When, where and how osteoporosis-associated fractures occur: an analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW).

OBJECTIVE: To examine when, where and how fractures occur in postmenopausal women. METHODS: We analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3. RESULTS: Among 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip). Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68-86% of NHNV and 68-83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling. CONCLUSION: In this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.

Intentional exposure to loud music: the second MTV.com survey reveals an opportunity to educate.

OBJECTIVES: Music-induced hearing loss (MIHL), an unconsciously self-inflicted public health concern, could evolve into an epidemic because of the appeal of loud music. After media attention about a previous hearing-loss survey with Music Television (MTV.com), we hypothesized that a repeat survey could compare awareness and behavior trends. STUDY DESIGN: We incorporated the 2002 survey into the new 73-question instrument presented to random visitors on the MTV.com website in 2007. A P < .05 value was used for independent t and z- tests. RESULTS: A total of 2500 completed surveys were analyzed. Hearing loss was considered a problem by 32% of respondents compared with other health issues such as drug/alcohol use (62%). However, nearly half of the respondents admitted experiencing symptoms such as tinnitus or hearing loss after loud music exposure. Health care providers were the least likely source of MIHL awareness despite the respondents favoring provider education for hearing protection behavior modification. CONCLUSION: Most respondents still could not recall learning about prevention of potential hearing loss, although the media has become the most informative source. Most respondents indicated that they would adopt protective ear behavior if made aware of hearing loss risk, especially if informed by health care professionals, revealing an educational opportunity.

Massa cervical atípica em criança / An unusual pediatric cervical mass

Reporta-se o caso de lactente, com 19 meses de idade, que se apresentou com massa cervical assintomática de dois meses de evolução e que foi submetida a cirurgia. Os achados clinico-patológicos foram consistentes, com cisto de duplicação laríngea. Apresenta-se revisão do diagnóstico diferencial e das características histopatológicas do cisto de duplicação laríngea.

A 19-month-old female who presented with a mo month history of an asymptomatic neck mass and who underwent surgery is reported. The clinicopathologic findings are consistent, with a laryngeal duplication cyst. A review of the differential diagnosis and histopathologic characteristics of laryngeal duplication cyst is presented.