RESUMO
BACKGROUND AND OBJECTIVE: To estimate the fracture risk with the FRAX in patients treated and not treated in clinical practice. MATERIAL AND METHODS: From a database of risk factors for osteoporosis and fracture, that included absorptiometry measurements, we selected all patients who met the following criteria: 1) Age between 40 and 90 years, 2) to have the weight and size, 3) To have the first study by DXA scan after September 2005, 4) To know the therapeutic intervention made after bone densitometry, and 5) Not have done any treatment before the first densitometry. The calculation of the fracture risk was achieved with the application available on the Web during June 2008. RESULTS: One hundred and ninety two people (45 men) were included, 81 of which received treatment after densitometry. Treated patients had more risk factors (1,06 + or - 0,97 [IC 95% 0,88-1,24] vs. 1,49 + or - 1,03 [IC 95% 1,27-1,71], p=0,003). Fracture risk was higher in treated patients in all groups (major osteoporotic fracture and hip fracture, with and without bone absorptiometry). In all cases, fracture risk was lower when using the densitometric value. In patients younger than 65 years, the fracture risk was significantly lower than in patients over 64 years in all cases. CONCLUSIONS: The risk of fracture measured by the FRAX is higher in patients receiving treatment, although there is a significant overlap between the two groups.
Assuntos
Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Osteoporose/complicações , Algoritmos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/tratamento farmacológico , Medição de Risco/métodosRESUMO
BACKGROUND AND OBJECTIVE: Giant cell arteritis (GCA) is the most frequent systemic vasculitis in adults. In recent years, the usefulness of temporal artery ultrasound (TAUS) as a diagnostic tool to assess the underlying inflammation of the vascular wall during the inflammatory process has been under clinical investigation. MATERIAL AND METHODS: Observational and descriptive cohort study of 120 TAUS in 60 patients with clinical suspicions of GCA, according to the ACR (American College of Rheumatology) classification criteria. RESULTS: Among all patients who underwent ultrasound, 42.3% met clinical criteria for GCA according to ACR. Sensitivity and specificity of TAUS in our cohort with clinical suspicion was 81.8% and 93.3%, respectively. A PPV of 90.1% and a VPN of 87.5% were observed. CONCLUSION: Our results showed that TAUS as a useful, indolent, fast, and accessible tool with high diagnostic specificity and diagnostic value.
Assuntos
Arterite de Células Gigantes/diagnóstico por imagem , Artérias Temporais/diagnóstico por imagem , Ultrassonografia Doppler , Feminino , Arterite de Células Gigantes/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To determine the impact of prior corticosteroid treatment on temporal artery biopsy (TAB) yield to establish the diagnosis of giant cell arteritis (GCA). METHODS: Retrospective study of a consecutive cohort of 78 patients clinically diagnosed and managed as GCA, who received corticosteroids before TAB. RESULTS: Among the 78 patients, TAB was positive in 57 (73%) and negative in 21 (27%). No significant differences in the length of the specimen were found between the positive and negative biopsies. We grouped patients according to treatment duration before TAB. In those with newly diagnosed GCA treated with high-dose steroid therapy, the biopsy results were positive in 78% (35/45) of patients treated for less than 2 weeks, in 65% of those treated for 2 to 4 weeks (13/20), and in 40% of those treated for more than 4 weeks (2/5). We also observed 8 patients that developed GCA on a background of a prior history of polymyalgia rheumatica (PMR); in this group biopsy was positive in 88% of the cases, after a median duration of treatment of 180 +/- 172 days and an average daily dose of 7.1 +/- 1.4 mg/d. CONCLUSION: The performance of TAB should not delay the prompt institution of steroid therapy on diagnosis of GCA, since the diagnostic yield of TAB seems valuable within 4 weeks of starting high-dose steroid treatment. In patients that developed GCA on a background of a prior history of PMR, a late TAB is also generally informative despite long-term treatment with low doses of corticosteroids.
Assuntos
Corticosteroides/administração & dosagem , Arterite de Células Gigantes/tratamento farmacológico , Arterite de Células Gigantes/patologia , Artérias Temporais/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de TempoRESUMO
BACKGROUND AND OBJECTIVE: The study is aimed at improving our knowledge about the functional impairment of the psoriatic arthritis through a multicentral series. PATIENTS AND METHOD: We have designed a transversal and multicentral study (centers of the same geographical area), including 343 patients with psoriatic arthritis. Eight medical centers have participated. Patients have been divided depending on the assistential level where they are visited. We have collected the following data: sex, age, assistential level, duration of psoriasis and arthritis, age at onset of psoriasis and arthritis, clinical form, ARA functional impairment, number of tender and swollen joints, presence of dactylitis, distal interphalangeal affection, axial involvement, ostheolisis or nail lesions, erithrocyte sedimentation rate (ESR), C-reactive protein, hemoglobine, leucocites, platelets, HLA-B27 and rheumatoid factor. RESULTS: 7.14% of the patients were significatly disabled (ARA functional class III and IV). 30.32% were patients visited in a primary assistential level, 30.90% in a secondary assistential level and 38.78% a tertiary and universitary hospital. We found statistically significant correlation between III and IV functional classes and age, assistential level, ostheolisis, corticoid treatment, ESR, leucocites, platelets and number of tender joints. CONCLUSIONS: We find a better functional capacity in our patients than in other studies. The inclusion of patients from different assistential levels instead of just patients visited in a tertiary hospital might be the cause of this difference.
