Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors / 전남의대학술지

Proton Pump Inhibitors are used widely to manage many gastric acid-related conditions such as gastroesophageal disease, gastritis, esophagitis, Barrett’s esophagus, Zollinger-Ellison syndrome, peptic ulcer disease, nonsteroidal anti-inflammatory drug-associated ulcers, and Helicobacter pylori eradication, around the globe. This review article focuses on adverse effects associated with the long-term use of proton pump inhibitors. Various observational studies, clinical trials, and meta-analyses have established the adverse effects associated with the long-term use of proton pump inhibitors including renal disorders (acute interstitial nephritis, acute kidney injury, chronic kidney disease, and end-stage renal disease), cardiovascular risks (major adverse cardiovascular events, myocardial infarction, stent thrombosis, and stroke), fractures, infections (Clostridium difficile infection, community-acquired pneumonia, and Coronavirus disease 2019), micronutrient deficiencies (hypomagnesemia, anemia, vitamin B12 deficiency, hypocalcemia, hypokalemia), hypergastrinemia, cancers (gastric cancer, pancreatic cancer, colorectal cancer, hepatic cancer), hepatic encephalopathy, and dementia. Clinicians including prescribers and pharmacists should be aware of the adverse effects of taking proton pump inhibitors for an extended period of time.In addition, the patients taking proton pump inhibitors for long-term should be monitored for the listed adverse effects. The American Gastroenterological association recommends a few non-pharmacological measures and the use of histamine 2 blockers to lessen gastrointestinal symptoms of gastroesophageal reflex disease and the utilization of proton pump inhibitors treatment if there is a definitive indication.Additionally, the American Gastroenterological association’s Best Practice Advice statements emphasize deprescribing when there is no clear indication for proton pump inhibitors therapy.

Predicting recurrence in oral cavity cancers: a review of 116 patients with buccal mucosa carcinoma in northwestern India

Background@#Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. @*Methods@#A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p 10 mm did not show statistically significant associations. @*Conclusion@#Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

Clinical and epidemiological trends in childhood leprosy: A 20-year retrospective analysis from a tertiary care hospital in Jammu, North India

Background: Slightly more than half the total number of childhood leprosy cases worldwide are from India. Aim: To analyze the clinical and epidemiological trends of childhood leprosy over 20 years in a tertiary care hospital. Methods: We retrieved the medical records of all children less than 15 years of age registered in the leprosy clinic between April 1998 and March 2018. We tabulated and analyzed data pertaining to demographic details along with clinical findings such as cutaneous lesions, nerves involved, sensory loss, deformities, reactions, smear status, histopathology and treatment. Results: Out of total 1548 leprosy cases registered during the study period, 55 (3.55%) cases of childhood leprosy were diagnosed. Thirty five (63.6%) children were in the age group of 11–15 years and 83.7% were migrants from other states. Thirteen (23.6%) children reported contact with a diagnosed case of leprosy, mainly in close contacts. Fifty three (96.4%) children presented with cutaneous lesions while 2 (3.6%) had pure neural involvement. Borderline tuberculoid leprosy was the most common clinical presentation in 27 (49.1%) followed by borderline lepromatous leprosy in 11 (18%). Thickened peripheral nerve trunks were detected in 42 (76.4%), most commonly the ulnar nerve. Reactional episodes occurred in 12 (21.8%) cases (Type 1 reaction, 10 (18.2%); Type 2 reaction, 2 (3.6%)). Grade 2 disability was detected in 4 (7.3%). Multidrug therapy was started in all patients, multibacillary (MB) regimen in 42 (76.3%) patients and paucibacillary (PB) regimen in 13 (23.7%). Twenty five (45.4%) children defaulted from the treatment. On comparing the data of 2008-18 with that of the previous decade (1998–2007), there was a higher proportion of migrant cases as compared to local cases (3:1–11:1) and MB cases as compared to PB cases (2:1–6:1). The proportion of treatment defaulters declined from 60% to 36%. Limitations: Relapse rate could not be calculated due to inadequate follow-up period. As it is a hospital-based retrospective study with no active surveys, these findings may not reflect trends in the community. Conclusion: Childhood leprosy continues to be a significant problem. There is a clear need to strengthen early detection, treatment and regular follow-up of these cases in both high and low endemic settings.

