards use of a Locking compression plate for treatment of fractures of the distal part of the tibia 8 . Compared with a conventional plate, a Lo cking compression plate imparts a higher degree of stability and provides better protection against primary and secondary losses of reduction and minimization of bone
A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture
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Egemen Kucuk
2014-04-01
Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.
Mechanical properties of highly defective graphene: from brittle rupture to ductile fracture
International Nuclear Information System (INIS)
Xu, Lanqing; Wei, Ning; Zheng, Yongping
2013-01-01
Defects are generally believed to deteriorate the superlative performance of graphene-based devices but may also be useful when carefully engineered to tailor the local properties and achieve new functionalities. Central to most defect-associated applications is the defect coverage and arrangement. In this work, we investigate, by molecular dynamics simulations, the mechanical properties and fracture dynamics of graphene sheets with randomly distributed vacancies or Stone–Wales defects under tensile deformations over a wide defect coverage range. With defects presented, an sp–sp 2 bonding network and an sp–sp 2 –sp 3 bonding network are observed in vacancy-defected and Stone–Wales-defected graphene, respectively. The ultimate strength degrades gradually with increasing defect coverage and saturates in the high-ratio regime, whereas the fracture strain presents an unusual descending–saturating–improving trend. In the dense vacancy defect situation, the fracture becomes more plastic and super-ductility is observed. Further fracture dynamics analysis reveals that the crack trapping by sp–sp 2 and sp–sp 2 –sp 3 rings and the crack-tip blunting account for the ductile fracture, whereas geometric rearrangement on the entire sheet for vacancy defects and geometric rearrangement on the specific defect sites for Stone–Wales defects account for their distinctive rules of the evolution of the fracture strain. (paper)
Vestergaard, Peter; Emborg, Charlotte; Støving, René K; Hagen, Claus; Mosekilde, Leif; Brixen, Kim
2002-11-01
To study fracture risk in patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not otherwise specified (EDNOS). Cohort study including all Danes diagnosed with AN (n = 2,149), BN (n = 1,294), or EDNOS (n = 942) between 1977 and 1998. Each patient was compared with three randomly drawn age- and gender-matched control subjects. Fracture risk was increased in AN after diagnosis compared to controls (incidence rate ratio: 1.98, 95% CI: 1.60-2.44), but not before. The increased fracture risk persisted more than 10 years after diagnosis. A significant increase in fracture risk was found before diagnosis in BN (1.31, 95% CI: 1.04-1.64), with a trend towards an increase after diagnosis (1.44, 95% CI: 0.93-2.22). EDNOS patients had a significant increase in fracture risk before (1.39, 95% CI: 1.06-1.81) and after diagnosis (1.77, 95% CI: 1.25-2.51). The increased fracture risk many years after diagnosis indicates permanent skeletal damage. Copyright 2002 by Wiley Periodicals, Inc.
Sabino, Raquel; Simões, Helena; Francisco, Mariana; Viegas, Carla; Toscano, Cristina; Batista, JuditeTeresa; Ferreira, Teresa; Veríssimo, Cristina
2017-01-01
Poster abstract publicado em: Mycoses. 2017;60(Suppl. S2):131-132. Disponível em:http://onlinelibrary.wiley.com/doi/10.1111/myc.12675/epdf Objectives: Aspergillus fumigatus is the most frequent agent of aspergilosis and reports on infections caused by this species or its siblings are becoming more frequent, together with the increasing number of at risk patients. Nowadays, due to the rising concerns on emerging antifungal resistance, the epidemiological surveillance for clinical and enviro...
Tuberculosis epidemiology in six provinces of Vietnam after the introduction of the DOTS strategy
Huong, N. T.; Duong, B. D.; Co, N. V.; Quy, H. T.; Tung, L. B.; Broekmans, J. F.; Bosman, M. C.; Verhage, C.; Kalisvaart, N.; Borgdorff, M. W.; Cobelens, F. G.
2006-01-01
SETTING: Six provinces in Vietnam where the DOTS strategy was introduced in 1989. OBJECTIVE: To assess the impact of improved tuberculosis (TB) control on TB epidemiology in Vietnam. METHODS: Data from the surveillance system in the period 1990-2003 were analysed to assess trends of notification
Epidemiology of Thyroid Cancer in an Area of Epidemic Thyroid Goiter
International Nuclear Information System (INIS)
Cossu, A.; Paliogiannis, P.; Scognamillo, F.; Attene, F.; Trignano, M.; Tanda, F.; Budroni, M.; Cesaraccio, R.; Palmieri, G.
2013-01-01
The aim of this study was to analyze and describe the epidemiological characteristics and trends of thyroid cancer in the province of Sassari (Sardinia, Italy), an area with epidemic thyroid goiter, in the period 1992-2010. Data were obtained from the local tumor registry which makes part of a wider registry web, coordinated today by the Italian Association for Tumor Registries. An increasing trend in the incidence of thyroid cancer in the province of Sassari was evidenced. This trend seems to follow the general worldwide trend and does not seem to be related to the high incidence of thyroid goiter in the area. The frequencies of the different histological subtypes were similar to those reported in numerous national and international reports. Women are affected earlier than men and, therefore, suffer greater professional, economic, and social impacts. Overall mortality is low and a relative 5-year survival is excellent, especially in comparison to other malignancies
Fracture of the styloid process associated with the mandible fracture
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K N Dubey
2013-01-01
Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.
Real-World Rib Fracture Patterns in Frontal Crashes in Different Restraint Conditions.
Lee, Ellen L; Craig, Matthew; Scarboro, Mark
2015-01-01
The purpose of this study was to use the detailed medical injury information in the Crash Injury Research and Engineering Network (CIREN) to evaluate patterns of rib fractures in real-world crash occupants in both belted and unbelted restraint conditions. Fracture patterns binned into rib regional levels were examined to determine normative trends associated with belt use and other possible contributing factors. Front row adult occupants with Abbreviated Injury Scale (AIS) 3+ rib fractures, in frontal crashes with a deployed frontal airbag, were selected from the CIREN database. The circumferential location of each rib fracture (with respect to the sternum) was documented using a previously published method (Ritchie et al. 2006) and digital computed tomography scans. Fracture patterns for different crash and occupant parameters (restraint use, involved physical component, occupant kinematics, crash principal direction of force, and occupant age) were compared qualitatively and quantitatively. There were 158 belted and 44 unbelted occupants included in this study. For belted occupants, fractures were mainly located near the path of the shoulder belt, with the majority of fractures occurring on the inboard (with respect to the vehicle) side of the thorax. For unbelted occupants, fractures were approximately symmetric and distributed across both sides of the thorax. There were negligible differences in fracture patterns between occupants with frontal (0°) and near side (330° to 350° for drivers; 10° to 30° for passengers) crash principal directions of force but substantial differences between groups when occupant kinematics (and contacts within the vehicle) were considered. Age also affected fracture pattern, with fractures tending to occur more anteriorly in older occupants and more laterally in younger occupants (both belted and unbelted). Results of this study confirmed with real-world data that rib fracture patterns in unbelted occupants were more distributed
Coupled processes in single fractures, double fractures and fractured porous media
International Nuclear Information System (INIS)
Tsang, C.F.
1986-12-01
The emplacement of a nuclear waste repository in a fractured porous medium provides a heat source of large dimensions over an extended period of time. It also creates a large cavity in the rock mass, changing significantly the stress field. Such major changes induce various coupled thermohydraulic, hydromechanic and hydrochemical transport processes in the environment around a nuclear waste repository. The present paper gives, first, a general overview of the coupled processes involving thermal, mechanical, hydrological and chemical effects. Then investigations of a number of specific coupled processes are described in the context of fluid flow and transport in a single fracture, two intersecting fractures and a fractured porous medium near a nuclear waste repository. The results are presented and discussed
Energy Technology Data Exchange (ETDEWEB)
Phillips, W.S.; Rutledge, J.T.; Gardner, T.L. [SPE, Richardson, TX (United States); Fairbanks, T.D.; Miller, M.E.; Schuessler, B.K. [Los Alamos National Lab., NM (United States)
1996-11-01
Patterns of microearthquakes detected downhole defined fracture orientation and extent in the Austin chalk, Giddings field, TX and the 76 field, Clinton Co., KY. We collected over 480 and 770 microearthquakes during hydraulic stimulation at two sites in the Austin chalk, and over 3200 during primary production in Clinton Co. Data were of high enough quality that 20%, 31% and 53% of the events could be located, respectively. Reflected waves constrained microearthquakes to the stimulated depths at the base of the Austin chalk. In plan view, microearthquakes defined elongate fracture zones extending from the stimulation wells parallel to the regional fracture trend. However, widths of the stimulated zones differed by a factor of five between the two Austin chalk sites, indicating a large difference in the population of ancillary fractures. Post-stimulation production was much higher from the wider zone. At Clinton Co., microearthquakes defined low-angle, reverse-fault fracture zones above and below a producing zone. Associations with depleted production intervals indicated the mapped fractures had been previously drained. Drilling showed that the fractures currently contain brine. The seismic behavior was consistent with poroelastic models that predicted slight increases in compressive stress above and below the drained volume.
Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.
Miranda, J Jaime; López-Rivera, Luis A; Quistberg, D Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada
2014-01-01
The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth. Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita. The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.
Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.
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J Jaime Miranda
Full Text Available The epidemiological profile and trends of road traffic injuries (RTIs in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31 on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43, while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43. Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP per capita.The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.
Epidemiology of human leptospirosis in Malaysia, 2004-2012.
Benacer, Douadi; Thong, Kwai Lin; Min, Ng Choung; Bin Verasahib, Khebir; Galloway, Renee L; Hartskeerl, Rudy A; Souris, Marc; Mohd Zain, Siti Nursheena
2016-05-01
Leptospirosis is an emerging disease, especially in countries with a tropical climate such as Malaysia. A dramatic increase in the number of cases has been reported over the last decade; however, information on the epidemiological trends of this disease is lacking. The objective of this study is to provide an epidemiological description of human leptospirosis cases over a 9-year period (2004-2012) and disease relationship with meteorological, geographical, and demographical information. A retrospective study was undertaken to describe the patterns of human leptospirosis cases and their association with intrinsic (sex, age, and ethnicity) and extrinsic (location, rainfall, and temperature) factors. Data was grouped according to age, sex, ethnicity, seasonality and geographical distribution, and analyzed using statistical tools to understand the influence of all the different factors on disease incidence. A total of 12,325 cases of leptospirosis were reported between 2004 and 2012 with an upward trend in disease incidence, with the highest in 2012. Three hundred thirty-eight deaths were reported with an overall case fatality rate of 2.74%, with higher incidence in males (9696; 78.7%) compared with female patients (2629; 21.3%), and overall male to female ratio of 3.69:1. Patients aged cohorts between 30-39 years old (16.22 per 100,000 population) had the highest disease incidence while the lowest incidence occurred between cases (1.80 per 100,000 population). Positive relationships were recorded between the number of reported cases with the number of raining days per month and monthly average temperature (p-valuecases. This collaborative efforts between medical, academic and governmental institutions has enabled the construction of this comprehensive database that is essential to understand the disease trends in Malaysia and add insights into the prevention and control of this disease. Copyright © 2016 Elsevier B.V. All rights reserved.
Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy
2018-06-01
The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.
Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture
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Teh KK
2009-11-01
Full Text Available Chance fracture is an unstable vertebral fracture, which usually results from a high velocity injury. An elderly lady with a previously healed osteoporotic fracture of the T12 and L1 vertebra which resulted in a severe kyphotic deformity subsequently sustained a Chance fracture of the adjacent L2 vertebrae after a minor fall. The previously fracture left her with a deformity which resulted in significant sagittal imbalance therefore predisposing her to this fracture. This case highlights the importance of aggressive treatment of osteoporotic fractures in order to prevent significant sagittal imbalance from resultant (i.e. kyphotic deformity.
... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...
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José Soares Hungria Neto
2011-01-01
Full Text Available OBJETIVO: O custo social e econômico das fraturas da região proximal do fêmur é elevado e decorre, dentre outros fatores, da morbimortalidade da própria fratura. Apesar de sua importância, estudos envolvendo esse tema ainda são escassos no Brasil. Esse foi um estudo retrospectivo, observacional, transversal (ecológico com objetivo de traçar um perfil epidemiológico da fratura do terço proximal do fêmur em idosos, analisar suas causas e as características físicas dos pacientes admitidos em um único hospital universitário de São Paulo. MÉTODOS: Estudo de prontuários no período de um ano e comparação dos grupos pelo teste do Qui-quadrado; p OBJECTIVE: The social and economic cost of proximal femoral fractures is high, due the morbidity and mortality relating to the fracture itself, among other factors. Despite the importance of this issue, studies on this topic are still scarce in Brazil. This was a retrospective, observational and cross-sectional (ecological study with the aims of outlining an epidemiological profile for proximal femoral fractures among the elderly and analyzing the causes of these fractures and the physical characteristics of patients admitted to a single university hospital in São Paulo. METHODS: This was a study on medical records over a one-year period, with group comparisons using the chi-square test; p < 0.05 was considered significant. RESULTS: Ninety-four individuals were evaluated: predominantly female (2:1; 81-85 years of age; body mass index within normal limits; white and Asian patients (p < 0.05. The vast majority of the fractures occurred through low-energy trauma and inside the patients' homes (p < 0.05. After excluding the trauma resulting from high-energy events, over 39% occurred as the patients were moving from sitting to standing up or were using stairs, and approximately 40% occurred while they were standing still or walking. A greater number of cases corresponded to the cold seasons of
Epidemiology and trends in non-fatal self-harm in three centres in England: 2000-2007.
Bergen, Helen; Hawton, Keith; Waters, Keith; Cooper, Jayne; Kapur, Navneet
2010-12-01
Self-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. Previous reports in the UK have come largely from single centres. To investigate trends in non-fatal self-harm in six general hospitals in three centres from the Multicentre Study of Self-harm in England, and to relate these to trends in suicide. Data on self-harm presentations to general hospital emergency departments in Oxford (one), Manchester (three) and Derby (two) were analysed over the 8-year period 1 January 2000 to 31 December 2007. Rates of self-harm declined significantly over 8 years for males in three centres (Oxford: -14%; Manchester: -25%; Derby: -18%) and females in two centres (Oxford: -2% (not significant); Manchester: -13%; Derby: -17%), in keeping with national trends in suicide. A decreasing proportion and number of episodes involved self-poisoning alone, and an increasing proportion and number involved other self-injury (e.g. hanging, jumping, traffic related). Episodes involving self-cutting alone showed a slight decrease in numbers over time. Trends in alcohol use at the time of self-harm and repetition within 1 year were stable. There were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. This was reflected mainly in a decline in emergency department presentations for self-poisoning.
Ankle fractures have features of an osteoporotic fracture.
Lee, K M; Chung, C Y; Kwon, S S; Won, S H; Lee, S Y; Chung, M K; Park, M S
2013-11-01
We report the bone attenuation of ankle joint measured on computed tomography (CT) and the cause of injury in patients with ankle fractures. The results showed age- and gender-dependent low bone attenuation and low-energy trauma in elderly females, which suggest the osteoporotic features of ankle fractures. This study was performed to investigate the osteoporotic features of ankle fracture in terms of bone attenuation and cause of injury. One hundred ninety-four patients (mean age 51.0 years, standard deviation 15.8 years; 98 males and 96 females) with ankle fracture were included. All patients underwent CT examination, and causes of injury (high/low-energy trauma) were recorded. Mean bone attenuations of the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis were measured on CT images. Patients were divided into younger age (fractures than the younger age group. With increasing age, bone attenuations tended to decrease and the difference of bone attenuation between the genders tended to increase in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis. Ankle fracture had features of osteoporotic fracture that is characterized by age- and gender-dependent low bone attenuation. Ankle fracture should not be excluded from the clinical and research interest as well as from the benefit of osteoporosis management.
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Pagès-Castellà Aina
2012-05-01
Full Text Available Abstract Background Knowledge on the epidemiology of non-hip fractures in Spain is limited and somewhat outdated. Using computerized primary care records from the SIDIAP database, we derived age and sex-specific fracture incidence rates for the region of Catalonia during the year 2009. Methods The SIDIAP database contains quality-checked clinical information from computerized medical records of a representative sample of >5,800,000 patients (80% of the population of Catalonia. We conducted a retrospective cohort study including all patients aged ≥50 years, and followed them from January 1 to December 31, 2009. Major osteoporotic fractures registered in SIDIAP were ascertained using ICD-10 codes and validated by comparing data to hospital admission and patient-reported fractures records. Incidence rates and 95% confidence intervals were calculated. Results In total, 2,011,430 subjects were studied (54.6% women. Overall fracture rates were 10.91/1,000 person-years (py [95%CI 10.89–10.92]: 15.18/1,000 py [15.15–15.21] in women and 5.78/1,000 py [5.76–5.79] in men. The most common fracture among women was wrist/forearm (3.86/1,000 py [3.74–3.98], while among men it was clinical spine (1.25/1,000 py [1.18–1.33]. All fracture rates increased with age, but varying patterns were observed: while most of the fractures (hip, proximal humerus, clinical spine and pelvis increased continuously with age, wrist and multiple rib fractures peaked at age 75–80 and then reached a plateau. Conclusions Our study provides local estimates of age, sex and site-specific fracture burden in primary health care, which will be helpful for health-care planning and delivery. A proportion of fractures are not reported in primary care records, leading to underestimation of fracture incidence rates in these data.
A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures
Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar
2015-01-01
First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare en...
A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.
Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar
2015-01-01
First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.
Epidemiological characteristics of hepatitis A in Serbian areas of Kosovo and Metohia
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Stevanović Jasmina
2016-01-01
Full Text Available Hepatitis A is an acute viral disease of the liver caused by the hepatitis A virus (HAV .In many areas of the world represents a significant epidemiological problem, and the infection is usually transmitted by contact, rarely contaminated water and food. The main objective of the study was to identify the most important epidemiological characteristics of hepatitis A in Serbian areas of Kosovo and Metohija. We used the data of reporting of infectious diseases, reports on infectious diseases (seven-day, month, year of the Department of Public Health Pristina in Kosovska Mitrovica. In our research we used epidemiological Studies of cross-section (cross-sectional. Between 2003-2015. in Kosovo and Metohija (Serbian middle registered 223 cases of hepatitis A. The average incidence in the reporting period was 11.03 / 10,0000. Analysis of age distribution revealed that the most common incidence in people aged 15-19 years, and the rarest people aged 50-59 years. Hepatitis A occurs throughout the year, showing seasonal variations. Trend of incidence shows a negative trend with a reduction in the number of cases in the territory of Kosovo and Metohija. Based on the results of our study we can conclude that hepatitis A is an important public health and socioeconomic problem. In order to prevent hepatitis A, it is important to continue to improve hygiene and sanitary conditions of life as the best general preventive measures.
Globalization and local response to epidemiological overlap in 21st century Ecuador
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Waters William F
2006-05-01
Full Text Available Abstract Background Third World countries are confronted by a complex overlay of two sets of health problems. Traditional maladies, including communicable diseases, malnutrition, and environmental health hazards coexist with emerging health challenges, including cardiovascular disease, cancer, and increasing levels of obesity. Using Ecuador as an example, this paper proposes a conceptual framework for linking epidemiologic overlap to emerging social structures and processes at the national and global levels. Discussion Epidemiologic trends can be seen as part of broader processes related to globalization, but this does not imply that globalization is a monolithic force that inevitably and uniformly affects nations, communities, and households in the same manner. Rather, characteristics and forms of social organization at the subnational level can shape the way that globalization takes place. Thus, globalization has affected Ecuador in specific ways and is, at the same time, intimately related to the form in which the epidemiologic transition has transpired in that country. Summary Ecuador is among neither the poorest nor the wealthiest countries and its situation may illuminate trends in other parts of the world. As in other countries, insertion into the global economy has not taken place in a vacuum; rather, Ecuador has experienced unprecedented social and demographic change in the past several decades, producing profound transformation in its social structure. Examples of local represent alternatives to centralized health systems that do not effectively address the complex overlay of traditional and emerging health problems.
