Biomedical subjects

G Poór

Publications and source records attributed to G Poór.

At least 37 records · Page 2Linked to original sources

PubMed1995

Predictors of hip fractures in elderly men.

To assess the influence on the risk of hip fractures in men of medical conditions associated with secondary osteoporosis or with an increased likelihood of falling, we conducted a population-based nested case-control study among the 232 Rochester, Minnesota, men with an initial hip fracture due to moderate trauma in 1965-1989 and an equal number of age-matched control men from the general population. Information on selected medical and surgical conditions and certain behavioral risk factors prior to fracture (or comparable index date for controls) was obtained from inpatient and outpatient medical records in the community that averaged over 36 years in duration. After adjusting for age, obesity, and inactivity, disorders linked with secondary osteoporosis were associated with a 2-fold increase in the risk of hip fracture in men (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.3-4.3), while conditions linked with an increased risk of falling were associated with almost a 7-fold increase in risk (OR 6.9; 95% CI 3.3-14.8). These factors together appeared to account for about 72% of the hip fractures in men. Increased attention must be paid to these conditions which, in aggregate, are very common in elderly men and lead to a substantial increase in the risk of hip fracture with its devastating sequelae of death, disability and cost.

Adult↗

PubMed1995

Age-related hip fractures in men: clinical spectrum and short-term outcomes.

Clinical spectrum, treatment and short-term outcomes were assessed among the 131 Rochester, Minnesota, men who contracted an initial hip fracture due to moderate trauma during 1978-89. Three-fourths of falls leading to hip fracture occurred indoors with little seasonality, and 91% of fractures were in men 65 years of age or older. The ratio of cervical to intertrochanteric femur fractures was 1.4:1, and there was a tendency toward more neurological conditions among the patients with cervical fractures. Hemiarthroplasty and total hip replacement were mostly performed for cervical fractures, while internal fixation was preferred for intertrochanteric fractures. In-hospital mortality was 11.5%, and the 30-day case fatality rate was 16.0%. Age and postoperative deterioration of mental status significantly increased the risk of early death, the latter even after adjustment in a multivariate model, while comorbidity had a suggestive but not statistically significant influence on mortality. More than half the men were discharged to nursing homes, and 79% of the patients who survived at 1 year resided in nursing homes or intermediate care facilities or were attended by home care. Only 41% of survivors recovered their prefracture level of functioning and nearly 60% of patients limped and required a cane or walker. After implementation of the prospective payment system in 1984, the length of hospital stay was reduced, but there was no change in early mortality rates, in the duration of physical therapy following fracture or in attendance at nursing homes. The results of this population-based study demonstrate the strong impact of hip fractures on short-term outcomes in men.

Accidental Falls↗

PubMed1995

Crystal arthritis.

Diagnostic and classification criteria have the purpose of separating patients with a certain disease from those without the condition and from normal subjects. Specific identification of the different microcrystals establishes the definite diagnosis of crystal arthritides. The diagnostic criteria for gouty arthritis set up by the American Rheumatism Association in 1975 function well; both their sensitivity and specificity are satisfactory. Unfortunately, we have had no data on the real value of the diagnostic criteria used in CPPD or in hydroxyapatite deposition disease. Status or ranking criteria for stratifying patients by state of disease, such as activity or damage, have not been developed as yet in any type of crystal induced arthropathies. Reliable prognostic criteria sets and outcome criteria are clearly needed to indicate the course of the diseases at the onset, as well as to define the overall impact, of crystal deposition diseases.

Apatites↗

PubMed1995

Determinants of reduced survival following hip fractures in men.

To assess determinants of poor survival after hip fractures in men, a population-based cohort study was conducted among 131 men in Rochester, MN, who had their first hip fracture during the period from 1978 to 1989, and an equal number of age-matched control men from the community. One hundred nine patients with fractures died during 373 person-years of followup, but only 75 control men died during 742 person-years of observation. The risk of dying increased with the level of comorbidity among hip fracture cases (hazard ratio 3.2; 95% confidence interval, 1.2-8.2), as well as with age (hazard ratio, 1.4 per 10-year increase; 95% confidence ratio, 1.1-1.8) and mental confusion during hospitalization (hazard ratio, 4.2; 95% confidence interval, 2.5-6.9). Discharge to a nursing home and low activity status also were predictors of death in the univariate analysis. Excess mortality among men with hip fractures can be explained best by interaction of the fracture with serious underlying medical conditions.

Activities of Daily Living↗

PubMed1992

[Epidemiologic aspects of osteoporosis and fractures in advanced age].

The most important word-wide and home trends of osteoporosis and age-related fractures are reviewed. The author summarizes the relationship between fractures and bone mass, the bone mass determinants and the risk factors for osteoporosis. He describes the secular trends, age- and sex specific incidence as well as geographic distribution of fractures of the proximal femur, vertebrae and distal forearm. Finally the social and financial impact of this major public health problem are discussed.

Age Factors↗

PubMed1992

Clinical and family studies in Hungarian patients with gout.

In this study we examined 22 Hungarian male probands with gout and 105 of their first degree relatives. This was the first family study in Hungary in which the characteristics of distribution of gout and hyperuricaemia among patients with gout and their first degree relatives, as well as the possible correlation between the prevalence of the disease and MHC class I antigens was investigated. Our gout patients showed the following characteristics: (1) There was a typical onset after age 40, benign oligoarticular form of arthritis, underexcretion of uric acid, moderate hypertension without evidence of reduced renal function, and a relatively high frequency of hyperostosis. (2) The prevalence of hyperuricaemia and gout exceeded the general population level in the first degree relatives of our gout patients. (3) The distribution of MHC class I antigens among the first degree relatives of our patients with gout showed no characteristic patterns. (4) There was no correlation between HLA B27 antigens and prevalence of gout or hyperostosis in family sibling studies. (5) The high frequency of gout and hyperuricaemia, as well as the lack of characteristic HLA patterns among the first degree relatives of gout patients in our family studies, point to the possible cumulative effect of several genes and environmental factors in the etiopathogenesis of this disease.

Adult↗

PubMed1989

Saturnine gout.

The history of saturnine gout is almost as old as civilization itself. Studies carried out in recent decades explain the development of hyperuricaemia and gout, with the inhibiting effect of lead on the tubular urate transport causing decreased urate excretion. In the case of lead intoxication these effects are often associated with renal failure but may occur without clinical features of lead toxicity and renal damage. The clinical features of saturnine gout are essentially similar to those of primary gout; however, acute attacks tend to occur in the knee more frequently than the first metatarsophalangeal joint. Acute attacks in saturnine gout are frequently polyarticular and tophi rarely develop. The diagnosis of saturnine gout rests on the history of exposure to lead, clinical features of lead toxicity, biochemical confirmation of high serum lead levels and other biochemical abnormalities, and the exclusion of other forms of gout. Treatment consists of excluding the patient from further exposure to lead, the use of chelating agents to remove lead, and control of acute gouty arthritis and hyperuricaemia.

Arthritis, Gouty↗

PubMed1987