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The barriers faced by people with intellectual disabilities are many. One of the areas in which many problems have been identified is the sexual domain. This descriptive study aims to analyze the attitudes of the family environment, professional carers, and the general population toward their sexuality. A cross-sectional descriptive study was carried out between 2022 and 2023, using convenience sampling among family members and carers from different centers working with people with intellectual disabilities in Spain, and among the general population not related to people with intellectual disabilities. A total of 583 responses were received and significant differences were found for all variables, with the variables related to family or work proximity being those that provided the most significant and relevant results. It was observed that the male sex has a more paternalistic attitude and that in rural areas there is a more permissive attitude towards the sexuality of people with intellectual disabilities. People who work with people with disabilities have more positive attitudes towards this group, while direct relatives have more paternalistic attitudes. Nursing care in the community and specialized centers should be based on an adequate therapeutic relationship and personalized care.

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INTRODUCTION: In January 2020, an outbreak of pneumonia caused by a zoonotic virus (SARS-CoV-2) appeared in China. The main route of transmission is considered to be the inhalation of large respiratory drops, by deposition in the mucosa and hands or contaminated fomites. The objective is to identify the interventions to be performed during hospitalization for the correct and safe handling of clothing and hygiene of patients and health professionals. METHOD: Scoping review carried out without chronological or language delimitation in the PUBMED and Cochrane databases. Tracking standards and recommendations of national and international government entities to answer the research question on the safe handling of clothing and skin hygiene in patients and in health professionals to avoid Covid-19 infection. The data analysis was carried out in 2 stages: in the first, identification and categorization of the studies, and in the second, content analysis as an informative and classifying criterion. RESULTS: 14 documents have been selected, mainly from government entities. The recommendations are structured in 5 sections on the management of clothing and skin hygiene of infected patients and health professionals in the hospital setting. CONCLUSION: The clothing of patients and healthcare personnel are transmitting vehicles of the disease. Its correct treatment helps to improve the control of the same and the correct use of the resources available at the moment. Proper skin hygiene, especially hand cleansing, is one of the basic pillars for infection prevention and control. We highlight the similarity of some of the guidelines collected and provided by the different agencies consulted.

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INTRODUCCIÓN: En enero de 2020 aparece en China un brote de neumonía causada por un virus zoonótico (SARS-CoV-2). Se considera que la ruta principal de transmisión es por inhalación de grandes gotas respiratorias, por deposición en las mucosas y las manos o los fómites contaminados. El objetivo es identificar las intervenciones a realizar durante la hospitalización para un manejo correcto y seguro de la ropa e higiene de los pacientes y profesionales sanitarios. MÉTODO: Scoping review realizada sin delimitación cronológica ni de idioma en las bases de datos PUBMED y Cochrane. Rastreo de normas y recomendaciones de entidades gubernamentales nacionales e internacionales para responder a la pregunta de investigación sobre el manejo seguro de la ropa y la higiene de la piel en pacientes y en profesionales sanitarios para evitar el contagio por Covid-19. El análisis de los datos fue realizado en dos etapas: en la primera, identificación y categorización de los estudios, y en la segunda, análisis de contenido como criterio informativo y clasificatorio. RESULTADOS: Se han seleccionado 14 documentos, principalmente de entidades gubernamentales. Las recomendaciones se estructuran en 5 epígrafes sobre manejo de ropa e higiene de la piel de pacientes infectados y profesionales sanitarios en el ámbito hospitalario. CONCLUSIÓN: La ropa de los pacientes y del personal sanitario son vehículos transmisores de la enfermedad. Su correcto tratamiento ayuda a mejorar el control de la misma y a una correcta utilización de los recursos disponibles en estos momentos. La adecuada higiene de la piel, en especial la limpieza de las manos, constituye uno de los pilares básicos para la prevención y el control de la infección. Destacamos la semejanza de algunas de las pautas recogidas y proporcionadas por los diferentes organismos consultados

