Successful Replantation Despite Improper Storage of Amputated Thumb: A Case Report.

Replantation of fingers is highly complex and technically challenging. Surgeons are serious with their selection criteria as many factors are involved in determining good surgical outcome. Improper storages of amputated parts are usually denied the option for replantation. We report a 42-year-old lady who was assaulted with a machete and presented with total amputation of left thumb. The amputated thumb was stored in a plastic bag directly on ice cubes which eventually melted; thumb immersed in water for two hours. On examination, the amputated thumb was neither macerated nor frozen. Replantation was attempted and was successful. There are limited reports on proper methods of storage of amputated fingers pertaining to daily practical scenario. Yet, it is a strict criterion for surgeons in attempting replantation. Direct contact of amputated fingers on ice and immersion in hypotonic solutions leads to irreversible tissue damage. In our case, two hours of unfavourable storage did not affect surgical outcome. In conclusion, clinical assessment of the amputated part is essential in deciding for replantation. Combination of direct contact with ice and immersion in hypotonic solution for two hours should not be a contraindication for replantation.

Demographics and outcome of patients with congenital haemophilia in Sarawak, Malaysia.

INTRODUCTION: Sarawak has a population that is geographically and characteristically widely varied. This study aimed to determine the demographic profile of patients in Sarawak, Malaysia. Materials and Methods - A cross-sectional study was conducted in 2019 at four major haemophilia treatment centres in Kuching, Sibu, Bintulu and Miri Hospitals, Sarawak. Demographic and clinical data were collected with consents from patients. RESULTS AND DISCUSSION: Ninety-six haemophilia patients were identified - 79(82.3%) haemophilia A(HA) and 17(17.7%) haemophilia B(HB). Severe haemophilia patients were noted in 45.6% (36/79) of HA and 64.7% (11/17) of HB. In all 44.3% of the HA and 52.9% of the HB population had no identifiable family history of haemophilia. Two-thirds of the patients with severe HA were on prophylaxis [24/36 (66.7%)] and only onethird [4/11 (36.4%)] in severe HB. Inhibitors developed in 9/79 (11.4%) of the HA population [3/79 (3.8%) high responders]. The median inhibitor titre was not significantly different between the different treatment groups - on demand versus prophylaxis (1.0BU versus 2.0BU; z statistic -1.043, p-value 0.297, Mann-Whitney test). None of the patients developed inhibitory alloantibodies to factor IX. Four HA patients (5.1%) underwent immune tolerance induction where one case had a successful outcome. Three severe HA patients received emicizumab prophylaxis and showed remarkable reduction in bleeding events with no thromboembolic events being reported. One female moderate HA patient received PEGylated recombinant anti-haemophilic factor. Eleven patients underwent radiosynovectomy. One mild HB patient succumbed to traumatic intracranial bleeding. Our data reported a prevalence (per 100,000 males) of 5.40 cases for all severities of HA, 2.46 cases for severe HA; 1.16 cases for all severities of HB, and 0.75 cases for severe HB. The overall incidence of HA and HB was 1 in 11,500 and 1 in 46,000, respectively. CONCLUSION: This study outlines the Sarawakian haemophilia landscape and offers objective standards for forward planning. Shared responsibilities among all parties are of utmost importance to improve the care of our haemophilia population.

Successfully endoscopic retrieval of ingested toothpicks in colorectum : a report of four cases.

BACKGROUND: Toothpick ingestion is a rare event, but due to the low efficacy of radiographic examination, it can induce severe complications including perforation, abscess, and sepsis. CASE REPORT: Four patients with either defecation problems or abdominal/anal pain were admitted to our hospital. Colonoscopy showed all four cases had a toothpick impacted in the colorectal wall without perforation. Direct retrieval of the toothpick under endoscopy was achieved. All four patients were relieved and remained well during the follow-up. CONCLUSION: Endoscopy is the most effective method to discover or retrieve ingested wooden foreign bodies when there are no severe complications.

[Evaluation of the application of moving epidemic method on making influenza epidemic thresholds in the 7 climate zones in China].

Objective: We planned to evaluate the effectiveness of moving epidemic method (MEM) in calculating influenza epidemic threshold of 7 climatic zones in China mainland. Methods: The positive rate of influenza virus was obtained from the National Influenza Surveillance Network System from 2010/2011 to 2017/2018. We divided the 31 provinces into 7 climatic zones according to previous literatures and applied MEM to calculate the influenza epidemic threshold of 2018/2019 influenza season for these climatic zones. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to evaluate the effectiveness of MEM. Results: Pre-epidemic threshold (the positive rate of influenza virus) varied from 9.66% (temperate zone) to 16.36% (subtropical zone) for 2018/2019 influenza season. The gap between pre-epidemic and post-epidemic thresholds was less than 5% except for plateau zone. The sensitivity was 86.16% (95CI:66.81%-98.23%), the specificity was 94.92% (95CI: 91.13%-98.41%), the positive predictive value was 89.87% (95%CI: 84.39%-94.38%), the negative predictive value was 92.96% (95%CI: 84.46%-99.17%). Conclusion: Overall, moving epidemic Method performs well in calculating influenza epidemic threshold in China, much better than the previous study.

