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Sjors Verlaan Gerdien C. Ligthart-Melis Sander L.J. Wijers Tommy Cederholm Andrea B. Maier Marian A.E. de van der Schueren 《Journal of the American Medical Directors Association》2017,18(5):374-382
Background
Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other.Methods
A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini- Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa.Results
In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P < .0001). However, the syndromes were not interchangeable: 68% of the malnourished older adults was physically frail, whereas only 8.4% of the physical frail population was malnourished.Conclusions
The systematic review and meta-analysis revealed that malnutrition and physical frailty in community-dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished. 相似文献4.
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Background context
Diffuse idiopathic skeletal hyperostosis (DISH) is a common but underdiagnosed condition relating to ossification of spinal ligaments that can cause compression of the esophagus and trachea. According to case reports, dysphagia or airway obstruction resulting from DISH is a rare occurrence.Purpose
This study was intended to identify all published cases of dysphagia and/or airway obstruction resulting from DISH to increase the epidemiologic/clinical knowledge of these related conditions.Study design
A systematic review of the literature was performed.Methods
The articles resulting from the systematic PubMed/EMBASE search of the literature were closely read, and predefined parameters were scored.Results
The search yielded a total of 118 articles (95 case reports and 23 case series) describing 204 patients with dysphagia and/or airway obstruction resulting from DISH. The number of cases demonstrated a steady increase from 1980 to 2009. This might be a real effect not ascribable to publication bias or expansion of the medical literature alone.Conclusions
Diffuse idiopathic skeletal hyperostosis as a cause of dysphagia and/or airway obstruction may be an increasing and underappreciated phenomenon. Diffuse idiopathic skeletal hyperostosis should be included in the differential diagnosis of dysphagia and airway obstruction. 相似文献7.
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The ankylosed spine is prone to fracture after minor trauma due to its changed biomechanical properties. Although many case
reports and small series have been published on patients with ankylosing spondylitis (AS) suffering spine fractures, solid
data on clinical outcome are rare. In advanced diffuse idiopathic skeletal hyperostosis (DISH), ossification of spinal ligaments
also leads to ankylosis. The prevalence of AS is stable, but since DISH may become more widespread due to its association
with age, obesity and type 2 diabetes mellitus, a systematic review of the literature was conducted to increase the current
knowledge on treatment, neurological status and complications of patients with preexisting ankylosed spines sustaining spinal
trauma. A literature search was performed to obtain all relevant articles concerning the outcome of patients with AS or DISH
admitted with spinal fractures. Predefined parameters were extracted from the papers and pooled to study the effect of treatment
on neurological status and complications. Ninety-three articles were included, representing 345 AS patients and 55 DISH patients.
Most fractures were localized in the cervical spine and resulted from low energy impact. Delayed diagnosis often occurred
due to patient and doctor related factors. On admission 67.2% of the AS patients and 40.0% of the DISH patients demonstrated
neurologic deficits, while secondary neurological deterioration occurred frequently. Surgical or nonoperative treatment did
not alter the neurological prospective for most patients. The complication rate was 51.1% in AS patients and 32.7% in DISH
patients. The overall mortality within 3 months after injury was 17.7% in AS and 20.0% in DISH. This review suggests that
the clinical outcome of patients with fractures in previously ankylosed spines, due to AS or DISH, is considerably worse compared
to the general trauma population. Considering the potential increase in prevalence of DISH cases, this condition may render
a new challenge for physicians treating spinal injuries. 相似文献
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Posterior short-segment pedicle screw constructs are commonly used for reduction and fixation of traumatic thoracolumbar spine fractures. Although this technique is usually simple and effective, complications such as loss of fixation or recurrence of deformity are common because of the insufficiency of the damaged anterior column. Anterior approaches to address this deficiency are associated with high morbidity and complications. We have developed a technique to reduce and support the fractured anterior column through a transpedicular approach. Balloon-assisted-endplate-reduction (BAER) followed by vertebroplasty (VTP) with calcium phosphate cement in combination with short segment pedicle screw construct seem to be a safe and effective technique to reconstruct the anterior column in a less invasive manner. In this article, the rationale behind this technique, experimental studies, and the first clinical results are discussed. 相似文献
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D. M. Mijnarends Y. C. Luiking R. J. G. Halfens S. M. A. A. Evers E. L. A. Lenaerts S. Verlaan M. Wallace Jos M. G. A. Schols J. M. M. Meijers 《The journal of nutrition, health & aging》2018,22(7):766-773