INTRODUCTION: In January 2020, an outbreak of pneumonia caused by a zoonotic virus (SARS-CoV-2) appeared in China. The main route of transmission is considered to be the inhalation of large respiratory drops, by deposition in the mucosa and hands or contaminated fomites. The objective is to identify the interventions to be performed during hospitalization for the correct and safe handling of clothing and hygiene of patients and health professionals. METHOD: Scoping review carried out without chronological or language delimitation in the PUBMED and Cochrane databases. Tracking standards and recommendations of national and international government entities to answer the research question on the safe handling of clothing and skin hygiene in patients and in health professionals to avoid Covid-19 infection. The data analysis was carried out in two stages: in the first, identification and categorization of the studies, and in the second, content analysis as an informative and classifying criterion. RESULTS: 14 documents have been selected, mainly from government entities. The recommendations are structured in 5 sections on the management of clothing and skin hygiene of infected patients and health professionals in the hospital setting. CONCLUSION: The clothing of patients and healthcare personnel are transmitting vehicles of the disease. Its correct treatment helps to improve the control of the same and the correct use of the resources available at the moment. Proper skin hygiene, especially hand cleansing, is one of the basic pillars for infection prevention and control.We highlight the similarity of some of the guidelines collected and provided by the different agencies consulted

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Mujer de 80 años que consultó por dolor en muslo izquierdo sin irradiación y sin ningún mecanismo traumático. En Atención Primaria se realizaron radiografías y ecografía de la zona afectada que se informaron como normales. Tras un año y medio de seguimiento del dolor y estudios por diferentes especialidades, se observó en una nueva radiografía de fémur efectuada un engrosamiento de la cortical de dicho hueso. Dado este hallazgo y que la paciente se encontraba en tratamiento con ácido ibandrónico desde hacía más de cuatro años, se derivó a traumatología, donde le solicitaron una resonancia magnética y gammagrafía. Estando a la espera de dichas pruebas y sin ningún mecanismo traumático, comenzó con dolor, impotencia funcional y deformidad de dicha extremidad inferior, por lo que fue derivada a urgencias, diagnosticándose de fractura atípica de fémur secundaria al uso de bifosfonatos. El médico de familia debe prestar atención a realizar una correcta valoración y prescripción de estos fármacos, así como a identificar los síntomas prodrómicos de sus complicaciones (AU)

80-year-old woman who consulted for pain in left thigh without radiation and without traumatic mechanism. The Primary Care physician ordered X-rays and ultrasound of the affected area, both reported to be normal. After a 1.5 year follow-up and study of the pain by different specialties, a new femur radiography showed a cortical thickening. Given this finding and that the patient had been undergoing treatment with ibandronic acid for more than four years, she was referred to traumatology where physicians ordered magnetic resonance imaging and scintigraphy. While waiting for these tests and without any traumatic mechanism, the patient began experiencing pain, functional impotence and deformity of the lower limb. She was therefore referred to emergency, where she was diagnosed with atypical femur fracture secondary to biphosphonate use. The family physician must ensure an adequate assessment and prescription of such drugs, as well as identify the prodromal symptoms of their complicationst (AU)

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La osteoporosis es la enfermedad metabólica ósea más frecuente en los países occidentales. Las fracturas por fragilidad son la consecuencia clínica más importante de esta enfermedad, con una importante morbimortalidad y un gran impacto sociosanitario. El abordaje fundamental de la osteoporosis por parte del médico de familia está en el control de los factores de riesgo, con el fin de evitar la aparición de fracturas. Entre los múltiples factores involucrados en el desarrollo de la osteoporosis, muchos están relacionados con la masa ósea, y solo unos pocos presentan una fuerte potencia de asociación y uniformidad en distintos estudios. Se han propuesto diferentes escalas clínicas de riesgo de osteoporosis y fractura, teniendo en cuenta los factores de riesgo más importantes.El presente artículo pretende revisar de forma somera los factores de riesgo involucrados en el desarrollo de la osteoporosis y de las fracturas osteoporóticas, así como ofrecer al médico de familia unas herramientas en forma de escalas de valoración del riesgo que le supongan una ayuda en su labor clínica diaria para responder a las preguntas anteriormente planteadas. Se realiza una revisión de las escalas de valoración de riesgo de baja masa ósea y las escalas de valoración del riesgo de fractura. Sin embargo, estas escalas no deben sustituir el abordaje holístico del paciente, propio del médico de familia (AU)