Relationships between fractures
Peacock, D. C. P.; Sanderson, D. J.; Rotevatn, A.
2018-01-01
Fracture systems comprise many fractures that may be grouped into sets based on their orientation, type and relative age. The fractures are often arranged in a network that involves fracture branches that interact with one another. Interacting fractures are termed geometrically coupled when they share an intersection line and/or kinematically coupled when the displacements, stresses and strains of one fracture influences those of the other. Fracture interactions are characterised in terms of the following. 1) Fracture type: for example, whether they have opening (e.g., joints, veins, dykes), closing (stylolites, compaction bands), shearing (e.g., faults, deformation bands) or mixed-mode displacements. 2) Geometry (e.g., relative orientations) and topology (the arrangement of the fractures, including their connectivity). 3) Chronology: the relative ages of the fractures. 4) Kinematics: the displacement distributions of the interacting fractures. It is also suggested that interaction can be characterised in terms of mechanics, e.g., the effects of the interaction on the stress field. It is insufficient to describe only the components of a fracture network, with fuller understanding coming from determining the interactions between the different components of the network.
A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures
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Gultekin Gulbahar
2015-01-01
Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.
Webb, Lawrence X
2002-01-01
Fractures of the proximal femur include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region which is exposed to large compressive stresses. Implants used to address these fractures must be able to accommodate significant loads while the fractures consolidate. Complications secondary to these injuries produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.
Fracture mechanisms and fracture control in composite structures
Kim, Wone-Chul
Four basic failure modes--delamination, delamination buckling of composite sandwich panels, first-ply failure in cross-ply laminates, and compression failure--are analyzed using linear elastic fracture mechanics (LEFM) and the J-integral method. Structural failures, including those at the micromechanical level, are investigated with the aid of the models developed, and the critical strains for crack propagation for each mode are obtained. In the structural fracture analyses area, the fracture control schemes for delamination in a composite rib stiffener and delamination buckling in composite sandwich panels subjected to in-plane compression are determined. The critical fracture strains were predicted with the aid of LEFM for delamination and the J-integral method for delamination buckling. The use of toughened matrix systems has been recommended for improved damage tolerant design for delamination crack propagation. An experimental study was conducted to determine the onset of delamination buckling in composite sandwich panel containing flaws. The critical fracture loads computed using the proposed theoretical model and a numerical computational scheme closely followed the experimental measurements made on sandwich panel specimens of graphite/epoxy faceskins and aluminum honeycomb core with varying faceskin thicknesses and core sizes. Micromechanical models of fracture in composites are explored to predict transverse cracking of cross-ply laminates and compression fracture of unidirectional composites. A modified shear lag model which takes into account the important role of interlaminar shear zones between the 0 degree and 90 degree piles in cross-ply laminate is proposed and criteria for transverse cracking have been developed. For compressive failure of unidirectional composites, pre-existing defects play an important role. Using anisotropic elasticity, the stress state around a defect under a remotely applied compressive load is obtained. The experimentally
The epidemiology of tuberculosis in recent years:
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Maliheh Metanat
2012-02-01
Full Text Available Background: Tuberculosis (TB is one of the most important health issues in developing countries. Understanding the epidemiology of tuberculosis is critical for effective disease control. The global burden of tuberculosis, risk factors for transmission, and the epidemiology of tuberculosis will be reviewed in this article.Materials and Method: We used Scopus, Embase, PubMed, World Health Organization (WHO and scientific Iranian journals from 2000 to 2011; and the last reports from Iranian ministry of health, for extracting data. Key words such as tuberculosis, epidemiology, Iran and Sistan- Balouchestan were used.Results: Descending trend of TB incidence was observed over the last 45 years in Iran. Pulmonary TB is the most prevalent kind of TB in Iran in which 53% were sputum smear positive. Extra-pulmonary TB consists 28% of TB patients. Sistan-Balouchestan and Golestan had the highest incidence and prevalence of TB among all provinces in Iran. According to the latest data from Iranian ministry of health, the incidence of TB in Zabol and Zahedan were reported 109.7 and 36.6 per 100000 populations, respectively. Conclusion: More than 80% of TB patients still belong to developing countries. Sistan-Balouchestan and Golestan had the highest incidence of TB and for achieving the goals of WHO, control and prevention of the disease should be followed seriously
Epidemiology of falls in older age.
Peel, Nancye May
2011-03-01
Worldwide, falls among older people are a public health concern because of their frequency and adverse consequences in terms of morbidity, mortality, and quality of life, as well as their impact on health system services and costs. This epidemiological review outlines the public health burden of falls and fall-related injuries and the impact of population aging. The magnitude of the problem is described in terms of the classification of falls and measurement of outcomes, including fall incidence rates across settings, sociodemographic determinants, international trends, and costs of falls and fall-related injuries. Finally, public health approaches to minimize falls risk and consequent demand on health care resources are suggested.
Energy Technology Data Exchange (ETDEWEB)
Poston, S.W.
1991-12-31
Joint funding by the Department of Energy and the State of Texas has Permitted a three year, multi-disciplinary investigation to enhance oil recovery from a dual porosity, fractured, low matrix permeability oil reservoir to be initiated. The Austin Chalk producing horizon trending thru the median of Texas has been identified as the candidate for analysis. Ultimate primary recovery of oil from the Austin Chalk is very low because of two major technological problems. The commercial oil producing rate is based on the wellbore encountering a significant number of natural fractures. The prediction of the location and frequency of natural fractures at any particular region in the subsurface is problematical at this time, unless extensive and expensive seismic work is conducted. A major portion of the oil remains in the low permeability matrix blocks after depletion because there are no methods currently available to the industry to mobilize this bypassed oil. The following multi-faceted study is aimed to develop new methods to increase oil and gas recovery from the Austin Chalk producing trend. These methods may involve new geological and geophysical interpretation methods, improved ways to study production decline curves or the application of a new enhanced oil recovery technique. The efforts for the second year may be summarized as one of coalescing the initial concepts developed during the initial phase to more in depth analyses. Accomplishments are predicting natural fractures; relating recovery to well-log signatures; development of the EOR imbibition process; mathematical modeling; and field test.
Identification of natural fractures and in situ stress at Rantau Dedap geothermal field
Artyanto, Andika; Sapiie, Benyamin; Idham Abdullah, Chalid; Permana Sidik, Ridwan
2017-12-01
Rantau Dedap Area is a geothermal field which is located in Great Sumatra Fault (GSF). The fault and fracture are main factor in the permeability of the geothermal system. However, not all faults and fractures have capability of to flow the fluids. Borehole image log is depiction of the borehole conditions, it is used to identify the natural fractures and drilling induced fracture. Both of them are used to identify the direction of the fracture, direction of maximum horizontal stress (SHmax), and geomechanics parameters. The natural fractures are the results of responses to stress on a rock and permeability which controlling factor in research area. Breakouts is found in this field as a trace of drilling induced fracture due to in situ stress work. Natural fractures are strongly clustered with true strike trending which first, second, and third major direction are N170°E - N180°E (N-S), N60°E - N70°E (NE-SW), and N310°E - N320°E (NW-SE), while the dominant dip is 80° -90°. Based on borehole breakout analysis, maximum horizontal stress orientation is identified in N162°E - N204°E (N-S) and N242°E (NE-SW) direction. It’s constantly similar with regional stress which is affected by GSF. Several parameters have been identified and analyzed are SHmax, SHmin, and Sy. It can be concluded that Rantau Dedap Geothermal Field is affected by strike-slip regime. The determination of in situ stress and natural fractures are important to study the pattern of permeability which is related to the fault in reservoir of this field.
Dating fractures and fracture movement in the Lac du Bonnet Batholith
International Nuclear Information System (INIS)
Gascoyne, M.; Brown, A.; Ejeckam, R.B.; Everitt, R.A.
1997-04-01
This report examines and summarizes all work that has been done from 1980 to the present in determining the age of rock crystallization, fracture initiation, fracture reactivation and rates of fracture movement in the Lac du Bonnet Batholith to provide information for Atomic Energy of Canada Limited's (AECL) Canadian Nuclear Fuel Waste Management Program. Geological and petrographical indicators of relative age (e.g. cross-cutting relationships, sequences of fracture infilling minerals, P-T characteristics of primary and secondary minerals) are calibrated with radiometric age determinations on minerals and whole rock samples, using 87 Rb- 87 Sr, 40 K- 39 Ar, 40 Ar- 39 Ar and fission track methods. Most fractures and fracture zones inclined at low angles are found to be ancient features, first formed in the Early Proterozoic under conditions of deuteric alteration. Following some movement on fractures in the Late Proterozoic and Early Paleozoic, reactivation of fractures during the Pleistocene is established from uranium-series dating methods and use of stable isotopic contents of fracture infilling minerals (mainly calcite). Some indication of movement on fracture zones during the Pleistocene is given by electron spin resonance dating techniques on fault gouge. The slow rate of propagation of fractures is indicated by mineral infillings, their P-T characteristics and U-series calcite ages in a fracture in sparsely fractured rock, accessible from AECL's Underground Research Laboratory. These results collectively indicate that deep fractures observed in the batholith are ancient features and the fracturing and jointing in the upper 200 m is relatively recent (< 1 Ma) and largely a result of stress release. (author)
Trends in puberty timing in humans and environmental modifiers
DEFF Research Database (Denmark)
Toppari, Jorma; Juul, Anders
2010-01-01
Secular trends in timing of puberty appear to continue although under-nutrition has not been any longer a limiting factor for pubertal development. Now obesity and other environmental reasons have been suspected to cause this trend, and endocrine disrupting chemicals have become into focus...... as possible contributors. Epidemiological studies on endocrine disrupters are still scarce and show only weak associations between exposures and timing of puberty. Since genetic background explains 50-80% of variability in the timing of puberty, it is not surprising that the observed environmental effects...... are rather modest when individual exposures are assessed. Despite that, some exposures have been reported to be associated to early (e.g., polybrominated biphenyls) or delayed (e.g., lead) puberty. Here we shortly review the available data on recent trends in timing of puberty and the possible role...
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Cassiano Ricardo Hoffmann
2012-04-01
Full Text Available OBJETIVO: Avaliar as características pessoais, das fraturas e do tratamento e suas complicações em pacientes com fraturas femorais diafisárias pediátricas atendidos no Serviço de Ortopedia Pediátrica do Hospital Infantil Joana de Gusmão. MÉTODOS: Trata-se de estudo retrospectivo e transversal com população composta por pacientes com fraturas diafisárias de fêmur, com idade entre o nascimento e 14 anos e 11 meses, divididos em quatro grupos etários. As informações foram obtidas nos prontuários e transferidas para o questionário de pesquisa que apresentava variáveis pessoais, das fraturas e do tratamento e suas complicações. RESULTADOS: A população do estudo foi composta por 96 pacientes. A média de idade encontrada foi de 6,8 anos. Houve predomínio no sexo masculino, fratura fechada, lado direito, 1/3 médio e traço simples. Quanto à etiologia das fraturas, houve predomínio na amostra global de acidentes de trânsito. A maioria dos pacientes (74-77,1% apresentou fratura de fêmur como lesão isolada. Houve predomínio do tratamento conservador na faixa etária menor que seis anos e do tratamento cirúrgico na faixa etária de seis anos a 14 anos e 11 meses. As complicações observadas até a união óssea foram: discrepância, infecção e limitação de movimento. O tempo médio de consolidação foi de 9,6 ± 2,4 semanas, variando com a idade. CONCLUSÃO: As características das fraturas estudadas foram semelhantes às citadas na literatura e o tratamento empregado apresentou bom resultado. O Hospital Infantil Joana de Gusmão (HIJG tem utilizado o tratamento proposto pela literatura nas fraturas femorais diafisárias pediátricas.OBJECTIVE: To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. METHODS: This was a retrospective cross-sectional study
Energy Technology Data Exchange (ETDEWEB)
Picard, D.
2005-09-15
The optimisation of the oil production requires a better characterisation of naturally fractured reservoirs. We consider and analyse two spatial distributions. One with systematic joints is arranged in an homogeneous way; joint spacing is linked to individual bedding thickness with propagation frequently interrupted by stratigraphic interfaces (single layer jointing). The second, so-called fracture swarms, consists in fractures clustering, where stratigraphic interfaces seem to play a minor role. The analysis is based on the singularity theory and matched asymptotic expansions method with a fine scale for local perturbations and a global one for general trends. We examine the conditions of fracture propagation that are determined herein using simultaneously two fracture criteria an energy and a stress condition. We consider two modes of loading. Usually, the joint (crack opening mode) and fracture swarm growths are explained by a first order phenomenon involving effective traction orthogonal to fracture plane. Although commonly used, this hypothesis seems unrealistic in many circumstances and may conflict with geological observations. Then, we try to describe fracture growth as a second order phenomena resulting from crack parallel compression. As far as propagation across layer interfaces is concerned, the effect of loading and geometry has been summarised in maps of fracture mechanisms, describing areas of 'step-over', 'straight through propagation' and 'crack arrest'. Fracture criteria, relative size of heterogeneities, contrast of mechanical properties between bed and layer are parameters of the problem. For fracture swarms, we present a discussion bringing out what is reasonable as a loading to justify their morphology. In particular, horizontal effective tension is unable to explain neighbouring joints. Simultaneous propagation of parallel near cracks is explained by finite width cracks growing under the influence of vertical
Richterich, Annika; Mittelstadt, Brent; Floridi, Luciano
2016-01-01
This chapter provides a critique of methodological developments in epidemiological surveillance of influenza enabled by digital technology. While public health surveillance conventionally relies on data from clinical and virological diagnosis or mortality rate statistics, approaches in
Siwani, Rizwan; Tombers, Nicole M; Rieck, Kevin L; Cofer, Shelagh A
2014-07-01
To review and compare the epidemiology and treatment of mandibular fractures in subgroups of a pediatric population. We conducted a retrospective review of pediatric patients (age, ≤18 years) with mandibular fractures treated at our institution from January 1996 through November 2011. We identified 122 patients (93 [76%] male) with 216 mandibular fractures. The prevalent mechanisms of injury were motor vehicle accidents (n=52 [43%]), sports injuries (n=24 [20%]), and assault (n=13 [11%]). The most common fracture sites were subcondylar, parasymphyseal, angle, and body. Two patients (2%) were treated conservatively by observation only, 67 (55%) underwent maxillomandibular fixation alone, 41 (34%) underwent maxillomandibular fixation with plate fixation, and 7 (5.7%) underwent plate fixation only. The average duration of maxillomandibular fixation was 26 days (range, 7-49 days). Complications occurred in 11 patients (9.0%) over a mean follow-up of 92 days (range, 21-702 days). Fifty patients (41.0%) had comorbid conditions or a history of mental illness at the time of injury, including attention deficit hyperactivity disorder (n=11 [9%]), mental disorders other than attention deficit hyperactivity disorder (n=23 [19%]), and asthma (n=17 [14%]). Twenty-six patients (21%) had a history of substance use, the most common being tobacco (n=18 [15%]), alcohol (n=13 [11%]), and marijuana (n=11 [9%]). Treatment approach and outcomes were affected by age and fracture characteristics. In addition, a marked proportion of this cohort had preexisting mental disorders and history of substance use, which may have implications on treatment approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Analysis and experimental validation of through-thickness cracked large-scale biaxial fracture tests
International Nuclear Information System (INIS)
Wiesner, C.S.; Goldthorpe, M.R.; Andrews, R.M.; Garwood, S.J.
1999-01-01
Since 1984 TWI has been involved in an extensive series of tests investigating the effects of biaxial loading on the fracture behaviour of A533B steel. Testing conditions have ranged from the lower to upper shelf regions of the transition curve and covered a range of biaxiality ratios. In an attempt to elucidate the trends underlying the experimental results, finite element-based mechanistic models were used to analyse the effects of biaxial loading. For ductile fracture, a modified Gunson model was used and important effects on tearing behaviour were found for through thickness cracked wide plates, as observed in upper shelf tests. For cleavage fracture, both simple T-stress methods and the Anderson-Dodds and Beremin models were used. Whilst the effect of biaxiality on surface cracked plates was small, a marked effect of biaxial loading was found for the through-thickness crack. To further validate the numerical predictions for cleavage fracture, TWI have performed an additional series of lower shelf through thickness cracked biaxial wide plate fracture tests. These tests were performed using various biaxiality loading conditions varying from simple uniaxial loading, through equibiaxial loading, to a biaxiality ratio equivalent to a circumferential crack in a pressure vessel. These tests confirmed the predictions that there is a significant effect of biaxial loading on cleavage fracture of through thickness cracked plate. (orig.)
Pakarinen, Harri
2012-12-01
The aim of this thesis was to confirm the utility of stability-based ankle fracture classification in choosing between non-operative and operative treatment of ankle fractures, to determine how many ankle fractures are amenable to non-operative treatment, to assess the roles of the exploration and anatomical repair of the AITFL in the outcome of patients with SER ankle fractures, to establish the sensitivities, specificities and interobserver reliabilities of the hook and intraoperative stress tests for diagnosing syndesmosis instability in SER ankle fractures, and to determine whether transfixation of unstable syndesmosis is necessary in SER ankle fractures. The utility of stability based fracture classification to choose between non-operative and operative treatment was assessed in a retrospective study (1) of 253 ankle fractures in skeletally mature patients, 160 of whom were included in the study to obtain an epidemiological profile in a population of 130,000. Outcome was assessed after a minimum follow-up of two years. The role of AITFL repairs was assessed in a retrospective study (2) of 288 patients with Lauge-Hansen SE4 ankle fractures; the AITFL was explored and repaired in one group (n=165), and a similar operative method was used but the AITFL was not explored in another group (n=123). Outcome was measured with a minimum follow-up of two years. Interobserver reliability of clinical syndesomosis tests (study 3) and the role of syndesmosis transfixation (study 4) were assessed in a prospective study of 140 patients with Lauge-Hansen SE4 ankle fractures. The stability of the distal tibiofibular joint was evaluated by the hook and ER stress tests. Clinical tests were carried out by the main surgeon and assistant, separately, after which a 7.5-Nm standardized ER stress test for both ankles was performed; if it was positive, the patient was randomized to either syndesmosis transfixation (13 patients) or no fixation (11 patients) treatment groups. The
International Nuclear Information System (INIS)
Meny, Lucienne.
1979-06-01
Fracture surfaces are considered as a useful source of informations: an introduction to fractography is presented; the fracture surface may be observed through X ray microanalysis, and other physical methods such as Auger electron spectroscopy or secundary ion emission. The mechanisms of macroscopic and microscopic crackgrowth and fracture are described, in the case of unstable fracture (cleavage, ductile with shear, intergranular brittleness) and of progressive crack propagation (creep, fatigue). Exemples of cracks are presented in the last chapter [fr
Epidemiology of Road Traffic Incidents in Peru 1973–2008: Incidence, Mortality, and Fatality
Miranda, J. Jaime; López-Rivera, Luis A.; Quistberg, D. Alex; Rosales-Mayor, Edmundo; Gianella, Camila; Paca-Palao, Ada; Luna, Diego; Huicho, Luis; Paca, Ada; Luis, López; Luna, Diego; Rosales, Edmundo; Best, Pablo; Best, Pablo; Egúsquiza, Miriam; Gianella, Camila; Lema, Claudia; Ludeña, Esperanza; Miranda, J. Jaime; Huicho, Luis
2014-01-01
Background The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth. Methods and Findings Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita Conclusions The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs. PMID:24927195
Scale-dependent Patterns in One-dimensional Fracture Spacing and Aperture Data
Roy, A.; Perfect, E.
