OBJECTIVE: To evaluate the bone status of ambulatory patients with physical and mental handicaps before a program of fracture prevention. METHODS: We recruited 58 walking adults. We retrospectively collected the past episodes of fractures, essentially peripheral, and epilepsy. The serum calcium, albumin, 25-hydroxyvitamin D, parathormone, CTX-1 and P1NP levels were prospectively measured in 36 consecutive patients. Each patient received daily calcium and vitamin D. The vertebral status has been not evaluated. RESULTS: Twenty-one patients had presented at least one fracture. Thirty nine per cent of the fractures were minor (nasal bone, hands, feet). The age of patients with fractures was significantly higher than patients without fracture (46 versus 40years, respectively; p=0.04). Patients with fractures had a significantly increased S-P1NP (63.5ng/ml+/-32.0 versus 41.9ng/ml+/-20.0, respectively; p=0.02). Nineteen patients suffered from epilepsy. We listed 23 fractures among 9 patients treated by phenobarbital and 8 fractures, which tended to be less severe among 5 patients epileptics without this drug. Minor fracture was often followed by severe fracture in case of phenobarbital treatment. This treatment was associated with a significantly lower serum calcium level (2.16mmol/l+/-0.05, versus epileptic patients without phenobarbital 2.32mmol/l+/-0.08, p<0.0004). CONCLUSIONS: The presence of a fracture, even minor, must encourage to improve the preventive and curative measures among patients with handicaps.
OBJECTIVE: To evaluate the bone status of ambulatory patients with physical and mental handicaps before a program of fracture prevention. METHODS: We recruited 58 walking adults. We retrospectively collected the past episodes of fractures, essentially peripheral, and epilepsy. The serum calcium, albumin, 25-hydroxyvitamin D, parathormone, CTX-1 and P1NP levels were prospectively measured in 36 consecutive patients. Each patient received daily calcium and vitamin D. The vertebral status has been not evaluated. RESULTS: Twenty-one patients had presented at least one fracture. Thirty nine per cent of the fractures were minor (nasal bone, hands, feet). The age of patients with fractures was significantly higher than patients without fracture (46 versus 40years, respectively; p=0.04). Patients with fractures had a significantly increased S-P1NP (63.5ng/ml+/-32.0 versus 41.9ng/ml+/-20.0, respectively; p=0.02). Nineteen patients suffered from epilepsy. We listed 23 fractures among 9 patients treated by phenobarbital and 8 fractures, which tended to be less severe among 5 patientsepileptics without this drug. Minor fracture was often followed by severe fracture in case of phenobarbital treatment. This treatment was associated with a significantly lower serum calcium level (2.16mmol/l+/-0.05, versus epilepticpatients without phenobarbital 2.32mmol/l+/-0.08, p<0.0004). CONCLUSIONS: The presence of a fracture, even minor, must encourage to improve the preventive and curative measures among patients with handicaps.
Authors: Marlon O Coulibaly; Debra L Sietsema; Travis A Burgers; Jim Mason; Bart O Williams; Clifford B Jones Journal: Crit Rev Eukaryot Gene Expr Date: 2010 Impact factor: 1.807
Authors: Christina L Addison; Gregory R Pond; Huijun Zhao; Sasha Mazzarello; Lisa Vandermeer; Robyn Goldstein; Eitan Amir; Mark Clemons Journal: Springerplus Date: 2014-10-01