Purposes: This study was designed to explore the stage distribution of subjects according to stage of change for calcium intake and for exercise, and to identify factors that could discriminate among subjects in various stages. METHODS: The sample consisted of 142 subjects who had taken bone mineral densitometry tests. The instruments used in this study were the Stage Placement Instrument for Calcium Intake and Exercise, the Osteoporosis Health Belief Scale and the Osteoporosis Knowledge Test, and the Osteoporosis Self Efficacy Scale. Data were analyzed using chi square, ANOVA, and discriminant analysis by using the SPSS 12.0 program. RESULTS: For calcium stages, economic level, calcium knowledge, positive social norms for calcium intake, & educational level showed high standardized canonical discriminant function coefficients. For exercise stages, exercise efficacy, susceptibility, exercise benefit, educational level, positive social norm to exercise, educational level, and exercise barrier showed high standardized canonical discriminant function coefficients. CONCLUSION: This study implies that bone mass promoting program incorporating a stages of change model can be applied as useful nursing intervention.
Bone Density ; Calcium ; Densitometry* ; Discrimination (Psychology) ; Nursing ; Osteoporosis ; Self Efficacy

Steroid is a critical component of immunosuppressive regimen. Unfortunately, steroid is associated with numerous adverse effects including diabetes, hypertension, hyperlipidemia, osteoporosis, sodium retention, and avascular necrosis. These adverse effects have prompted trials of steroid withdrawal with introduction of potent immunosuppressive agents in renal transplantation. Although late steroid withdrawal raised acute rejection rate compared with early steroid withdrawal, results of recent trials that used diverse steroid withdrawal protocols suggest good short and long term graft outcomes. But, in patients survival, patients with steroid withdrawal is similar to patients administered steroid. This review summarizes usefulness according to timing of steroid withdrawal and re-exams benefits of steroid withdrawal in renal transplantation.
Humans ; Hyperlipidemias ; Hypertension ; Immunosuppressive Agents ; Kidney Transplantation ; Necrosis ; Osteoporosis ; Rejection (Psychology) ; Retention (Psychology) ; Sodium ; Transplants

OBJECTIVETo investigate the impact of self-efficacy theory health education in patients of diabetic osteoporosis.

METHODSWe used SPSS 19.0 software to generate random numbers and 260 diabetic osteoporosis patients were randomly divided into an observation group and a control group. There was 130 patients in observation group, 130 in control group. The self-efficacy theory health education was carried out in observation group, and routine health education in control group. SF-36 questionnaire was used to assess the quality of life. Osteoporosis self-efficacy scale (OSES) was used to assess self-efficacy. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. Blood glucose was detected by glucose oxidase method. Glycosylated hemoglobin was detected by high efficiency liquid chromatography to estimate the index change before intervention and after one year's follow up.

RESULTSThe number of patients that had completed follow-up was 104 in control group and 107 in observation group. The self-efficacy scores, movement efficiency scores and calcium intake efficiency scores were all higher in intervention group ((82.25 ± 13.54) , (79.26 ± 15.37) , (84.39 ± 17.09) points) than which in the control group ((71.14 ± 14.19), (63.89 ± 19.87), (75.24 ± 10.70) points) after one year's follow up, there were significant differences in two groups (t values were 6.04, 7.95, 5.77, all P values<0.05). The scores of quality of life in the dimension of general health, vitality, social function, role emotional and mental health were all higher in intervention group ((75.29 ± 14.90) , (68.61 ± 17.38) , (75.74 ± 18.50) , (71.22 ± 17.93) , (73.69 ± 14.40 ) points) than in the control group ( (44.25 ± 11.01) , (47.39 ± 18.90) , (63.54 ± 15.95), (49.04 ± 19.36), (55.15 ± 19.74) points), there were significant differences in two groups (t values were 8.45, 8.83, 6.92, 8.79, 8.05, all P values<0.05) . Fasting blood-glucose 2 hour postprandial blood glucose and glycosylated hemoglobin were all lower in intervention group ((7.29 ± 1.81) mmol/L, (8.21 ± 2.37) mmol/L, (6.59 ± 0.92) %) than in the control group ((8.53 ± 1.66) mmol/L, (9.41 ± 3.30) mmol/L, (7.66 ± 1.50) %) , there were significant differences in two groups (t values were 5.33, 4.67, 5.49, all P values<0.05). There were 1 (0.93%) fracture case in observation group and 7 (6.73%) cases in control group during one year's follow up, there are significant difference in two groups (χ(2) = 4.86, P = 0.028).