Comparison between tunneling and standard endoscopic submucosal dissection for treatment of large esophageal superficial neoplasm.

BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) has been established as a standard endoscopic method for treating esophageal superficial neoplasms, and it can be performed using a conventional or a tunneling method. The aim of the present study was to compare the safety and efficacy of tunneling ESD (t-ESD) and standard ESD (s-ESD) for treating large esophageal superficial neoplasms and to explore the risk factors for postoperative strictures. PATIENTS AND METHODS: Fifty-five consecutive patients with large esophageal superficial neoplasms were treated by t-ESD or s-ESD. Demographics, lesion characteristics, procedure-related parameters, and follow-up results were retrospectively collected to compare the efficacy and safety of these procedures. Multivariate analyses were conducted to determine the potential risk factors for postoperative strictures. RESULTS: Of the 55 patients, 13 underwent t-ESD and 42 underwent s-ESD. The dissection speed of t-ESD was significantly faster than that of s-ESD (7.42±1.99 min/cm2 vs. 9.01±2.11 min/cm2, P<0.05). En bloc resection was achieved in 98.2% (54/55) of the cases, while R0 resection was achieved in 92.7% (51/55). Curative resection was achieved in 78.2% (43/55) of the cases. Fourteen patients (25.5%) had postoperative strictures, which resolved with endoscopic dilation and/or stent insertion. Circumferential involvement of >3/4 and lesion length of >3 cm were independent risk factors for strictures. CONCLUSIONS: T-ESD is a safe and effective method for treating large esophageal superficial neoplasms with a faster dissection speed than s-ESD, but postoperative strictures may be encountered for lesions involving more than three-fourths of the circumference or longer than 3 cm.

[Technical guidelines for seasonal influenza vaccination in China, 2018-2019].

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and its complications. Currently, China has licensed trivalent (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. In most parts of China, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients need to pay for it. To strengthen the technical guidance for prevention and control of influenza and the operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC), Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" , based on most recent existing scientific evidences. The main updates include: epidemiology and disease burden of influenza, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, and, IIV3 and IIV4 vaccines'major immune responses, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The recommendations include: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for any influenza vaccine product for persons who can accept ≥1 licensed, recommended, and appropriate products. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-60 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to pregnant during the influenza season. Children aged 6 months to 8 years old require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in previous influenza season, 1 dose is recommended. People ≥ 9 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. Influenza vaccination should continue to be available for those unable to be vaccinated before the end of October during the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for CDC members who are working on influenza control and prevention, PoVs members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and members of maternity and child care institutions at all levels.

[Technical guidelines for seasonal influenza vaccination in China (2018-2019)].

Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) and quadrivalent inactivated influenza vaccine (IIV4), including split-virus influenza vaccine and subunit vaccine. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccine Technical Working Group (TWG), updated the 2014 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2018-2019)" . The main updates in this version include: epidemiology, disease burden, types of influenza vaccines, northern hemisphere influenza vaccination composition for the 2018-2019 season, IIV3 and IIV4 immune response, durability of immunity, immunogenicity, vaccine efficacy, effectiveness, safety, cost-effectiveness and cost-benefit. The influenza vaccine TWG provided the recommendations for influenza vaccination for the 2018-2019 influenza season based on existing scientific evidence. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. To decrease the risk of severe infections and complications due to influenza virus infection among high risk groups, the recommendations prioritize seasonal influenza vaccination for children aged 6-59 months, adults ≥60 years of age, persons with specific chronic diseases, healthcare workers, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. If they were vaccinated in 2017-2018 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels.

[History of influenza pandemics in China during the past century].

Five influenza pandemics had occurred during the past century (1918 "Spanish flu" , 1957 "Asian flu" , 1968 "Hong Kong flu" , 1977 "Russian flu" and 2009 H1N1 Pandemic), accounting for hundreds of millions of people infected and tens of millions dead. China was influenced by all the five pandemics, and three of them (1957 "Asian flu" , 1968 "Hong Kong flu" and 1977 "Russian flu" ) were originated from China. The pandemics triggered the establishment of public health agencies and influenza surveillance capacities. In addition, more resources were allocated to influenza-related research, prevention and control. As a leader in the field of influenza, China should further strengthen its pandemic preparedness and response to contribute to global health.

