Efficacy and cost-effectiveness of nutritional intervention in elderly after hip fracture: design of a randomized controlled trial

Background: Hip fracture patients often have an impaired nutritional status at the time of fracture, which can result in a higher complication rate, prolonged rehabilitation time and increased mortality. A study was designed to evaluate the effect of nutritional intervention on nutritional status, functional status, total length of stay, postoperative complications and cost-effectiveness. Methods: Open-labelled, multi-centre, randomized controlled trial in hip fracture patients aged 55 years and above. The intervention group receives dietetic counselling (by regular home visits and telephone calls) and oral nutritional supplementation for three months after surgery. The control group receives usual dietetic care as provided by the hospital. Outcome assessment is performed at three and six months after hip fracture. Discussion: Patient recruitment has started in July 2007 and has ended in December 2009. First results are expected in 2011. Trial registration: ClinicalTrials.gov NCT00523575Mechanical, Maritime and Materials Engineerin

The Rotterdam Study: 2010 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in close to a 1,000 research articles and reports (see www.epib.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods

The Rotterdam Study: 2012 objectives and design update

The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, oncological, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over a 1,000 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods

Increase in pore area, and not pore density, is the main determinant in the development of porosity in human cortical bone

This study investigated the relative contributions of pore size and pore density (number of pores per mm2) to porosity in the midshaft of the human femur. Cross-sections were obtained from 168 individuals from a modern Australian population (mostly Anglo-Celtic). The study group comprised 73 females and 95 males, aged from 20 to 97 years. Microradiographs were made of 100-µm sections and porosity, pore areas and pore densities determined using image processing software. The cortex was divided into three rings radially and into octants circumferentially, and the porosity, pore area and pore density of each segment were calculated. Results show that 81% of the variance in porosity can be explained by changes in mean pore area with only a further 12–16% explained by changes in pore density. These effects were found to be constant across all areas of the cortex and in both sexes. These results are significant in their consistency and ordered gradation and indicate a well-regulated and systematic process of bone removal with ageing. The results show a regular progression from less porous to more porous bone; this is a uniform process that occurs in all individuals, and factors such as sex and rate of ageing determine where on this continuum any individual is at a particular time