2013-12-01
spatially-distributed aperture values may be replaced by length data and it may be determined if long fractures are statistically found next to each other. In the case of time series such as, for example, rainfall data, this technique could be used to delineate trends in pH within individual precipitation events.
Trends in the prevalence of pathogens causing urethritis in Asturias, Spain, 1989-2000.
Varela, José A; Otero, Luis; García, María José; Palacio, Virgilo; Carreño, Francisco; Cuesta, Mar; Sánchez, Carmen; Vázquez, Fernando
2003-04-01
There are few studies of recent trends in the etiology and epidemiologic characteristics of specific microorganisms causing urethritis in men. The objective of the current study was to show the clinical experience in our country and to evaluate the trends in the prevalence of the pathogens in male urethritis, as well as the epidemiologic patterns in a series of 2101 patients. This was a descriptive study of the etiological agents causing urethritis in our sexually transmitted disease clinics in a period of 12 years (1989-2000), with a comparison of two periods of time. There were 97 cases of gonococcal urethritis (4.6%), 2004 of nongonococcal urethritis (95.4%), and 82 of mixed urethritis (3.9%). An association was found between gonococcal urethritis and heterosexual men; between chlamydial urethritis and homosexual/bisexual men; Ureaplasma urealyticum urethritis and heterosexual men and patients younger than 30 years of age; and between trichomonal urethritis and patients more than 30 years of age and the presence of HIV antibodies. During the period of research there was a significant decrease in cases of Neisseria gonorrhoeae and Chlamydia trachomatis urethritis and an increase in those of U urealyticum urethritis. In conclusion, this report describes changes in the etiology and epidemiologic patterns of urethritis in our country in recent years.
Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...
DEFF Research Database (Denmark)
Bach-Mortensen, Pernille; Hyldstrup, Lars; Appleyard, Merete
2006-01-01
affecting DXR bone mineral density (BMD) in this cohort. The study is based on data from a subgroup of women participating in the third Copenhagen City Heart Study and additional data from a questionnaire obtained in 1999. The mean follow-up time was 6.1 years. During the observation period, 245 women...... later osteoporotic fracture and seems to provide meaningful information on bone mass in epidemiological studies, where DXA measurements are not available....
Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.
LENUS (Irish Health Repository)
Burke, Neil G
2014-01-01
Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well.
Numerical modelling of intergranular fracture in polycrystalline materials and grain size effects
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P. Wriggers
2011-07-01
Full Text Available In this paper, the phenomenon of intergranular fracture in polycrystalline materials is investigated using a nonlinear fracture mechanics approach. The nonlocal cohesive zone model (CZM for finite thickness interfaces recently proposed by the present authors is used to describe the phenomenon of grain boundary separation. From the modelling point of view, considering the dependency of the grain boundary thickness on the grain size observed in polycrystals, a distribution of interface thicknesses is obtained. Since the shape and the parameters of the nonlocal CZM depend on the interface thickness, a distribution of interface fracture energies is obtained as a consequence of the randomness of the material microstructure. Using these data, fracture mechanics simulations are performed and the homogenized stress-strain curves of 2D representative volume elements (RVEs are computed. Failure is the result of a diffuse microcrack pattern leading to a main macroscopic crack after coalescence, in good agreement with the experimental observation. Finally, testing microstructures characterized by different average grain sizes, the computed peak stresses are found to be dependent on the grain size, in agreement with the trend expected according to the Hall-Petch law.
Use of fracture mechanics in the US industry
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Landes, J.D. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Materialforschung
2001-07-01
The modern fracture mechanics technology began in the US in the 1960's. It was developed in response to failure problems that could not be explained by current technology. Some segments of the US industry were quick to embrace this new technology. The period of 1960 to middle 1980's marked a time of active fracture mechanics research in the US industry. From this various codes and assessment procedures have been developed to apply the fracture mechanics approach to evaluate the safety and reliability of critical structural components. This report discusses the US industry use of fracture mechanics. It considers the historical developments, some of the fracture mechanics tools that are available and present practices. Several different industry segments that have used the fracture mechanics approach are considered. These include aerospace, military, power generation, petrochemical and pipelines, metal producers, and construction/transportation. Their current use of the fracture mechanics methods involves the implementation of codes and procedures, the development of software packages, the use of outside consulting groups and some in-house research efforts. (orig.) [German] Die Entwicklung der modernen Bruchmechanik in den USA begann in den 1960er Jahren im Zusammenhang mit einer Reihe von Versagensfaellen, die auf konventionelle Weise nicht erklaert werden konnten. Die neuen Ansaetze wurden von einigen Branchen schnell aufgegriffen und weiterentwickelt. Die Periode von 1960 bis in die Mitte der 1980er Jahre markiert eine Zeit intensiver Forschungsarbeit in der amerikanischen Industrie. Eine Reihe von Codes und Vorschriften zur Bewertung der Sicherheit und Zuverlaessigkeit gefaehrdeter Strukturen hat ihren Ursprung in dieser Zeit. Der vorliegende Aufsatz thematisiert die Anwendung bruchmechanischer Methoden in der Industrie der USA anhand historischer Aspekte, des heute verfuegbaren Instrumentariums der Bauteilbewertung und der gaengigen Praxis bei der
Trends and predictors of folic acid awareness and periconceptional use in pregnant women
de Jong-van den Berg, LTW; Hernandez-Diaz, S; Werler, MM; Louik, C; Mitchell, AA
Objective: The purpose of this study was to describe recent trends in folic acid awareness and use in the periconceptional period among pregnant women in relation to maternal sociodemographic and other relevant factors. Study design: From 1988 to 2002, 16,555 women from the Slone Epidemiology Center
DEFF Research Database (Denmark)
Lauritzen, J B; Lund, B
1993-01-01
In a follow-up study during 1976-1984, the risk of a subsequent hip fracture was investigated in women aged 60-99 years, hospitalized for the following fractures: lumbar spine (n 70), olecranon (n 52), knee (n 129) and ankle (n 200). Follow-up ranged from 0 to 9 years. Observation time of the 4...... different fractures were 241, 180, 469, and 779, person-years, respectively. In women aged 60-79 years with one of the following fractures the relative risk of a subsequent hip fracture was increased by 4.8 (lumbar spine), 4.1 (olecranon), 3.5 (knee) and 1.5 (ankle). The relative risk of hip fracture showed...... a tendency to level off 3 years after the primary fracture....
[Epidemiology of gunshot wounds at Ciudad Juárez, Chihuahua General Hospital].
Moye-Elizalde, G A; Ruiz-Martínez, F; Suarez-Santamaría, J J; Ruiz-Ramírez, M; Reyes-Gallardo, A; Díaz-Apodaca, B A
2013-01-01
Since 2007, Ciudad Juárez, Chihuahua has been considered as one of the most violent cities in the world. The General Hospital in this city is the main facility where patients with gunshot wounds are taken. The increased number of admissions of patients with these injuries to many hospitals in the country deserves special attention, as it has an impact on hospital resources and management protocols. To disseminate the epidemiology of fractures caused by gunshot wounds and the hospital care of these patients. A retrospective, observational cohort study was conducted of patients admitted to the Traumatology and Orthopedics Service, Cd. Juárez General Hospital, in Chihuahua, Mexico, from January 2008 to December 2010. All of them sustained fractures resulting from gunshot wounds. A total of 1281 patients with a diagnosis of gunshot wounds were admitted to the hospital; 402 of them were included in this study with 559 fractures; 329 were males and 73 females. Of the 559 fractures, 257 involved the upper limb, 294 the lower limb, and 8 the pelvis. Gunshot wounds-related fractures were classified according to the Gustilo classification. Seventy-nine patients had grade I fractures, 302 grade III, and 21 patients had both grades. Conservative treatment was used in 44.3% of fractures and osteosynthesis in 55%. One patient underwent amputation upon admission. The most widely used osteosynthesis methods were external fixator (37%), straight plates (21%) and intramedullary nail (17%). Five patients (1.3%) underwent amputation: two with femur fracture and 3 with humeral fracture. There were 27 deep infections (6%); one of them resulted in late amputation of the pelvic limb. The most common associated injuries included: chest injuries in 20 patients and abdominal injuries in 17. The range of hospital stay was 1-18 days, with a mean stay of 11 days. The overall mortality rate considering the total number of patients admitted (1,281) was 99 patients (7.72%). From 2006 to 2010 the
J.H. Wolleswinkel-van den Bosch (Judith); C.W.N. Looman (Caspar); F.W.A. van Poppel (Frans); J.P. Mackenbach (Johan)
1997-01-01
textabstractBACKGROUND: The objective of this study is to produce a detailed yet robust description of the epidemiologic transition in The Netherlands. METHODS: National mortality data on sex, age, cause of death and calendar year (1875-1992) were extracted from
Spatial and temporal trends in alcohol consumption in Belgian cities: A wastewater-based approach.
Boogaerts, Tim; Covaci, Adrian; Kinyua, Juliet; Neels, Hugo; van Nuijs, Alexander L N
2016-03-01
In recent years, scientific evidence has emerged that wastewater-based epidemiology can deliver complementary information concerning the use of different substances of abuse. In this study, the potential of wastewater-based epidemiology in monitoring spatial and temporal trends in alcohol consumption in different populations in Belgium has been examined. Concentrations of ethyl sulphate, a minor Phase-II metabolite of ethanol, in 163 influent wastewater samples from eight wastewater treatment plants in Belgium in the period 2013-2015 were measured with liquid chromatography coupled to tandem mass spectrometry and used to estimate alcohol consumption. The highest levels of alcohol consumption were detected in the metropoles Antwerp and Brussels compared to smaller villages. Annual variations were detected, with a higher alcohol consumption measured in 2013 compared with 2014. The weekly pattern showed a clear week and weekend difference in alcohol use, with intermediate levels on Monday and Friday. The results were extrapolated and a use of 5.6L pure alcohol per year per inhabitant aged 15+ has been estimated in Belgium. The comparison with available information on drinking habits of the Belgian population further demonstrated the usefulness of the wastewater-based epidemiology approach. This is the largest wastewater-based epidemiology study monitoring alcohol consumption to date, demonstrating that objective and quick information on spatio-temporal trends in alcohol consumption on a local and (inter)national scale can be obtained. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Participatory epidemiology: the contribution of participatory research to epidemiology
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Mario Bach
2017-02-01
Full Text Available Abstract Background Epidemiology has contributed in many ways to identifying various risk factors for disease and to promoting population health. However, there is a continuing debate about the ability of epidemiology not only to describe, but also to provide results which can be better translated into public health practice. It has been proposed that participatory research approaches be applied to epidemiology as a way to bridge this gap between description and action. A systematic account of what constitutes participatory epidemiology practice has, however, been lacking. Methods A scoping review was carried out focused on the question of what constitutes participatory approaches to epidemiology for the purpose of demonstrating their potential for advancing epidemiologic research. Relevant databases were searched, including both the published and non-published (grey literature. The 102 identified sources were analyzed in terms of comparing common epidemiologic approaches to participatory counterparts regarding central aspects of the research process. Exemplary studies applying participatory approaches were examined more closely. Results A highly diverse, interdisciplinary body of literature was synthesized, resulting in a framework comprised of seven aspects of the research process: research goal, research question, population, context, data synthesis, research management, and dissemination of findings. The framework specifies how participatory approaches not only differ from, but also how they can enhance common approaches in epidemiology. Finally, recommendations for the further development of participatory approaches are given. These include: enhancing data collection, data analysis, and data validation; advancing capacity building for research at the local level; and developing data synthesis. Conclusion The proposed framework provides a basis for systematically developing the emergent science of participatory epidemiology.
Trends in the investigation of social determinants of health: selected themes and methods
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Roger Keller Celeste
2011-01-01
Full Text Available We analyze bibliometric trends of topics relevant to the epidemiologic research of social determinants of health. A search of the PubMed database, covering the period 1985-2007, was performed for the topics: socioeconomic factors, sex, race/ethnicity, discrimination/prejudice, social capital/support, lifecourse, income inequality, stress, behavioral research, contextual effects, residential segregation, multilevel modeling, regression based indices to measure inequalities, and structural equation modeling/causal diagrams/path analysis. The absolute, but not the relative, frequency of publications increased for all themes. Total publications in PubMed increased 2.3 times, while the subsets of epidemiology/public health and social epidemiologic themes/methods increased by factors of 5.3 and 5.2, respectively. Only multilevel and contextual analyses had a growth over and above that observed for epidemiology/public health. We conclude that there is clearly room for wider use of established techniques, and for new methods to emerge when they satisfy theoretical needs.
Epidemiology of Dermatophytoses in Crete, Greece.
Maraki, Sofia; Mavromanolaki, Viktoria Eirini
2016-01-01
Dermatophytoses are among the most frequently diagnosed skin infections worldwide. However, the distribution of pathogenic species and the predominating anatomical sites of infection vary with geographical location and change over time. The aim of this study was to determine the epidemiological and aetiological factors of dermatophytoses in Crete, Greece over the last 5-year period (2011-2015) and their incidence in relation to the gender and the age of the patients. We compared our findings with those previously reported from the same area and from other parts of the world. A total of 2,910 clinical specimens (skin scrapings, nail clippings, and hair specimens) obtained from 2,751 patients with signs of dermatomycoses were examined using direct microscopy and culture. Overall, 294 specimens (10.1%) were proved mycologically positive for dermatophytes. The age of the patients ranged from 2 to 86 years (mean age, 37 years). Tinea corporis was the predominant clinical type of infection, followed by tinea unguium, tinea pedis, tinea capitis, tinea faciei, tinea cruris and tinea manuum. Among dermatophytes, eight species were isolated: Microsporum canis (35.8%), Trichophyton rubrum (35.1%), Trichophyton mentagrophytes (23.3%), Epidermophyton floccosum (2.5%), Microsporum gypseum (1.8%), Trichophyton violaceum (0.7%), Trichophyton verrucosum (0.4%), and Trichophyton tonsurans (0.4%). In our area, the most common dermatophyte was M. canis followed by T. rubrum. Increased migration, mass tourism, and climate changes will contribute to further changes in the epidemiology of dermatophytoses in our area. Continuing studies are necessary for determining the new epidemiological trends and to implement the appropriate control measures.
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Burningham Zachary
2012-10-01
Full Text Available Abstract Sarcomas account for over 20% of all pediatric solid malignant cancers and less than 1% of all adult solid malignant cancers. The vast majority of diagnosed sarcomas will be soft tissue sarcomas, while malignant bone tumors make up just over 10% of sarcomas. The risks for sarcoma are not well-understood. We evaluated the existing literature on the epidemiology and etiology of sarcoma. Risks for sarcoma development can be divided into environmental exposures, genetic susceptibility, and an interaction between the two. HIV-positive individuals are at an increased risk for Kaposi’s sarcoma, even though HHV8 is the causative virus. Radiation exposure from radiotherapy has been strongly associated with secondary sarcoma development in certain cancer patients. In fact, the risk of malignant bone tumors increases as the cumulative dose of radiation to the bone increases (p for trend
The dose dependence of fracture toughness Of F82H steel
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Sokolov, M. [Oak Ridge National Laboratory, Materials Science and Technology Div., TN (United States); Tanigawa, H.; Ando, M.; Shiba, K. [Japan Atomic Energy Agency, Tokai-mura, Naga-gun, Ibaraki-ken (Japan); Odette, G. [UCSB, Santa-Barbara, Dept. of Mechanical Engineering UCSB, AK (United States); Hirose, T. [Blanket Engineering Group, Japan Atomic Energy Agency, Naka, Ibaraki (Japan); Klueh, R.L. [Oak Ridge Noational Laboratory, TN (United States)
2007-07-01
Full text of publication follows: The ferritic-martensitic steel F82H is a primary candidate low-activation material for fusion applications, and it is being investigated in the joint U.S. Department of Energy-Japan Atomic Energy Agency. As a part of this program, several capsules containing fracture toughness specimens were irradiated in High-Flux Isotope Reactor. These specimens were irradiated to a wide range of doses from 3.5 to 25 dpa. The range of irradiation temperature was from 250 deg. C to 500 deg. C. This paper summarizes the changes in fracture toughness transition temperature and decrease in the ductile fracture toughness as result of various irradiation conditions. It is shown that in the 3.5 to 25 dpa dose range, irradiation temperature plays the key rote in determination of the shift of the transition temperature. Highest embrittlement observed at 250 deg.C and the lowest at 500 deg. C. At a given irradiation temperature, shift of the fracture toughness transition temperature increases slightly with dose within the studied dose range. It appears that main gain in transition temperature shift occurred during initial {approx}5 dpa of irradiation. The present data are compared to the available published trends. (authors)
Al Kharusi, Laiyyan M.
Sequence stratigraphy relates changes in vertical and lateral facies distribution to relative changes in sea level. These relative changes in carbonates effect early diagenesis, types of pores, cementation and dissolution patterns. As a result, in carbonates, relative changes in sea level significantly impact the lithology, porosity, diagenesis, bed and bounding surfaces which are all factors that control fracture patterns. This study explores these relationships by integrating stratigraphy with fracture analysis and petrophysical properties. A special focus is given to the relationship between mechanical boundaries and sequence stratigraphic boundaries in three different settings: (1) Mississippian strata in Sheep Mountain Anticline, Wyoming, (2) Mississippian limestones in St. Louis, Missouri, and (3) Pennsylvanian limestones intermixed with elastics in the Paradox Basin, Utah. The analysis of these sections demonstrate that a fracture hierarchy exists in relation to the sequence stratigraphic hierarchy. The majority of fractures (80%) terminate at genetic unit boundaries or the internal flooding surface that separates the transgressive from regressive hemicycle. Fractures (20%) that do not terminate at genetic unit boundaries or their internal flooding surface terminate at lower order sequence stratigraphic boundaries or their internal flooding surfaces. Secondly, the fracture spacing relates well to bed thickness in mechanical units no greater than 0.5m in thickness but with increasing bed thickness a scatter from the linear trend is observed. In the Paradox Basin the influence of strain on fracture density is illustrated by two sections measured in different strain regimes. The folded strata at Raplee Anticline has higher fracture densities than the flat-lying beds at the Honaker Trail. Cemented low porosity rocks in the Paradox Basin do not show a correlation between fracture pattern and porosity. However velocity and rock stiffness moduli's display a slight
Grieshober, Jason A; Mehran, Nima; Photopolous, Christos; Fishman, Matthew; Lombardo, Stephen J; Kharrazi, F Daniel
2018-05-01
Vitamin D is believed to play a role in influencing fracture risk and athletic performance. Insufficiency of vitamin D affects an estimated three-quarters of the United States population. Hypovitaminosis D has also been demonstrated to be quite common among professional basketball players in the National Basketball Association (NBA). To determine whether a relationship exists between vitamin D levels and fracture risk and athletic performance (as measured by NBA draft status) among elite basketball players. Descriptive epidemiology study. Data were obtained from the NBA regarding combine participants from 2009 through 2013. This information included vitamin D level, demographic information, fracture history, and NBA draft status. The data were analyzed to determine associations between vitamin D level and fracture risk and NBA draft status. Vitamin D levels were measured for 279 players at the NBA Combine from 2009 through 2013. Vitamin D deficiency (30 ng/mL) were present in only 26.5%. A total of 118 players had a history of at least 1 fracture. Vitamin D level was not predictive of fracture risk. Contrary to our hypothesis, players with a history of stress fracture had a significantly greater mean vitamin D level than those without such history (30.7 vs 25.1 ng/mL; P = .04). A majority (79.6%) of participants were selected in the NBA draft. Players with deficient vitamin D levels had a significantly lower rate of being drafted into the NBA ( P = .027). The NBA draft rate was found to increase with increasing levels of vitamin D ( P = .007). Hypovitaminosis D is quite common among NBA Combine participants, affecting 73.5%. While no significant relationship was found between vitamin D level and fracture history, patients with a history of stress fracture had significantly greater mean vitamin D levels. Additionally, participants with greater vitamin D levels were more likely to be drafted into the NBA. This information supports the potential role of vitamin D in
High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture.