CONCLUSIONSThe self-efficacy theory health education may improve the quality of life and decreased fracture risk of diabetic osteoporosis patients.

Aged ; Blood Glucose ; Bone Density ; Diabetes Complications ; psychology ; Humans ; Osteoporosis ; psychology ; Quality of Life ; Self Efficacy ; Surveys and Questionnaires

Distal radius fractures are one of the most common types of fractures in the elderly. It is well documented that increased risk of a distal radius fracture in older patients is associated with decreased bone mineral density. Also, low bone mineral density increased severity of fracture and instability of fracture after reduction. Fracture displacement in the elderly does not necessarily result in functional impairment. Therefore, conservative treatment has been a mainstay treatment even in unstable fracture in the elderly. However, there is an increasing trend toward operative treatment recently, because functional demand increased in the elderly due to active life style and volar locking plate fixation enables the elderly early return to daily activity even in osteoporotic distal radius fracture.
Aged ; Bone Density ; Displacement (Psychology) ; Humans ; Life Style ; Osteoporosis ; Radius ; Radius Fractures

The avulsion fracture of the calcaneal tuberosity is rare injury. Usually, it occurs from indirect trauma in old patients with osteoporosis or in patients with diabetic neuropathy. Especially, the bone and joint damage occurred in active patient with severe sensory loss or arthropathy related to nerve damage regardless of the cause is referred to neuropathic arthropathy. Generally, a patient with nondisplacement or minimally displacement is treated by conservative therapy and a patient with severe displacement is treated by open reduction and internal fixation. We experienced a 33 years-old woman with diabetes mellitus who had the displaced avulsion fracture of the calcaneal tuberosity without significant trauma and did not treat. We report upon this case at the 2 years follow-up.
Diabetes Mellitus ; Diabetic Neuropathies ; Displacement (Psychology) ; Female ; Follow-Up Studies ; Humans ; Joints ; Natural History ; Osteoporosis

As a result of aging population, the incidence of pelvic insufficiency fracture has been increasing. Pain-related immobility caused by pelvic insufficiency fractures may result in a serious dependency and high mortality with preexisting comorbidities. We present two cases of pelvic insufficiency fracture in elderly patients which had good clinical outcome by parathyroid hormone 1-34(teriparatide) treatment as well as a literature review.
Aged ; Aging ; Comorbidity ; Dependency (Psychology) ; Fractures, Stress ; Humans ; Incidence ; Osteoporosis ; Parathyroid Hormone ; Pelvis

Osteoporosis is charactered by body bone mass reduce and bone microstructure degration. With the improvement of biology-psychology-social medical model, it have found a certain relation between osteoporosis and psychology. Psychology have an influence on BMD, contents of bone transition index, bone cytokine consistency and fragility fracture rate. Meantime, life of quality of the patients have been affected by osteoporosis, leading to their psychology situation have an according changes.
Bone Density ; Fractures, Bone ; epidemiology ; Humans ; Mental Disorders ; complications ; metabolism ; Osteoporosis ; etiology ; psychology ; Quality of Life

