The incidence of hip, forearm, humeral, ankle, and vertebral fragility fractures in Italy: results from a 3-year multicenter study

INTRODUCTION: We aimed to assess the incidence and hospitalization rate of hip and "minor" fragility fractures in the Italian population. METHODS: We carried out a 3-year survey at 10 major Italian emergency departments to evaluate the hospitalization rate of hip, forearm, humeral, ankle, and vertebral fragility fractures in people 45 years or older between 2004 and 2006, both men and women. These data were compared with those recorded in the national hospitalizations database (SDO) to assess the overall incidence of fragility fractures occurring at hip and other sites, including also those events not resulting in hospital admissions. RESULTS: We observed 29,017 fractures across 3 years, with hospitalization rates of 93.0% for hip fractures, 36.3% for humeral fractures, 31.3% for ankle fractures, 22.6% for forearm/wrist fractures, and 27.6% for clinical vertebral fractures. According to the analyses performed with the Italian hospitalization database in year 2006, we estimated an annual incidence of 87,000 hip, 48,000 humeral, 36,000 ankle, 85,000 wrist, and 155,000 vertebral fragility fractures in people aged 45 years or older (thus resulting in almost 410,000 new fractures per year). Clinical vertebral fractures were recorded in 47,000 events per year. CONCLUSIONS: The burden of fragility fractures in the Italian population is very high and calls for effective preventive strategies

Effects of urea-fertilization rates on the environmental performance of giant reed lignocellulosic feedstock produced for biorefinery purpose

A life cycle assessment (LCA) was carried out to investigate the environmental constrains of Arundo donax L. (common name giant reed) feedstock cultivation, for biorefinery purpose, treated with different amount of nitrogen fertilizations: 50 and 100 kg ha−1 of N as urea (low input- LI and high input- HI, respectively). The analysis was addressed for a cultivation of giant reed (GR) under Mediterranean conditions, considering primary data for the first eight years of cultivation and further modeled for the whole life cycle (15 years). The goals were, to ascertain and compare the environmental profile as well as to identify the hotspots for both investigated N- management techniques. Results highlighted a potential higher environmental performance for the LI giant reed cultivation, due to the reduced up-stream and direct field emissions linked to urea application. LI impacts resulted to be 24% lower than HI impacts, as averaged values for all impact categories. Crop yield represented a driving parameter and the lower biomass productivity under N low input management partially counteracted the entailed benefits of the lower fertilization rates. Through the inclusion of soil carbon storage, after seven years of harvesting, the whole crop phase revealed a net greenhouse gases sink and also differences between LI (−0.21 kg CO2 eq) and HI (−0.09 kg CO2 eq) appeared amplified. This was due to the enhanced C accumulation rate in LI trials (about 7.7 ton C ha−1 at the end of the seventh harvest year of GR cultivation), likely promoted by reduced soil organic matter mineralization at lower nitrogen availability. Nevertheless, in order to provide a full and comprehensive picture of the environmental performance of GR feedstock under different N-fertilization, further studies are needed encompassing the whole production chain: from the cultivation, through selected efficient conversion processes towards the co-production of added value products in the framework of the BioPoliS project