A recent study has identified a high incidence of undiagnosed cervical spondylotic myelopathy (CSM) amongst patients with a hip fracture. This is relatively unrecognised consequent of CSM.Additionally, there is some evidence to systems designed to offer protection in the case of a fall. Hip protectors, for example appear to decrease the number of hip fractures among the elderly, but they are often not used. Management
Most hip fractures are treated surgically by implanting a prosthesis. Surgical treatment outweighs the risks of nonsurgical treatment which requires extensive bedrest. Prolonged immobilization increases risk of thromboembolism, pneumonia, deconditioning, and decubitus ulcers. Regardless, the surgery is a major stress, particularly in the elderly. Pain is also significant, and can also result in immobilization, so patients are encouraged to become mobile as soon as possible, often with the assistance of physical therapy. Skeletal traction pending surgery is not supported by the evidence. Regional nerve blocks are useful for pain management in hip fractures. Peripheral nerve blocks may reduce pain on movement and acute confusional state, may improve time to first mobilisation, and may reduce the risk of postoperative lower respiratory tract infection. Surgery can be performed under general anaesthesia or with neuraxial techniques – choice is based on surgical and patient factors, as outcomes such as mortality and post-procedure complications including pneumonia, MI, stroke or confusion, are not affected by anaesthetic technique.Red blood cell transfusion is common for people undergoing hip fracture surgery due to the blood loss sustained during surgery and from the injury.
Caffeine and nicotine are the most popular stimulants used today, with roughly 400 million cups of coffee consumed daily and 36.5 million current cigarette smokers, according to a 2015 study conducted by the Centers for Disease Control and Prevention. Nicotine, however, is treated separately psychiatrically under tobacco use disorder. Conversely, caffeine misuse does not qualify as an addictive disorder; thus it can not be diagnosed as a stimulant use disorder or any other substance use disorder. Certain isolated conditions related to caffeine are recognized in the DSM-5’s "substance-related" section, however: caffeine intoxication, caffeine withdrawal and other caffeine-induced disorders (e.g., Anxiety and Sleep Disorders). Signs and symptoms
Short-term effects
Even in small doses, stimulants cause a decrease in appetite, an increase in physical activity and alertness, convulsions, an elevated body temperature, increased respiration, irregular heartbeat, and increased blood pressure; some of which can cause sudden death depending upon the medical history of the user, even among first-time users. Long-term effects
The long-term use of stimulants can ultimately cause very serious medical issues, including addiction. Stimulant addiction, similar to other kinds of addiction, involves neurobiological changes that cause sensitization of the reward system to the stimulus in question (stimulants, in this case). People who use stimulants for a prolonged period frequently experience physiological changes that can be detrimental to their quality of life and require long-term treatment.