Lee, Bong-Gun; Sung, Yoon-Kyoung; Kim, Dam; Choi, Yun Young; Kim, Hunchul; Kim, Yeesuk
2017-02-01
The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture. One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors. Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57). The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Rajasekhar Gali
2015-01-01
Full Text Available Background and Objective: The incidence of maxillofacial trauma is increasing at a very fast pace in developing countries like India and poses a major health burden. Hence, the epidemiological data of maxillofacial trauma during a 6 year period, was analyzed to study the characteristics, factors predisposing, and aid in advocating strict guidelines to prevent the same. Materials and Methods: Data related to 638 cases with maxillofacial trauma, from January 2008 to December 2014 were reviewed retrospectively and the data regarding gender, age, etiology, anatomic location of fracture, alcohol consumption, associated head and other injuries, modality of treatment rendered and associated complications were analyzed with descriptive statistics. Results: A total of 638 patients presenting with 869 maxillofacial fractures were analyzed. Most of them [344 (53.9%] were young adults aged 18-40, whereas, 123 (19.2% were 11 to 17 years, and 97(15.2% adults. Men (79.4% were more affected than women. Road traffic accidents remain the main etiology causing fractures in 470 (73.6%, whereas 397 (62.2% had history of consumption of alcohol. Those with alcohol intoxication had multiple injuries. Mandible was more frequently involved with 360 (41.4% fractures, and condyle being the most common site. A total of 374 (58.6% underwent open reduction with internal fixation under general anesthesia. Prevalence of other injuries was noted in 207 (32.4% and complications of fracture treatment in 41(6.4% cases. Conclusion: Road traffic accidents under alcohol influence were most commonly associated with comminuted facial fractures with head injuries, frequently leading to death. Mandible was the most commonly fractured facial bone followed by zygoma
Mnif, H; Koubaa, M; Zrig, M; Trabelsi, R; Abid, A
2009-11-01
Trochanteric fractures are a major source of mortality, morbidity and functional impairment in the elderly. Morbidity is closely related to the degree of instability and comminution and is substantially influenced by the quality of reduction and internal fixation. Advanced age and associated co-morbidities are two decisive factors of mortality secondary to trochanteric fracture. This prospective study examined the epidemiological profile of trochanteric fractures and assessed mortality and morbidity with the aim of establishing management guidelines and improving prevention strategies. One hundred patients were included; 60% were male. Mean age was 76 years (range, 60-96 yrs). One, or more than one, co-morbidities were present in 68% of cases. The fractures were caused by a simple fall in 90% of cases. Fractures were classified according to the criteria of Ramadier and the ones of Ender. Sixty-five percent of these fractures were unstable. A dynamic hip screw was systematically used as the standard means of internal fixation. Anatomic and functional results were analyzed in 82 patients (18 had died within the first year following fracture occurrence). Mean follow-up period was 24 months (range, 12-36 months). Bone healing was achieved in 96% of cases. There were numerous postoperative complications (four cases of thromboembolism, fourteen immobility-related complications, two infections, six secondary displacement combined to loss of fixation, four non-unions, and nine malunions). At 2 years follow-up, 28 patients had died. Mortality was strongly correlated with older age (over 90 years), associated co-morbidity and fracture instability. Good functional outcomes (72%) correlated with younger age (60-74 years), fracture stability, adequate reduction and internal fixation. In stable trochanteric fractures, osteosynthesis by dynamic screw-plate is more effective than alternative techniques (blade-plate, nail-plate, Ender nail or even trochanteric nail). In unstable
External fixation of tibial pilon fractures and fracture healing.
Ristiniemi, Jukka
2007-06-01
Distal tibial fractures are rare and difficult to treat because the bones are subcutaneous. External fixation is commonly used, but the method often results in delayed union. The aim of the present study was to find out the factors that affect fracture union in tibial pilon fractures. For this purpose, prospective data collection of tibial pilon fractures was carried out in 1998-2004, resulting in 159 fractures, of which 83 were treated with external fixation. Additionally, 23 open tibial fractures with significant > 3 cm bone defect that were treated with a staged method in 2000-2004 were retrospectively evaluated. The specific questions to be answered were: What are the risk factors for delayed union associated with two-ring hybrid external fixation? Does human recombinant BMP-7 accelerate healing? What is the role of temporary ankle-spanning external fixation? What is the healing potential of distal tibial bone loss treated with a staged method using antibiotic beads and subsequent autogenous cancellous grafting compared to other locations of the tibia? The following risk factors for delayed healing after external fixation were identified: post-reduction fracture gap of >3 mm and fixation of the associated fibula fracture. Fracture displacement could be better controlled with initial temporary external fixation than with early definitive fixation, but it had no significant effect on healing time, functional outcome or complication rate. Osteoinduction with rhBMP-7 was found to accelerate fracture healing and to shorten the sick leave. A staged method using antibiotic beads and subsequent autogenous cancellous grafting proved to be effective in the treatment of tibial bone loss. Healing potential of the bone loss in distal tibia was at least equally good as in other locations of the tibia.
A vast increase in the use of CT scans for investigating occult hip fractures
International Nuclear Information System (INIS)
Jordan, Robert; Dickenson, Edward; Westacott, Daniel; Baraza, Njalalle; Srinivasan, Kuntrapka
2013-01-01
Background: Early diagnosis in neck of femur fractures has been shown to improve outcome. The National Institute for Clinical Excellence recommends if an occult hip fracture is suspected then an MRI should be performed and if not available within 24 h a CT should be considered. At our centre, emergency MRI is rarely available and so CT is commonly used. Objectives: Our study aims to analyse the trends in CT use over a five year period for the diagnosis of neck of femur fractures. Methods: Both the number of patients with a hip fracture and those undergoing a CT hip to diagnose an occult injury were identified across two district general hospitals between 2006–2007 and 2010–2011. The time from initial radiograph to CT and initial radiograph to operation were calculated. Results: In 2006–2007, of 547 hip fractures, 20 CT hips were performed and 6 reported as a fractured neck of femur (30%). In 2010–2011, of 499 hip fractures, 239 CT hips were performed and 65 fractures were recognised (27%). The mean time from radiograph until CT scan was 2.0 days in 2007 and 3.2 days in 2011, which was a statistically significant difference (p < 0.001). For those diagnosed using a CT scan the mean time from admission X-ray to surgery was 1.2 days in 2007 and 3.6 days in 2011. Conclusion: Clinicians are becoming increasingly reliant on CT for the diagnosis of hip fractures with our data suggesting further imaging is one factor that can delay time to diagnosis and theatre
A vast increase in the use of CT scans for investigating occult hip fractures
Energy Technology Data Exchange (ETDEWEB)
Jordan, Robert, E-mail: Robert.jordan@doctors.org.uk; Dickenson, Edward, E-mail: edwarddickenson@doctors.org.uk; Westacott, Daniel, E-mail: dan_westacott@hotmail.com; Baraza, Njalalle, E-mail: njaleb@Doctors.Org.Uk; Srinivasan, Kuntrapka, E-mail: bijusri@Yahoo.Co.Uk
2013-08-15
Background: Early diagnosis in neck of femur fractures has been shown to improve outcome. The National Institute for Clinical Excellence recommends if an occult hip fracture is suspected then an MRI should be performed and if not available within 24 h a CT should be considered. At our centre, emergency MRI is rarely available and so CT is commonly used. Objectives: Our study aims to analyse the trends in CT use over a five year period for the diagnosis of neck of femur fractures. Methods: Both the number of patients with a hip fracture and those undergoing a CT hip to diagnose an occult injury were identified across two district general hospitals between 2006–2007 and 2010–2011. The time from initial radiograph to CT and initial radiograph to operation were calculated. Results: In 2006–2007, of 547 hip fractures, 20 CT hips were performed and 6 reported as a fractured neck of femur (30%). In 2010–2011, of 499 hip fractures, 239 CT hips were performed and 65 fractures were recognised (27%). The mean time from radiograph until CT scan was 2.0 days in 2007 and 3.2 days in 2011, which was a statistically significant difference (p < 0.001). For those diagnosed using a CT scan the mean time from admission X-ray to surgery was 1.2 days in 2007 and 3.6 days in 2011. Conclusion: Clinicians are becoming increasingly reliant on CT for the diagnosis of hip fractures with our data suggesting further imaging is one factor that can delay time to diagnosis and theatre.
Modern Trends in the Surgical Management of Paget's Disease.
Wong, Stephanie M; Freedman, Rachel A; Stamell, Emily; Sagara, Yasuaki; Brock, Jane E; Desantis, Stephen D; Golshan, Mehra
2015-10-01
We examined the incidence and modern national trends in the management of Paget's disease (PD), including the use of breast-conserving surgery (BCS), mastectomy, axillary surgery, and receipt of radiotherapy. Using surveillance, epidemiology and end results (SEER) data, we identified 2631 patients diagnosed with PD during 2000-2011. Of these patients, 185 (7%) had PD of the nipple only, 953 (36.2%) had PD with ductal carcinoma in situ (PD-DCIS), and 1493 (56.7%) had PD with invasive ductal carcinoma (PD-IDC). Trends in age-adjusted incidence, primary surgery, sentinel lymph node biopsy (SLNB), and axillary lymph node dissection were examined. Multivariable logistic regression was used to evaluate factors associated with receipt of BCS and radiotherapy. A decrease in the age-adjusted incidence of PD occurred from 2000 to 2011 (-4.3% per year, p modern trends in local therapy suggest that BCS, SLNB, and adjuvant radiotherapy remain underutilized.
Studer, Patrick; Suhm, Norbert; Wang, Qing; Rosenthal, Rachel; Saleh, Hatem Al-Fadel; Jakob, Marcel
2015-12-01
of this fragment during internal fixation of pertrochanteric hip fractures should be aimed for despite the inability of current cephalomedullary implants to do so. III prognostic and epidemiological study. Copyright © 2015 Elsevier Ltd. All rights reserved.
Radiographic anatomy of the proximal femur: femoral neck fracture vs. transtrochanteric fracture
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Ana Lecia Carneiro Leão de Araújo Lima
Full Text Available ABSTRACT OBJECTIVE: To evaluate the correlation between radiographic parameters of the proximal femur with femoral neck fractures or transtrochanteric fractures. METHODS: Cervicodiaphyseal angle (CDA, femoral neck width (FNW, hip axis length (HAL, and acetabular tear drop distance (ATD were analyzed in 30 pelvis anteroposterior view X-rays of patients with femoral neck fractures (n = 15 and transtrochanteric fractures (n = 15. The analysis was performed by comparing the results of the X-rays with femoral neck fractures and with transtrochanteric fractures. RESULTS: No statistically significant differences between samples were observed. CONCLUSION: There was no correlation between radiographic parameters evaluated and specific occurrence of femoral neck fractures or transtrochanteric fractures.
International Nuclear Information System (INIS)
Miyakawa, Kimio; Tanaka, Yasuharu
1996-01-01
To contribute good understanding of geo-hydrogeological structure in and around the Koongarra uranium deposit, the borehole TV logging and the three dimensional groundwater flow analysis were conducted. The results of the borehole TV measurement showed directional trends in the schistosity represented folds which were the most characteristic structure in the site scale. This fold structure was in accord with the directional trends in fracture and fracture frequency, and the axes of the interference test drawdown. The three dimensional groundwater flow analysis was taken into account the hydraulic anisotropy which derived from the assumption that the direction normal to schistosity agree with minimum hydraulic conductivity. The result of analysis showed that directions of ground water flow agreed with drawdown axes, and the conceptual model of hydrogeological structure governed the site scale fold was verified. (author)
Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people.
Nakamura, K; Takahashi, S; Oyama, M; Oshiki, R; Kobayashi, R; Saito, T; Yoshizawa, Y; Tsuchiya, Y
2010-08-01
This 1-year cohort study of nursing home residents revealed that historical fractures of upper limbs or nonhip lower limbs were associated with hip fracture (hazard ratio = 2.14), independent of activities of daily living (ADL), mobility, dementia, weight, and type of nursing home. Prior nonhip fractures are useful for predicting of hip fracture in institutional settings. The aim of this study was to evaluate the utility of fracture history for the prediction of hip fracture in nursing home residents. This was a cohort study with a 1-year follow-up. Subjects were 8,905 residents of nursing homes in Niigata, Japan (mean age, 84.3 years). Fracture histories were obtained from nursing home medical records. ADL levels were assessed by caregivers. Hip fracture diagnosis was based on hospital medical records. Subjects had fracture histories of upper limbs (5.0%), hip (14.0%), and nonhip lower limbs (4.6%). Among historical single fractures, only prior nonhip lower limbs significantly predicted subsequent fracture (adjusted hazard ratio, 2.43; 95% confidence interval (CI), 1.30-4.57). The stepwise method selected the best model, in which a combined historical fracture at upper limbs or nonhip lower limbs (adjusted hazard ratio, 2.14; 95% CI, 1.30-3.52), dependence, ADL levels, mobility, dementia, weight, and type of nursing home independently predicted subsequent hip fracture. A fracture history at upper or nonhip lower limbs, in combination with other known risk factors, is useful for the prediction of future hip fracture in institutional settings.
Analysis of bone healing in flail chest injury: do we need to fix both fractures per rib?
Marasco, Silvana; Liew, Susan; Edwards, Elton; Varma, Dinesh; Summerhayes, Robyn
2014-09-01
Surgical rib fixation (SRF) for severe rib fracture injuries is generating increasing interest in the medical literature. It is well documented that poorly healed fractured ribs can lead to chronic pain, disability, and deformity. An unanswered question in SRF for flail chest injury is whether it is sufficient to fix one fracture per rib, on successive ribs, thus converting a flail chest injury into simple fractured ribs, or whether both ends of the floating segment of the chest wall should be fixed. This study aimed to analyze SRF in flail chest injury, assessing 3-month outcomes for nonfixed fractured rib ends in the flail segment. This is a retrospective review (2005-2013) of 60 consecutive patients who underwent SRF for flail chest injury admitted to the Alfred Hospital, Melbourne, Australia. Imaging by three-dimensional computed tomography (3D CT) of the chest at admission was compared with follow-up 3D CT at 3 months after injury. The 3-month CT scans were assessed for degree of healing and presence of residual deformity at the fracture fixation site. Follow-up CT was performed in 52 of the 60 patients. At 3 months after surgery, 86.5% of the patients had at least partial healing with good alignment and adequate fracture stabilization. Hardware failure was noted in five patients (9.6%) and occurred with the absorbable prostheses only. Six patients who had preoperative overlapping or displacement showed no improvement in deformity despite fixing the lateral fractures. Callus formation and bony bridging between adjacent ribs was often noted in the rib fractures not fixed (28 of 52 patients, 54%) This retrospective review of 3D CT chest at 3 months after rib fixation indicates that a philosophy of fixing only one fracture per rib in a flail segment does not avoid deformity and displacement, particularly in posterior rib fractures. Therapeutic study, level V; epidemiologic study, level V.
Time trends and epidemiological patterns of perinatal lamb mortality in Norway.
Holmøy, Ingrid Hunter; Waage, Steinar
2015-09-30
Perinatal mortality is a major cause of loss in the sheep industry. Our aim was to explore time trends in crude population stillbirth and neonatal mortality rates in Norway. We used data on 6,435,715 lambs from flocks enrolled in the Norwegian Sheep Recording System (NSRS) from 2000 through 2010 for descriptive analysis of trends. Longitudinal patterns of mortality rates were compared for lambs within different levels of variables suspected to be associated with perinatal loss. There was an approximately linear increase in the annual proportion of stillborn lambs during the study period, from 3.3 % in 2000 to 4.7 % in 2010. In the same time period, average litter size of ewes in NSRS flocks increased from 2.00 to 2.19. However, a steady rise in stillbirth rate was observed within each litter size group, suggesting a gradually increasing impact on stillbirth risk of other, yet unidentified, factors. Average flock size increased during the study period. The highest stillbirth rates were found in the largest and smallest flocks. Early neonatal mortality rates (0-5 days of life) varied from year to year (minimum 2.2 %, maximum 3.2 %) and were invariably higher among triplets and quadruplets than among singletons and twins. Annual fluctuations were parallel within the various litter sizes. A significant overall decreasing trend was present within all litter sizes with the exception of singletons. Weather data for the prime lambing months (April and May) 2000-2010 indicated a relationship between low temperatures and high neonatal mortality rates. At the flock level, there was a significant positive correlation between stillbirths and early neonatal mortality rates (r = 0.13), between stillbirth rates in two consecutive years (r = 0.43) and between early neonatal mortality rates in two consecutive years (r = 0.40). The substantial increase in ovine stillbirth rate in recent years in Norway was to some extent related to a corresponding increase in the
Peter, Raphael Simon; Brehme, Torben; Völzke, Henry; Muche, Rainer; Rothenbacher, Dietrich; Büchele, Gisela
2016-06-01
Knowledge of epidemiologic research topics as well as trends is useful for scientific societies, researchers and funding agencies. In recent years researchers recognized the usefulness of keyword network analysis for visualizing and analyzing scientific research topics. Therefore, we applied keyword network analysis to present an overview of current epidemiologic research topics in Germany. Accepted submissions to the 9th annual congress of the German Society for Epidemiology (DGEpi) in 2014 were used as data source. Submitters had to choose one of 19 subject areas, and were ask to provide a title, structured abstract, names of authors along with their affiliations, and a list of freely selectable keywords. Keywords had been provided for 262 (82 %) submissions, 1030 keywords in total. Overall the most common keywords were: "migration" (18 times), "prevention" (15 times), followed by "children", "cohort study", "physical activity", and "secondary data analysis" (11 times each). Some keywords showed a certain concentration under one specific subject area, e.g. "migration" with 8 of 18 in social epidemiology or "breast cancer" with 4 of 7 in cancer epidemiology. While others like "physical activity" were equally distributed over multiple subject areas (cardiovascular & metabolic diseases, ageing, methods, paediatrics, prevention & health service research). This keyword network analysis demonstrated the high diversity of epidemiologic research topics with a large number of distinct keywords as presented at the annual conference of the DGEpi.
Pickrell, Brent B; Serebrakian, Arman T; Maricevich, Renata S
2017-05-01
Mandible fractures account for a significant portion of maxillofacial injuries and the evaluation, diagnosis, and management of these fractures remain challenging despite improved imaging technology and fixation techniques. Understanding appropriate surgical management can prevent complications such as malocclusion, pain, and revision procedures. Depending on the type and location of the fractures, various open and closed surgical reduction techniques can be utilized. In this article, the authors review the diagnostic evaluation, treatment options, and common complications of mandible fractures. Special considerations are described for pediatric and atrophic mandibles.
Epidemiologic analysis and evaluation of complications in 1266 cases with maxillofacial trauma
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Cenk Demirdover
2018-01-01
Full Text Available Introduction: Patients with maxillofacial trauma represent a major group of patients in plastic surgery practice. These traumas are often caused by in-car and noncar road accidents and can result in permanent damages. This study aims at providing an epidemiologic analysis of such cases together with their diagnostic procedures, treatment methods, and postoperative complications. Materials and Methods: A total of 1266 maxillofacial trauma cases that were operated on between 2003 and 2017 were studied, and analyzed for fractured bones, etiology, diagnosis and treatment principles, and complications. Results: The major etiologic factor causing maxillofacial trauma in our study is noncar road accidents (25.5%. Mandible fractures were seen to be the most common type of bone fracture (52.2%. Together with physical examination, computerized tomography and orthopantomography are the diagnostic procedures we effectively use in our clinic. Rigid and semi-rigid fixation with plate and screws are the most frequently used treatment methods, and complication rates are seen to be lower (by 6.6% than those reported in the literature. Conclusion: Careful and meticulous processes, as well as effective follow-up of the patient are required to achieve optimal esthetic and functional results in maxillofacial trauma cases. Such approach can help to reduce the possibility of complications and allow for their early identification, hence early intervention.
