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OBJECTIVE: There are great variations in the yearly incidence and the evolution of hip fractures secondary to bone fragility and associated to minimum trauma in patients older than 50. Because of the lack of data about these fractures in the province of Cáceres, we carried out a study to know their incidence and prevalence, and their evolutionary trend. MATERIAL AND METHODS: One thousand five hundred seventy seven hip fractures in the years 1997 through 2000 (both included) are studied. The type of fracture is obtained through 820.00 to 829.00 corresponding codes. RESULTS: One thousand one hundred ninety nine occur in women and 378 in men, being the average presentation age 81 +/- 9 years and 74 +/- 18 years, respectively; both data were significantly lower in men (p < 0.0001). The incidence index by sex is 2.6 women/men/100,000 inhabitants/year. The percentage of fractures by sex do not vary, depending on the anatomical location. The higher number of fractures in both sexes is in the trochanter (p < 0.0001); in men is higher in the year 2000 than in 1997 (p < 0.0001); in women their incidence and prevalence is also higher in the year 2000 than in the previous years (p < 0.0001). In conclusion we can point out that the incidence of the hip fractures secondary to low-energy trauma in the province of Cáceres population is increasing in the last few years, and that this incidence is higher in women than men, although the percentage of the fracture type according to its anatomical location is the same in women and men.

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Objetivo. Hay amplias variaciones en la incidencia/año y en su evolución para las fracturas de cadera en pacientes mayores de 50 años y que siendo por trauma mínimo se consideran fracturas por fragilidad ósea. No se conocen las de la provincia de Cáceres, por lo que quisimos saber las mismas y su tendencia evolutiva. Material y métodos. Se estudian 1.577 fracturas de cadera que tuvieron lugar en los años 1997 al 2000, ambos inclusive. El tipo de fractura se obtiene de los códigos 820 a 829 correspondientes. Resultados. Mil ciento noventa y nueve ocurren en mujeres y 378 en varones, siendo la edad media de presentación de 81 ñ 9 y de 74 ñ 18 años respectivamente, ambos datos significativamente menores en los varones (p < 0,0001). El índice de incidencia por sexos es de 2,6 mujeres/varones/ 100.000 habitantes/año. El porcentaje de fracturas habidas por sexos, dependiendo de la localización anatómica, no varía. El mayor número de fracturas en ambos sexos es a nivel trocantérico (p < 0,0001) y su incidencia y prevalencia es mayor en el año 2000 para los varones que en el año 1997 (p <0,0001) y en las mujeres también es mayor que en los años anteriores (p < 0,0001). En conclusión, podemos señalar que la incidencia de las fracturas de cadera por trauma no violento en la población extremeña de la provincia de Cáceres están aumentando en estos últimos años y que su incidencia es mayor en mujeres que en varones, aunque el porcentaje del tipo de fractura, según su localización anatómica, es el mismo por sexos (AU)

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OBJECTIVE: To evaluate the relevance of the so called risk factors for osteoporosis among women. MATERIALS AND METHODS: A total of 150 consecutive postmenopausal women who had been enrolled in the gynecology outpatient clinics of the Health Areas affiliated to the Alcalá de Henares University Hospital. Bone mass of these women was calculated as index of metacarpal cortical area/total area (CA/TA) (mm2), measured by radiogrammetry. RESULTS: With the ANOVA test, a late menarchial age and a shorter reproductive life induced a lower bone mass (p < 0.0005 and < 0.05, respectively); also, a history of bone fractures without previous relevant trauma (p < 0.05) was obtained. By correlational studies, there was a negative significance between CA/TA index and chronological age, menarchial age, menopausal age and number of fractures (r = -0.20 to -0.30; p < 0.05 to < 0.0001) and a positive significance with years of reproductive life (r = 0.17; p < 0.05). These values virtually remain unchanged when with partial correlation are weight adjusted, but with the multiple regression model, the CA/TA index is negatively significant only with menopause years (p < 0.005). Taking the average of the metacarpal CA/TA index as value, a sensitivity of 50% and an specificity of 78% were obtained to indicate fractures and a negative predictive value of 92%. CONCLUSION: These results indicate the greater importance of menarchial age, of reproductive life years and therefore of menopausal years, as determinants of postmenopausal bone mass and show a very acceptable specificity of the CA/TA index as predictive for bone fracture.