Assuntos
Artrite Psoriásica/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Diagnosis and therapy of patients with early onset rheumatoid arthritis (RA) is influenced by accessibility to specialized care devices. We attempted to analyze the impact of their availability. METHODS: We analyzed time related to diagnosis delay measuring: 1) Time from first clinical symptoms to the first visit with the Rheumatologist; 2) Time from referral to the first visit of Rheumatology; 3) Time between first symptom until final diagnosis; 4) time between first symptom until the initiation of the first disease-modifying antirheumatic drug (DMARD). The presence of these 6 rheumatology devices was defined: 1) early arthritis monographic clinics, 2) RA monographic clinics, 3) Mechanisms for fast programming, 4) Algorithms for referral from primary care (PC), 5) rheumatology consultation services in PC and 6) consulting services in PC. RESULTS: The mean time from onset of symptoms to diagnosis or the establishment of a DMARD in RA patients in Catalonia is very long (11 months). Patients seen in rheumatology devices such as RA monographic clinics, rheumatology consultation in PC and specially in early arthritis clinics are treated early with DMARDs. CONCLUSION: the existence of monographic clinics or consulting in primary care centers is essential to improve early care of RA patients.
Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico , Diagnóstico Tardio/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/tratamento farmacológico , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Atenção Primária à Saúde , Encaminhamento e Consulta/estatística & dados numéricos , Espanha , Fatores de TempoRESUMO
UNLABELLED: Primary Sjögren syndrome (PSS) is a chronic inflammatory autoimmune disease. Interstitial lung disease (ILD) can be an extraglandular complication. OBJECTIVE: To evaluate the clinical characteristics of patients diagnosed with PSS with ILD. METHODS: Multicentre cohort study with 25 patients diagnosed with PSS and ILD. Data of PSS, prognostic factors, pulmonary involvement variables, complementary tests that suggest a worse diagnosis and treatment given were collected. EULAR index was measured for Sjögren's syndrome. RESULTS: We identified 25 patients. In 15/25 the diagnosis of ILD was done before the diagnosis of PSS. The histopathological patterns found were: 12 NSIP, 5 UIP, 4 OP, 2 LIP. PFRs showed restrictive pattern. The majority of the patients received glucocorticoid therapy, antimalarial or immunosuppressive treatment. CONCLUSIONS: Patients affected with PSS must be screened to catch a precocious diagnosis of ILD. The majority of the patients were diagnosed of ILD before being diagnosed of PSS. Multicenter cohorts are increasingly demanded and a multidisciplinary management is needed.
Assuntos
Doenças Pulmonares Intersticiais/etiologia , Síndrome de Sjogren/complicações , Adulto , Idoso , Feminino , Seguimentos , Humanos , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/patologiaRESUMO
BACKGROUND AND OBJECTIVE: To assess the effect of the application in routine clinical practice of a proposal of thresholds for the indication of bone densitometry in Spanish postmenopausal women. PATIENTS AND METHODS: We determined the risk of major fracture (RMF) by FRAX(®) of the patients referred to a bone densitometry unit from Primary Care who were untreated. We calculated how many scans would have been avoided if they had been performed only to women ≥ 65 years with a RMF < 10% or women<65 years with a RMF ≥ 3.6%. RESULTS: We included 643 women with a mean age of 61 (9) years. Twenty-three percent had a normal bone mineral density, 56% had osteopenia, and 21% osteoporosis. The RMF was 5.9 (5.5)%. Eighty of 217 (37%) bone scans in women ≥ 65 years and 273 of 426 (64%) in women<65 years would have been avoided. As a whole, 55% of the scans would have been avoided. The sensitivity of the threshold of 3.6% of RMF for the diagnosis of osteoporosis was 51%, specificity 68%, positive predictive value 20%, and negative predictive value 20%. CONCLUSIONS: The application of the proposed thresholds for the indication of bone densitometry in Spanish postmenopausal women, based on age and risk of fracture calculated by FRAX(®) would result in a significant decrease of the activity of the bone densitometry unit.
