Radiographic images were reviewed to assign fracture pattern and

Radiographic images were reviewed to assign fracture pattern and distinguish atypical femur fracture from non-atypical femur fracture. Differences in clinical characteristics and pharmacologic

exposures were compared.\n\nResults: Among 79 women (38 subtrochanteric and 41 femoral shaft fracture), 38 had an atypical femur fracture. Compared to those with a non-atypical femur fracture, women with atypical femur fracture were significantly younger (74.0 vs 81.0 years), more likely to be Asian (50.0 vs 2.4%) and to have received bisphosphonate therapy (97.4 vs 41.5%). Similarly, the contralateral femur showed a stress or complete fracture in 39.5% of atypical femur fractures vs 2.4% non-atypical femur fracture, and focal cortical hypertrophy of the contralateral femur in an additional 21.1% of atypical YAP-TEAD Inhibitor 1 molecular weight cases.\n\nConclusions: Women suffering atypical femur fractures have a markedly different clinical profile from

those sustaining typical fractures. Women with atypical femur fracture tend to be younger, Asian, and bisphosphonate-exposed. The high frequency of contralateral femur findings suggests a generalized process. (C) 2012 Elsevier Inc. All rights reserved.”
“Background: Sepsis is the commonest RG-7112 precipitating factor for acute kidney injury in hospitalised patients, and similarly patients with acute kidney injury are predisposed to sepsis. Mortality remains high despite improvements in supportive care. Methods: Literature search of Medline and Web of Science. Results: Above a threshold dialytic dose of 20 ml/kg/h for continuous renal AZD0530 cell line replacement therapy and a sessional Kt/V of 1.2 for intermittent dialysis, further increases in dose do not appear to impact on survival. Similarly, no treatment mode offers survival advantage, and renal support should be targeted to maintain electrolyte homeostasis and correct volume overload.

Additional therapies designed to reduce the inflammatory milieu associated with sepsis have been studied, including increased permeability dialysers, plasma filtration and adsorption techniques, endotoxin filters, selective leucapheresis and bio-artificial renal devices. Antibiotic-coated catheters have been shown to reduce catheter-associated bacteraemia. Conclusions: Although no modality confers survival advantage, prevention of intratreatment hypotension may result in increased dialysis independence in the survivors, and as such treatments should be designed to minimise the risk of hypotension. As patients with acute kidney injury are at risk of sepsis, catheter-associated bacteraemia should be minimised by using antibiotic-or antiseptic-coated catheters, and hub colonisation reduced with appropriate catheter locks. Further trials of adjunct therapies designed to reduce the inflammatory milieu are required before these potential advances can be recommended for clinical practice. Copyright (C) 2011 S.

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