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O.A. Kauts
2010-03-01
Full Text Available The article concerns the current status of the topical problem in traumatology - treatment of juxta-articular fractures of proximal part of a femur and their effect. Analytical review of domestic and foreign literature has allowed to determine the basic problems in treatment of the particular group of patients and to define long-term trends of osteosynthesis of juxta-articular fractures of proximal part of a femur at the present stage
Stanek, F.; Jechumtalova, Z.; Eisner, L.
2017-12-01
We present a geomechanical model explaining microseismicity induced by hydraulic fracturing in shales developed from many datasets acquired with two most common types of seismic monitoring arrays, surface and dual-borehole arrays. The geomechanical model explains the observed source mechanisms and locations of induced events from two stimulated shale reservoirs. We observe shear dip-slip source mechanisms with nodal planes aligned with location trends. We show that such seismicity can be explained as a shearing along bedding planes caused by aseismic opening of vertical hydraulic fractures. The source mechanism inversion was applied only to selected high-quality events with sufficient signal-to-noise ratio. We inverted P- and P- and S-wave arrival amplitudes to full-moment tensor and decomposed it to shear, volumetric and compensated linear vector dipole components. We also tested an effect of noise presented in the data to evaluate reliability of non-shear components. The observed seismicity from both surface and downhole monitoring of shale stimulations is very similar. The locations of induced microseismic events are limited to narrow depth intervals and propagate along distinct trend(s) showing fracture propagation in direction of maximum horizontal stress from injection well(s). The source mechanisms have a small non-shear component which can be partly explained as an effect of noise in the data, i.e. events represent shearing on faults. We observe predominantly dip-slip events with a strike of the steeper (almost vertical) nodal plane parallel to the fracture propagation. Therefore the other possible nodal plane is almost horizontal. The rake angles of the observed mechanisms divide these dip-slips into two groups with opposite polarities. It means that we observe opposite movements on the nearly identically oriented faults. Realizing a typical structural weakness of shale in horizontal planes, we interpret observed microseismicity as a result of shearing
Recognizing and reporting vertebral fractures: reducing the risk of future osteoporotic fractures
International Nuclear Information System (INIS)
Lentle, B.C.; Brown, J.P.; Khan, A.
2007-01-01
Given the increasing evidence that vertebral fractures are underdiagnosed and not acted on, Osteoporosis Canada and the Canadian Association of Radiologists initiated a project to develop and publish a set of recommendations to promote and facilitate the diagnosis and reporting of vertebral fractures. The identification of spinal fractures is not uniform. More than 65% of vertebral fractures cause no symptoms. It is also apparent that vertebral fractures are inadequately recognized when the opportunity for diagnosis arises fortuitously. It is to patients' benefit that radiologists report vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. The present recommendations can help to close the gap in care in recognizing and treating vertebral fractures, to prevent future fractures and thus reduce the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to the health care system. Several studies indicate that a gap exists in regard to the diagnosis of vertebral fractures and the clinical response following such diagnosis. All recommendations presented here are based on consensus. These recommendations were developed by a multidisciplinary working group under the auspices of the Scientific Advisory Council of Osteoporosis Canada and the Canadian Association of Radiologists. Prevalent vertebral fractures have important clinical implications in terms of future fracture risk. Recognizing and reporting fractures incidental to radiologic examinations done for other reasons has the potential to reduce health care costs by initiating further steps in osteoporosis diagnosis and appropriate therapy. Physicians should be aware of the importance of vertebral fracture diagnosis in assessing future osteoporotic fracture risk. Vertebral fractures incidental to radiologic examinations done for other reasons should be identified and reported. Vertebral fractures
Prediction of fracture toughness K/sub Ic/ of steel from Charpy impact test results
Energy Technology Data Exchange (ETDEWEB)
Iwadate, Tadao; Tanaka, Yasuhiko; Takemata, Hiroyuki; Terashima, Shuhei
1986-08-01
This paper presents a method to predict the fracture toughness K/sub Ic/ and/or K/sub Id/ of steels using their Charpy impact test results and tensile properties. The fracture toughness, Charpy impact and tensile properties of 2 1/4 Cr-1Mo, ASTM A508 Cl.1, A508 Cl.2 A508 Cl.3 and A533 Gr.B Cl.1 steels were measured and analysed on the basis of the excess temperature (test temperature minus FATT) and Rolfe-Novak correlation. The relationship between K/sub Ic//K/sub Ic-us/ and the excess temperature, where K/sub Ic-us/ is the upper-shelf fracture toughness K/sub Ic/ predicted by Rolfe-Novak correlation, discloses that the K/sub Ic/ transition curves of several steels are representable by only one trend curve of K/sub Ic//K/sub Ic-us/ or K/sub Id//K/sub Id-us/ versus excess temperature relation. This curve is denoted as a ''master curve''. By using this curve, the fracture toughness of steel can be predicted using Charpy impact and tensile test results. By taking account of the scattering of both the fracture toughness and Charpy impact test results, the confidence limits of the master curve were also determined. Another approach to develop more general procedure of predicting the fracture toughness K/sub Ic/ is also discussed.
Trends in stroke hospitalisation rates and in-hospital mortality in Aragon, 1998-2010.
Giménez-Muñoz, A; Ara, J R; Abad Díez, J M; Campello Morer, I; Pérez Trullén, J M
2018-05-01
Despite the impact of cerebrovascular disease (CVD) on global health, its morbidity and time trends in Spain are not precisely known. The purpose of our study was to characterise the epidemiology and trends pertaining to stroke in Aragon over the period 1998-2010. We conducted a retrospective, descriptive study using the data of the Spanish health system's Minimum Data Set and included all stroke patients admitted to acute care hospitals in Aragon between 1 January 1998 and 31 December 2010. We present data globally and broken down by stroke subtype, sex, and age group. The number of cases increased by 13% whereas age- and sex-adjusted hospitalisation rates showed a significant decrease for all types of stroke (mean annual decrease of 1.6%). Men and women in younger age groups showed opposite trends in hospitalisation rates for ischaemic stroke. Case fatality rate at 28 days (17.9%) was higher in patients with intracerebral haemorrhage (35.8%) than in those with subarachnoid haemorrhage (26.2%) or ischaemic stroke (13%). CVD case fatality showed a mean annual decline of 2.8%, at the expense of the fatality rate of ischaemic stroke, and it was more pronounced in men than in women. Understanding stroke epidemiology and trends at the regional level will help establish an efficient monitoring system and design appropriate strategies for health planning. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Simulation of complex fracture networks influenced by natural fractures in shale gas reservoir
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Zhao Jinzhou
2014-10-01
Full Text Available When hydraulic fractures intersect with natural fractures, the geometry and complexity of a fracture network are determined by the initiation and propagation pattern which is affected by a number of factors. Based on the fracture mechanics, the criterion for initiation and propagation of a fracture was introduced to analyze the tendency of a propagating angle and factors affecting propagating pressure. On this basis, a mathematic model with a complex fracture network was established to investigate how the fracture network form changes with different parameters, including rock mechanics, in-situ stress distribution, fracture properties, and frac treatment parameters. The solving process of this model was accelerated by classifying the calculation nodes on the extending direction of the fracture by equal pressure gradients, and solving the geometrical parameters prior to the iteration fitting flow distribution. With the initiation and propagation criterion as the bases for the propagation of branch fractures, this method decreased the iteration times through eliminating the fitting of the fracture length in conventional 3D fracture simulation. The simulation results indicated that the formation with abundant natural fractures and smaller in-situ stress difference is sufficient conditions for fracture network development. If the pressure in the hydraulic fractures can be kept at a high level by temporary sealing or diversion, the branch fractures will propagate further with minor curvature radius, thus enlarging the reservoir stimulation area. The simulated shape of fracture network can be well matched with the field microseismic mapping in data point range and distribution density, validating the accuracy of this model.
Cretaceous joints in southeastern Canada: dating calcite-filled fractures
Schneider, David; Spalding, Jennifer; Gautheron, Cécile; Sarda, Philippe; Davis, Donald; Petts, Duane
2017-04-01
To resolve the timing of brittle tectonism is a challenge since the classical chronometers required for analyses are not often in equilibrium with the surrounding material or simply absent. In this study, we propose to couple LA-ICP-MS U-Pb and (U-Th)/He dating with geochemical proxies in vein calcite to tackle this dilemma. We examined intracratonic Middle Ordovician limestone bedrock that overlies Mesoproterozoic crystalline basement, which are cut by NE-trending fault zones that have historic M4-5 earthquakes along their trace. E-W to NE-SW vertical joint sets, the relatively youngest stress recorded in the bedrock, possess 1-7 mm thick calcite veins that seal fractures or coat fracture surfaces. The veins possess intragranular calcite that are lined with fine-grained calcite along the vein margin and can exhibit µm- to mm-scale offset (e.g. displaced fossil fragments in host rock). Calcite d18O and d13C values are analogous to the bulk composition of Middle to Late Ordovician limestones, and suggest vein formation from a source dominated by connate fluids. The calcite contain trails of fluid inclusions commonly along fractures, and 3He/4He analyses indicate a primitive, deep fluid signature (R/Ra: 0.5-2.7). Trace element geochemistry of the calcite is highly variable, generally following the elevated HREE and lower LREE of continental crust trends but individual crystals from a single vein may vary by three orders of magnitude. LA-ICP-MS geochemical traverse across veins show elevated concentrations along (sub)grain boundaries and the vein-host rock contact. Despite abundant helium concentrations, (U-Th)/He dating was unsuccessful yielding highly dispersed dates likely from excess helium derived from the fluid inclusions. However, LA-ICP-MS U-Pb dating on calcite separated from the veins yielded model ages of 110.7 ± 6.8 Ma (MSWD: 0.53; n: 16) to 81.4 ± 8.3 Ma (MSWD: 2.6; n: 17). Since all veins are from the same ENE-trend, we regressed all the calcite dates
Klop, C; van Staa, Indira; Cooper, C; Harvey, N C; de Vries, F
One-year mortality following a fracture was greater for men compared to women, varied markedly between regions in England with the lowest rates in the London region, and was higher among black women compared to white women. The excess in mortality did not change during the study period.
Numerical investigations of rib fracture failure models in different dynamic loading conditions.
Wang, Fang; Yang, Jikuang; Miller, Karol; Li, Guibing; Joldes, Grand R; Doyle, Barry; Wittek, Adam
2016-01-01
Rib fracture is one of the most common thoracic injuries in vehicle traffic accidents that can result in fatalities associated with seriously injured internal organs. A failure model is critical when modelling rib fracture to predict such injuries. Different rib failure models have been proposed in prediction of thorax injuries. However, the biofidelity of the fracture failure models when varying the loading conditions and the effects of a rib fracture failure model on prediction of thoracic injuries have been studied only to a limited extent. Therefore, this study aimed to investigate the effects of three rib failure models on prediction of thoracic injuries using a previously validated finite element model of the human thorax. The performance and biofidelity of each rib failure model were first evaluated by modelling rib responses to different loading conditions in two experimental configurations: (1) the three-point bending on the specimen taken from rib and (2) the anterior-posterior dynamic loading to an entire bony part of the rib. Furthermore, the simulation of the rib failure behaviour in the frontal impact to an entire thorax was conducted at varying velocities and the effects of the failure models were analysed with respect to the severity of rib cage damages. Simulation results demonstrated that the responses of the thorax model are similar to the general trends of the rib fracture responses reported in the experimental literature. However, they also indicated that the accuracy of the rib fracture prediction using a given failure model varies for different loading conditions.
Incidence of Symptomatic Vertebral Fractures in Patients After Percutaneous Vertebroplasty
International Nuclear Information System (INIS)
Hierholzer, Johannes; Fuchs, Heiko; Westphalen, Kerstin; Baumann, Clemens; Slotosch, Christine; Schulz, Rudolf
2008-01-01
The aim of this study was to evaluate the incidence of secondary symptomatic vertebral compression fractures (VCFs) in patients previously treated by percutaneous vertebroplasty (VTP). Three hundred sixteen patients with 486 treated VCFs were included in the study according to the inclusion criteria. Patients were kept in regular follow-up using a standardized questionairre before, 1 day, 7 days, 6 months, and 1 year after, and, further on, on a yearly basis after VTP. The incidence of secondary symptomatic VCF was calculated, and anatomical distribution with respect to previous fractures characterized. Mean follow-up was 8 months (6-56 months) after VTP. Fifty-two of 316 (16.4 %) patients (45 female, 7 male) returned for treatment of 69 secondary VCFs adjacent to (35/69; 51%) or distant from (34/69; 49%) previously treated levels. Adjacent secondary VCF occurred significantly more often compared to distant secondary VCF. Of the total 69 secondary VCFs, 35 of 69 occurred below and 27 of 69 above pretreated VCFs. Of the 65 sandwich levels generated, in 7 of 65 (11%) secondary VCFs were observed. Secondary VCF below pretreated VCF occurred significantly earlier in time compared to VCF above and compared to sandwich body fractures. No major complication occurred during initial or follow-up intervention. We conclude that secondary VCFs do occur in individuals after VTP but the rate found in our study remains below the level expected from epidemiologic studies. Adjacent fractures occur more often and follow the cluster distribution of VCF as expected from the natural history of the underlying osteoporosis. No increased rate of secondary VCF after VTP was observed in this retrospective analysis. In accordance with the pertinent literature, short-term and also midterm clinical results are encouraging and provide further support for the usefulness and the low complication rate of this procedure as an adjunct to the spectrum of pain management in patients with severe
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Marcos Paulo Wille
2013-05-01
Full Text Available Candida species are an important cause of bloodstream infections (BSI. To evaluate the epidemiological, clinical and microbiological aspects of two cohorts {1994-1999 [period 1 (P1 ]; 2000-2004 [period 2 (P2 ]} of candidaemic patients, we performed a retrospective analysis from a laboratory-based survey. A total of 388 candidaemias were identified, with an incidence of 0.20/1,000 patient-days and a significant increase in P2 vs. P1 (0.25 vs. 0.15, p = 0.04. Cancer and prior antibiotic use were frequent and Candida albicans was the most prevalent species found (42.4%. Resistance to fluconazole was found in 2.47% of the strains. No differences were observed in the species distribution of Candida during the study periods. In the P2 cohort, there were higher prevalence of elderly individuals, cardiac, pulmonary and liver diseases, renal failure, central venous catheters and antibiotic therapy. In P1, there were higher prevalence of neurological diseases and chemotherapy. The crude mortality was 55.4%. In conclusion, our incidence rates remained high. Furthermore, the distribution pattern of Candida species and the fluconazole resistance profile remained unchanged. Moreover, we found a clear trend of higher prevalence of candidaemia among the elderly and among patients with comorbidities. Finally, it is necessary to discuss strategies for the prevention and control of Candida BSI in Brazil.
Xie, H-L; Wu, B-H; Xue, W-Q; He, M-G; Fan, F; Ouyang, W-F; Tu, S-L; Zhu, H-L; Chen, Y-M
2013-11-01
In this case-control study, we examined the relationship between the consumption of fruit and vegetables and risk of hip fractures in 646 pairs of incident cases and controls in elderly Chinese. We found that greater consumption of both fruit and vegetables in men and vegetables in women was associated with a lower risk of osteoporotic hip fractures in elderly Chinese. The association between fruit and vegetable consumption and the risk of osteoporotic fractures remains controversial due to limited published evidence. The purpose of this study was to determine whether consuming fruits and vegetables has a protective effect against hip fractures. Between January 2008 and December 2012, 646 (162 males, 484 females) incident cases (70.9 ± 6.8 years) of hip fractures were enrolled from five hospitals, with 646 sex- and age-matched (±3 years) controls (70.7 ± 6.8 years) from hospitals or the community. Face-to-face interviews were conducted to assess habitual dietary intakes using a 79-item food frequency questionnaire and various covariates by structured questionnaires. Multivariate conditional logistic regression analyses showed dose-dependent inverse correlations between the intake of total fruit (p-trend = 0.014), total vegetables (p-trend fruits and vegetables combined (p-trend fruits, vegetables and the combination of fruits and vegetables were 0.53 (0.32-0.87), 0.37 (0.23-0.60) and 0.25 (0.15-0.41), respectively. Stratified analyses showed that the benefits remained significant in males (p = 0.001) but not in females (p = 0.210) (p-interaction 0.045). Among the subcategories of fruits and vegetables, similar associations were observed for all subgroups except light-coloured fruits. Our findings suggest that greater consumption of both fruits and vegetables in men and vegetables in women may decrease the risk of osteoporotic hip fractures in elderly Chinese.
Survival trends and predictors of mortality in severe pelvic trauma
DEFF Research Database (Denmark)
Pohlemann, Tim; Stengel, Dirk; Tosounidis, Georgios
2011-01-01
STUDY OBJECTIVE: To determine longitudinal trends in mortality, and the contribution of specific injury characteristics and treatment modalities to the risk of a fatal outcome after severe and complex pelvic trauma. METHODS: We studied 5048 patients with pelvic ring fractures enrolled in the German...... Pelvic Trauma Registry Initiative between 1991 and 1993, 1998 and 2000, and 2004 and 2006. Complete datasets were available for 5014 cases, including 508 complex injuries, defined as unstable fractures with severe peri-pelvic soft tissue and organ laceration. Multivariable mixed-effects logistic...... regression analysis was employed to evaluate the impact of demographic, injury- and treatment-associated variables on all-cause in-hospital mortality. RESULTS: All-cause in-hospital mortality declined from 8% (39/466) in 1991 to 5% (33/638) in 2006. Controlling for age, Injury Severity Score, pelvic vessel...
Radiotherapy of pathologic fractures and skeletal lesions bearing the risk of fracture
International Nuclear Information System (INIS)
Rieden, K.; Kober, B.; Mende, U.; Zum Winkel, K.
1986-01-01
Radiotherapy is of great importance in the treatment of pathologic fractures and skeletal lesions bearing the risk of fracture which are induced by malignomas, especially if these are in an advanced stage. In dependence on site and extent of skeletal destruction as well as on the general tumor dissemination, it can be distinguished between palliative radiotherapy and curative radiotherapy aiming at analgesia and remineralization. A retrospective analysis of 27 pathologic fractures and 56 skeletal lesions bearing the risk of fracture in malignoma patients showed an analgetic effect obtained by radiotherapy in 67% of pathological fractures and in 80% of skeletal lesions bearing the risk of fracture, whereas a remineralization could be demonstrated for 33% of pathological fractures and 50% of destructions bearing the risk of fracture. A stabilization of destructions progressing before therapy was found in 55% of pathological fractures and 40% of skeletal lesions bearing the risk of fracture. Thus a partial loading, supported by orthopedic prostheses, was possible for more than 50% of all patients. (orig.) [de
[Trochanteric femoral fractures].
Douša, P; Čech, O; Weissinger, M; Džupa, V
2013-01-01
At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (pfractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (pfractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (pTrochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (pfractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1
Jogger's fracture and other stress fractures of the lumbo-sacral spine
International Nuclear Information System (INIS)
Abel, M.S.
1985-01-01
The posterior rings of the lower lumbo-sacral vertebrae are subject to stress fractures at any part - pedicle, pars, or lamina. The site of fracture is apparently determined by the axis of weight bearing. The three illustrative clinical examples cited include a jogger with a laminar fracture, a ballet dancer with pedicle fractures, and a nine-year-old boy with fractures of pars and lamina. Chronic low back pain is the typical complaint with stress fractures of the lower lumbo-sacral spine. Special imaging techniques are usually needed to demonstrate these lesions, including vertebral arch views, multi-directional tomography, and computed tomography (CT). (orig.)
