Calcifying aponeurotic fibroma: Radiologic-pathologic analysis of ten cases and review of the literature.

Calcifying aponeurotic fibroma (CAF) is a very rare benign entity that principally affects the volar fascia, tendons, and aponeuroses of the hands and feet with a peak incidence of between 5 and 15 years, although there have been cases found for a wide age range and at various anatomical sites. We present ten CAF cases; consisting of eight children and two adults. CAF occurred in the extremities in nine of the cases and in the chest wall in one case. CAF ultrasound and radiological findings are nonspecific but may help orientate diagnosis. Magnetic resonance imaging should be performed when there are doubtful cases, when occurring in nontypical sites, and when there are cases of nontypical clinical presentation. Histologically, all cases showed two components, a fibromatosis-like component and a nodular component. Chondroid areas were present in five cases. Calcifications were observed in nine cases. ERG immunostaining showed the same patterns in all the cases; diffuse positivity in pericalcified areas, and patchy positivity in areas away from calcifications. CAF has distinctive histopathological features which should aid in the differential diagnoses with other entities.

Efficacy of Antiresorptive Treatment in Osteoporotic Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

OBJECTIVES: To investigate concerns surrounding the benefits of antiresorptive drugs in older adults, a systematic review was carried out to evaluate the efficacy of these treatments in the prevention of osteoporotic hip fractures in older adults. DESIGN: a systematic review and meta-analysis of randomized clinical trials. SETTING AND PARTICIPANTS: older adults ≥65 years with osteoporosis, with or without a previous fragility fracture. Studies with cancer-related and corticosteroid-induced osteoporosis, participants <65 years and no reported hip fracture were not included. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science and Scopus databases were searched. The primary outcome was hip fracture, and subgroup analysis (≥75 years, with different drug types and secondary prevention) and sensitivity analysis was carried out using a GRADE evaluation. Secondary outcomes were any type of fractures, vertebral fracture, bone markers and adverse events. The risk of bias was assessment with the Cochrane risk of bias tool. RESULTS: A total of 12 randomised controlled trials (RCTs) qualified for this meta-analysis, with 36,196 participants. Antiresorptive drugs have a statistically significant effect on the prevention of hip fracture (RR=0.70; 95%CI 0.60 to 0.81), but with a moderate GRADE quality of evidence and a high number needed to treat (NNT) of 186. For other outcomes, there is a statistically significant effect, but with a low to moderate quality of evidence. Antiresorptives showed no reduction in the risk of hip fracture in people ≥75 years. The results for different drug types, secondary prevention and sensitivity analysis are similar to the main analyses and have the same concerns. CONCLUSIONS: Antiresorptive drugs have a statistically significant effect on preventing hip fracture but with a moderate quality (unclear/high risk of bias) and high NNT (186). This small benefit disappears in those ≥75 years, but increases in secondary prevention. More RCTs in very old osteoporotic adults are needed.

[A sociodemographic study of pregnant women and relation to pregnancy acceptance]. / Estudio sociodemográfico de las gestantes y su relación con la aceptación del embarazo.

BACKGROUND: Control of normal pregnancy in the scope of primary Health care has been implemented recently; this is the reason why, many factors which have an influence on the use of this service, still remain unknown. We carried out this descriptive study in two Primary Health Care Centers of the VIII Health Area in Asturias, in order to approach the pregnant woman's profile from our primary health care centers, and to study the relation between pregnancy acceptance and sociodemographic characteristics. METHODS: The social histories of all women, who requested health care for their pregnancy during 1991, were collected; the most interesting sociodemographic variables and those ones directly related to pregnancy were obtained. RESULTS: Out of a total of 139 women, the mean age was 0.4 0.0006. There is a 16% of unmarried women. In relation with the pregnancy acceptance or desire, it was found that 31% of women did not desire it and this rejection was greater among unmarried women, younger than 20 years, (p = 0.0002) among those ones, whose contraceptive method had failed, (p = 0.0000) and among those ones, whose relations with their family were bad or not good enough (p = 0.0004). CONCLUSIONS: A pregnant woman's profile, from our health centers, is obtained. It is necessary to develop health education programmes and family planning in the groups of women with higher number of not desired pregnancies, (young unmarried women).