RESUMO
Osteoporotic hip fractures (OHF) are not limited to elderly; however, studies in non-elderly are scarce. Thus, the aim of this study was to evaluate co-morbidities in non-elderly patients with OHF in a Community Teaching Hospital. All hospitalizations due to OHF during a 3-year period in a Community Teaching Hospital were retrospectively evaluated for co-morbidities, and patients 18-64 years old were compared with those ≥65 years old. Of all hospitalizations, 232 (0.73%) were due to hip fractures, and 120/232 (51.7%) patients had OHF. The comparison of the 13 (10.8%) OHF patients <65 years old (47.3 ± 9.7 years) with 107 (89.2%) ≥65 years old (80.4 ± 7.7 years) revealed a male predominance (61.5 vs. 27.1%, P = 0.022) and a distinct ethnic distribution with a lower proportion of Caucasians in the former (61.5 vs. 86.9%, P = 0.033). Moreover, non-elderly OHF patients had higher frequencies of insulin-dependent DM (38.5 vs. 3.7%, P = 0.001) and alcoholism (38.5 vs. 4.7%, P = 0.001) than aged patients. In contrast, rates of age-related co-morbidities such as stroke (7.7 vs. 18.7%, P = 0.461), heart failure (23.1 vs. 14.0%, P = 0.411), and dementia (7.7 vs. 15.9%, P = 0.689) were comparable in both groups. Logistic regression analysis demonstrated that insulin-dependent DM (OR = 25.4, 95% CI = 4.7-136.8, P < 0.001) and alcoholism (OR = 20.3, 95% CI = 3.9-103.3, P < 0.001) remained as independent risk factors for OHF in non-elderly patients. Osteoporosis is an important cause of HF in Community Hospital. Non-elderly patients with OHF have a peculiar demographic profile and associated co-morbidities. These findings reinforce the need of early osteoporosis diagnosis and rigorous fracture prevention in patients with DM and alcoholism.
Assuntos
Fraturas do Quadril/epidemiologia , Osteoporose/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/epidemiologia , Brasil/epidemiologia , Doenças Cardiovasculares/epidemiologia , Distribuição de Qui-Quadrado , Comorbidade , Demência/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Fraturas do Quadril/etnologia , Hospitais Comunitários , Hospitais de Ensino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Osteoporose/etnologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Adulto JovemRESUMO
Trinta e cinco pacientes portadores de lúpus eritematosos sistémico com diferentes graus de lesäo renal evidenciada por microscopia óptica, com pesquisa de imunocomplexos por imunofluorescência foram avaliados para antígenos de histocompatibilidade de classe I. A freqüência génica e antigénica dos alelos e associaçäo à nefropatia foram estudadas. Ocorreu associaçäo näo significante dos antígenos HLA-A11. Aw36, B8 e B13 nos pacientes com envolvimento renal
Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Antígenos HLA/genética , Frequência do Gene , Lúpus Eritematoso Sistêmico/genética , Nefropatias/complicaçõesRESUMO
Os autores relatam um caso de dermatomiosite (DM) numa paciente de 15 años de idade e que apresentava sorologia compatível com toxoplasmose aguda. Foi introduzida terapêutica para toxoplasmose porém houve piora gradativa do quadro de fraqueza muscular a despeito dessa terapêutica, sendo necessário administraçäo de altas doses de corticosteróides EV com sucesso. Säo discutidas as dificuldades diagnósticas e terapêuticas na presença da associaçäo de miosite com toxoplasmose