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Objetivo. Valorar la importancia de los denominados factores de riesgo para la osteoporosis en las mujeres. Material y métodos. Se estudian 150 mujeres postmenopáusicas, seleccionadas de forma consecutiva en las consultas ambulatorias de ginecología del área de salud del Hospital Universitario de Alcalá de Henares, cuya masa ósea se calcula como índice área cortical/área total (AC/AT) metacarpiana (mm2) determinada por radiogrametría. Resultados. Por el análisis de varianza ANOVA se determina que una menarquía tardía y una vida reproductiva más corta inducen una menor masa ósea (p < 0,0005 y < 0,05, respectivamente) y también el antecedente de fracturas óseas sin trauma importante previo (p < 0,05). Por estudios de correlación hay una significación negativa entre el índice AC/AT y la edad cronológica, la de la menarquía, la de la menopausia y el número de fracturas (r = -0,20 a -0,30, p < 0,05 a < 0,0001) y positiva con los años de vida reproductiva (r = 0,17, p < 0,05). Estos valores prácticamente no cambian cuando con correlación parcial se ajustan al peso, pero al hacer una regresión múltiple el índice AC/AT es únicamente significativo de forma negativa con los años de menopausia (p < 0,005). Tomando como valor el medio del índice AC/AT metacarpiana del grupo de mujeres con antecedente con fracturas se observa una sensibilidad del 50 por ciento y una especificidad del 78 por ciento para indicar fracturas y un valor predictivo negativo el 92 por ciento. Conclusión. Estos resultados señalan la mayor importancia de la edad de la menarquía, de los años de vida reproductiva y, por ende, de los años de menopausia como determinantes de la masa ósea postmenopáusica y demuestran de muy aceptable especificidad del índice AC/AT como predictivo de fractura ósea (AU)

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OBJECTIVE: To compare in a 3 month, multicenter, double blind, parallel study the efficacy and safety of a nonsteroidal antiinflammatory drug, aceclofenac, 100 mg bid orally, with that of tenoxicam, 20 mg orally at bedtime, in the treatment of adult patients with active ankylosing spondylitis (AS). METHODS: A total of 273 patients (135 in the aceclofenac group and 138 in the tenoxicam group) entered the study. Eight efficacy variables were assessed: morning stiffness, visual analog pain scale, control of additional paracetamol, modified Schöber's test, C7 line-iliac crest distance, lateral flexion of the spine, thoracic expansion, and occiput-wall distance. RESULTS: Seven of the 8 variables improved significantly in both groups, with no differences between the 2 groups in any variable at the end of the study. Six percent of patients taking aceclofenac and 5% of patients taking tenoxicam withdrew because of unsatisfactory therapeutic action. Forty-two adverse events possibly or probably related to treatment were observed in the aceclofenac group and 37 in the tenoxicam group. However, only 2.2% of patients in the aceclofenac group and 1.4% in the tenoxicam group withdrew for this reason. CONCLUSION: Aceclofenac and tenoxicam are similar in terms of safety and effectiveness; and aceclofenac, 100 mg orally twice daily, is a safe, effective, and convenient treatment for active AS.

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The serum level of tartrate-resistant acid phosphatase (TRAP) was measured in 130 children (61 M: 69 F). TRAP was found to be significantly higher in children under 5 years (n = 20) than in those aged between 5 and 9 years (n = 47) (8.3 + 2.4 vs 6.3 + 1.3 U/L, p less than 0.05). This last group had significantly lower TRAP levels than the one composed by children between 10 to 14 years (n = 60) (6.3 + 1.3 vs 7.5 + 1.2 U/L, p less than 0.02). We observed that a significant correlation existed between TRAP and alkiline phosphatase (r = 0.672, p less than 0.001). There was no correlation between TRAP and age and no difference between sexes. These results suggest that TRAP is useful as a marker of bone remolding in children.

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We studied three members of a single family who had basal ganglia calcifications (BGC): two with BGC alone and one associated with parkinsonism and hypoparathyroidism (H). This family links together BGC and H and may help resolve the apparent controversy about relationship of both.

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