[Epidemiology of addictive disorders and behaviors in Japan].
Osaki, Yoneatsu; Kinjo, Aya
2015-09-01
Nationwide surveys to clarify the characteristics and trends of the addictive disorders and behaviors including alcohol dependence, nicotine dependence, internet addiction and pathological gambling among Japanese adults were carried out in 2003, 2008, and 2013. At the part of the surveys on addictive behaviors in disaster stricken area by the Great East Japan Earthquake, the nationwide survey on benzodiazepine dependence was conducted in 2013. Epidemiological features of prevalent addictive disorders and behaviors were described. We observed large number of estimated patients with addictive disorders or behaviors in Japan, and the considerable proportion of them was not connect to appropriate medical services.
MICROBIOLOGICAL PATTERN AND EPIDEMIOLOGIC TRENDS OF FUNGAL KERATITIS IN NORTH INDIA
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Yusuf Rizvi
2016-06-01
Full Text Available CONTEXT Spectrum of fungal keratitis continues to change with geographical location and season. Microbiological and epidemiological data provide guidelines to the treating physician facilitating chances of successful treatment. PURPOSE To report microbiologic and epidemiologic profile of 119 culture-positive cases of fungal keratitis treated at a tertiary centre in North India. SETTINGS AND DESIGN All cases reporting directly or referred to the OPD of Eye Department of Rohilkhand Medical College and Hospital, Bareilly, India, diagnosed and treated as fungal keratitis during a 3-year period between March 2012 and Feb 2015. METHODS Retrospective analysis of clinical and microbiological data of 119 culture-positive cases of fungal keratitis. Demographic features, risk factors, clinical course and laboratory findings were reviewed. RESULTS All patients were residents of 11 adjoining districts of Northern India. Of the 119 patients, 76 (63.8% were males (male: female ratio 1.79:1. 81(68% patients were in young productive age group of 20-45 years. 87 (73% were rural based. Ocular trauma with vegetative material, especially sugarcane leaf or dust falling in eyes were the chief precipitating factors; n = 89 (74.7%. Microbiologically Fusarium was the predominant isolate, 64 cases (53.7%, followed by Aspergillus 34(28.6% and Candida 11(9.2%. 2 cases of Alternaria and Curvularia and solitary cases of Acremonium and Scedosporium were reported. 4 strains remained unidentified. Mode of injury had a causal relation with fungal aetiology. Majority of Fusarium infections were caused by vegetative injuries 39(61%. Of these, 15(23.4% were attributed to sugarcane leaves. Soil/dust fall in eye or Surma application were responsible for bulk of Aspergillus infections; 21(61.7%. Candida infections were sporadic with a higher presenting age (Mean av 51.2 years and a frequent association with topical steroid usage, (8 of 11 cases. Aspergillus infections were predominant
Freedberg, D E; Haynes, K; Denburg, M R; Zemel, B S; Leonard, M B; Abrams, J A; Yang, Y-X
2015-10-01
Proton pump inhibitors (PPIs) are associated with risk for fracture in osteoporotic adults. In this population-based study, we found a significant association between PPIs and fracture in young adults, with evidence of a dose-response effect. Young adults who use PPIs should be cautioned regarding risk for fracture. Proton pump inhibitors (PPIs) are associated with fracture in adults with osteoporosis. Because PPI therapy may interfere with bone accrual and attainment of peak bone mineral density, we studied the association between use of PPIs and fracture in children and young adults. We conducted a population-based, case-control study nested within records from general medical practices from 1994 to 2013. Participants were 4-29 years old with ≥ 1 year of follow-up who lacked chronic conditions associated with use of long-term acid suppression. Cases of fracture were defined as the first incident fracture at any site. Using incidence density sampling, cases were matched with up to five controls by age, sex, medical practice, and start of follow-up. PPI exposure was defined as 180 or more cumulative doses of PPIs. Conditional logistic regression was used to estimate the odds ratio and confidence interval for use of PPIs and fracture. We identified 124,799 cases and 605,643 controls. The adjusted odds ratio for the risk of fracture associated with PPI exposure was 1.13 (95% CI 0.92 to 1.39) among children aged young adults aged 18-29 years old. In young adults but not children, we observed a dose-response effect with increased total exposure to PPIs (p for trend young adults, but overall evidence did not support a PPI-fracture relationship in children. Young adults who use PPIs should be cautioned regarding potentially increased risk for fracture, even if they lack traditional fracture risk factors.
Andersson, Sören
1999-01-01
This thesis encompasses immunological, virological and epidemiological studies of HIV-1 and HIV-2 infections in Guinea-Bissau. We have established a robust and reliable diagnostic strategy based on a combination of enzyme-linked immunosorbent assays (ELISAs) and rapid simple tests. Evaluations showed that the strategy had a high capacity to discriminate between HIV-1 and HIV-2 and a high concordance with polymerase chain reaction (PCR) testing. Epidemiological studies in...
Imaging of insufficiency fractures
Energy Technology Data Exchange (ETDEWEB)
Krestan, Christian [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)], E-mail: christian.krestan@meduniwien.ac.at; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)
2009-09-15
This review focuses on the occurrence, imaging and differential diagnosis of insufficiency fractures. Prevalence, the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures occur with normal stress exerted on weakened bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. Other conditions which affect bone turnover include osteomalacia, hyperparathyroidism, chronic renal failure and high-dose glucocorticoid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures, and to differentiate them from other bone lesions. Radiographs are still the most widely used imaging method for identification of insufficiency fractures, but sensitivity is limited, depending on the location of the fractures. Magnetic resonance imaging (MRI) is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures. Thin section, multi-detector computed tomography (MDCT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but limited specificity. The most important differential diagnosis is underlying malignant disease leading to pathologic fractures. Bone densitometry and clinical history may also be helpful in confirming the diagnosis of insufficiency fractures.
Influence of structures on fracture and fracture toughness of cemented tungsten carbides
International Nuclear Information System (INIS)
Zhao, W.; Zhang, X.
1987-01-01
A study was made of the influence of structures on fracture and fracture toughness of cemented tungsten carbides with different compositions and grain sizes. The measurement of the fracture toughness of cemented tungsten carbide was carried out using single edge notched beam. The microstructural parameters and the proportion for each fracture mode on the fracture surface were obtained. The brittle fracture of the alloy is mainly due to the interfacial decohesion fracture following the interface of the carbide crystals. It has been observed that there are localized fractures region ahead of the crack tip. The morphology of the crack propagation path as well as the slip structure in the cobalt phase of the deformed region have been investigated. In addition, a study of the correlation between the plane strain fracture toughness and microstructural parameters, such as mean free path of the cobalt phase, tungsten carbide grain size and the contiguity of tungsten carbide crystals was also made
Cancer burden trends in Umbria region using a joinpoint regression
Directory of Open Access Journals (Sweden)
Giuseppe Michele Masanotti
2015-09-01
Full Text Available INTRODUCTION. The analysis of the epidemiological data on cancer is an important tool to control and evaluate the outcomes of primary and secondary prevention, the effectiveness of health care and, in general, all cancer control activities. MATERIALS AND METHODS. The aim of the this paper is to analyze the cancer mortality in the Umbria region from 1978 to 2009 and incidence from 1994-2008. Sex and site-specific trends for standardized rates were analyzed by "joinpoint regression", using the surveillance epidemiology and end results (SEER software. RESULTS. Applying the jointpoint analyses by sex and cancer site, to incidence spanning from 1994 to 2008 and mortality from 1978 to 2009 for all sites, both in males and females, a significant joinpoint for mortality was found; moreover the trend shape was similar and the joinpoint years were very close. In males standardized rate significantly increased up to 1989 by 1.23% per year and significantly decreased thereafter by -1.31%; among females the mortality rate increased in average of 0.78% (not significant per year till 1988 and afterward significantly decreased by -0.92% per year. Incidence rate showed different trends among sexes. In males was practically constant over the period studied (not significant increase 0.14% per year, in females significantly increased by 1.49% per year up to 2001 and afterward slowly decreased (-0.71% n.s. estimated annual percent change − EAPC. CONCLUSIONS. For all sites combined trends for mortality decreased since late '80s, both in males and females; such behaviour is in line with national and European Union data. This work shows that, even compared to health systems that invest more resources, the Umbria public health system achieved good health outcomes.
The epidemiology of sports-related injuries in older adults: a central European epidemiologic study.
Kammerlander, Christian; Braito, Matthias; Kates, Stephen; Jeske, Christian; Roth, Tobias; Blauth, Michael; Dallapozza, Christian
2012-10-01
The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.
Ismail, A A; Silman, A J; Reeve, J; Kaptoge, S; O'Neill, T W
2006-01-01
Population studies suggest that rib fractures are associated with a reduction in bone mass. While much is known about the predictive risk of hip, spine and distal forearm fracture on the risk of future fracture, little is known about the impact of rib fracture. The aim of this study was to determine whether a recalled history of rib fracture was associated with an increased risk of future limb fracture. Men and women aged 50 years and over were recruited from population registers in 31 European centres for participation in a screening survey of osteoporosis (European Prospective Osteoporosis Study). Subjects were invited to complete an interviewer-administered questionnaire that included questions about previous fractures including rib fracture, the age of their first fracture and also the level of trauma. Lateral spine radiographs were performed and the presence of vertebral deformity was determined morphometrically. Following the baseline survey, subjects were followed prospectively by annual postal questionnaire to determine the occurrence of clinical fractures. The subjects included 6,344 men, with a mean age of 64.2 years, and 6,788 women, with a mean age of 63.6 years, who were followed for a median of 3 years (range 0.4-5.9 years), of whom 135 men (2.3%) and 101 women (1.6%) reported a previous low trauma rib fracture. In total, 138 men and 391 women sustained a limb fracture during follow-up. In women, after age adjustment, those with a recalled history of low trauma rib fracture had an increased risk of sustaining 'any' limb fracture [relative hazard (RH)=2.3; 95% CI 1.3, 4.0]. When stratified by fracture type the predictive risk was more marked for hip (RH=7.7; 95% CI 2.3, 25.9) and humerus fracture (RH=4.5; 95% CI 1.4, 14.6) than other sites (RH=1.6; 95% CI 0.6, 4.3). Additional adjustment for prevalent vertebral deformity and previous (non-rib) low trauma fractures at other sites slightly reduced the strength of the association between rib fracture and
Epidemiology and costs of diabetes.
Bruno, G; Landi, A
2011-01-01
The prevalence of diabetes is increasing worldwide, particularly in developing countries. In the next decades, India and China are expected to provide the greatest numbers of affected people, mainly owing to the increasing incidence of this disease in those countries. Regarding developed countries, such as in Europe and the United States, the increasing trend is mainly due to the prolonged survival of both the general and the diabetic populations. From an epidemiologic point of view, the first relevant point is that almost 80% of diabetes cases could be prevented just by avoiding overweight and obesity. The estimated attributable risk of excess body weight is extremely high; no other modifiable effect has such an impact on the health of the general population. The second relevant point is that the global trend of the disease shows a tendency to onset at a younger age. The third point is that in developed countries the prevalence of diabetes is increasing mainly among the elderly, who are responsible for the highest consumption of health care resources in absolute terms. Regarding type 1 diabetes, which represents one-tenth of affected individuals, both large geographic and temporal variations in disease incidence have been found, supporting the hypothesis of as yet unknown environmental determinants. The incidence is increasing in linear fashion, not supporting the hypothesis of younger age at onset as the main explanation for this trend. Because the prevalences of both type 1 and type 2 diabetes are increasing worldwide, they will produce a profound impact on overall health care costs. Copyright © 2011 Elsevier Inc. All rights reserved.
Jian-Ming, Wang; Yan-Kai, Xia; Hui-Juan, Zhu; Feng, Chen; Hong-Bing, Shen
2016-05-10
To analyze the projects on the infectious disease epidemiology sponsored by the National Natural Science Foundation of China (NSFC), explore the hotspot and development trend, and offer a reference for researchers in this field. Based on the NSFC database, the projects on the infectious disease epidemiology (H2609) sponsored from 1987 to 2014 were analyzed. The changes of fund numbers, amounts and research fields were described. During the study period, NSFC sponsored 373 projects, including 228 general projects (61.1%), 78 youth projects (20.9%) and 67 other projects (18.0%). The average amount of the grant was 358.2 thousand Yuan (20 thousand-8 million). The main sponsored research fields were mechanisms of pathogen and immunity (36.2%) and population-based epidemiological studies (33.0%). The top three diseases were hepatitis, HIV/AIDS and tuberculosis. The amount of funding on researches of infectious disease epidemiology has increased continuously, which has played an important role in training scientific talents in the field of prevention and control of infectious diseases.
... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...
Dekker, M.; Verkerk, R.
2003-01-01
Background Many epidemiological studies have tried to associate the intake of certain food products with a reduced risk for certain diseases. Results of these studies are often ambiguous, conflicting, or show very large deviations of trends. Nevertheless, a clear and often reproduced inverse
Energy Technology Data Exchange (ETDEWEB)
Robert Jacobi; John Fountain; Stuart Loewenstein; Edward DeRidder; Bruce Hart
2007-03-31
For two consecutive years, 2004 and 2005, the largest natural gas well (in terms of gas flow/day) drilled onshore USA targeted the Ordovician Trenton/Black River (T/BR) play in the Appalachian Basin of New York State (NYS). Yet, little data were available concerning the characteristics of the play, or how to recognize and track T/BR prospects across the region. Traditional exploration techniques for entry into a hot play were of limited use here, since existing deep well logs and public domain seismic were almost non-existent. To help mitigate this problem, this research project was conceived with two objectives: (1) to demonstrate that integrative traditional and innovative techniques could be used as a cost-effective reconnaissance exploration methodology in this, and other, areas where existing data in targeted fracture-play horizons are almost non-existent, and (2) determine critical characteristics of the T/BR fields. The research region between Seneca and Cayuga lakes (in the Finger Lakes of NYS) is on strike and east of the discovery fields, and the southern boundary of the field area is about 8 km north of more recently discovered T/BR fields. Phase I, completed in 2004, consisted of integrating detailed outcrop fracture analyses with detailed soil gas analyses, lineaments, stratigraphy, seismic reflection data, well log data, and aeromagnetics. In the Seneca Lake region, Landsat lineaments (EarthSat, 1997) were coincident with fracture intensification domains (FIDs) and minor faults observed in outcrop and inferred from stratigraphy. Soil gas anomalies corresponded to ENE-trending lineaments and FIDs. N- and ENE-trending lineaments were parallel to aeromagnetic anomalies, whereas E-trending lineaments crossed aeromagnetic trends. 2-D seismic reflection data confirmed that the E-trending lineaments and FIDs occur where shallow level Alleghanian salt-cored thrust-faulted anticlines occur. In contrast, the ENE-trending FIDs and lineaments occur where Iapetan
Change in the use of hormone replacement therapy and the incidence of fracture in Oslo.
Meyer, H E; Lofthus, C M; Søgaard, A J; Falch, J A
2009-05-01
Fracture incidence in Oslo decreased from the 1970s to the 1990s in younger postmenopausal women, but not in older women or in men. Concurrently, hormone replacement therapy increased considerably. Using data from the Oslo Health Study, we estimated that roughly half the decline might be attributed hormone replacement therapy. Between the late 1970s and the late 1990s, the incidence of hip fracture and distal forearm fracture decreased in younger postmenopausal women in Oslo, but not in elderly women or in men. The purpose of this report is to evaluate whether the decreased incidence was coherent with trends in use of hormone replacement therapy (HRT). Data on estrogens were collected from official drug statistics, data on fractures from published studies and data on bone mineral density (BMD) from the Oslo Health Study. The sale of all estrogens increased 22 times from 1979 to 1999, and the sub-category estradiol combined with progestin increased 35 times. In the corresponding period the incidence of distal forearm fracture in women aged 50-64 years decreased by 33% and hip fracture by 39%. Based on differences in BMD between users and non-users of HRT, we estimated that up to half of this decline might be due to HRT. The reduction in fracture incidence in postmenopausal women in Oslo occurred in a period with a substantial increase in the use of HRT. Future surveillance will reveal whether the last years' decline in use of HRT will be translated into increasing fracture rates.
Quantifying Discrete Fracture Network Connectivity in Hydraulic Fracturing Stimulation
Urbancic, T.; Ardakani, E. P.; Baig, A.
2017-12-01
Hydraulic fracture stimulations generally result in microseismicity that is associated with the activation or extension of pre-existing microfractures and discontinuities. Microseismic events acquired under 3D downhole sensor coverage provide accurate event locations outlining hydraulic fracture growth. Combined with source characteristics, these events provide a high quality input for seismic moment tensor inversion and eventually constructing the representative discrete fracture network (DFN). In this study, we investigate the strain and stress state, identified fracture orientation, and DFN connectivity and performance for example stages in a multistage perf and plug completion in a North American shale play. We use topology, the familiar concept in many areas of structural geology, to further describe the relationships between the activated fractures and their effectiveness in enhancing permeability. We explore how local perturbations of stress state lead to the activation of different fractures sets and how that effects the DFN interaction and complexity. In particular, we observe that a more heterogeneous stress state shows a higher percentage of sub-horizontal fractures or bedding plane slips. Based on topology, the fractures are evenly distributed from the injection point, with decreasing numbers of connections by distance. The dimensionless measure of connection per branch and connection per line are used for quantifying the DFN connectivity. In order to connect the concept of connectivity back to productive volume and stimulation efficiency, the connectivity is compared with the character of deformation in the reservoir as deduced from the collective behavior of microseismicity using robustly determined source parameters.
Decoding flow unit evolution upon annealing from fracture morphology in metallic glasses
Energy Technology Data Exchange (ETDEWEB)
Gao, M., E-mail: gaomeng10@hotmail.com; Cao, X.F.; Ding, D.W.; Wang, B.B.; Wang, W.H., E-mail: whw@iphy.ac.cn
2017-02-16
The intrinsic correlation between the fracture morphology evolution and the structural heterogeneity of flow units in a typical Zr{sub 52.5}Ti{sub 5}Cu{sub 17.9}Ni{sub 14.6}Al{sub 10} (vit105) metallic glass (MG) upon annealing was investigated. By systematically tuning the annealing time at temperature below the glass transition temperature, a series of dimple-like fracture morphology were obtained, which is the unique fingerprint-like pattern for every annealing state. Based on the structural relaxation model of flow units, the evolution of the typical dimple sizes, the largest and smallest dimple size, with annealing were well fitted. Then the evolution of flow unit density was estimated from the fracture morphology evolution, which displays the same evolution trend with that measured from thermal relaxation. A stochastic dynamic model considering the interaction of activated flow units was proposed to analyze the effect of the initial flow unit density and the flow unit interaction intensity on the dynamic evolution of dimple distribution. Our work may provide a novel scheme to investigate the structural fingerprint information on flow units from fracture morphology, and enlighten the microscopic structural origin of the ductile-to-brittle transition during structural relaxation in MGs.
DEFF Research Database (Denmark)
Schwensen, Jakob F; Bregnbak, David; Johansen, Jeanne Duus
2016-01-01
the last 5 years, a comprehensive review of methylisothiazolinone, chromium, cobalt, rubber accelerators and fragrance ingredients were conducted. Of each allergen we discuss in detail the temporal trend of prevalence, source of exposure, clinical manifestation of allergic contact dermatitis...
Barnhoorn, A.; Cox, S.F.
