Search

The article presents a study which aims to evaluate the rates of initializing osteoporosis treatment during the hospitalization of patients with acute fragility hip fracture. The study uses analysis of variance (ANOVA) or chi-square tests to assess the differences in the mean age and length of stay (LOS). The results show that osteoporosis treatment rates increases among patients with fragility fracture and can help reduce mortality and morbidity post fracture.

The article presents a study on the relationship between musculoskeletal injuries and anabolic-androgenic steroids. The study is undertaken to investigate the association between anabolic-androgenic steroids and the prevalence of musculoskeletal injuries common to a group of retired professional football players of the National Football League (NFL). It is undertaken through the use of a set of general health questionnaire answered by 2,552 retired professional football players of which survey data are collected. The results of the study are presented which concludes that the relationship between anabolic-androgenic steroid and musculoskeletal injuries may exist.

The article assesses the factors associated with discharge disposition to either inpatient rehabilitation or home after acute stroke hospitalization. The authors found that older age, a greater number of intensive care unit days, higher total therapy charges and lower poverty in their country of residence were associated with discharge to acute inpatient rehabilitation. The authors also report that factors associated with discharge to home included younger age, fewer intensive care unit days, lower therapy charges and higher poverty in their country of residence.

The article evaluates the association of race and acute discharge to inpatient stroke rehabilitation in the state of Maryland. The study used the data from the Maryland Health Services Cost Review Commission database for 2000 in determining the rate of disposition to inpatient rehabilitation facilities. Multiple logistic regression analyses were used to examine factors related with discharge to inpatient rehabilitation facilities in black patients. It was found that urban-dwelling black stroke patients were more likely to be discharged to inpatient rehabilitation facilities acutely after stroke.

The article presents a study that evaluates the connection between race and medical referral to cardiac rehabilitation programs in Baltimore, Maryland. It was revealed that racial disparities exist in recommendation for cardiac rehabilitation programs in city hospitals. White Americans tend to be referred for cardiac treatment than African Americans. Race is noted to be one of the factors that affects the accessibility of adequate health services. Researchers suggest the provision of educational programs to patients and healthcare providers about the services for cardiac rehabilitation initiatives.

A response by Patricia C. Gregory, Thomas A. LaVeist and Crystal F. Simpson to a letter to the editor about their article "Racial Discrimination in Access to Cardiac Rehabilitation" is presented.

The article focuses on acute arterial occlusion, a serious but treatable complication of knee-joint arthroplasty. It claims that its threat from limb ischemia requires prompt evaluation to identify the location of the occlusion. In the case study presented, a prevalence of 0.03-0.17% has been cited in acute arterial occlusion after knee arthroplasty. It is presumed to be caused by the use of tourniquets, which cause pressure on preexisting atheromatous plaques. The use of torniquet is also claimed to produce an ischemic state that lessens blood loss, a clearer operating field, and a better environment for the cement-to-bone interface. Moreover, it resolves that careful monitoring of the neurovascular status of the limb in the postoperative phase is the key to early diagnosis and treatment.

Objective: Deep venous thromboembolism (DVT) is an important health issue in the hospitalized geriatric population that leads to increased length of stay, morbidity, and mortality. Patients with hemorrhagic strokes are usually not placed on prophylactic therapy because of the risk of hemorrhagic extension of the stroke. The purpose of this study was to evaluate the prevalence of DVTs in hospitalized patients with hemorrhagic vs. thromboembolic strokes., Design: Retrospective chart review of data obtained from the Maryland Health Services Cost Review Commission data base for 1999 to determine the prevalence of DVTs in both hemorrhagic and thromboembolic stroke patients hospitalized acutely. Multiple logistic regression was performed to evaluate possible risk factors., Results: There were 1926 patients hospitalized with a primary diagnosis of hemorrhagic stroke and 15599 with thromboembolic stroke. Women in general had more strokes than men did. Older patients were more likely to have strokes as evidenced by the mean ages of 66 and 71 yr for hemorrhagic and thromboembolic strokes, respectively. A total of 37 patients (1.9%) with hemorrhagic strokes had DVTs, whereas 74 patients (0.5%) with thromboembolic strokes had DVTs. Hemorrhagic stroke was an independent risk factor for DVT (odds ratio, 2.60; 95% confidence interval, 1.49-4.55; P = 0.0008)., Conclusions: DVT prevalence and risk was higher among patients with hemorrhagic strokes in comparison with patients with thromboembolic strokes.

Paraneoplastic cerebellar degeneration is a neurologic syndrome associated with carcinoma. Medical management is limited to treatment of the underlying malignancy with excision, plasmapharesis, immunosuppression, or chemotherapy. We report on the case of a woman with paraneoplastic cerebellar degeneration who showed improvements in functional mobility after 3 wk of comprehensive inpatient rehabilitation. This case demonstrates the functional improvements of one patient with paraneoplastic cerebellar degeneration after intensive rehabilitation and describes the specific treatment interventions utilized.

Objective: Previous studies have identified risk factors for decline in physical function, but they have not examined specific reasons older adults report difficulty with mobility tasks., Design: Community-dwelling people ( n = 160) aged 59 yr and older in an observational cohort study were questioned to determine the most common cited reasons for self-reported difficulty in task performance., Results: Mobility tasks were most often reported to be difficult (66%). The reasons cited for difficulty in low exercise tolerance tasks were task modification by method (33%) and rate (33%). For high exercise tolerance tasks, reasons cited included having to modify the rate of performing the task (20%) or the method (13%). Among those who reported difficulty with low exercise tolerance mobility tasks, >80% reported modification (odds ratio, 46.4 [95% confidence limits: 9.75, 220.51]) and 32% also report frequency change (odds ratio, 5.9 [95% confidence limits: 2.72, 12.85]) as the reason for perceiving difficulty. For those who reported difficulty performing high exercise tolerance-demanding tasks, >90% reported modification (odds ratio, 5.5 [95% confidence limits: 2.05, 14.88]) and 61% also report frequency changes (odds ratio, 3.9 [95% confidence limits: 1.93, 8.04])., Conclusion: The findings suggest that people are able to cite specific reasons for difficulty with mobility task performance, most commonly related to task modification.