Evaluation of Auditory Stream Segregation in Musicians and Nonmusicians

Abstract Introduction One of the major cues that help in auditory stream segregation is spectral profiling. Musicians are trained to perceive a fine structural variation in the acoustic stimuli and have enhanced temporal perception and speech perception in noise. Objective To analyze the differences in spectral profile thresholds in musicians and nonmusicians. Methods The spectral profile analysis threshold was compared between 2 groups (musicians and nonmusicians) in the age range between 15 and 30 years old. The stimuli had 5 harmonics, all at the same amplitude (f0 = 330 Hz, mi4). The third (variable tone) has a similar harmonic structure; however, the amplitude of the third harmonic component was higher, producing a different timbre in comparison with the standards. The subject had to identify the odd timbre tone. The testing was performed at 60 dB HL in a sound-treated room. Results The results of the study showed that the profile analysis thresholds were significantly better in musicians compared with nonmusicians. The result of the study also showed that the profile analysis thresholds were better with an increase in the duration of music training. Thus, improved auditory processing in musicians could have resulted in a better profile analysis threshold. Conclusions Auditory stream segregation was found to be better in musicians compared with nonmusicians, and the performance improved with an increase in several years of training. However, further studies are essential on a larger group with more variables for validation of the results.

Antidiabetic Activity of Nigella Sativa (Black Seeds) and Its Active Constituent (Thymoquinone) – A Review of Human and Experimental Animal Studies / 전남의대학술지

The use of herbal medicine to manage chronic conditions including diabetes has become a recent global trend. Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. The present review is aimed to analyze the antidiabetic activity of N. sativa as many type 2 diabetic patients use it as a complementary therapy along with their modern allopathic medications or as an alternative therapy. The literature was reviewed in databases like Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, Web of science, EMBASE, Directory of open access journals (DOAJ), and reference lists to identify relevant articles supporting the use of N. sativa in diabetes management. Numerous clinical and animal studies have demonstrated the antidiabetic efficacy of black seeds (N. sativa) and its major bioactive constituent thymoquinone. Based on these findings patients with diabetes may use N. sativa as an adjuvant therapy, which may help to reduce the dose and incidence of adverse effects of modern antidiabetic medicines.

Clinical Characteristics and Risk Factors of CarbapenemResistant Enterobacteriaceae: A Case-Control Study in a Tertiary Hospital in Malaysia

@#Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) is increasingly reported worldwide causing serious threats to healthcare. This study aimed to identify the common organisms associated with CRE, the clinical characteristics and risk factors for acquiring CRE infection and colonisation among hospitalised patients. Methods: This is a matched, case-control study. Patients aged 18 years and above whom were hospitalised from January 2019 to December 2019 and had CRE isolated from clinical specimens were matched with carbapenem-susceptible controls (CSE), based on gender and age. Univariate and multivariate statistical analysis was performed. Results: Among 184 patients, Klebsiella pneumoniae was the most common organism causing CRE infection and colonisation. Chronic kidney disease (p=0.025, OR:3.12, 95% CI:1.15-8.41), urinary catheterisation (p=0.005, OR:3.67, 95% CI:1.49- 9.00), prior use of cephalosporin (p<0.001, OR:4.69, 95% CI:1.96–11.22) and beta-lactam combination agent (p<0.001, OR:7.18, 95% CI:2.98-17.26) were identified as the independent risk factors. Conclusion: Chronic kidney disease, urinary catheterisation, prior use of cephalosporin and beta-lactam combination agents were independently associated with CRE infection and colonisation. These findings enable targeting potential CRE cohorts, hence, necessitate early undertaking of prevention measures to delay the onset of CRE. A rigorous effort by antibiotic stewardship an infection control team are pivotal.

