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      A pacemaker lead infection as a complication of a discitis post fall in an elderly: A case report

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          A BSTRACT

          The population around the world is growing in age, and taking care of the elderly has become a medical challenge as new pathologies, risk factors, treatments, and approaches are being explored. One of the most important chapters that should be focused on is falls in the elderly, as it is a common reason for, not only fractures but also dependency, morbidity, and mortality in this population. The chapter on fall is vast and can be further categorized. In this article, we aim to focus on one of the complications, which is discitis post-vertebral fracture. The patient studied was a 78-year-old female patient who consulted post-fall and was admitted to the geriatric ward for a vertebral fracture. The hospitalization was complicated by a spinal infection and later on by a rarely-seen pacemaker lead infection. Vertebral fractures are very common in the geriatric population, whether spontaneously or post-trauma. Although treatment can be surgical or conservative, complications are commonly seen and can be fatal. Discitis is a medical challenge as the germs can be difficult to isolate, the pain management is difficult and in frail elderly patients, the infection and inflammation can be fatal. Prevention of falls is important in the elderly population as a simple slip can have drastic outcomes. Understanding the possible complications of falls is essential for better management.

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          Falls: epidemiology, pathophysiology, and relationship to fracture.

          Falls are common in the elderly, and frequently result in injury and disability. Most falls result from an interaction between individual characteristics that increase an individual's propensity to fall and acute mediating risk factors that provide the opportunity to fall. Predisposing risk factors include age-associated changes in strength and balance, comorbidities such as osteoarthritis, visual impairment and dementia, psychotropic medications, and certain types of footwear. Fewer studies have focused on acute precipitating factors, but environmental and situational factors are clearly important to fall risk. Approximately 30% of falls result in an injury that requires medical attention, with fractures occurring in approximately 10%. In addition to the risk factors for falls, the fall descent, fall impact, and bone strength are all important determinants of whether a fall will result in a fracture. In recent years, numerous studies have been directed toward the development of effective fall and fall-related fracture prevention interventions.
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            Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis

            Background With increasing life expectancy, declining mortality, and birth rates, the world's geriatric population is increasing. Falls in the older people are one of the most common and serious problems. Injuries from falls can be fatal or non-fatal and physical or psychological, leading to a reduction in the ability to perform activities of daily living. The aim of this study was to determine the prevalence of falls in the older people through systematic review and meta-analysis. Methods In this systematic review and meta-analysis, the data from studies on the prevalence of falls in the older people in the world were extracted in the databases of Scopus, Web of Science (WoS), PubMed and Science Direct, and Google Scholar, Magiran and Scientific Information Database (SID) without any time limit until August 2020. To analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies with the I 2 index was investigated. Data analysis was conducted with Comprehensive Meta-Analysis software (Version 2). Results In the review of 104 studies with a total sample size of 36,740,590, the prevalence of falls in the older people of the world was 26.5% (95% CI 23.4–29.8%). The highest rate of prevalence of falls in the older people was related to Oceania with 34.4% (95% CI 29.2–40%) and America with 27.9% (95% CI 22.4–34.2%). The results of meta-regression indicated a decreasing trend in the prevalence of falls in the older people of the world by increasing the sample size and increasing the research year ( P  < 0.05). Conclusion The problem of falls, as a common problem with harmful consequences, needs to be seriously considered by policymakers and health care providers to make appropriate plans for preventive interventions to reduce the rate of falls in the older people.
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              Post-traumatic Spondylodiscitis. Update, Series of 17 Patients and Review of the Literature

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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                J Family Med Prim Care
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                June 2023
                30 June 2023
                : 12
                : 6
                : 1234-1236
                Affiliations
                [1 ] Groupe Hospitalier Inetercommunal Le Rancy Montfermeil – Montfermeil, France
                [2 ] Lebanese American University Medical Center – Rizk Hospital - Beirut, Lebanon
                [3 ] APHP – Lariboisiere Hospital – Paris, France
                Author notes
                Address for correspondence: Dr. Mahmoud El Hussein, Department of Emergency, APHP Lariboisiere Hospital, Paris, France. E-mail: Mahmoud.el-hussein@ 123456hotmail.com
                Article
                JFMPC-12-1234
                10.4103/jfmpc.jfmpc_207_23
                10451602
                37636195
                f5472529-9547-4fe8-a68d-d351802da687
                Copyright: © 2023 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 31 January 2023
                : 30 March 2023
                : 11 April 2023
                Categories
                Case Report

                discitis,fall,geriatrics,lumbar pain,pace-maker infection,vertebral fracture

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