Hip fractures in elderly people. The surgical treatment in Leuven, Belgium

From 1978 to 1990 inclusive more than 1,200 patients above 70 years of age have been treated surgically for a hip fracture at the University Hospitals of Leuven. Intracapsular fractures were classified as to Garden and extracapsular fractures as to Evans. The physical and mental conditions of the patients at the time of the accident were largely determining the choice of the treatment, a treatment that held quo ad vitam only little risk for the patient and that permitted early weight bearing on the operated limb. We concluded that: Stable intracapsular fractures have to be treated with simple cancellous bone screws. For unstable intracapsular fractures, a total hip prosthesis is the best solution; hemiarthroplasty must be reserved for high risk patients with a limited life expectancy. Nearly all type 1 pertrochanteric fractures can be treated with a (modified) dynamic hip screw technique. Prosthetic surgery is only indicated in very complex type 1d fractures. For type 2 fractures, the gamma-nail is (may be) the best solution.     

Lycopene from two food sources does not affect antioxidant or cholesterol status of middle-aged adults

Background

Epidemiological studies have reported associations between reduced cardiovascular disease and diets rich in tomato and/or lycopene. Intervention studies have shown that lycopene-containing foods may reduce cholesterol levels and lipid peroxidation, factors implicated in the initiation of cardiovascular disease. The objective of this study was to determine whether consumption of lycopene rich foods conferred cardiovascular protection to middle-aged adults as indicated by plasma lipid concentrations and measures of ex vivo antioxidants.

Methods

Ten healthy men and women consumed a low lycopene diet with no added lycopene (control treatment) or supplemented with watermelon or tomato juice each containing 20 mg lycopene. Subjects consumed each treatment for three weeks in a crossover design. Plasma, collected weekly was analyzed for total cholesterol, high density lipoprotein cholesterol (HDL-C) and triglyceride concentrations and for the antioxidant biomarkers of malondialdehyde formation products (MDA), plasma glutathione peroxidase (GPX) and ferric reducing ability of plasma (FRAP). Data were analyzed using Proc Mixed Procedure and associations between antioxidant and lipid measures were identified by Pearson's product moment correlation analysis.

Results

Compared to the control diet, the lycopene-containing foods did not affect plasma lipid concentrations or antioxidant biomarkers. Women had higher total cholesterol, HDL-C and triglyceride concentrations than did the men. Total cholesterol was positively correlated to MDA and FRAP while HDL-C was positively correlated to MDA and GPX. GPX was negatively correlated to triglyceride concentration.

Conclusions

The inclusion of watermelon or tomato juice containing 20 mg lycopene did not affect plasma lipid concentrations or antioxidant status of healthy subjects. However, plasma cholesterol levels impacted the results of MDA and FRAP antioxidant tests.