Antidiabetic Activity of Nigella Sativa (Black Seeds) and Its Active Constituent (Thymoquinone) – A Review of Human and Experimental Animal Studies / 전남의대학술지

The use of herbal medicine to manage chronic conditions including diabetes has become a recent global trend. Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. The present review is aimed to analyze the antidiabetic activity of N. sativa as many type 2 diabetic patients use it as a complementary therapy along with their modern allopathic medications or as an alternative therapy. The literature was reviewed in databases like Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, Web of science, EMBASE, Directory of open access journals (DOAJ), and reference lists to identify relevant articles supporting the use of N. sativa in diabetes management. Numerous clinical and animal studies have demonstrated the antidiabetic efficacy of black seeds (N. sativa) and its major bioactive constituent thymoquinone. Based on these findings patients with diabetes may use N. sativa as an adjuvant therapy, which may help to reduce the dose and incidence of adverse effects of modern antidiabetic medicines.

A Three Point Assessment Protocol for Tympanoplasty Outcomes: A Retrospective Analysis

Abstract Introduction The surgical outcome of chronic otitis media (COM) of the mucosal type in the pediatric population with high rates of recurrent tympanic membrane perforation is indeed a concern for the attending surgeon. Objective The present study was done to evaluate the outcome of tympanoplasty in children with chronic otitis media mucosal type. Methods A retrospective analysis of the medical records of all children, aged < 16 years old, who underwent tympanoplasty for COM of the mucosal type was performed. These patients were addressed by a three-point assessment, for predicting outcome of tympanoplasty, which included the age of the patient, addressing the nasal/pharyngeal issues, and the status of the COM (discharging or dry). Surgical success was assessed in terms of graft uptake and improvement of hearing. Factors affecting the surgical outcome were also analyzed. Results A total of 90 children underwent type 1 tympanoplasty; 7 were lost to follow-up and 10 had incomplete audiometric results. In the 73 tympanoplasties analyzed, graft uptake was seen in 91.7% of the patients. Children with longer duration of ear discharge (> 8 years) had greater hearing loss. Children aged > 8 years old showed statistically significant higher chance of graft uptake (p = 0.021). Five of the six children who had graft rejection had bilateral disease. Conclusion A three-point assessment in the management of pediatric COM of the mucosal type offers good outcomes with post-tympanoplasty graft uptake rates > 90%.

Nerve Conduction Study Findings in Ulnar-Median Nerve Intercommunications in the Upper Limb: A Short Review

Intercommunications between ulnar and median nerves in the forearm and hand are a commonly encountered phenomenon. Clinicians should be aware of these communications for better diagnosis and management of the patient, as the clinical presentation can often be misleading. Surgeons should be aware of these anastomoses so as to prevent any iatrogenic injury during the course of treatment. Furthermore, these intercommunications can distort the findings on nerve conduction studies, leading to misinterpretation and misdiagnosis. In the forearm region, there are two prominent median-ulnar anastomoses, namely, Martin–Gruber anastomosis (MGA) and reverse MGA (Marinacci anastomosis). Similarly, in the palm too, there are two major anastomoses, namely, Riche–Cannieu anastomosis and Berrittini anastomosis. Here, in this review, we would like to emphasize on electrophysiological findings that can be observed in the presence of such anastomoses.

Thrombocytopenia due to monsoon related illness: as an underestimated cause of maternal mortality and morbidity