Effects of pheophorbide a-mediated photodynamic therapy on proliferation and metastasis of human prostate cancer cells.

OBJECTIVE: To observe the effects of pheophorbide a-mediated photodynamic therapy (Pa-PDT) on the in vitro proliferation, apoptosis, invasion and metastasis of human prostate cancer PC-3 cells and to investigate its possible mechanism. MATERIALS AND METHODS: Pa-PDT in gradient concentrations (0 µM, 0.25 µM, 0.5 µM, 1 µM, 2 µM, and 4 µM) were used to act on PC-3 cells; the cell proliferation in each group was detected via methyl thiazolyl tetrazolium (MTT) assay and clone formation assay, and the cell apoptosis was detected via Hochst33258 staining and Annexin V/propidium iodide (PI) double labeling. Moreover, the effects of Pa-PDT on invasion and proliferation of PC-3 cells were observed via wound healing assay and transwell chamber assay. Finally, the expressions of apoptosis-related proteins, epithelial-mesenchymal transition (EMT)-related proteins and matrix metalloproteinases (MMPs) in each group were detected after treatment by Western blotting. RESULTS: MTT and clone formation assays showed that Pa-PDT could inhibit the proliferation of PC-3 cells in a dose-dependent manner. The results of apoptosis assay revealed that Pa-PDT could significantly promote the apoptosis of PC-3 cells, obviously up-regulate the expressions of pro-apoptotic proteins, such as B-cell lymphoma-2-associated X protein (BAX), Caspase-3 and poly adenosine diphosphate-ribose polymerase (PARP), and inhibit the expression of Bcl-2. Besides, the wound healing assay and Transwell chamber assay showed that Pa-PDT could inhibit the invasion and metastasis capacities of PC-3 cells, whose relevant mechanisms were related to the fact that Pa-PDT inhibited the EMT process and down-regulated the expressions of MMPs in PC-3 cells. CONCLUSIONS: Pa-PDT can inhibit the proliferation and promote the apoptosis of PC-3 cells. Moreover, it can also inhibit the invasion and metastasis capacities of PC-3 cells via inhibiting the EMT process and down-regulating the expressions of MMPs.

[A survey of deployment of sidewalks in central urban areas of 12 cities, China].

Objective: To explore the deployment of sidewalks and the possible relationship with local GDP, population density and prosperity of streets in 12 cities selected in China. Methods: For all the streets in 333 blocks of 12 cities surveyed (Beijing, Tianjin, Shanghai, Qingdao, Hangzhou, Shaoxing, Suzhou, Nantong, Zhenjiang, Chengdu, Xining and Harbin), the deployment and management of sidewalks were observed. And we collected the GDP data of the 12 cities, the population data of 333 blocks, and the numbers of stores and restaurants along the streets. Results: A total of 4 255 streets were included in the study. In the 12 cities, 71.1% of the streets had sidewalks. The deployment rates of sidewalks was high in Qingdao (91.9%) and Harbin (90.6%), and low in Suzhou (48.6%) and Shaoxing (52.6%), the differences were significant. The higher GDP of city was, the more sidewalks were deployed. But on the other hand there were more parking cars and obstacles on the sidewalks. The higher the population density was, the worse the condition of sidewalks was. Conclusions: The survey of sidewalks in the 12 cities indicated that efforts could be made to improve the condition of sidewalks. Attention should be paid not only to the deployment of sidewalks, but also the management of sidewalks. Reasonable deployment of sidewalks should be considered according to the local population density and traffic flow.

Intravenous Fentanyl for Dyspnea at the End of Life: Lessons for Future Research in Dyspnea.

OBJECTIVES: To determine the efficacy of intravenous (IV) Fentanyl in dyspnoeic patients with advanced cancer. METHODS: Dyspnoeic patients with advanced cancer satisfying the selection criteria received (IV) Fentanyl and were evaluated for response 24 hours post-administration in a prospective observational study. RESULTS: Altogether 36 patients were enrolled into the study. However, data from only 16 patients could be analysed as 20 patients had died or were too sick to self-report scores. Seven out of 16 patients responded to IV Fentanyl although the result was not statistically significant (non-responders versus responders: 56.3% vs 43.8%, p = 0.33). The strongest correlations for variables predictive of responder status were the absence of anxiety and lung metastases. CONCLUSIONS: This exploratory study shows that IV Fentanyl can alleviate dyspnea in some patients but is an example of the difficulties conducting dyspnea research. Future studies would benefit from novel developments in the areas of measuring dyspnea in dying patients and statistical analysis of small sample sizes.