2012-01-01
Fracturing experiments on very low-porosity dolomite rocks shows a difference in growth of fracture networks by stress-driven fracturing and fluid-driven fracturing. Stress-driven fracture growth, in the absence of fluid pressure, initially forms fractures randomly throughout the rocks followed by
Directory of Open Access Journals (Sweden)
Esther Kim, BS
2018-04-01
Full Text Available History of present illness: A 25-year-old, right-handed male presented to the emergency department with left wrist pain after falling from a skateboard onto an outstretched hand two-weeks prior. He otherwise had no additional concerns, including no complaints of weakness or loss of sensation. On physical exam, there was tenderness to palpation within the anatomical snuff box. The neurovascular exam was intact. Plain films of the left wrist and hand were obtained. Significant findings: The anteroposterior (AP plain film of this patient demonstrates a full thickness fracture through the middle third of the scaphoid (red arrow, with some apparent displacement (yellow lines and subtle angulation of the fracture fragments (blue line. Discussion: The scaphoid bone is the most commonly fractured carpal bone accounting for 70%-80% of carpal fractures.1 Classically, it is sustained following a fall onto an outstretched hand (FOOSH. Patients should be evaluated for tenderness with palpation over the anatomical snuffbox, which has a sensitivity of 100% and specificity of 40%.2 Plain films are the initial diagnostic modality of choice and have a sensitivity of 70%, but are commonly falsely negative in the first two to six weeks of injury (false negative of 20%.3 The Mayo classification organizes scaphoid fractures as involving the proximal, mid, and distal portions of the scaphoid bone with mid-fractures being the most common.3 The proximal scaphoid is highly susceptible to vascular compromise because it depends on retrograde blood flow from the radial artery. Therefore, disruption can lead to serious sequelae including osteonecrosis, arthrosis, and functional impairment. Thus, a low threshold should be maintained for neurovascular evaluation and surgical referral. Patients with non-displaced scaphoid fractures should be placed in a thumb spica splint.3 Patients with even suspected scaphoid fractures should be placed in a thumb spica splint and re
Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks
Chen, Mingjie; Sun, Yunwei; Fu, Pengcheng; Carrigan, Charles R.; Lu, Zhiming; Tong, Charles H.; Buscheck, Thomas A.
2013-08-01
Hydraulic fracturing has been used widely to stimulate production of oil, natural gas, and geothermal energy in formations with low natural permeability. Numerical optimization of fracture stimulation often requires a large number of evaluations of objective functions and constraints from forward hydraulic fracturing models, which are computationally expensive and even prohibitive in some situations. Moreover, there are a variety of uncertainties associated with the pre-existing fracture distributions and rock mechanical properties, which affect the optimized decisions for hydraulic fracturing. In this study, a surrogate-based approach is developed for efficient optimization of hydraulic fracturing well design in the presence of natural-system uncertainties. The fractal dimension is derived from the simulated fracturing network as the objective for maximizing energy recovery sweep efficiency. The surrogate model, which is constructed using training data from high-fidelity fracturing models for mapping the relationship between uncertain input parameters and the fractal dimension, provides fast approximation of the objective functions and constraints. A suite of surrogate models constructed using different fitting methods is evaluated and validated for fast predictions. Global sensitivity analysis is conducted to gain insights into the impact of the input variables on the output of interest, and further used for parameter screening. The high efficiency of the surrogate-based approach is demonstrated for three optimization scenarios with different and uncertain ambient conditions. Our results suggest the critical importance of considering uncertain pre-existing fracture networks in optimization studies of hydraulic fracturing.
XFEM modeling of hydraulic fracture in porous rocks with natural fractures
Wang, Tao; Liu, ZhanLi; Zeng, QingLei; Gao, Yue; Zhuang, Zhuo
2017-08-01
Hydraulic fracture (HF) in porous rocks is a complex multi-physics coupling process which involves fluid flow, diffusion and solid deformation. In this paper, the extended finite element method (XFEM) coupling with Biot theory is developed to study the HF in permeable rocks with natural fractures (NFs). In the recent XFEM based computational HF models, the fluid flow in fractures and interstitials of the porous media are mostly solved separately, which brings difficulties in dealing with complex fracture morphology. In our new model the fluid flow is solved in a unified framework by considering the fractures as a kind of special porous media and introducing Poiseuille-type flow inside them instead of Darcy-type flow. The most advantage is that it is very convenient to deal with fluid flow inside the complex fracture network, which is important in shale gas extraction. The weak formulation for the new coupled model is derived based on virtual work principle, which includes the XFEM formulation for multiple fractures and fractures intersection in porous media and finite element formulation for the unified fluid flow. Then the plane strain Kristianovic-Geertsma-de Klerk (KGD) model and the fluid flow inside the fracture network are simulated to validate the accuracy and applicability of this method. The numerical results show that large injection rate, low rock permeability and isotropic in-situ stresses tend to lead to a more uniform and productive fracture network.
Energy Technology Data Exchange (ETDEWEB)
Stafford, Paige L. [Univ. of Tennessee, Knoxville, TN (United States). Dept. of Geological Sciences
1996-05-01
Simulations of a tritium tracer experiment in fractured shale saprolite, conducted at the Oak Ridge National Laboratory, were performed using 1D and 2D equivalent porous medium (EPM) and discrete-fracture/matrix-diffusion (DFMD) models. The models successfully reproduced the general shape of the breakthrough curves in down-gradient monitoring wells which are characterized by rapid first arrival, a slow-moving center of mass, and a persistent ``tail`` of low concentration. In plan view, the plume shows a large degree of transverse spreading with the width almost as great as the length. EPM models were sensitive to dispersivity coefficient values which had to be large (relative to the 3.7m distance between the injection and monitoring wells) to fit the tail and transverse spreading. For example, to fit the tail a longitudinal dispersivity coefficient, αL, of 0.8 meters for the 2D simulations was used. To fit the transverse spreading, a transverse dispersivity coefficient, αT, of 0.8 to 0.08 meters was used indicating an αL/αT ratio between 10 and 1. Transverse spreading trends were also simulated using a 2D DFMD model using a few larger aperture fractures superimposed onto an EPM. Of the fracture networks studied, only those with truncated fractures caused transverse spreading. Simulated tritium levels in all of the cases were larger than observed values by a factor of approximately 100. Although this is partly due to input of too much tritium mass by the models it appears that dilution in the wells, which were not purged prior to sampling, is also a significant factor. The 1D and 2D EPM models were fitted to monitoring data from the first five years of the experiment and then used to predict future tritium concentrations.
International Nuclear Information System (INIS)
Stafford, P.L.
1996-05-01
Simulations of a tritium tracer experiment in fractured shale saprolite, conducted at the Oak Ridge National Laboratory, were performed using 1D and 2D equivalent porous medium (EPM) and discrete-fracture/matrix-diffusion (DFMD) models. The models successfully reproduced the general shape of the breakthrough curves in down-gradient monitoring wells which are characterized by rapid first arrival, a slow-moving center of mass, and a persistent ''tail'' of low concentration. In plan view, the plume shows a large degree of transverse spreading with the width almost as great as the length. EPM models were sensitive to dispersivity coefficient values which had to be large (relative to the 3.7m distance between the injection and monitoring wells) to fit the tail and transverse spreading. For example, to fit the tail a longitudinal dispersivity coefficient, α L , of 0.8 meters for the 2D simulations was used. To fit the transverse spreading, a transverse dispersivity coefficient, α T , of 0.8 to 0.08 meters was used indicating an α L /α T ratio between 10 and 1. Transverse spreading trends were also simulated using a 2D DFMD model using a few larger aperture fractures superimposed onto an EPM. Of the fracture networks studied, only those with truncated fractures caused transverse spreading. Simulated tritium levels in all of the cases were larger than observed values by a factor of approximately 100. Although this is partly due to input of too much tritium mass by the models it appears that dilution in the wells, which were not purged prior to sampling, is also a significant factor. The 1D and 2D EPM models were fitted to monitoring data from the first five years of the experiment and then used to predict future tritium concentrations
Mortality Following Periprosthetic Proximal Femoral Fractures Versus Native Hip Fractures.
Boylan, Matthew R; Riesgo, Aldo M; Paulino, Carl B; Slover, James D; Zuckerman, Joseph D; Egol, Kenneth A
2018-04-04
The number of periprosthetic proximal femoral fractures is expected to increase with the increasing prevalence of hip arthroplasties. While native hip fractures have a well-known association with mortality, there are currently limited data on this outcome among the subset of patients with periprosthetic proximal femoral fractures. Using the New York Statewide Planning and Research Cooperative System, we identified patients from 60 to 99 years old who were admitted to a hospital in the state with a periprosthetic proximal femoral fracture (n = 1,655) or a native hip (femoral neck or intertrochanteric) fracture (n = 97,231) between 2006 and 2014. Within the periprosthetic fracture cohort, the indication for the existing implant was not available in the data set. We used mixed-effects regression models to compare mortality at 1 and 6 months and 1 year for periprosthetic compared with native hip fractures. The risk of mortality for patients who sustained a periprosthetic proximal femoral fracture was no different from that for patients who sustained a native hip fracture at 1 month after injury (3.2% versus 4.6%; odds ratio [OR], 0.90; 95% confidence interval [CI], 0.68 to 1.19; p = 0.446), but was lower at 6 months (3.8% versus 6.5%; OR, 0.74; 95% CI, 0.57 to 0.95; p = 0.020) and 1 year (9.7% versus 15.9%; OR, 0.71; 95% CI, 0.60 to 0.85; p accounting for age and comorbidities. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
International Nuclear Information System (INIS)
Kanis, John A.; Johansson, Helena; Oden, Anders; McCloskey, Eugene V.
2009-01-01
Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.
Fraturas do anel pélvico: estudo epidemiológico Pelvic ring fractures: epidemiological study
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Alceu Gomes Chueire
2004-03-01
Full Text Available De fevereiro de 2000 a setembro de 2001, 84 pacientes apresentando fratura do anel pélvico foram avaliados, segundo determinado protocolo aplicado. Houve predomínio do sexo masculino (67%, a maioria dos pacientes eram brancos (86% e a idade média foi de 37 anos. Quanto ao tipo de acidente, os mais freqüentes foram os relacionados ao trânsito (58% - carro, moto e atropelamento - pacientes vítimas de traumas de alta energia. As fraturas foram classificadas de acordo com Tile(13 em estáveis, em 55% (fraturas do tipo A; rotacionalmente instáveis, em 30% (fraturas do tipo B e rotacional e verticalmente instáveis, em 15% (fraturas do tipo C. A fratura mais freqüentemente encontrada foi a dos ramos isquiopúbicos. O tratamento cirúrgico foi realizado em 29% dos pacientes. Houve necessidade de transfusão sangüínea em 20% dos pacientes, utilizando-se uma média de cinco unidades de sangue total; exceto dois pacientes (2,4% com lesão arterial intra pélvica que necessitaram mais de 10 unidades de sangue nas primeiras 48 horas. A mortalidade foi de sete por cento tendo relação significativa com traumas extra pélvicos.From February 2000 to September 2001, 84 patients with pelvic fractures were assessed, using a determined protocol. There were more men (67% than women. Most of the patients were white (86% and the average was 37 years of age. The most frequent accident was reported to have been traffic accidents (58% such as motor vehicle, motorcycle and running over - victims of high-energy injuries. The pelvic ring fractures were classified according to Tile (13 as stable in 55% (type A injury, as rotationally unstable in 30% (type B injury and as unstable in translation in 15% (type C injury. The most frequent lesion affecting the pelvic girdle was the isquiopubic bones fracture (transpubic instability. The overall rate of operative stabilization was 29%. An average of five units of total blood transfusion was required in 20% of the
Time-Trend in Epidemiological and Pathological Features of Schistosoma-Associated Bladder Cancer
International Nuclear Information System (INIS)
ZAGHLOUL, M.S.; EL-BARADIE, M.; NAZMY, M.; NOUH, A.; MONEER, M.; YOUNIS, A.
2008-01-01
To investigate the different emerging trends in the features of bladder cancer along 17 years. Patients and Methods: During a 17-year period (1988- 2004), 5071 epithelial bladder cancer patients underwent radical cystectomy at the National Cancer Institute (NCI), Cairo University, Egypt. The time was divided into 3 time periods to detect changes of the clinico pathologic features of patients in these periods. Results: There was a significant progressive increase in the patients' age with time and decrease in squamous/ transitional ratio, with transient increase in male predominance during the 2nd time period. Moreover, there was a decrease in the well differentiated (grade 1) tumor (p<0.001) and an increase in the frequency of pelvic nodal involvement (p<0.001). Transitional cell carcinoma (TCC) patients were significantly older than those with squamous cell carcinoma (SCC) (p<0.001). Progressive increase of age with time was evident in TCC, SCC and adenocarcinoma patients. Male to female ratio changed significantly in TCC and SCC. Conclusion: Time trend was confirmed with relative decrease in frequency of SCC and increase of TCC with changes in their pathological details. The differences between their characteristics and that of the Western countries are decreasing.
[Falls and fractures among older adults living in long-term care].
Del Duca, Giovâni Firpo; Antes, Danielle Ledur; Hallal, Pedro Curi
2013-03-01
To investigate the prevalence of falls and fractures over the past 12 months and associated factors among older adults living in long-term care. Census of all long-term care located in the city of Pelotas, Brazil, in 2008. Falls over the past 12 months were assessed using the following question: "Over the last 12 months, have you fallen?" For those who replied positively, another question was asked: "In any of these falls, have you fractured a bone?" Sex, age, schooling, disability relating to basic activities of daily living, type of financing of the long-term care and hospital admissions were the independent variables. We used chi-square tests for heterogeneity and linear trend in the unadjusted analysis, and Poisson regression with robust variance in the adjusted one. Within the 24 long-term care studied, we collected data for 466 individuals. The prevalence of falls in the past year was 38.9% (95%CI 34.5; 43.4). Among those who have fallen, 19.2% had fractures. Femur (hip) was the most frequent site fractured (43.4%), followed by wrist (10%). In the adjusted analysis, older age, disability for 1-5 basic activities of daily living, living in public institutions and hospital admissions in the last year were associated with higher risk of falls. The high prevalence of falls and fractures highlights the fragility of the individuals living in long-term care. Special attention should be paid to older adults and those with hospital admissions in the last year.
Barrera-Ochoa, S; Haddad, S; Rodríguez-Alabau, S; Teixidor, J; Tomás, J; Molero, V
To report the outcomes of surgical treatment of lower limb fractures in patients with chronic spinal cord injuries. A total of 37 lower limb fractures were treated from 2003 to 2010, of which 25 fractures were treated surgically and 12 orthopaedically. Patients of the surgical group had better clinical results, range of motion, bone consolidation, and less pressure ulcers and radiological misalignment. No differences were detected between groups in terms of pain, hospital stay, and medical complications. There is no currently consensus regarding the management of lower limb fractures in patients with chronic spinal cord injuries, but the trend has been conservative treatment due to the high rate of complications in surgical treatment. Chronic spinal cord injuries patients with lower limb fractures who are treated surgically achieved a more reliable consolidation, practically a free range of motion, low rate of cutaneous complications, and pain associated with the fracture. This allows a quick return to the previous standard of living, and should be considered as an alternative to orthopaedic treatment in these patients. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.
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Margolin, B., E-mail: mail@crism.ru; Sorokin, A.; Shvetsova, V.; Minkin, A.; Potapova, V.; Smirnov, V.
2016-11-15
The radiation swelling effect on the fracture properties of irradiated austenitic steels under static loading has been studied and analyzed from the mechanical and physical viewpoints. Experimental data on the stress-strain curves, fracture strain, fracture toughness and fracture mechanisms have been represented for austenitic steel of 18Cr-10Ni-Ti grade (Russian analog of AISI 321 steel) irradiated up to neutron dose of 150 dpa with various swelling. Some phenomena in mechanical behaviour of irradiated austenitic steels have been revealed and explained as follows: a sharp decrease of fracture toughness with swelling growth; untypical large increase of fracture toughness with decrease of the test temperature; some increase of fracture toughness after preliminary cyclic loading. Role of channel deformation and channel fracture has been clarified in the properties of irradiated austenitic steel and different tendencies to channel deformation have been shown and explained for the same austenitic steel irradiated at different temperatures and neutron doses.
Fracture characteristics in Japanese rock
International Nuclear Information System (INIS)
Ijiri, Yuji; Sawada, Atsushi; Akahori, Kuniaki
1999-11-01
It is crucial for the performance assessment of geosphere to evaluate the characteristics of fractures that can be dominant radionuclide migration pathways from a repository to biosphere. This report summarizes the characteristics of fractures obtained from broad literature surveys and the fields surveys at the Kamaishi mine in northern Japan and at outcrops and galleries throughout the country. The characteristics of fractures described in this report are fracture orientation, fracture shape, fracture frequency, fracture distribution in space, transmissivity of fracture, fracture aperture, fracture fillings, alteration halo along fracture, flow-wetted surface area in fracture, and the correlation among these characteristics. Since granitic rock is considered the archetype fractured media, a large amount of fracture data is available in literature. In addition, granitic rock has been treated as a potential host rock in many overseas programs, and has JNC performed a number of field observations and experiments in granodiorite at the Kamaishi mine. Therefore, the characteristics of fractures in granitic rock are qualitatively and quantitatively clarified to some extent in this report, while the characteristics of fractures in another rock types are not clarified. (author)
Reasons for the low flowback rates of fracturing fluids in marine shale
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Yongjun Lu
2018-02-01
trend, namely, the lower the flowback rates, the more developed the micro fractures, the better the volume simulation effect and the higher the gas production rates. Keywords: Shale, Fracturing fluid, Core, Adsorption, Flowback rate, Mineralization degree, Origin, Marine shale in south China, Gas production rate
Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H
2005-07-01
To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.
Influence of perforation erosion on multiple growing hydraulic fractures in multi-stage fracturing
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Yongming Li
2018-02-01
Full Text Available In multi-stage hydraulic fracturing, the limited-entry method is widely used to promote uniform growth of multiple fractures. However, this method's effectiveness may be lost because the perforations will be eroded gradually during the fracturing period. In order to study the influence of perforation erosion on multiple growing hydraulic fractures, we combined the solid–fluid coupled model of hydraulic fracture growth with an empirical model of perforation erosion to implement numerical simulation. The simulations show clearly that the erosion of perforation will significantly deteriorate the non-uniform growth of multiple fractures. Based on the numerical model, we also studied the influences of proppant concentration and injection rates on perforation erosion in multi-stage hydraulic fracturing. The results indicate that the initial erosion rates become higher with the rising proppant concentration, but the growth of multiple hydraulic fractures is not sensitive to the varied proppant concentration. In addition, higher injection rates are beneficial significantly to the limited-entry design, leading to more uniform growth of fractures. Thus, in multi-stage hydraulic fracturing enough high injection rates are proposed to keep uniform growths. Keywords: Unconventional oil and gas reservoir, Horizontal well, Perforation friction, Perforation erosion, Multi-stage hydraulic fracturing, Numerical simulation, Mathematic model, Uniform growth of fractures
Characteristic fracture spacing in primary and secondary recovery for naturally fractured reservoirs
Gong, J.; Rossen, W.R.
2018-01-01
If the aperture distribution is broad enough in a naturally fractured reservoir, even one where the fracture network is highly inter-connected, most fractures can be eliminated without significantly affecting the flow through the fracture network. During a waterflood or enhanced-oil-recovery
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El Ouahed, Abdelkader Kouider; Mazouzi, Amine [Sonatrach, Rue Djenane Malik, Hydra, Algiers (Algeria); Tiab, Djebbar [Mewbourne School of Petroleum and Geological Engineering, The University of Oklahoma, 100 East Boyd Street, SEC T310, Norman, OK, 73019 (United States)
2005-12-15
maps throughout the entire area of interest. A mathematical model based on 'the weighting method' was then applied to obtain fracture network maps, which led to a better description of the major fracture trends. The obtained maps were compared and the results show that the proposed approach is a feasible and practical methodology to map the fracture network.