Background: Thrombocytopenia is a second leading cause of blood disorder in pregnancy after anaemia. It is defined as platelet count below 1,50,000/ul. It is a common condition occurring in approximately 7-10% of pregnancies. Gestational thrombocytopenia is physiological and occurs in 70-80% of population having platelet count of 1,30,000/ul-1,50,000/ul with no adverse consequences. Other causes of thrombocytopenia in pregnancy could be immune related like immune thrombocytopenia, thrombotic thrombocytopenia or pregnancy related disorders like hypertensive disorders, eclampsia, HELLP and fatty liver of pregnancy. Besides this, pregnant ladies can have thrombocytopenia associated with fever which is commonly observed in monsoon season. It could be because of various causes like dengue, malaria, leptospirosis or other viral infections. Thrombocytopenia carries a risk of haemorrhage for both mother as well as newborn. It carries a risk of vertical transmission leading to premature birth, neonatal thrombocytopenia, intracranial haemorrhage and foetal death. There is relatively less information regarding importance of diversity of infectious diseases on pregnancy outcome.Methods: 14 pregnant patients were studied on the basis of their history of fever, platelet count below 1,50,000/ul and any  history of haemorrhage or petechie during monsoon period from June to September 2019 admitted in gynaecological ward in HBTMC and Dr. R. N. Cooper Hospital, Mumbai. All patients were subjected to fever profile, repeated haemogram for platelet trend and medical reference was done.Results: Out of 14 patients, 9 patients had negative fever profile, 2 were dengue positive, 2 were widal positive and one was leptospira positive patient. All patients had platelet count less than 1,50,000/ul out of which 3 patients received platelet transfusion..Conclusions: Monsoon fever with thrombocytopenia requires early diagnosis and optimal treatment to reduce maternal mortality and to avoid adverse fetal outcome. There is a strong need to create awareness amongst the community.

Knowledge and preventive practices regarding dengue in an urban area of Palakkad

Background: Dengue is the most rapidly spreading viral disease in the world. Kerala had reported high incidence of dengue cases recently including deaths. Integrated vector management is the most effective method of vector control which requires community participation. As high incidence of dengue cases are reported in Palakkad district, it is imperative to assess the knowledge level and preventive practices followed by the community. This will help to formulate further action plans including awareness creation and behaviour change.Methods: A cross sectional study was conducted in two randomly selected wards of Palakkad municipality from July to August 2017. An adult from each household was interviewed using a semi-structured questionnaire. The household and its surroundings were also observed to identify breeding sources and calculate relevant vector indices.Results: 95.9% of informants knew that dengue is transmitted through bite of infected mosquito. 67.8% felt that dengue mosquito bites during the daytime. 53.0% of the families observed dry day practices. 15.8% used mosquito repellent creams and only 25.9% used mosquito nets. The house index, container index and breteau index were found to be 24.60%, 23.55% and 33.43% respectively.Conclusions: The awareness regarding modes of transmission and biting time of Aedes mosquito is good but the usage of personal protective measures is quite low. Although majority of the respondents had knowledge about breeding places, there were significant numbers of breeding sources especially plastic containers. Vector indices were also high indicating risk of transmission of dengue.

Adjustment of Modified Carbapenem Inactivation Method Conditions for Rapid Detection of Carbapenemase-Producing Acinetobacter baumannii

BACKGROUND: The existing modified carbapenem inactivation methods (mCIMs) recommended by the CLSI for detecting carbapenemase production have not been applicable for Acinetobacter baumannii. We evaluated the influence of matrices used in mCIMs and CIMTris on the stability of the disks for detecting carbapenemase producers and suggested optimal mCIM conditions for detecting carbapenemase-producing A. baumannii. METHODS: Seventy-three A. baumannii isolates characterized for antimicrobial susceptibility and carbapenemase encoding genes were tested for carbapenemase production using mCIM and CIMTris. The influence of the matrices (Tryptic soy broth [TSB] and Tris-HCl) used in these methods on the stability of the meropenem (MEM) disk was also evaluated. The mCIM conditions were adjusted to enhance screening sensitivity and specificity for detecting carbapenemase-producing A. baumannii. RESULTS: The matrices had an impact on the stability of the MEM disk after the incubation period (two or four hrs). TSB nutrient broth is an appropriate matrix for mCIM compared with Tris-HCl pH 7.6, which leads to the loss of MEM activity in CIMTris. The sensitivity and the specificity of the optimal mCIM were both 100%. CONCLUSIONS: We established optimal mCIM conditions for simple, accurate, and reproducible detection of carbapenemase-producing A. baumannii.

Determination of Biofilm-Forming Capacity of Otopathogens Isolated from Discharging Ears in Children with Chronic Otitis Media

Chronic otitis media is a common disease of the developing world with persistent ear discharge, leading to major complications. This study describes the microorganisms isolated from the middle ear and nasopharynx of children with chronically discharging ears. Middle ear and nasopharyngeal swabs from 89 children were studied, and the microorganisms isolated were assessed for biofilm-forming ability. Methicillin-susceptible Staphylococcus aureus was common in the nasopharynx, while the middle ear showed predominantly pseudomonas and Methicillin-resistant S. aureus. Pseudomonas aeruginosa showed strong biofilm formation, whereas Escherichia coli, Proteus sp. and Providentia sp. were weak biofilm producers. S. aureus isolates were negative for biofilm formation.