Osteoporosis is the most frequent metabolic bone disease in western countries. Fragility fractures are the most important clinical outcome of osteoporosis, with an important morbi-mortality and a great socio-sanitary impact.The main objective of the family physician’s approach to osteoporosis is the control of risk factors in order to prevent osteoporotic fractures. Among the numerous factors involved in the development of osteoporosis, most of them are related to bone mass, and only a few present high evidence of association and similar results in different studies. Some clinical scales of osteoporosis and fracture risk have been proposed, attending to the most important risk factors.The present article briefly reviews the risk factors related to the development of osteoporosis and osteoporotic fractures, as well as offering family physicians risk assessment scales that will help them in their daily clinical work. A review of the low bone mass risk assessment and fracture risk assessment scales is made. However, these scales can not replace the patient holistic attention as the basic approach of the family physician (AU)

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Objetivo. Evaluar el grado de acuerdo entre los médicos de atención primaria (MAP) y los reumatólogos en la valoración de los criterios de derivación en pacientes con sospecha de espondiloartritis (EspA) precoz. Material y métodos. Se derivaron los pacientes con sospecha de EspA precoz, a través de la plataforma electrónica, por MAP siguiendo unos criterios de derivación predeterminados a Unidades de EspA precoz, donde fueron de nuevo evaluados por reumatólogos y confirmados los diagnósticos. Se ha analizado la concordancia de los criterios de derivación predeterminados entre MAP y reumatólogos mediante el índice kappa (k) en aquellos pacientes con diagnóstico de EspA precoz. Resultados. Analizamos 802 pacientes, de los que el 8,31% fueron mal derivados. El grado de acuerdo en relación con criterios de derivación predeterminados fue pobre para la lumbalgia inflamatoria (k=0,16; intervalo de confianza del 95% [IC 95%] 0,09-0,23), sacroilitis radiológica (k=0,31; IC 95% 0,211-0,428), raquialgia o artralgia (k=0,21; IC 95% 0,14-0,29); moderado para el criterio de artritis asimétrica (k=0,51; IC 95% 0,43-0,59), HLA B27 positivo (k=0,59; IC 95% 0,52-0,67) e historia familiar (k=0,50; IC 95% 0,415-0,604). Los grados de acuerdo fueron buenos o muy buenos para la presencia de uveítis anterior (k=0,81; IC 95% 0,68-0,93), enfermedad inflamatoria intestinal (k=0,87; IC 95% 0,79-0,96) y psoriasis (k=0,73; IC 95% 0,65-0,81). Conclusiones. El grado de acuerdo entre MAP y reumatólogos respecto a la valoración de los criterios preestablecidos para derivación de EspA precoz es variable. La concordancia es baja para criterios de derivación clave para el diagnóstico de pacientes con EspA. Facilitar programas de formación y entrenamiento para MAP resulta fundamental para identificar a pacientes con EspA precoz (AU)