Assuntos
Absorciometria de Fóton/estatística & dados numéricos , Algoritmos , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico , Osteoporose Pós-Menopausa/diagnóstico , Inquéritos e Questionários , Procedimentos Desnecessários , Idoso , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/epidemiologia , Estudos Transversais , Feminino , Fêmur/diagnóstico por imagem , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/prevenção & controle , Humanos , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/epidemiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Espanha/epidemiologiaRESUMO
OBJECTIVE: To describe a large series of patients with mutilans/resorptive arthritis (AM) of a representative population of patients with psoriatic arthritis (PsA) and analyze the associated variables. METHODS: Multicenter cross-sectional study of consecutive patients affected by PsA in 8 centers. In patients with swelling or deformity of the hands or feet we performed an anteroposterior rx. The patient was affected by AM if erosive disorder affecting both articular surfaces completely was present. RESULTS: Of the 360 patients studied, 24 had PsA and AM (6.7%). The duration of their disease was significantly higher, and they exhibited a worse functional capacity as well as more DIP joint affection (P<.05). 30% had radiological changes indistinguishable from nodular osteoarthritis. CONCLUSIONS: AM in PA is associated with a worse functional capacity. Its possible association with nodular hand osteoarthritis deserves further study.
Assuntos
Artrite Psoriásica/fisiopatologia , Reabsorção Óssea/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Psoriásica/diagnóstico por imagem , Reabsorção Óssea/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , RadiografiaRESUMO
OBJECTIVES: The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. METHOD: A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. RESULTS: A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. CONCLUSIONS: The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended.
Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Artrite/tratamento farmacológico , Imunoglobulina G/administração & dosagem , Preferência do Paciente , Receptores do Fator de Necrose Tumoral/administração & dosagem , Doença Crônica , Educação em Enfermagem , Desenho de Equipamento , Etanercepte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SeringasRESUMO
UNLABELLED: In March 2008, FRAX, developed by Kanis and collaborators in the University of Sheffield and supported by the World Health Organization, became available online to calculate absolute risk of osteoporotic fracture in the next 10 years. OBJECTIVE: To analyze the risk of fracture calculated by FRAX and its determinants in the patients sent to a densitometry unit for bone mineral density (BMD) testing. METHODS: All the patients submitted by Primary Care to the Densitometry Unit for BMD testing underwent a self administered questionnaire to assess the clinical risk factors included in FRAX and a bone densitometry of lumbar spine and proximal femur with a DXA densitometer Hologic QDR 4500. They were classified as having a normal BMD, osteopenia or osteoporosis along with the recommendations of the International Society for Clinical Densitometry. As the reference population to calculate the T and Z scores, we used the one from the NHANES III study for femoral neck and total hip and the one from the Study of the Spanish Population for total spine. With the data of the questionnaire, we calculated, by FRAX, the absolute risk in the next ten years of having a major fracture (MFR) or a hip fracture (HFR). Both risks were calculated with or without the inclusion in the algorithm of BMD: MFR+, MFR-, HFR+ and HFR-. The results were recorded in an Access 2003 database and analyzed with the statistical package SPSS 15.0 for Windows. RESULTS: We analyzed the data from 853 women with a mean age of 61.9 (8.9) years and a mean body mass index of 27.0 (4.2)kg/m(2). Mean BMD at lumbar spine was 0.873 (0.127)g/cm(2); at femoral neck, 0.704 (0.105)g/cm(2); and at total hip, 0.817 (0.107)g/cm(2). Twenty percent of the patients had a normal BMD, 55% had osteopenia and 25%, osteoporosis. Yet excluding age and body mass index, the number of fracture risk factors seems low: 31% of the patients had no risk of fracture; 40%, had one; 22%, two; 6%, three; 1%, four; and one patient had five. Mean MFR+ was 5.4 (4.8)%; mean MFR-, 6.3 (5.5)%; mean HFR+, 1.5 (2.9)%; and HFR-, 2.1 (3.3)%. When BMD was included in the algorithm for the calculation of the risk of fracture, the risk was statistically lower (p<0.001), especially in patients with better BMD. CONCLUSIONS: The risk of fracture calculated by FRAX in the patients sent to a densitometry unit for bone BMD testing seems low and, probably, a better selection of the patients would detect a higher risk of fracture population. When the fracture risk is calculated with the introduction of BMD in the algorithm, it is lower than without including BMD.
