OBJECTIVES. This study was undertaken to determine whether vigorous and frail older people who identify environmental hazards in their homes have an increased risk for falls. METHODS. A 1-year prospective study was conducted among 266 female and 59 male community-dwelling volunteers aged 60 to 93 years who had fallen at least once during the previous year. Composite measures of home safety and of frailty were derived using principal components analysis. Participants were divided into vigorous and frail groups, and associations between baseline home safety measures and falls at home over the follow-up year were compared between the two groups. RESULTS. Frail individuals were more than twice as likely as vigorous individuals to fall during follow-up (rate ratio [RR] = 2.24; 95% confidence interval [CI] = 1.54, 3.27). In the study group as a whole, falls were not strongly associated with the presence of home hazards. However, when compared with vigorous older persons living with fewer home hazards, vigorous older persons living with more home hazards were more likely to fall. The increased risk for falls among vigorous elderly was limited to falls where home hazards were present. By contrast, living with more home hazards was not associated with increased likelihood of falls among frail older persons. CONCLUSIONS. While frail older persons experience higher overall fall rates, vigorous older persons should not be overlooked in fall prevention projects.

No abstract

Expression of netrin-1 has significant impact on time to tumor relapse in adenocarcinoma of the pancreas. Netrin-1 expression is associated with worse outcome in poorly differentiated pancreatic adenocarcinomas. Risk-stratification according to the UNC5H3 receptor expression pattern shows that node positive patients (pN1) with no to little UNC5H3 expression carry a significantly worse prognosis than those with middle to strong UNC5H3 expression.

When treating introchanteric fractures with PFNA reduction in neutral or even slight valgus, aiming for a TAD < 25 mm and a correct position of the blade within the femoral head reduced the risk for secondary varus displacement significantly. Furthermore, we suggest to aim for a central nail-shaft axis.

No abstract