PURPOSE: The purpose of this study was to evaluate the results of treating senile osteoporotic peritrochanteric fracture with proximal femoral nail antirotation (PFNA). MATERIALS AND METHODS: Between November 2006 and December 2007, 21 patients older than 65 years of age with intertrochanteric and subtrochanteric fractures were treated with PFNA. The mean duration of follow-up was 12.9 months and the mean age was 74.5 years. RESULTS: The mean operation time was 48.8 minutes (range: 25-90 minutes). The time to ambulation averaged 7.9 days. Eighty point nine percent (17 cases) of the patients returned to their previous walking status at 6 months after operation. The average T-score was -3.3. Eighteen cases (85.7%) achieved acceptable reduction and the mean time to radiologic bony union was 17.4 weeks. The average amount of PFNA blade sliding was 4 mm and the neck-shaft angle was changed to 1.3 degrees varus displacement at the final follow-up. The complications included pulmonary edema in 1 case and protrusion of the PFNA blade into the hip joint in 1 case. CONCLUSION: Because of the reduced operation time, favorable walking ability and low rate of complications, PFNA is an acceptable alternative for fixation of senile osteoporotic peritrochanteric fracture.
Displacement (Psychology) ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip Joint ; Humans ; Nails ; Osteoporosis ; Pulmonary Edema ; Walking

PURPOSE: To determine follow-up results for elderly patients with osteoporosis that received standard cemented bipolar hemiarthroplasty with double loop and tension band wiring for treatment of unstable intertrochanteric hip fractures. MATERIALS AND METHODS: Between May 2000 and May 2006, 86 cemented bipolar hemiarthroplasties were done in elderly patients who had unstable intertrochanteric fractures. The mean age at the time of surgery was 82 years. The average follow-up period was 5.3 years. We evaluated post-operative results by clinical and radiographic methods. RESULTS: At the final follow-up, the mean Harris hip score was 79.2. The mean time needed for full weight bearing following surgery was 4.2 weeks and 82.5 % of patients regained their preoperative level of ambulation. All patients achieved union in the lesser trochanter fracture, but substantial trochanter displacement was observed in 4 cases. There was one case of acetabular erosion. Superficial infections were found Post-operatively in 2 cases. One case with stem subsidence (<5 mm) showed satisfactory results without subsidence in further follow-ups. CONCLUSION: If cemented bipolar hemiarthroplasty is properly applied in the treatment of unstable intertrochanteric hip fractures in the elderly, systematic postoperative rehabilitation, and pain control can be achieved.
Aged ; Displacement (Psychology) ; Femur ; Follow-Up Studies ; Hemiarthroplasty ; Hip ; Hip Fractures ; Humans ; Osteoporosis ; Walking ; Weight-Bearing

PURPOSE: This study was conducted to develop an instrument measuring awareness of osteoporosis. METHODS: The process included construction of a conceptual framework, generation of 86 preliminary items, verification of content validity, selection of secondary items, verification of construct validity and extraction of final items. The 86 items were reviewed for content validity by two groups of experts and were tested to evaluate inter item correlation coefficient by two groups of adult women. From June to August 2007, data were collected from 383 adult women who lived in Seoul and provinces in Korea. Data were analyzed by performing item analysis, Varimax factor analysis and Cronbach's alpha. RESULTS: There were 31 items in the final instrument categorized into 5 factors. The factors were labeled as "preventive behaviors (10 items)", "risk factors (5 items)", "characteristics of osteoporosis (6 items)", "improving bone health (5 items)", and "bone physiology (5 items)". Cumulative percent of variance was 60.92% and eigen values ranged from 1.20 to 12.44. Cronbach's alpha was .948 and ranged from .804 to .917. CONCLUSION: Validity and reliability of the scale are confirmed in this study showing its utility for measuring awareness of osteoporosis for women. Utilization of the scale will also contribute to designing an appropriate prevention program for osteoporosis.
Adult ; Attitude to Health ; Awareness ; Female ; Humans ; Middle Aged ; Osteoporosis/*prevention & control/psychology ; Program Development ; Questionnaires ; Risk Factors ; Women's Health