Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women's Health and Aging Study (WHAS) II.

OBJECTIVES: The goal of this study was to examine the associations between severe osteopenia and osteoporosis and/or sarcopenia on frailty status, a major geriatric syndrome in community-dwelling older women. DESIGN: Cross-sectional analysis. SETTING: Women's Health and Aging Studies II (WHAS-II), Baltimore, Maryland. PARTICIPANTS AND MEASUREMENTS: The analytic sample for this study included 250 women aged 76-86 years old who underwent DXA evaluation at round 4. Frailty was determined using validated screening criteria. Severe osteopenia was defined as BMD between -2.0 SD and -2.49 SD and osteoporosis as BMD less than -2.5 SD (lumbar spine and/or proximal femur). Sarcopenia was determined by the appendicular lean mass by height(2) (aLM/ht(2) method) and considered present when the value was less then -2 SD compared to young women. RESULTS: Mean age of study subjects was 79.6 (±2.7) years. Overall prevalence of frailty was 6.8% (n=17). Severe osteopenia/osteoporosis occurred in 42.1% (n=7) in the frail group, 28% (n=33) in the pre frail group and 25.2% in the robust group. Sarcopenia was present in 52.9% (n=9) in the frail group, 42% (n=50) in the pre frail and 41.2% (n=47) in the robust group. Almost sixteen percent (n=39) had severe osteopenia/osteoporosis concomitant to sarcopenia. In an adjusted logistic regression model, severe osteopenia/osteoporosis (OR: 2.1; 95% CI: 0.68-6.6, p=0.196) and sarcopenia (OR: 3.1; 95% CI: 0.88-11.1; p=0.077) were individually associated with frailty, though not statistically significant. On the other hand, the likelihood of being frail was substantially higher in the presence of these two syndromes (OR: 6.4; 95% CI: 1.1-36.8, p=0.037). CONCLUSION: These findings suggest a concomitant impact of severe osteopenia/osteoporosis plus sarcopenia in regard to frailty status in a sample of oldest old women living in the community.

Correlação anatomopatológica entre a biópsia de fragmentos e a biópsia excisional nas lesões da mama / Histological correlation between core biopsy and excisional biopsy of breast lesion

A biópsia de fragmentos é uma importante opção para a abordagem das lesões palpáveis e não palpáveis da mama. O objetivo deste estudo é comparar os achados histológicos da biópsia de fragmentos com os da biópsia excisional. Foram comparados os resultados de 267 biópsias de fragmentos com os da biópsia excisional de lesões palpáveis e não palpáveis da mama, realizadas no Serviço de Mastologia dos Hospitais Luxemburgo e Mário Penna. A concordância entre a biópsia de fragmentos e a biópsia excisional foi de 96,6%. A incidência de lesões benignas foi de 52,4%, com achado de lesões malignas em 46,7% dos casos. A sensibilidade foi de 96,2 % e a especificidade, 98,7%, com valores preditivos positivo e negativo de 96,6 % e 98,5%, respectivamente. Os resultados deste estudo são compatíveis com aqueles da literatura mundial e confirmam que a biópsia de fragmentos é uma excelente opção no diagnóstico das lesões da mama, com a vantagem de ser um procedimento menos custoso e poder evitar um grande número de cirurgias.

Core-biopsy is an important option to approach palpable and non-palpable breast lesions. The objective of this study is to compare the histological findings of core-biopsy and excisional biopsy. A total of 267 core-biopsies were compared to the excisional biopsies of palpable and non-palpable lesions of the breast, performed at Mário Penna and Luxemburgo Hospital's Breast Department. The concordance between core-biopsy and surgical biopsy was 96,6%. The incidence of benign disorders was 52,4% with finding of malignant lesions in 46,7% of the cases. The sensibility was 96,2% and the specificity was 98,7%, with positive predictive value and negative predictive value 96,6 and 98,5%, respectively. The results of this study are compatible with those of the world literature and confirm that core-biopsy is an excellent option for the diagnosis of breast lesions, with the advantage of being a less expensive procedure that can avoid a large number of surgeries.

Hip axis length as an independent risk factor for hip fracture independently of femural bone mineral density in Caucasian elderly Brazilian women.

Studies carried out in several countries and in different ethnic groups have suggested that the hip axis length (HAL) may be a risk factor for hip fractures. To evaluate if the HAL is an independent risk factor for hip fractures in elderly Caucasian Brazilian women, this study includes 112 participants sustaining proximal femur osteoporosis. Through HAL and bone mineral density (BMD) measurements, a statistical analysis using a multivaried regression curve was done. HAL was significantly longer in women sustaining a hip fracture than in the control group (99.24 +/- 5.9 mm vs. 96.95 +/- 5.6 mm, P < 0.05). After adjusting the standard HAL deviation for neck and trochanter BMD, OR was 1.43 (IC 95% 0.29 - 1.07; P < 0.08). When HAL was categorized for 97.8 mm (average HAL in all women), OR was 2.24 (IC 95% 1.04 - 4.84; P < 0.05). In conclusion, HAL may be associated with risk of hip fracture regardless of age, weight or BMD of elderly Brazilian Caucasian women.

Novos paradigmas do modelo assistencial no setor saúde: conseqüência da explosäo populacional dos idosos no Brasil / New paradigms of the assistential model in the health sector: consequence of aging population growth in Brazil

O processo de envelhecimento da populaçäo mundial tem as suas origens enraizadas nas transformações econômico-sociais vividas pelas nações desenvolvidas no século passado e que, no entanto, só produziram modificações significativas nas suas variáveis demográficas na virada do século XX

Alteraçöes da cor de resinas compostas. Parte I. Influência das soluçöes de café, chá e vinho / Modification of colour composite resins. Part I. Influence of coffee, tea and wine solutions

Verificou-se o manchamento de algumas resinas compostas quando imersas em soluçöes comumente ingeridas. As soluçöes selecionadas para este estudo foram: café, chá e vinho e como controle a água destilada. Os corpos de prova em forma de disco, permaneceram por 10 dias nas soluçöes e receberam escores de 1 a 5, como meio de avaliaçäo da alteraçäo de cor. Os corpos de prova foram avaliados diariamente e os resultados evidenciaram diferenças estatisticamente significantes

Alteraçäo de cor de algumas resinas restauradoras - Parte II. Superfícies lisas, rugosas e glaseadas / Modification of color composite resins - Part II. Smooth, roughs and glasing surfaces

Os autores estudaram o comportamento de algumas resinas submetidas a três tipos de tratamentos superficiais; superfície lisa, superfície rugosa e superfície glaseada. Os resultados mostraram que: 1) As superfícies rugosas mancharam-se menos intensamente que as superfícies glaseadas e lisas. 2) As superfícies glaseadas mancharam-se mais intensamente que as superfícies lisas. 3) As resinas compostas mancharam-se mais intensamente que a resina acrílica