Objective: To evaluate the degree of agreement between primary care physicians and rheumatologists when evaluating the referral criteria in patients with suspected early spondyloarthropathy (Spa). Material and methods: Patients with suspected early Spa (according to predefined clinical referral criteria) were sent by primary care physicians to early Spa units (where a rheumatologist evaluated the same criteria and confirmed the diagnosis) through an on-line platform. We assessed the agreement between primary care physicians and rheumatologists regarding the predefined clinical refererral criteria among patients with definitive Spa using the kappa index (k). Results: Eight hundred and two patients were analysed, 8.31% of whom were incorrectly referred to the rheumatologist. The degree of agreement regarding the predefined clinical referral criteria was poor for inflammatory back pain (k = 0.16; 95% confidence interval [95% CI] 0.09-0.23), radiographic sacroiliitis (k = 0.31; 95% CI 0.211-0.428), back or joint pain (k = 0.21; 95% CI 0.14-0.29); mild for asymmetric arthritis (k = 0.51; 95% CI 0.43-0.59), positive HLA B27 (k = 0.59; 95% CI 0.52-0.67) and family history (k = 0.50; 95% CI 0.415-0.604); and it was good or very good for anterior uveitis (k = 0.81; 95% CI 0.68-0.93), inflammatory bowel disease (k = 0.87; 95% CI 0.79-0.96) and psoriasis (k = 0.73; 95% CI 0.65-0.81),. Conclusions: The degree of agreement between primary care physicians and rheumatologists regarding the predefined clinical referral criteria was variable. Agreement was very poor for variables like inflammatory back pain, which are crucial for the diagnosis of Spa. Training programs for primary care physicians are important in order for them to correctly identify early Spa patients (AU)

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OBJECTIVE: To evaluate the degree of agreement between primary care physicians and rheumatologists when evaluating the referral criteria in patients with suspected early spondyloarthropathy (Spa). MATERIAL AND METHODS: Patients with suspected early Spa (according to predefined clinical referral criteria) were sent by primary care physicians to early Spa units (where a rheumatologist evaluated the same criteria and confirmed the diagnosis) through an on-line platform. We assessed the agreement between primary care physicians and rheumatologists regarding the predefined clinical referral criteria among patients with definitive Spa using the kappa index (k). RESULTS: Eight hundred and two patients were analysed, 8.31% of whom were incorrectly referred to the rheumatologist. The degree of agreement regarding the predefined clinical referral criteria was poor for inflammatory back pain (k=0,16; 95% confidence interval [95% CI] 0,09-0,23), radiographic sacroiliitis (k=0,31; 95% CI 0,211-0,428), back or joint pain (k=0,21; 95% CI 0,14-0,29); mild for asymmetric arthritis (k=0,51; 95% CI 0,43-0,59), positive HLA B27 (k=0,59; 95% CI 0,52-0,67) and family history (k=0,50; 95% CI 0,415-0,604); and it was good or very good for anterior uveitis (k=0,81; 95% CI 0,68-0,93), inflammatory bowel disease (k=0,87; 95% CI 0,79-0,96) and psoriasis (k=0,73; 95% CI 0,65-0,81),. CONCLUSIONS: The degree of agreement between primary care physicians and rheumatologists regarding the predefined clinical referral criteria was variable. Agreement was very poor for variables like inflammatory back pain, which are crucial for the diagnosis of Spa. Training programs for primary care physicians are important in order for them to correctly identify early Spa patients.

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Objetivo: Establecer una correlación entre los valores de riesgo de fractura obtenidos con las herramientas FRAX® y QFractureScoresT. Diseño del estudio: Observacional descriptivo retrospectivo. Emplazamiento: Centro de Especialidades de Toledo. Participantes: Pacientes con osteoporosis de una consulta de Metabolismo Óseo. Mediciones: Revisión de historias clínicas, obteniendo los datos del momento en que se inició el tratamiento antiosteoporótico, aplicando los índices de riesgo FRAX®, con y sin densitometría (en los casos en que la tengan), y QFractureScoresT, y estableciendo la correlación entre ambos. Resultados: 99 pacientes (88,9% mujeres), edad media (± desviación estándar) 62,3 ± 9,3 años. El valor medio del FRAX® sin densitometría fue de 7,37 ± 6,33 para fractura osteoporótica mayor (FOM) y de 2,6 ± 3,71 para fractura de cadera (FC). Con densitometría (n=74) los valores fueron de 8,6 ± 7,35 y 3,36 ± 4,64, respectivamente. El riesgo a 10 años con QFractureScoresT fue de 4,56 ± 2,83 para FOM y de 1,58 ± 1,91 para FC. El 37,4% presentaba un índice FRAX® (FOM / FC) ≥ 20% / 3%. La correlación entre FRAX® y QFractureScoresT para FOM fue de 0,751 (IC95% 0,620-0,882) y para FC de 0,771 (IC95% 0,645-0,897), disminuyendo al incluir los valores de las densitometrías [r=0,573 en FOM (IC95% 0,384-0,762) y r=0,487 en FC (IC95% 0,286-0,688)]. Conclusiones: Los índices FRAX® y QFractureScoresT presentan una correlación moderada-fuerte, especialmente si no se incluyen los valores de las densitometrías. Su uso puede recomendarse en Atención Primaria, sobre todo para valorar los factores de riesgo de osteoporosis. Actualmente no disponemos de puntos de corte fiables para tomar decisiones diagnóstico-terapéuticas en nuestro medio (AU)

