Real World Experience of Denosumab Treatment in the Belfast Osteoporosis Service.

Osteoporosis is a significant global health and economic burden associated with bone fracture, morbidity and mortality. Denosumab, a novel human monoclonal antibody second-line treatment, inhibits osteoclast-mediated bone resorption and increases bone mineral density (BMD). Treatment achieves reductions in vertebral, non-vertebral and hip fracture risk.

Previously undiagnosed aortic stenosis revealed by auscultation in the hip fracture population--echocardiographic findings, management and outcome.

The 2001 Report of the National Confidential Enquiry into Perioperative Deaths recommended that an echocardiogram should be performed on patients with aortic stenosis prior to anaesthesia. In this study we present the patient details, management and outcome of the 272 hip fracture patients with a previously undiagnosed murmur and echocardiographically proven aortic stenosis admitted from 2001-2005 in our hospital. The patients with aortic stenosis were significantly older, and had significantly lower Abbreviated Mental Test Scores, than the control group of 3698 hip fracture patients without aortic stenosis.

Outcome following proximal femoral fracture in Northern Ireland.

Objective: To study the outcome following treatment for proximal femoral fracture in elderly people.

Methods: All consecutive males and females admitted to the acute fracture service at the Royal Victoria Hospital and the Belfast City Hospital for the 3 years from 1999 to 2001 were studied. The data was collected by trained research nurses.

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.

A study of bone mineral density in women with forearm fracture in Northern Ireland.

A group of Northern Ireland women aged 40-75 years of age with low-trauma forearm fracture were studied to determine the incidence of such fractures and the prevalence of osteoporosis in this fracture population. A total of 1,147 subjects were identified in 1997 and 1998 throughout Northern Ireland following low-trauma forearm fractures, as well as 699 residents in the Eastern Health and Social Services Board (EHSSB), enabling calculation of the annual incidence rate of new low-trauma forearm fractures at 2.69/1,000 population aged 40-75.

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.