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densitometry values were compared with those from 106 age-matched controls (mean age 74.3 years, range 66-90). RESULTSOf the 174 patients, 73 (42%) were osteoporotic (t score £ -2.5) and 65 (37%) were osteopenic (t score -1 to -2.4). This compares with a 27% incidence of osteoporosis in the control group ( P = 0.022). There were also no significant correlations between prostate specific antigen levels, Gleason score, tumour stage, biochemical markers and the presence or absence of osteoporosis risk factors. CONCLUSIONPatients with advanced prostate cancer requiring ADT have a high incidence of osteoporosis before treatment. In addition, osteoporosis in these men cannot be predicted from clinical or biochemical values. Therefore, bone densitometry should be used in all patients with advanced cancer requiring ADT, as the results have implications for the choice of cancer therapy and the prophylaxis for osteoporosis.

Objective: Androgen deprivation therapy (ADT) is a common treatment for prostate cancer (PC). However, it may increase the risk of falls due to decreases in testosterone, lean body mass and strength. Falls are a leading cause of morbidity and mortality in older adults.However, the impact of ADT on falls remains unclear. Materials and methods: Three groups matched on age and education were recruited: PC patients starting continuous ADT (ADT users) (n = 88), PC patients not receiving ADT (PC controls) (n = 86), and healthy controls (n = 86). Patients retrospectively reported any falls in the 12 months prior to study entry and prospectively at 3 time points over the next 12 months (after starting ADT). Physical performance measures were done at each time point. The risks of having a fall at both baseline and over 1 year of follow-up were analyzed using logistic regression. Result: At baseline 13.8% (n = 36) of patients (ADT users = 14.7%, PC controls = 8.1%, healthy controls = 18.6%, p = 0.132) reported falls in the prior year. In the multivariable model, Timed Up and Go, marital status and working status predicted fall risk at baseline. Over 12 months, 24.8% (n = 62) of patients (ADT users = 34.5%, PC controls = 18.1%, healthy controls = 21.7%, p = 0.035) reported falls. Prior history of falls, being unmarried and arthritis were independent predictors of falls whereas ADT use was borderline (p = 0.08). Conclusion: ADT use may be associated with an increased risk of falls, but larger confirmatory studies are needed. Additionally, multiple non-physical factors including prior history of falls and arthritis predict future falls in older men on ADT. Falls Prostate cancer Men Aged BackgroundProstate cancer is the most common non-skin cancer and the second most common cause of cancer mortality in American men, with 1 out of every 6 men developing it in their lifetime. 75% of prostate cancer incident cases and more than 90% of prostate cancer deaths occur in men aged >65 years 1 . Prostate cancer has been recognized as an androgen-sensitive disease since the seminal work of Huggins and Hodges in 1941 42 . Indications for androgen deprivation therapy (ADT) have expanded over the years. As such, ADT is now used in patients as primary therapy for localized cancer 2 , with locally advanced disease 3 , with biochemical relapse 4 , and with metastatic disease 5 .

SummaryBackground: Severe alcoholic hepatitis patients have high mortality and limited

Aging is associated with increased levels of coagulation factors and decrease in natural anticoagulant factors. This strongly supports that age-related hypercoagulable state occurs in elderly. This study aimed to measure the plasma levels of coagulation factors and anticoagulant levels in young and elderly to observe the effect of age on haemostatic system. Ninety healthy individuals, both men and women were divided into two groups on the basis of age. Group I included participants of less than 40 years of age, whereas, group II comprised of participants more than 60 years of age. Fibrinogen activity was assessed by using Clauss technique. Coagulation factor VII, and factor VIII activity by corresponding one stage assay based on prothrombin time and activated partial thromboplastin time. Antithrombin III was measured by the chromogenic method. Our results showed that significantly increased levels of fibrinogen (P = 0.001) were observed in the elderly population as compared to young. Higher fibrinogen levels in younger women than men and comparatively higher level than other races was observed in our local population. Increase in factor VII levels (P = 0.05) was also observed in the elderly group. This increase was statistically significant with age in women (P = 0.03). Factor VIII rose with age in both sexes (P = 0.001). Higher antithrombin activity was observed in the younger group whereas the older group demonstrated significantly lower antithrombin activity (P = 0.001). We conclude that considerable effects of age and sex are observed on coagulation factors and naturally occurring inhibitors.