Objective: To establish a correlation between the values of fracture risk obtained by FRAX® and QFractureScoresT tools. Design of the study: Retrospective observational study Location: Speciality Centre in Toledo. Participants: Patients with osteoporosis from a Bone Metabolism consultation. Measurements: Review of clinical history, with data obtained from the moment the antiosteoporotic treatment was commenced, applying FRAX® risk indices, with and without densitometry (in the cases affected by it) and QFractureScoresT, and establishing a correlation between them. Results: 99 patients (88.9% female) average age (± standard deviation) 62,3 ± 9,3 years. The average FRAX® value without densitometry was 7,37 ± 6,33 for major osteoporotic fracture (MOF) and 2,6 ± 3,71 for hip fracture (HF). With densitometry (n=74), the values were 8,6 ± 7,35 and 3,36 ± 4,64, respectively. A 10 year risk with QFractureScoresT was 4,56 ± 2,83 for MOF and 1,58 ± 1,91 for hip fracture. 37.4% showed a FRAX® (MOF / HF) ≥ 20% / 3% index. The correlation between FRAX® and QFractureScoresT for MOF was 0,751 (IC95% 0,620-0,882) and HF, 0,771 (IC95% 0,645-0,897), getting lower when densitometry values are included [r=0,573 in MOF (IC95% 0,384-0,762) and r=0,487 in HF (IC95% 0,286-0,688)]. Conclusions:FRAX® and QFractureScoresT indices show a moderate to strong correlation, especially if densitometry values are not included. Its use can be recommended in primary health care, above all in order to assess the risk of osteoporosis. We do not currently have a reliable benchmark to take diagnostic and therapeutic decisions in our environment (AU)

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Objetivo. Describir las características de los pacientes en tratamiento para la osteoporosis que no recibirían dicho tratamiento basándose en los resultados del FRAX®. Diseño. Estudio observacional descriptivo transversal. Emplazamiento. Atención Primaria - Centro de Especialidades de Toledo. Participantes. Pacientes diagnosticados de osteoporosis en tratamiento con fármacos antirresortivos, osteoformadores o mixtos vistos en las consultas de Reumatología (Metabolismo Óseo) en abril y mayo de 2009. Intervenciones. Revisión de historias clínicas obteniendo los datos del momento en que se inició el tratamiento antiosteoporótico, aplicando el índice de riesgo FRAX® con y sin densitometría (en los casos en que la tengan). Mediciones y resultados. 99 pacientes (88,9% mujeres), edad media (± desviación estándar) 62,3 ± 9,33 años. 62,6% presentaban un índice FRAX® < 20%/3%, siendo más jóvenes (58,95 vs. 67,92 años; p<0,001), y sin diferencias por sexo e IMC. Los pacientes “FRAX® (-)” tenían menor porcentaje de fracturas previas (33,9% vs. 83,8%; p<0,001), sobre todo vertebrales y de húmero, en menor número (0,55 vs. 1,75; p<0,001) y a edad más temprana (54,88 vs. 63 años; p=0,02). Además, tenían una puntuación T en cuello femoral superior (-1,87 vs. -2,50; p<0,001). La probabilidad de fractura a 10 años era menor en los pacientes “FRAX® (-)” sin densitometría (4,18% vs. 12,72% en fractura osteoporótica mayor; p<0,001; 0,91% vs. 5,43% en fractura de cadera; p<0,001) y con densitometría (4,70 vs. 14,30 en fractura osteoporótica mayor; p<0,001; 1,14 vs. 6,62 en fractura de cadera; p<0,01). La densitometría no afecta significativamente el porcentaje de pacientes que supera el límite del 20%/3%. Conclusiones. La herramienta FRAX® puede tener relativa utilidad en Atención Primaria, especialmente en aquellos pacientes sin osteoporosis densitométrica o establecida. Sin embargo, no parece que el criterio de coste-efectividad obtenido por los anglosajones pueda adoptarse de forma directa y única en nuestro medio (AU)

