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Biomedical subjects

G Iolascon

Publications and source records attributed to G Iolascon.

7 recordsLinked to original sources

Incidence and costs of hip fractures compared to acute myocardial infarction in the Italian population: a 4-year survey.

INTRODUCTION: Few data are available about the incidence and costs of hip fractures in Italy. We aimed to determine the impact of hip fractures vs. acute myocardial infarction (AMI). METHODS: We studied the national hospitalization database to calculate their incidence and costs in adults aged >or=45 between 1999 and 2002. RESULTS: In 2002, there were 86,719 hip fractures with a 10.0% increase over 4 years. We observed a predominance of women (77.1%) and a strong age effect: 92.7% of patients were >or=65 years old and 80% of fractures occurred in women aged >or=75, showing a clear relationship with the incidence of osteoporosis. Hospitalizations due to AMI after 45 years of age in 1999 were only 9% higher than those for hip fracture, although this difference increased over the 4 examined years up to 24%. Considering the DRGs costs, hip fractures resulted in being more expensive than AMI overall and concerning elderly people. CONCLUSIONS: This study shows that in the Italian population aged >or=45, hospitalizations following hip fracture and AMI between 1999 and 2002 were comparable, while hip fractures' direct costs were higher and grew faster than costs for AMI. Hip fractures in Italy are a serious medical problem and a leading health-cost driver.

Age Distribution↗

[Idiopathic and secondary osteoporosis in childhood].

Osteoporosis is a common disease characterized by reduced bone mass, with a consequent increase in bone fragility and susceptibility to fracture risk. Bone mineral density (BMD) measurement is used to make the diagnosis of osteoporosis prior to incident fracture, and to predict fracture risk. BMD is determined by the peak bone mass achieved, and the rate and timing of subsequent bone loss. Dual-energy X-ray absorptiometry (DEXA) is the most popular and effective method utilized for osteoporosis screening. Bone disease is a side effect of concern regarding chronic glucocorticoid (GC) administration. Most GC-treated patients exhibit a process of bone loss, frequently leading to osteoporosis, with increased fracture risk, especially in spinal vertebrae. Osteogenesis imperfecta is an inherited and generalized connective tissue disorder characterized mainly by bone fragility. Idiopathic osteoporosis of childhood or adolescence without blue sclerae and other stigmata of osteogenesis imperfecta is occasionally observed and sometimes more than one sib is affected. Beta-thalassemia major is associated with significant bone disease. The etiology of the bone disease is still debatable, many factors can adversely affect bone accretion in thalassemic patients. These include delayed puberty, bone marrow expansion, the deleterious effects of desferrioxamine, iron overload and genetic factors. Current treatment alternatives of osteoporosis include bisphosphonates, calcitonin, and selective estrogen receptor modulators.

Absorptiometry, Photon↗

Osteoporosis in beta-thalassaemia major patients: analysis of the genetic background.

Regular blood transfusions from infancy until adulthood in beta-thalassaemia major patients have substituted severe bone deformities with less marked skeletal lesions as osteoporosis. Osteoporosis is characterized by low bone mass and disruption of bone architecture, resulting in reduced bone strength and increased risk of fractures. Genetic factors have an important role in determining bone mineral density (BMD). We have investigated the possible association between BMD and two polymorphisms in 135 beta-thalassaemic patients: (i) a substitution G-->Tau in a regulatory region of the COLIA1 gene encoding for the major protein of bone (type 1 collagen), and (ii) a one-base deletion in intron 4 (713-8del C) of transforming growth factor beta 1 (TGF-beta1) gene. We have found a remarkable incidence (90%) of osteopenia and osteoporosis among regularly transfused patients. Bone mass was lower in men than in women (P = 0.0023), with a more prevalent osteopenia/osteoporosis of the spine in men than in women (P = 0. 001). The sample was stratified on the basis of BMD expressed as Z-score, i.e. normal, osteopenic and osteoporotic patients, and genotype frequencies of each group were evaluated. TGF-beta1 polymorphism failed to demonstrate a statistical difference in BMD groups. However, subjects with heterozygous or homozygous polymorphism of the COLIA1 gene showed a lower BMD than subjects without the sequence variation (P = 0.012). The differences among genotypes were still present when the BMD was analysed as adjusted Z-score and when men and women were analysed separately (P = 0.022 and 0.004 respectively), with men more severely affected. Analysis of COLIA1 polymorphism could help to identify those thalassaemic patients at risk of osteoporosis and fractures.

Adult↗

[The importance of estradiol treatment by the transdermal route in preventing postmenopausal osteoporosis].

The authors selected 18 women in surgical menopause in order to evaluate the validity of estrogen treatment for the prevention of postmenopausal osteoporosis. Ten of these patients were given transdermal estradiol continuously for 12 months while the remaining eight served as untreated controls. Urinary hydroxyproline and bone density were assessed before and at previously determined intervals during treatment: the results showed the importance of estrogen replacement therapy for the prevention of postmenopausal osteoporosis.

Administration, Cutaneous↗