Fecal carriage of carbapenem resistant Enterobacteriaceae among the intensive care unit patients

Background: The war against multidrug-resistant bacteria is challenging and of global concern. Hospitals are increasingly plagued by resistant gram negative pathogens. Bacteria of the family Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae are part of the normal human intestinal flora but are also often responsible for community- and healthcare-associated infections. These bacteria are prone to acquiring resistance genes.Methods: Rectal swabs/swabs from the peri-anal area of the patients who were admitted in the Intensive Care Unit (ICU) of the accident and emergency department of this teaching hospital. Swabs were collected first on day 1 of admission, then day 4, and thereafter weekly during the period of stay in the ICU. All the swabs were immediately inoculated into trypticase soy broth with one 10μg  meropenem disc and were incubated overnight at 35±2ºC, ambient air. Next day, the broth was vortexed, and then sub-cultured onto a MacConkey agar plate. On the third day, MacConkey agar plates were examined for lactose fermenting (pink-coloured) colonies. The representative isolated colonies were subjected to conventional antimicrobial susceptibility testing by the Kirby Bauer Disc diffusion method following the CLSI guidelines to know the susceptibility to carbapenem and other antimicrobial agents. Carbapenemase production was done by a Modified Hodge Test (MHT) and Imipenem-EDTA test.Results: Out of 89 patients, carbapenem resistant Klebsiella pneumoniae and E. coli isolates were recovered from 35 (39.3%) patients i.e. Klebsiella pneumoniae isolates from fifteen patients and carbapenem resistant E. coli isolates from twenty patients. Prevalence of carbapenemase producing isolates was found to be 1.42%.  Conclusions: Surveillance for CRE can definitely help reduce rates of healthcare associated infections.

Riscos microbiológicos e higiene das mãos de manipuladores e superfícies utilizadas por food trucks em eventos de rua / Microbiological risks and hygiene of handlers 'hands and surfaces used by food truck in street events

Avaliou-se os riscos microbiológicos e a higiene das mãos e superfícies de manipulação utilizadas por food truck em eventos de rua. O estudo foi realizado com 38 manipuladores e 38 superfícies de food trucks de Curitiba, Paraná. Os critérios de higiene foram avaliados através de uma lista de verificação. Verificou-se ainda a presença de Staphylococcus aureus, Escherichia coli e aeróbios mesófilos nas mãos e superfícies de manipulação. Constatou-se baixo percentual de adequação nos critérios de higiene da superfície e das mãos. Na análise microbiológica, 7,89% mãos apresentaram contaminação, enquanto que esse resultado foi encontrado em 39,47% das superfícies. Conclui-se que os riscos microbiológicos são evidentes e que as práticas de higiene das superfícies e das mãos dos manipuladores de food trucks precisam ser reavaliadas durante os eventos.

Elaboração e validação de instrumento de avaliação de rotulagem de alimentos / Elaboration and validation of food labeling evaluation instrument

Apesar de existirem inúmeras legislações sobre normas de rotulagem de alimentos, não há até o momento um instrumento padronizado e específico para avaliar a rotulagem de alimentos. O objetivo desse trabalho foi elaborar e validar um instrumento para avaliação da rotulagem de alimentos. Estudo do tipo observacional analítico e transversal onde se elaborou um instrumento para avaliação de rotulagem de alimentos com base nas legislações vigentes. A validação do conteúdo foi realizada pelo Índice de Validade de Conteúdo (IVC). Os itens que apresentaram IVC inadequado foram excluídos ou modificados conforme sugestões dos avaliadores. O instrumento final ficou estruturado com 54 itens e 19 constructos. Esse instrumento validado é uma ferramenta que pode facilitar a elaboração de rotulagem de alimentos.

