Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy.

Background: Corticosteroid treatment is considered the 'gold standard' for Duchenne muscular dystrophy (DMD); however, it is also known to induce osteoporosis and thus increase the risk of vertebral fragility fractures. Good practice in the care of those with DMD requires prevention of these adverse effects. Treatments to increase bone mineral density include bisphosphonates and vitamin D and calcium supplements, and in adolescents with pubertal delay, testosterone.

Recombinant PTH: a study of the outcome of teriparatide therapy for 138 patients with osteoporosis.

Introduction: Osteoporosis results in significant morbidity and mortality for a large number of patients within Northern Ireland. Recombinant PTH (Teriparatide) is one of a growing number of treatment options for the disease.

Methods: A retrospective analysis was carried out for all patients who had been commenced on Teriparatide since it was first used in the Belfast Health and Social Care Trust (BHSCT) in 2007.

Hip fracture in Northern Ireland, 1985-2010. Are age-specific fracture rates still rising?

Background: The aims of this study were to review and update previous projections of the number of proximal femoral fractures in the Northern Ireland population and to ascertain if the trend of increasing age-specific fracture incidence was continuing.

Methods: Data from 1985 to 1997 was obtained from hospital theatre records to ascertain the number of surgical procedures for proximal femoral fracture. Data for the years 2005 and 2010 was obtained from Northern Ireland's Fracture Outcomes Research Database (FORD) and locally held records in one region not then using FORD.

Paraneoplastic limbic encephalitis in an elderly patient with small cell lung carcinoma.

We report a case of paraneoplastic limbic encephalitis (PLE) in an elderly lady with small-cell lung carcinoma (SCLC) and positive anti-RI neuronal auto-antibody. PLE is a relatively rare clinical entity associated with cancer patients, but is probably under-diagnosed. PLE typically presents clinically with affective changes in personality, cognitive dysfunction and seizures in a patient with malignancy, particularly SCLC.

A study of male patients with forearm fracture in Northern Ireland.

Osteoporosis, although considered less common, still occurs in men. We present a cross-sectional study of a group of Northern Ireland men with low-trauma forearm fractures to determine the presence of osteoporosis and screen for secondary causes of low bone mineral density. Male patients aged 30-75 years, presenting with distal forearm fracture in 2000-2001 in Northern Ireland, were identified through a Colles fracture database.

Factors affecting adherence to use of hip protectors amongst residents of nursing homes--a correlation study.

Background: Hip protectors are protective pads designed to cover the greater trochanter and attenuate or disperse the force of a fall sufficiently to prevent a hip fracture. Promising results from randomised controlled trials in nursing homes have resulted in hip protectors being widely recommended in the health care literature and in national guidelines.

Objectives: The objectives of the study were to identify characteristics of individual residents, and the organisational features of the homes in which they live, which may affect adherence to wearing hip protectors.

The effect of type of hip protector and resident characteristics on adherence to use of hip protectors in nursing and residential homes--an exploratory study.

Objectives: To investigate the factors influencing the acceptability of hip protectors to residents of nursing and residential homes, especially the effect of hip protector type, and resident characteristics.

Design: A randomised controlled trial with 12 weeks follow-up. Participants were randomised to receive either Safehip or HipSaver hip protectors.

A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes.

Objectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes.

Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation.

Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland.

Orthogeriatric care in patients with fractures of the proximal femur.

How are we to cope with the complex problems that now surround elderly patients with fractures? What are these problems and what systems should be in place to address them? No matter how successful we may be in treatment of osteoporosis and prevention of falls, it is inevitable that a massive worldwide increase in incidence of fragility fractures will occur in the next 50 years. It is crucial that we upgrade our systems to cope with this, if severe disruption of health services is to be avoided. This review considers the topics of falls, osteoporosis, and impact modification.

Factors influencing prescription of CNS medications in different elderly populations.

Factors influencing the use of neuroleptic and other CNS-acting medications ('antidepressants' and 'hypnotics/anxiolytics') were examined in different elderly populations (> 65 years): long-stay care hospital subjects (n = 381), nursing home subjects (n = 1247), private residential home subjects (n = 321), statutory residential home subjects (n = 525), old age psychiatry facility subjects (n = 48), community dwellers (n = 97), in different geographical areas (urban n = 1223 and rural n = 1396). Neuroleptics were prescribed in 28% of the individuals, hypnotics/anxiolytics in 33% and antidepressants in 12%. Prescription of neuroleptics was significantly predicted by institutional placement (other than long-stay care hospital facility), lower cognitive function and rural geographical area.

Institutional care for elderly people in North and West Belfast. A decade of change from 1989-1999.

Background And Aims: We wished to document the pattern of institutional care for dependent elderly people during a period of altered provision of care, namely a shift from National Health Service long-term hospital care provision to residential and nursing home provision in the private sector.

Methods: We systematically studied all Institutionalized people aged 65+ years in a single geographic area in 1989, 1992, 1995 and 1999. Subjects' physical and mental function was assessed using the Barthel Index and the Abbreviated Mental Test.