Road to future: iPSC clinical application in Parkinson's disease treatment.

Cell-replacement therapy using Parkinson's disease (PD) specific induced pluripotent stem cell (iPSC) holds great promise in treating PD. However, the problem of iPSC safety and efficiency restrict its clinical application. Meanwhile the requirement of skin biopsy for fibroblast will increase the risk of complication. In the past few years, the advances of iPSC technology in efficiency, cell resource, safety and cell culture have made it possible to use the derivatives of iPSCs to clinical PD treatment. This review will summarize these progresses of iPSC technique in this fast-moving community.

High-rate low-temperature growth of vertically aligned carbon nanotubes.

We report the low-temperature growth of vertically aligned carbon nanotubes (CNTs) at high growth rates by a photo-thermal chemical vapour deposition (PTCVD) technique using a Ti/Fe bilayer film as the catalyst. The bulk growth temperature of the substrate is as low as 370 °C and the growth rate is up to 1.3 µm min(-1), at least eight times faster than the values reported by traditional thermal CVD methods. Transmission electron microscopy observations reveal that as-grown CNTs are uniformly made of highly crystalline 5-6 graphene shells with an approximately 10 nm outer diameter and a 5-6 nm inner diameter. The low-temperature rapid growth of CNTs is strongly related to the unique top-down heating mode of PTCVD and the use of a Ti/Fe bimetallic solid solution catalyst. The present study will advance the development of CNTs as interconnects in nanoelectronics, through a CMOS-compatible low-temperature deposition method suitable for back-end-of-line processes.

Effects of vascular endothelial growth factor (VEGF) on MC3T3-E1.

UNLABELLED: Osteogenesis and angiogenesis are closely correlated. Vascular endothelial growth factor (VEGF) is believed to play a critical role in skeletal development. OBJECTIVE: To investigate whether VEGF has direct effects on bone cells activities and to better understand how VEGF promotes bone remodeling. MATERIALS AND METHODS: MC3T3-E1 cell line was cultured with and without VEGF in vitro. The cells in both control and test groups were collected at different culture time points of 24, 48 and 72 h. Real-time polymerase chain reaction (qPCR) was carried out to quantify the mRNA expression of VEGF receptor (VEGFR2), alkaline phosphatase (ALP) and osteocalcin (OCN), osteoprotegerin (OPG) and receptor activator of nuclear factor kappa ß ligand (RANKL). RESULTS: The expression of VEGFR2 significantly increased by 53% at 24 h and remained increased by 8% at 72 h compared to control (p < 0.05). ALP showed an early increase by 73% at 24 h (p < 0.001), but dropped by 14 and 41% at 48 and 72 h, respectively (p < 0.05). OCN was down-regulated by 41% at 24 h but then up-regulated by 149% at 72 h (p < 0.001). The expression of OPG significantly decreased by 7% at 24 h (p < 0.001) while dramatically increased by 133% at 72 h (p < 0.001). RANKL remained unchanged at all three time points (p > 0.05). CONCLUSION: VEGF promotes bone remodeling by direct effects on osteoblastic cells via regulating gene expression of ALP, OCN, and OPG through VEGFR2 signaling pathway.

Reducing scanning electron microscope charging by using exponential contrast stretching technique on post-processing images.

An exponential contrast stretching (ECS) technique is developed to reduce the charging effects on scanning electron microscope images. Compared to some of the conventional histogram equalization methods, such as bi-histogram equalization and recursive mean-separate histogram equalization, the proposed ECS method yields better image compensation. Diode sample chips with insulating and conductive surfaces are used as test samples to evaluate the efficiency of the developed algorithm. The algorithm is implemented in software with a frame grabber card, forming the front-end video capture element.

Knowledge and attitude of university students in health sciences on the prevention of cervical cancer.

Cervical cancer is the second most common female cancer after breast cancer both in Malaysia and worldwide although it can be mostly prevented. The objective of this study was to assess the knowledge level and attitude of University Kebangsaan Malaysia female students in the Faculties of Pharmacy and Allied Health Sciences on the prevention of cervical cancer. A total of 675 respondents were recruited for this cross-sectional study involving pre-tested questionnaires. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 15.0. There was significant association between grade and mean score of knowledge with different faculties and year of education (p<0.05). However, significant association was shown only between grade of knowledge with different programs in the Faculty of Allied Health Sciences. For mean score of knowledge, significant difference only existed among different races (p<0.05). Mass media was the most common source of information. In conclusion, the knowledge level of respondents on cervical cancer and its prevention was not satisfactory despite their positive attitude on prevention. Thus, more awareness programs should be conducted in University campuses to provide students with knowledge on prevention of cervical cancer.