Eurycoma longifolia, a promising suppressor of RANKL-induced differentiation and activation of osteoclasts: An in vitro mechanistic evaluation

Background: Eurycoma longifolia (E. longifolia) has gained remarkable recognition due to its promisingefficacy of stimulating bone formation in androgen-deficient osteoporosis. Numerous in vivo studies haveexplored the effects of E. longifolia on osteoporosis; however, the in vitro cellular mechanism was notdiscovered yet.Objectives: The present study was aimed to investigate the effect of E. longifolia on the proliferation,differentiation and maturation of osteoclasts and the translational mechanism of inhibition of osteoclastogenesis using RAW 264.7 cells as an in vitro osteoclastic model.Materials and methods: Having assessed cytotoxicity, the cell viability, cell proliferation rate and osteoclastic differentiation capacity of E. longifolia was investigated by evaluating the tartrate-resistant acidphosphatase (TRAP) activity in receptor activator of nuclear factor-kB (NF-kB) ligand (RANKL)-inducedosteoclasts. Taken together, the time-mannered expression of osteoclast-related protein biomarkers suchas matrix metallopeptidase-9 (MMP-9), cathepsin-K, TRAP, nuclear factor of activated T-cells cytoplasmic1 (NFATc1), superoxide (free radicals) generation and superoxide dismutase activity were also measuredto comprehend the mechanism of osteoclastogenesis.Results: E. longifolia did not show significant effects on cytotoxicity and cell proliferation of RAW 264.7cells; however, a significant inhibition of cells differentiation and maturation of osteoclasts was observed.Moreover, a significant down-regulation of RANKL-induced TRAP activity and expression of MMP-9,cathepsin-K, TRAP, NFATc1 and generation of superoxide and enhanced superoxide dismutase activitywas observed in E. longifolia treated cell cultures.Conclusion: We anticipated that E. longifolia that enhances bone regeneration on the one hand andsuppresses osteoclast’s maturation on the other hand may have great therapeutic value in treatingosteoporosis and other bone-erosive diseases such as rheumatoid arthritis and metastasis associatedwith bone loss.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Queda entre idosos: preditores e distribuição espacial / Falls in older adults: predictors and space distribution / Caída entre personas mayores: predictores y distribución del espacio

RESUMO Objetivos Calcular a prevalência de quedas, nos últimos 12 meses, entre idosos da comunidade; verificar a ocorrência de quedas em idosos da comunidade, segundo características sociodemográficas e de saúde e identificar clusters de quedas, entre idosos no município de Uberaba. Métodos Estudo transversal conduzido com 612 idosos residentes na zona urbana de Uberaba. Procederam-se às análises descritiva e bivariada com o teste qui-quadrado (p<0,05). Para estimar a intensidade dos eventos utilizou-se o Kernel estimation. Projeto aprovado pelo Comitê de Ética em Pesquisa, parecer N° 573.833. Resultados Constatou-se que 24,7% dos idosos tiveram quedas nos últimos 12 meses. A maior proporção dos idosos que sofreu quedas era do sexo feminino (p=0,004); com 80 anos ou mais (p=0,001); sem escolaridade (p=0,026); morava só (p=0,049); sem companheiro (p=0,002); com autopercepção de saúde negativa (p<0,001); dependente para as ABVD (p=0,049) e AIVD (p=0,027); com menor participação nas AAVD (p=0,003); pré-frágeis/frágeis (p<0,001) e com desempenho físico baixo/ruim (p<0,001). Os maiores aglomerados de ocorrência de quedas foram na região centro-oeste do município, seguido pela região sudeste. Conclusão Conhecer o perfil e os fatores associados à ocorrência de quedas entre idosos possibilita que os profissionais de saúde desenvolvam ações direcionadas a prevenção, ao monitoramento e controle desses fatores.(AU)