Aim. To describe the characteristics of the patients treated for osteoporosis that could not been treated according to FRAX® scores. Design. Observational, descriptive, cross-sectional study. Setting. Primary Care – Toledo Speciality Centre. Participants. Outpatients with osteoporosis diagnosis treated with antirresortive, osteogenic or mixed drugs and visited in Rheumatology Service (Bone Metabolism) in april-may 2009. Intervention. Clinical charts review extracting the data from the antiosteoporotic treatment starting date, and applying the FRAX® risk index with and without bone densitometry (in that patients with it). Measurements and results. 99 patients (88.9% women), medium age (± standard deviation) 62.3 ± 9.33 years old. 62.6% had a FRAX® index <20%/3%; these patients were younger (58.95 vs. 67.92 years old) than those with a FRAX® ≥20%/3%, with neither gender nor BMI differences. “FRAX® (-)” patients had less previous fractures (33.9% vs. 83.8%; p<0.001), specially from spine and humerus; these patients also had a smaller fracture number (0.55 vs. 1.75; p<0.001), and their fractures were produced at a younger age (54.88 vs. 63% years old; p=0.02). Also, their T-score of hip was bigger (-1.87 vs. -2.50; p<0.001). The 10-year probability of fracture was smaller in the “FRAX® (-)” patients without densitometry (4.18% vs. 12.72% in major osteoporotic fracture; p<0.001; 0.91% vs. 5.43% in hip fracture; p<0.001) and with it (4.70% vs. 14.30% in major osteoporotic fracture; p<0.001; 1.14% vs. 6.62% in hip fracture; p<0.01). Bone densitometry does not significantly affect the percentage of patients that surpass the 20%/3% limit. Conclusions. The FRAX® tool can be relatively useful in Primary Care, especially in those patients without densitometry or established osteoporosis. However, the NOF cost-effectivity criteria cannot be adopted directly in our environment (AU)

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As part of the Spanish Multicenter Normative Studies (NEURONORMA project), we provide age- and education-adjusted norms for the following instruments: verbal span (digits), visuospatial span (Corsi's test), letter-number sequencing (WAIS-III), trail making test, and symbol digit modalities test. The sample consists of 354 participants who are cognitively normal, community-dwelling, and age ranging from 50 to 90 years. Tables are provided to convert raw scores to age-adjusted scaled scores. These were further converted into education-adjusted scaled scores by applying regression-based adjustments. The current norms should provide clinically useful data for evaluating elderly Spanish people. These data may be of considerable use for comparisons with other normative studies. Limitations of these normative data are mainly related to the techniques of recruitment and stratification employed.