Golkari, Sina; Teunis, Teun; Ring, David; Vranceanu, Ana-Maria
2015-01-01
To test the difference in symptoms of (1) depression, (2) health anxiety, and (3) catastrophic thinking between 1 and 6 weeks after injury to the radius. In total, 69 adult patients with a minimally displaced radial head or distal radius fracture were prospectively enrolled. After diagnosis, we recorded demographic variables, 11-point ordinal numerical pain score, and agreement with "no pain, no gain"; Disabilities of the Arms, Shoulder, and Hand (DASH) questionnaire; Center for Epidemiologic Studies Depression Scale; the Whiteley Index; and the Pain Catastrophizing Scale. In total, 55 patients (80%) returned after 1 month to reevaluate pain, Disabilities of the Arms, Shoulder, and Hand, Center for Epidemiologic Studies Depression, Whiteley Index, and Pain Catastrophizing Scale scores. Center for Epidemiologic Studies Depression scores decreased by an average of 5 ± 9 points (p psychologic measures are used as a screening tool to predict outcome after treatment, one should account for a patient's disease phase. Prognostic level I. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
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Fan Fan
Full Text Available OBJECTIVES: Fish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures. METHODS: A case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years, were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates. RESULTS: Univariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: <0.001-0.016. After adjusting for covariates, the associations were slightly attenuated but remained significant for all (p-trend: <0.001-0.017 except for fresh-water fish (p = 0.553. The ORs (95%CI of hip fractures for the highest (vs. lowest quartile were 0.80 (0.48-1.31 for fresh-water fish, 0.31 (0.18-0.52 for sea fish, 0.55 (0.34-0.88 for mollusca and shellfish, and 0.47 (0.28-0.79 for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052. CONCLUSION: Higher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.
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Roberto Guarniero
2011-01-01
como as suas causas.Objectives: 1 to evaluate the incidence of fractures in children and adolescents in an universitarian hospital 2 to quantify the incidence based on age, sex gender, type of accident, anatomic location, association with other lesions, and treatment. 3 according to the type of fracture,to determine the adequacy of the treatment and training protocols, either for graduation or medical residency training in our medical services. Methods: a transversal prospective observational study. The medical records from 543 patients were analysed, aging one day to 19 years old, treated in a period of three months in our institutions, three different university hospitals, with a special protocol to determine the characteristics of the fractures in this series. Results: 531 fractures (isolated were analysed along with 12 dislocations,394 (72.5% male and 149 (27.4% female. The age ranged from one day to 19 years old. The most frequent etiology of those episodes was “fall from own height”, followed by “fall from height” which refers to a more severe trauma. The upper limbs were most affected, with 404 fractures and eleven dislocations (six in the elbows, five in the shoulder combining for 76.08% of all fractures against 127 fractures (combining for 23.91% of all in the lower limbs. In the casuistic is included two vertebral fractures (coccix and one nasal fracture. Conclusions: the first obvious observation would concern the need of a directed prevention program, especially for the male teenagers, emphasizing the upper limbs. As of teaching programs and studies, it would be recommendable that the treatment of upper limbs trauma should be emphasized,in all of its segments.
Zhang, Chen; Zhu, Deyu; Luo, Qun; Liu, Luofu; Liu, Dongdong; Yan, Lin; Zhang, Yunzhao
2017-09-01
Natural fractures in seven wells from the Middle Permian Lucaogou Formation in the Junggar Basin were evaluated in light of regional structural evolution, tight reservoir geochemistry (including TOC and mineral composition), carbon and oxygen isotopes of calcite-filled fractures, and acoustic emission (AE). Factors controlling the development of natural fractures were analyzed using qualitative and/or semi-quantitative techniques, with results showing that tectonic factors are the primary control on fracture development in the Middle Permian Lucaogou Formation of the Junggar Basin. Analyses of calcite, dolomite, and TOC show positive correlations with the number of fractures, while deltaic lithofacies appear to be the most favorable for fracture development. Mineral content was found to be a major control on tectonic fracture development, while TOC content and sedimentary facies mainly control bedding fractures. Carbon and oxygen isotopes vary greatly in calcite-filled fractures (δ13C ranges from 0.87‰ to 7.98‰, while δ18O ranges from -12.63‰ to -5.65‰), indicating that fracture development increases with intensified tectonic activity or enhanced diagenetic alteration. By analyzing the cross-cutting relationships of fractures in core, as well as four Kaiser Effect points in the acoustic emission curve, we observed four stages of tectonic fracture development. First-stage fractures are extensional, and were generated in the late Triassic, with calcite fracture fills formed between 36.51 °C and 56.89 °C. Second-stage fractures are shear fractures caused by extrusion stress from the southwest to the northeast, generated by the rapid uplift of the Tianshan in the Middle and Late Jurassic; calcite fracture fills formed between 62.91 °C and 69.88 °C. Third-stage fractures are NNW-trending shear fractures that resulted from north-south extrusion and thrusting in a foreland depression along the front of the Early Cretaceous Bogda Mountains. Calcite fracture
Fracture mechanical materials characterisation
International Nuclear Information System (INIS)
Wallin, K.; Planman, T.; Nevalainen, M.
1998-01-01
The experimental fracture mechanics development has been focused on the determination of reliable lower-bound fracture toughness estimates from small and miniature specimens, in particular considering the statistical aspects and loading rate effects of fracture mechanical material properties. Additionally, materials aspects in fracture assessment of surface cracks, with emphasis on the transferability of fracture toughness data to structures with surface flaws have been investigated. Further a modified crack-arrest fracture toughness test method, to increase the effectiveness of testing, has been developed. (orig.)
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Martins Junior, José Carlos
2010-06-01
Full Text Available Introduction: Accidents involving the face have increased incidence in the last four decades. The medical literature refers to the increase in motor vehicle collisions and urban violence as the major causes of injuries, especially in young individuals. Objective: Raise the epidemiological profile of 222 patients with facial fractures at the Hospital Santo Antonio from 2004 to 2009. Method: Case study with retrospective analysis of records of patients diagnosed with facial fractures. Several variables were considered: gender, age, occupation, education level, origin, location and number of bones involved, etiology, and mean hospital stay of patients. Results: The male sex predominated with 178 cases (80.1%, the average age was 29.6 years, 86 (38.73% had a steady job. Unmarried 178 cases (80.18%. Primary school predominated among the patients, 74 (33.34%, and most live in the city of Blumenau, 175 (78.82%. The assault was primarily responsible for the surgical indication in 79 cases (35.58%, involving a bone in 193 cases (86.9%. The main bone involved was the mandible in 90 cases (40.54%. The average length of stay was 2.5 days. Conclusions: The epidemiological profile of 222 patients is an individual male, aged 20-29 years old, unmarried, low education and employee. The most prevalent etiology was assault, involving a bone, the mandible being the most involved bone.
Zehnder, Alan T
2012-01-01
Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering. He teaches applied mechanics and his research t...
Fractures and fracture infillings of the Eye-Dashwa Lakes pluton, Atikokan, Ontario
International Nuclear Information System (INIS)
Stone, Denver; Kamineni, D.C.
1982-01-01
Fractures in the Eye-Dashwa pluton near Atikokan, Ontario can be subdivided on the basis of their filling materials. These materials include aplite, epidote, chlorite, and gypsum-carbonate-clay, listed in order of decreasing age established from crosscutting relations. Textues indicate that infilling occurred during fracture growth. Continuous cooling of the pluton during fracturing is inferred from the expected crystallization temperatures of fillings. Fracturing began before the pluton was completely solidified (650-600 0 C) and continued to temperatures below 100 0 C. Many fractures appear to have been sealed by the filling materials after initiation but were subsequently sheared and filled by lower temperatue materials. Apparently the majority of fractures formed during or immediately after pluton solidification and new fractures became smaller and more restricted in location as cooling progressed. Fractures and filling materials are seen as important features in assessing the possibility of movement of radionuclides in aqueous solutions away from a nuclear fuel waste repository
Computed tomograms of blowout fracture
International Nuclear Information System (INIS)
Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo.
1985-01-01
We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author)
Computed tomograms of blowout fracture
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Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo
1985-02-01
We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author).
2016-2017 Update of Hydraulic Fracturing Induced Earthquakes near Fox Creek, Alberta
Wang, R.; Gu, Y. J.; Zhang, M.
2017-12-01
With a reported Richter magnitude (ML) of 4.8, the January 12, 2016 earthquake near Fox Creek is the largest event in Alberta during the past decade. This event led to the suspension of a nearby hydraulic fracturing well, in compliance with the provincial "traffic-light" protocol. In previous study, we examine the hypocenter location and focal mechanism of this earthquake, and the results support an anthropogenic origin. Since then (until August 2017), no event reached ML=4, while several ML>3 events occurred in the Fox Creek area. Their focal mechanisms are consistent with the ones from previous events that were induced by hydraulic fracturing, suggesting a strike-slip mechanism with either N-S or E-W trending fault. In 2017, the near-source station (distance Fox Creek region.
Simple Sugar Intake and Hepatocellular Carcinoma: Epidemiological and Mechanistic Insight
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Juan Carlos Laguna
2014-12-01
Full Text Available Sugar intake has dramatically increased during the last few decades. Specifically, there has been a clear trend towards higher consumption of fructose and high fructose corn syrup, which are the most common added sugars in processed food, soft drinks and other sweetened beverages. Although still controversial, this rising trend in simple sugar consumption has been positively associated with weight gain and obesity, insulin resistance and type 2 diabetes mellitus and non-alcoholic fatty liver disease. Interestingly, all of these metabolic alterations have also been related to the development of hepatocellular carcinoma. The purpose of this review is to discuss the evidence coming from epidemiological studies and data from animal models relating the consumption of simple sugars, and specifically fructose, with an increased risk of hepatocellular carcinoma and to gain insight into the putative molecular mechanisms involved.
Ricketts, Sophie; Gill, Hameet S; Fialkov, Jeffery A; Matic, Damir B; Antonyshyn, Oleh M
2016-02-01
After reading this article, the participant should be able to: 1. Demonstrate an understanding of some of the changes in aspects of facial fracture management. 2. Assess a patient presenting with facial fractures. 3. Understand indications and timing of surgery. 4. Recognize exposures of the craniomaxillofacial skeleton. 5. Identify methods for repair of typical facial fracture patterns. 6. Discuss the common complications seen with facial fractures. Restoration of the facial skeleton and associated soft tissues after trauma involves accurate clinical and radiologic assessment to effectively plan a management approach for these injuries. When surgical intervention is necessary, timing, exposure, sequencing, and execution of repair are all integral to achieving the best long-term outcomes for these patients.
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David Nicoletti Gumieiro
2015-04-01
Full Text Available OBJECTIVE: To assess whether serum vitamin D concentration is associated with gait status and mortality among patients with fractures of the proximal femur, six months after suffering the fracture.METHODS: Consecutive patients aged ≥65 years with fractures of the proximal femur, who were admitted to the orthopedics and traumatology ward of our service between January and December 2011, were prospectively evaluated. Clinical, radiological, epidemiological and laboratory analyses were performed, including vitamin D. The patients underwent surgery and were followed up as outpatients, with return visits 15, 30, 60 and 180 days after discharge, at which the outcomes of gait and mortality were evaluated.RESULTS: Eighty-eight patients were evaluated. Two of them were excluded because they presented oncological fractures. Thus, 86 patients of mean age 80.2 ± 7.3 years were studied. In relation to serum vitamin D, the mean was 27.8 ± 14.5 ng/mL, and 33.7% of the patients presented deficiency of this vitamin. In relation to gait, univariate and multivariate logistic regression showed that vitamin D deficiency was not associated with gait recovery, even after adjustment for gender, age and type of fracture (OR: 1.463; 95% CI: 0.524-4.088; p = 0.469. Regarding mortality, Cox regression analysis showed that vitamin D deficiency was not related to its occurrence within six months, even in multivariate analysis (HR: 0.627; 95% CI: 0.180-2.191; p = 0.465.CONCLUSION: Serum vitamin D concentration was not related to gait status and/or mortality among patients with fractures of the proximal femur, six months after suffering the fracture.
Ahern, Benjamin J; Richardson, Dean W; Boston, Raymond C; Schaer, Thomas P
2010-07-01
To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Case series. Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5-fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.
Radionuclide transport in fractured media
International Nuclear Information System (INIS)
Williams, M.M.R.
1993-01-01
Until recently, the classical advective-dispersive transport equation was considered to be an adequate model for describing the motion of a solute (e.g. radionuclides) in porous and fractured media. In this model, the dispersion coefficient is either obtained from a microscopic model of the porous medium or by carefully controlled experiments. As a result of such experiments, a large body of data has been accumulated on the dispersivity. Detailed examination of these data has resulted in a curious phenomenon being discovered; namely, that the longitudinal dispersion length is 'scale-dependent'. That is to say the value deduced depends on the 'size' of the experiment, i.e. on the distance over which measurements are made. Several interesting attempts have been made to develop theories which explain this phenomenon, all based on treating the velocity of the water in the porous medium as a spatially random variable, but retaining the advective-dispersive balance equation. In this work we present an entirely new approach to the problem of solute transport in fractured media based upon an analogy with neutron transport. The new method has several advantages over the previous theories and these will be explained below. Results from the new theory are in agreement with experimental trends and do not require any further adjustment to explain the scale-dependent effect
Hanke, John R.; Fischer, Mark P.; Pollyea, Ryan M.
2018-03-01
In this study, the directional semivariogram is deployed to investigate the spatial variability of map-scale fracture network attributes in the Paradox Basin, Utah. The relative variability ratio (R) is introduced as the ratio of integrated anisotropic semivariogram models, and R is shown to be an effective metric for quantifying the magnitude of spatial variability for any two azimuthal directions. R is applied to a GIS-based data set comprising roughly 1200 fractures, in an area which is bounded by a map-scale anticline and a km-scale normal fault. This analysis reveals that proximity to the fault strongly influences the magnitude of spatial variability for both fracture intensity and intersection density within 1-2 km. Additionally, there is significant anisotropy in the spatial variability, which is correlated with trends of the anticline and fault. The direction of minimum spatial correlation is normal to the fault at proximal distances, and gradually rotates and becomes subparallel to the fold axis over the same 1-2 km distance away from the fault. We interpret these changes to reflect varying scales of influence of the fault and the fold on fracture network development: the fault locally influences the magnitude and variability of fracture network attributes, whereas the fold sets the background level and structure of directional variability.
Andrade, Neelam N; Choradia, Smriti; Sriram S, Ganapathy
2015-09-01
In maxillofacial surgery, children represent a special group of patients, as they have significant differences from adults as far as the facial skeleton is concerned. The etiology and epidemiology of pediatric trauma involving the facial skeleton has been reported in a large series of patients. Nevertheless, few of these reports review large numbers of pediatric patients, and little is known about treatment protocols for fractures in children. The aims of this study were to retrospectively analyze the treatment methods and outcomes of pediatric mandibular fractures in children and young adolescents up to the age of 15 years, to discuss the findings, and to propose treatment protocols for maxillofacial fractures in childhood. The present study retrospectively analyzed the treatment methods and outcome of the pediatric mandibular fractures in children and young adolescents' up to the age of 15 years over a period of 5 years. All patients were followed up for an average period of 18 months, with a maximum follow-up of 2 years. A total of 74 patients were treated for mandibular and dentoalveolar fractures in children upto the age of 15 years at the Department of Oral and Maxillofacial Surgery at Nair Hospital Dental College, Mumbai from 2007 to 2012. AND CONCLUSIONS: The treatment methods used at our centre had satisfactory outcomes at the end of a follow-up period of 2 years. Reported complications were minimal. Our results confirm the usefulness of open reduction and plate fixation in older children (>12 years of age) and a conservative approach in younger children (≤12 years of age) in treating mandibular fractures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
International Nuclear Information System (INIS)
Marschall, C.W.; Landow, M.P.; Wilkowski, G.M.
1993-10-01
Material characterization tests were conducted on laboratory specimens machined from pipes to determine the effect of dynamic loading (i.e., rates comparable to those for high amplitude seismic events) on tensile properties and fracture resistance at 288 C (550 F). Specimens were fabricated from seven different pipes, including carbon steels and stainless steels (both base metal and weld metal), which were to be subjected to full-scale pipe tests in IPIRG Task 1.0. For the stainless steels tested at 288 C (550 F), tensile strength was unchanged, while yield strength and fracture resistance were increased. The increase in fracture resistance was modest for the wrought base metals and substantial for the weld metal and the cast base metal. The carbon steels tested were sensitive to dynamic strain aging, and hence the strength and toughness was affected by both temperature and strain rate effects. The carbon steel base metal and welds exhibited ultimate tensile strength values at 288 C (550 F) that were greater than at room temperature. Furthermore, the ultimate tensile strength at 288 C (550 F) was lowered significantly by increased strain rate and, in the carbon steel base metals, increased strain rate also lowered the fracture resistance, substantially in the base metal of one pipe. In comparing these results to the IPIRG pipe test results to date, it was found that the trends of these tests agree well with the Subtask 1.2 quasi-static and dynamic pipe fracture experiments. Loads measured in the Subtask 1.1 pipe experiments were, however, somewhat higher than would have been expected by the trends observed in the laboratory tests
Mechanics of Hydraulic Fractures
Detournay, Emmanuel
2016-01-01
Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.
DEFF Research Database (Denmark)
Hassager, Ole
Fracture is a phenomenon that is generally associated with solids. A key element in fracture theory is the so-called weakest link idea that fracture initiates from the largest pre-existing material imperfection. However, recent work has demonstrated that fracture can also happen in liquids, where...... surface tension will act to suppress such imperfections. Therefore, the weakest link idea does not seem immediately applicable to fracture in liquids. This presentation will review fracture in liquids and argue that fracture in soft liquids is a material property independent of pre-existing imperfections....... The following questions then emerge: What is the material description needed to predict crack initiation, crack speed and crack shape in soft materials and liquids....
McCall, N.; Gulick, S. P. S.; Morgan, J. V.; Hall, B. J.; Jones, L.; Expedition 364 Science Party, I. I.
2017-12-01
During Expedition 364, IODP/ICDP drilled the peak ring of the Chicxulub impact crater at Site M0077, recovering core from 505.7 to 1334.7 mbsf. The core has been imaged via X-ray Computer Tomography (CT) as a noninvasive method to create a 3-dimensional model of the core, providing information on the density and internal structure at a 0.3 mm resolution. Results from the expedition show that from 748 mbsf and deeper the peak ring is largely composed of uplifted and fractured granitic basement rocks originally sourced from approximately 8-10 km depth. Impact crater modeling suggests the peak ring was formed through dynamic collapse of a rebounding central peak within 10 minutes of impact, requiring the target rocks to temporarily behave as a viscous fluid. The newly recovered core provides a rare opportunity to investigate the cratering process, specifically how the granite was weakened, as well as the extent of the hydrothermal system created after the impact. Based on the CT data, we identify four classes of fractures based on their CT facies deforming the granitoids: pervasive fine fractures, discrete fine fractures, discrete filled fractures, and discrete open fractures. Pervasive fine fractures were most commonly found proximal to dikes and impact melt rock. Discrete filled fractures often displayed a cataclastic texture. We present density trends for the different facies and compare these to petrophysical properties (density, NGR, P-wave seismic velocity). Fractured areas have a lower density than the surrounding granite, as do most filled fractures. This reduction suggests that fluid migrating through the peak ring in the wake of the impact either deposited lower density minerals within the fractures and/or altered the original fracture fill. The extent and duration of fluid flow recorded in these fractures will assist in the characterization of the post-impact hydrothermal system. Future work includes combining information from CT images with thin sections