Osteoporosis in the European Union: medical management, epidemiology and economic burden: a report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EPPIA)

Summary: This report describes the epidemiology, burden, and treatment of osteoporosis in the 27 countries of the European Union (EU27).Introduction: Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures which represent the main clinical consequence of the disease. Fragility fractures are associated with substantial pain and suffering, disability and even death for affected patients and substantial costs to society. The aim of this report was to characterize the burden of osteoporosis in the EU27 in 2010 and beyond.Methods: The literature on fracture incidence and costs of fractures in the EU27 was reviewed and incorporated into a model estimating the clinical and economic burden of osteoporotic fractures in 2010.Results: Twenty-two million women and 5.5 million men were estimated to have osteoporosis; and 3.5 million new fragility fractures were sustained, comprising 610,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures). The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Incident fractures represented 66 % of this cost, long-term fracture care 29 % and pharmacological prevention 5 %. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining.Conclusions: In spite of the high social and economic cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by the aging populations, the use of pharmacological interventions to prevent fractures has decreased in recent years, suggesting that a change in healthcare policy is warranted

A testkép komplexitása és a szervátültetés sikeressége. Vesetranszplantált páciensek longitudinális vizsgálata

Háttér és célok Az utóbbi évek interdiszciplináris kutatásai felhívják a figyelmet, hogy a szervátültetés következtében megváltozhat a test szubjektíven észlelt egysége, sérülhet a testkép integritása, komplexitása (CALIA és mtsai, 2011; PASQUALE és mtsai, 2010). Kutatásunkban els?dleges célként t?ztük ki a transzplantáció utáni testkép-jellegzetességek feltérképezését és azok hatását az új szerv optimális, hosszú távú m?ködésére. Módszer 50, vese-transzplantáción átesett személlyel a Spielberger-féle ?llapot- és Vonásszorongás Kérd?ívet, a Beck Depresszió Skálát és egy saját tervezés? projektív rajztesztet (sajátalak- és veserajz) vettünk fel. A páciensek felépülését három évig követtük nyomon, negyedévente rögzítve a vesefunkciós értékeket és a kilök?dési epizódokat. Eredmények és következtetések A szorongóbb és depresszívebb pácienseknél a projektív rajztesztben a transzplantált szerv nagyobb méretben jelent meg, ami az átültetett vese intrapszichés integrációjának a zavarára utalhat. Logisztikus regressziós modellben a hazabocsátáskor mért szérum kreatinin érték és a testkép komplexitása prediktív a beültetett vese hosszú távú m?ködésében. Kutatási eredményeink szerint a transzplantációt követ? testképváltozások negatív hatással lehetnek a páciens egészségi állapotára és hosszú távon hozzájárulhatnak a beültetett szerv kilök?déséhez

Towards high-level human activity recognition through computer vision and temporal logic

Most approaches to the visual perception of humans do not include high-level activity recognitition. This paper presents a system that fuses and interprets the outputs of several computer vision components as well as speech recognition to obtain a high-level understanding of the perceived scene. Our laboratory for investigating new ways of human-machine interaction and teamwork support, is equipped with an assemblage of cameras, some close-talking microphones, and a videowall as main interaction device. Here, we develop state of the art real-time computer vision systems to track and identify users, and estimate their visual focus of attention and gesture activity. We also monitor the users' speech activity in real time. This paper explains our approach to high-level activity recognition based on these perceptual components and a temporal logic engine

The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)-quality of life during the first 4 months after fracture

UNLABELLED: The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. INTRODUCTION: The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. METHODS: ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. RESULTS: The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. CONCLUSIONS: The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries