Demographics and clinical features of elderly patients undergoing regular dialysis in Brazil

An increasing number of elderly people in renal support is expected in the coming years. The objective of this study was to report the clinical and socio-demographic data of end-stage renal disease (ESRD) adult patients undergoing regular dialysis treatment comparing elderly (≥65 years old) and non-elderly subjects using data from the Brazilian Dialysis Registry database. The regional distribution of the sample was Southeast (48.8%), South (33.7), Northeast (13.1%), Midwest (5.1%), and North (0.1%). A total of 18,030 patients were included in the analysis with elderly patients accounting for 29.5% of the sample. The elderly patients were predominantly male, white, retired, and literate. Elderly ESRD patients had a slightly higher frequency of undernourishment and a lower frequency of obesity than the non-elderly adults. A higher frequency of elderly patients were from the South and Southeast regions. The dialysis treatment of patients from both groups was predominantly funded by the public system, but the percent of non-public funding was higher for the elderly group. The most used initial access in the elderly was the central venous catheter and hemodialysis was the main modality at the beginning of treatment (93.2%), as well as during maintenance therapy (91.8%). Advanced age was associated with greater use of central venous catheter in the first dialysis session. The survival of the elderly on dialysis was lower than that of the non-elderly early in the course of dialysis and this difference increased over time. This is yet the largest national epidemiological study of elderly people on chronic dialysis.

Policondrite recorrente. / Reccurent polychondritis

Os autores descrevem um caso raro entre nos, enfatizando as primeiras e principais manifestacoes que sao condrite nasal e das orelhas, as ultimas em forma de couve-flor a primeira em nariz em sela.Consideram que devido a frequencia dos sintomas articulares, os pacientes procuram um reumatologista; analisam a etiopatogenia e o diagnostico diferencial com outras doencas reumaticas e afeccoes otorrinolaringologicas; discutem varios metodos terapeuticos, enfatizando a eficacia dos corticosteroides, principalmente nas formas laringotraqueobronquicas, e o uso de "dapsnone" no tratamento da doenca a longo prazo