Comparación de la eficacia clínica de una inyección intraarticular o intralesional de dos preparados de betametasona en pacientes con artrosis o epicondilitis / Comparative effects of intra articular injections of two betametasone preparations in patients with osteoarthritis or epicondilytis

Background: Local infiltration with corticoids is a simple therapy for rheumatic disorders devoid of systemic adverse reactions. Aim: To compare the efficacy of two betametasone preparations from two different pharmaceutical laboratories in the treatment of patients with osteoarthritis or epicondilytis. Patients and methods: Fourty patients with knee osteoarthritis and 12 patients with epicondilytis were studied. Using a double blind protocol, one of the two betametasone preparations was used for local infiltration of the lesions. The change in a global score of clinical variables including pain and disability was assessed after 30 days of the infiltration. Results: In patients with osteoarthritis, the global score decreased significantly with both preparations, but no differences were observed between preparations (7.3ñ1.8 to 3.9ñ2.3 with preparation A and 7.8ñ1.9 to 3.6ñ2.3 with preparation B). In patients with epicondilytis, pain was also significantly reduced but no differences between preparations was observed (7ñ2.1 to 1.4ñ2.5 for preparation A and 4.6ñ2.8 to 1.2ñ1.6 for preparation B). Conclusions: Local infiltration with both betametasone preparations was equally effective in the treatment of patients with knee osteoarthritis or epicondilytis

Tendencia de las tasas de fracturas de cadera en 12 años en Chile: ¿aumento independiente del envejecimiento poblacional? / Twelve years tendency of hip fracture rates in Chile: is there an increase independent of population aging?

All hospital discharges that occurred in Chile from 1982 to 1993 were analyzed, looking for the diagnosis of hip fracture. National censuses in the same period were also analyzed searching for possible changes in the age structure of the population. Fracture rates were analyzed for three age groups, and changes along the years were calculated correlating the rates with the number of the year. Results: In the twelve year period, women aged 55-64 years old had a correlation of 0.32 (NS), women aged 65-74 years old had a correlation of 0.58 (NS) and women aged over 75 years old had a correlation of 0.95 (p < 0.001). This age group corresponded to 2.01 percent of the whole population in 1982 and to 2.52 percent in 1993. The mean age of the group increased from 80.7 to 80.9 years in the same lapse. Conclusions: Fracture rates increased in the 12 years period studied, specially among women older than 75 years old. During the same period the proportion of people over 75 years old also increased, but there was only a slight increase in its mean age. Thus, the increase in fracture rates is disproportionate to population againg and could be related to changes in lifestyles

Pacientes con artritis reumatoidea: estudio de correlación entre la densidad de receptores de glucocorticoides en sinoviocitos y la respuesta clínica al tratamiento esteroidal / Patients with rheumatoid arthritis: correlation study between glucocorticoid receptors density in synoviocits and clinical response to steroidal treatment

The target cellular response to glucocorticoids is proportional to the concentration or affinity of specific receptors to these substances. To look for a correlation between glucocorticoid receptors concentrations in synovial wall cells and the clinical response to steroidal treatment in patients with rheumatoid arthritis. Twenty eight patients with rheumatoid arthritis were studied. Each subject was subjected to a synovial biopsy in which a dry radioautographic technique for diffusable compounds was used. Patients were treated afterwards with 3 500mg iv pulses of methilprednisolone. A mean of 44.8 percent of synovial cells (range 30.1-62.8 percent) had binding sites for 3H dexamethasone. All patients had a significant clinical improvement after methilprednisolone. Multiple regression analysis did not show a correlation between clinical response and glucocorticoid receptor concentration. The lack of association between glucocorticoid receptor concentration and clinical response could be due to the large steroid dose used, that saturated all available receptors

Epidemiología de las fracturas en Chile / Epidemiology of bone fractures in Chile

Bone fractures represented 3.3% of diagnosis among 1,003,267 patients discharged from National Health System Hospital in Chile during 1985. Among 75,534 cfertified deaths, 1.2% followed fractures. Significantly higher rates were observed in males; after age 75, fractures wree more common in females. Rates per 100,000for different fractures were: radio-cubital 45.4, shine and fibula 41, ankle 28.1, humerus 25.3, and hip 23.5. Among males the figures were shine and fibula 66.2, radius and cubitus 64.9, face 37.5 and ankle 37.1. Among females, hip 28.2, radius and cubitus 26.3, ankle 19.3 and humerus 16.5. Hip fracture is clearly related to age, the incidence raising from below 60 per 100,000 under age 60 to 617 in females and 330 in males above that age. Other fractures that increase with age include radius and cubitus, shine and fibula, ankle, humerus and fumur