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Objetivo. Estudiar las características de los pacientes diagnosticados de gonartrosis en un área de salud; secundariamente, el perfil de tratamiento y la calidad de cumplimentación de los criterios diagnósticos de gonartrosis. Diseño. Estudio observacional descriptivo transversal por reclutamiento. Emplazamiento. Cinco Centros de Salud urbanos y rurales de un área sanitaria. Participantes. Un total de 99 pacientes diagnosticados de gonartrosis que dieron su consentimiento a la inclusión en el estudio. Mediciones. Datos sociodemográficos, enfermedades concomitantes, índice de masa corporal (IMC), tratamiento para la artrosis, tratamientos anteriores y causa del cambio. Registro en la historia clínica de los criterios clínicos y radiológicos de la A.C.R. para el diagnóstico de gonartrosis, y gradación radiológica. Resultados. El 80,8% fueron mujeres. La edad media fue de 68,04 años (DE 9,38), sin diferencias por sexo. Una mayor proporción de mujeres tenía un IMC ≥ 30 (71,3% vs. 47,4%; ?2=3,94; p=0,047). El tiempo medio de diagnóstico era de 10,61 años (DE 9,44). Los criterios clínicos para el diagnóstico constaban en el 69,7% de los casos, y los radiológicos en el 25,3%. El tiempo medio de tratamiento era de 24,62 meses (DE 38,01), sin diferencias por sexo ni edad (el 39,4% mantenía el mismo tratamiento prescrito inicialmente). Los fármacos más frecuentemente prescritos eran los AINEs (50,5%), el paracetamol (45,5%) y otros analgésicos no antiinflamatorios (21,2%). La distribución de la afectación radiológica fue: grado I (13,3%), grado II (13,3%), grado III (42,7%), grado IV (30,7%). El 11,8% presentaba una artrosis secundaria. Conclusiones. La obesidad y el sexo femenino predominan en los pacientes con gonartrosis en nuestra muestra. Debe mejorarse la cumplimentación del diagnóstico y el tratamiento prescrito. Sería necesario descartar causas secundarias de gonartrosis realizando un estudio radiológico a todos los pacientes (AU)

Objective. To determine the characteristics of patients with knee osteoarthritis in a health region, their treatment profile and the quality of recording knee osteoarthritis diagnostic criteria. Design. Observational, descriptive, cross-sectional study. Setting. Five primary health centres (urban and rural) of a health region. Participants. 99 patients diagnosed with knee osteoarthritis who had given their informed consent to be included in the study. Measurements. Social demographic data, concomitant diseases, body mass index (BMI), treatment for osteoarthritis, previous treatments and reason for change. Entering of ACR clinical and radiological criteria for diagnosing knee osteoarthritis in medical records, and radiological assessment. Results. 80.8% were women. Mean age was 68.04 years (SD 9.38), with no gender differences. BMI ≥ 30 was more frequent in women (71.3% vs. 47.4%; ?2=3.94; p=0.047). Mean time from diagnosis was 10.61 years (SD 9.44). Clinical criteria for osteoarthritis diagnosis was recorded for 69.7% of patients, while radiological criteria was recorded for 25.3%. Mean treatment time was 24.62 months (SD 38.01), with neither gender nor age differences (39.4% were receiving the same treatment as that initially prescribed). The most frequently prescribed drugs were NSAIDs (50.5%), acetaminophen (45.5%) and other non-anti-inflammatory analgesics (21.2%). The radiological damage distribution was: grade I (13.3%), grade II (13.3%), grade III (42.7%), and grade IV (30.7%). 11.8% had secondary osteoarthritis. Conclusions. Obesity and female gender prevail in patients with knee osteoarthritis in our sample. The medical recording of diagnosis should be improved, as well as the prescribed treatment. A radiological study should be performed on all the patients in order to rule out secondary osteoarthritis (AU)

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To date, hepatotoxicity with anti-TNF therapy has been associated with concomitant liver-toxicity drugs, infection or malignant diseases. We report the case of one patient with spondyloarthropathty who presented severe liver dysfunction related to infliximab. After the second infusion serum controls showed an slightly increase of transaminases. Before the administration of fifth infusion, infliximab therapy was stopped due to severe liver damage (AST 327 mU/ml, ALT 656 mU/mL, GGT 140 mU/mL, alkaline phosphate 227 mU/mL). Ten weeks after infliximab discontinuation serum concentrations of liver blood tests were normal but ankylosing spondylitis symptoms had relapsed. Therefore, he was treated with etanercept with a rapid and sustained improvement. Serum concentrations of albumin, AST, ALT, GGT and alkaline phosphate were followed and did not change for five months.

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