MRSA breast abscesses in postpartum women.

BACKGROUND: Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are being increasingly observed in patients who lack traditional risk factors. While mastitis and breast abscesses are commonly encountered in post-natal women, CA-MRSA breast infections have rarely been reported. MATERIALS AND METHODS: We reviewed 15 postpartum women with methicillin-resistant Staphylococcus aureus (MRSA) breast abscesses observed in our unit from June 2005 to April 2007. Ultrasonographic examination was performed in all cases. MRSA infection was diagnosed on microbiological analysis cultured from the abscesses of these patients. RESULTS: The median age of the patients was 31.5 years. The majority of the patients were primiparae (80%). Only one patient was immunocompromised. None of the patients had history of previous breast infection and none developed recurrence. Eleven patients (73.3%) underwent aspiration of pus and four patients (26.7%) underwent incision and drainage. All the cultures were sensitive to co-trimoxazole and vancomycin. Eight (53.3%) of the cultures were also sensitive to erythromycin. CONCLUSION: CA-MRSA is an emerging problem in our obstetric population. CA-MRSA breast infections are clinically responsive to common oral antibiotics such as co-trimoxazole and erythromycin. A high index of suspicion is essential to avoid delay in the clinical response to empirical beta-lactams as these patients may benefit from an early change of antibiotics.

Distribution of serotonin receptors and interacting proteins in the human sigmoid colon.

This study aimed to examine the distribution of 5-HT receptors in the human colon. 5-HT induces desensitization of the circular muscle and as this is facilitated by G-protein coupled receptor kinases (GRKs) and other proteins, we also examined their distribution. Human sigmoid colon samples were dissected into three separate layers (mucosa, taeniae coli and intertaenial strips) and RNA was amplified by RT-PCR. The 5-HT(2B) receptor and all 5-HT(7) receptor splice variants were expressed in all tissues. 5-HT(4) a,b,c and n splice variants were also expressed in all tissues and 5-HT(4d), 5-HT(4g) and 5-HT(4i) were only detected in some samples. The 5-HT(2A) receptor was seen predominantly in the intertaenial strips of the colon. Only one transcript of the serotonin transporter (SERT) was detected in the muscle layers. Variation was seen in GRK expression with GRK2 and 3 predominantly expressed in the mucosa, while GRK5 and 6 were found more commonly in the taeniae coli. PDZ (named after postsynaptic density protein, Drosophila disc large tumour suppressor and tight junction protein ZO-1) domain containing proteins, which may be involved in 5-HT receptor trafficking, were also detected throughout the sigmoid colon. The 5-HT(3A) subunit was expressed in all tissues, whereas the 5-HT(3E) subunit was mainly found in the mucosa layer while the 5-HT(3B) subunit was more common in the muscle layers. Receptor interacting chaperone (RIC-3), which is involved in transporting 5-HT(3) receptor subunits, is expressed less in mucosa compared to muscle layers. In conclusion, these results show that there is variation in distribution of 5-HT receptors and interacting proteins within the sigmoid colon that may contribute to colonic function.

Inadequate dietary calcium intake in elderly patients with hip fractures.

INTRODUCTION: Calcium supplementation and pharmacotherapy are recommended in the preventive management of osteoporosis. Many previous studies report of underdiagnosis and undertreatment of osteoporosis among elderly patients with hip fractures. We undertook this study to determine the dietary calcium levels in our local elderly population who were admitted with hip fractures. METHODS: 77 patients, between the ages of 60 and 98 years of age, and admitted to our department between January 2001 and September 2001 for hip fractures, were studied. The dietary calcium intakes of these patients were determined by a food frequency questionnaire and a detailed diet history. Bone mineral density (BMD) studies were performed on 55 of these patients to confirm the diagnosis of osteoporosis. RESULTS: The mean daily calcium intake was found to be 650 mg. Only six of our hip fracture patients (7.8 percent) had a daily calcium intake above the recommended levels of 1,000 mg per day. For the 55 patients who had BMD performed, only one patient had a BMD within the normal range. 34 patients (64.2 percent) had hip T-scores in the osteoporotic range and 18 patients (33.9 percent) had hip T-scores in the osteopenic range. We found that the patients with BMD in the osteoporotic and osteopenic ranges had no significant difference in the dietary calcium intake. CONCLUSION: The dietary calcium intake of our elderly patients with hip fractures is insufficient. They would benefit from dietary education and calcium supplements to prevent deterioration in bone density and subsequent osteoporotic fractures.