Incidence rates of fragility hip fracture in middle-aged and elderly men and women in southern Norway.

BACKGROUND: Hip fracture contributes to increased morbidity and mortality in the elderly population. As the average age of the population is increasing, the burden of hip fracture on the health-care system is a growing challenge. The highest incidence of hip fracture worldwide has been reported from Scandinavia in fact from Oslo the capital of Norway. During the last decades, efforts have been undertaken to reduce hip fracture risk. OBJECTIVE: To study the incidence of fragility hip fracture in southern Norway. DESIGN: A validated retrospective epidemiological study. SETTING: Population-based study. SUBJECTS: All patients with fragility hip fractures aged 50 years or older in 2004 and 2005 in southern Norway. METHODS: The hip fracture patients were identified from the four hospitals (Kristiansand, Arendal, Flekkefjord and Mandal) located in the two most southern counties in Norway, Vest-Agder and Aust-Agder County. Age-adjusted and age-specific incidence rates for men and women were calculated. We also explored for seasonal variations and differences between rural and urban areas. RESULTS: A total of 951 (271 men, 680 women) individuals aged ≥50 years with hip fracture were identified. The age-adjusted incidence rate was 34.6 for men and 75.8 for women per 10,000 person-years. Age specific incidence rates were significantly higher in women than in men but only for age groups between 70 and 90 years. CONCLUSION: Age-adjusted incidence of hip fracture in men and women in southern Norway is the lowest reported from Norway and among the lowest in Scandinavia. No differences were seen between rural and urban areas. The number of fragility hip fractures was statistically significant higher in winter compared with the other seasons.

A Nationwide Study of Norwegian Patients with Hereditary Angioedema with C1 Inhibitor Deficiency Identified Six Novel Mutations in SERPING1.

Hereditary angioedema with C1 inhibitor deficiency (C1-INH-HAE) is characterized by relapsing, non-pruritic swelling in skin and submucosal tissue. Symptoms can appear in early infancy when diagnosis is more difficult. In the absence of a correct diagnosis, treatment of abdominal attacks often lead to unnecessary surgery, and laryngeal edema can cause asphyxiation. A cohort study of 52 patients from 25 unrelated families in Norway was studied. Diagnosis of C1-INH-HAE was based on international consensus criteria including low functional and/or antigenic C1-INH values and antigenic C4. As SERPING1 mutations in Norwegian patients with C1-INH-HAE are largely undescribed and could help in diagnosis, we aimed to find and describe these mutations. Mutation analysis of the SERPING1 gene was performed by Sanger sequencing of all protein coding exons and exon-intron boundaries. Samples without detected mutation were further analyzed by multiplex ligation-dependent probe amplification to detect deletions and duplications. Novel mutations suspected to lead to splice defects were analyzed on the mRNA level. Fifty-two patients from 25 families were included. Forty-four (84,6%) suffered from C1-INH-HAE type I and eight (15,4%) suffered from C1-INH-HAE type II. Pathogenic or likely pathogenic mutations were found in 22/25 families (88%). Thirteen unique mutations were detected, including six previously undescribed. There were three missense mutations including one mutation affecting the reactive center loop at codon 466, three nonsense mutations, three small deletions/duplications, three gross deletions, and one splice mutation.

The epidemiology of low- and high-energy distal radius fracture in middle-aged and elderly men and women in Southern Norway.

BACKGROUND: Distal radius is one of the most frequent sites for fractures in the elderly population. Despite this, there is a paucity of epidemiological data for distal radius fracture, in particular, distinguishing between high- and low-energy fractures. Our aim was to study the epidemiology of high- and low-energy distal radius fracture in middle-aged and elderly men and women in Southern Norway, and search for associates with high- or low-energy distal radius fracture in this population. METHODOLOGY/PRINCIPAL FINDINGS: Patients with distal radius fractures aged ≥ 50 years were identified from all four hospitals in Southern Norway between 2004 and 2005. Age-adjusted and age-specific incidence rates for men and women were calculated, and potential associates with high- and low-energy distal radius fracture were explored both in univariate and multivariate analyses. A total of 799 individuals (118 men and 681 women) aged ≥ 50 years with low-energy and 84 (48 men and 36 women) with high-energy distal radius fracture were identified. The overall age-adjusted incidence rate per 10,000 person-years was 18.9 for men (low energy, 12.8 vs. high-energy, 6.1) and 75.1 for women (low energy, 71.1 vs. high energy, 4.0). In multivariate model, younger age, male gender, summer season, and living in a rural area were independently associated with an increased risk of high-energy fracture. CONCLUSION: An approximately fourfold higher age-adjusted incidence rate for distal radius fracture was found among women, when compared with men. However, the proportion of patients with high-energy distal radius fracture was approximately fivefold higher in men than in women. Our data suggest that younger age, male gender, summer seasons, and living in rural areas are independent risk factors for increased risk of high-energy distal radius fracture.