ABSTRACT Objective This work seeks to calculate the prevalence of falls in the last 12 months among the elderly from the community of the city of Uberaba; verify the occurrence of falls in the elderly of the community according to sociodemographic and health characteristics; and identify and group the types of falls among the older individuals in the city of Uberba. Methods Cross-sectional study carried out with 612 elderly people living in the urban area of Uberaba. Descriptive and bivariate analyzes were performed using the chi-square test (p<0.05). The kernel density estimation was used to estimate the intensity of the events. This project was approved by the Research Ethics Committee through Protocol No. 573.833. Results It was found that 24.7% of the elderly had falls in the last 12 months. The highest proportion of the elderly who suffered falls was female (p=0.004); aged 80 years or more (p=0.001); illiterate (p=0.026); who lived alone (p=0.049); without partner (p=0.002); with negative self-perception of health (p<0.001); dependent for BADL (p=0.049) and IALD (p=0.027); with a lower participation in AADL (p=0.003); pre-fragile/fragile (p<0.001); and with low/poor physical performance (p<0.001). The clusters with the most frequently reported falls were in the center-west region of the city, followed by the southeast region. Conclusion To know the profile and the factors associated with the occurrence of falls among the elderly allows health professionals to develop actions directed to prevent, monitor and control these factors.(AU)

RESUMEN Objetivos Calcular la prevalencia de caídas en los últimos 12 meses entre los ancianos que viven en la comunidad; para verificar la ocurrencia de caídas en ancianos de la comunidad, de acuerdo con las características sociodemográficas y de salud, e identificar grupos de caídas, entre los ancianos en la ciudad de Uberaba. Métodos Estudio transversal realizado con 612 ancianos residentes en el área urbana de Uberaba. Se realizaron análisis descriptivos y bivariadas con la prueba de chi-cuadrado (p<0,05). Para estimar la intensidad de los eventos, utilizamos la estimación de Kernel. Proyecto aprobado por el Comité de Ética en Investigación, N°. 573,833. Resultados Se encontró que el 24,7% de los ancianos tuvieron caídas en los últimos 12 meses. La mayor proporción de ancianos que sufrieron caídas fueron mujeres (p=0,004); mayores de 80 años (p=0,001); sin educación (p=0,026); vivió solo (p=0,049); sin pareja (p=0,002); con salud negativa autovalorada (p<0,001); dependiente de ABVD (p=0,049) y IADL (p=0,027); con menor participación en AADL (p=0,003); pre-frágil / frágil (p<0,001) y con un rendimiento físico pobre/pobre (p<0,001). Los grupos más grandes de ocurrencia de caídas se encontraban en la región del medio oeste del municipio, seguidos por la región sureste. Conclusión Conocer el perfil y los factores asociados con la ocurrencia de caídas entre los ancianos permite a los profesionales de la salud desarrollar acciones dirigidas a la prevención, monitoreo y control de estos factores.(AU)

A six-year study of leiomyomata with emphasis on lipoleiomyoma

Background: Leiomyoma is the most common benign neoplasm of the uterus. Lipoleiomyoma is a rare variant usually affecting women in the postmenopausal age group. Incidence of lipoleiomyoma varies from 0.59% - 2.1%. This study was undertaken to analyse the different variants, degenerative changes and to determine the incidence, clinical and morphological features of lipoleiomyoma amongst all the leiomyomas studied.Methods: This study was done in the Department of Pathology over a period of 6 years. Authors studied 575 patients with leiomyoma constituting a total of 1122 leiomyomata as some patients presented with multiple leiomyomata. Further clinicopathological correlation was done.Results: In the present study 98.03% of leiomyomata were uterine in location, 1.06% were cervical, 0.62% were in broad ligament and 0.26 % were in ovary. Among the 1122 leiomyomata studied, degenerative changes were noted in 19.6% of which hyaline degeneration was the most common. Leiomyoma variants constituted 5.27% of all leiomyomata. The incidence of lipoleiomyoma was 0.71% with size ranging from 3-10cm.Conclusions: Leiomyoma is a common tumor of the uterus and lipoleiomyoma variant is very uncommon with unknown etiology. They occur in postmenopausal as well as reproductive age group. The site of lipoleiomyoma can be uterine or extrauterine location such as broad ligament. Coexistance of metabolic derangement is an observation that may have a role in development of lipoleiomyoma.