Assuntos
Absorciometria de Fóton , Densidade Óssea , Fraturas Espontâneas/epidemiologia , Índice de Gravidade de Doença , Absorciometria de Fóton/estatística & dados numéricos , Idoso , Algoritmos , Índice de Massa Corporal , Feminino , Colo do Fêmur/química , Fraturas Espontâneas/etiologia , Humanos , Vértebras Lombares/química , Pessoa de Meia-Idade , Modelos Biológicos , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/diagnóstico por imagem , Medição de Risco , Fatores de Risco , Espanha , Inquéritos e Questionários , Centros de Atenção TerciáriaRESUMO
UNLABELLED: The Catalan Agency for Health Technology Assessment and Research (AETIM) proposed, in 2001, criteria for performing a bone densitometry (BD) for use in the consultations of the public health system. OBJECTIVE: To determine the sensitivity, specificity, positive predictive value and negative predictive value of the criteria to indicate BD. MATERIAL AND METHODS: Five groups of volunteers (premenopausal women aged 46 to 65 years, postmenopausal women aged 46 to 65 years, postmenopausal women aged> 65 years and men 46 to 65 years and> 65 years) underwent BD and a questionnaire on risk factors. The results obtained with the AETIM criteria are related to criteria for indication of BD proposed by the World Health Organization (1999 and 2003 criteria), the National Osteoporosis Foundation (1998 amd 2010 criteria) and the International Committee of Clinical Guidelines on Osteoporosis. RESULTS: Criteria from the Catalan Agency have low sensitivity to detect both low bone mass (T index<-1) and osteoporosis (T index<-2.5), specificity varied according to the group. The positive predictive value is low, but the negative predictive value for osteoporosis is high in all groups (except for postmenopausal women aged> 65 years). The remaining criteria have a high negative predictive value and, in women, good sensitivity and low specificity, especially for identifying patients with osteoporosis. CONCLUSION: Catalan Agency criteria are useful for selecting patients who would not need BD, but lack sufficient sensitivity to identify individuals with low bone mass. The other criteria also have a high negative predictive value for osteoporosis, and a better sensitivity.
Assuntos
Densitometria , Osteoporose/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Espanha , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Due to increasing improvement in the diagnosis, evaluation and management of osteoporosis and the development of new tools and drugs, the Spanish Society of Rheumatology (SER) has promoted the development of recommendations based on the best evidence available. These recommendations should be a reference to rheumatologists and other health professionals involved in the treatment of patients with osteoporosis. METHODS: Recommendations were developed following a nominal group methodology and based on a systematic review. The level of evidence and degree of recommendation were classified according to the model proposed by the Center for Evidence Based Medicine at Oxford. The level of agreement was established through Delphi technique. Evidence from previous consensus and available clinical guidelines was used. RESULTS: We have produced recommendations on diagnosis, evaluation and management of osteoporosis. These recommendations include the glucocorticoid-induced osteoporosis, premenopausal and male osteoporosis. CONCLUSIONS: We present the SER recommendations related to the biologic therapy risk management.
Assuntos
Osteoporose , Absorciometria de Fóton , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Feminino , Humanos , Masculino , Osteoporose/complicações , Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/terapia , Fatores de Risco , EspanhaRESUMO
Castleman's disease is a rare lymphoproliferative disorder having two types of presentation: the localized and the multicentric form. Multicentric Castleman's disease (MCD) typically presents with constitutional symptoms, generalized peripheral lymphadenopathy, hepatosplenomegaly, and laboratory markers of inflammation. Rash and arthritis may also be initial complaints of this disease. In these cases, MCD can resemble adult-onset Still's disease (AOSD), especially if the arthritis precedes other manifestations. We describe a patient with initial clinical suspicion of AOSD. Eighteen months later evidence of MCD was ascertained when the patient developed insidiously growing axillary lymphadenopathies. Despite its rarity, MCD should be borne in mind in the differential diagnosis of patients with suspicion of AOSD.
Assuntos
Hiperplasia do Linfonodo Gigante/diagnóstico , Doença de Still de Início Tardio/diagnóstico , Anti-Inflamatórios não Esteroides/uso terapêutico , Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/tratamento farmacológico , Diagnóstico Diferencial , Humanos , Doenças Linfáticas/diagnóstico , Doenças Linfáticas/etiologia , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Indução de Remissão , Resultado do TratamentoRESUMO
OBJECTIVE: To characterize rheumatoid arthritis patients seen in Rheumatology Units at different health care levels. MATERIAL AND METHODS: Questionnaire and clinical examination of rheumatoid arthritis patients seen as outpatients in Rheumatology Units from Primary Care, county Hospitals and Reference Hospitals. Demographic, social, labour and disease data were collected. Statistical study included a description of the variables and a multiple correspondence analysis to define patient profiles. RESULTS: Eight hundred and twelve patients with rheumatoid arthritis were included. There were significant differences in patient profiles at the different care level. In Primary Care, patients were older, with basic studies, and with short duration and generally mild rheumatoid arthritis. In local hospitals the typical patient was a man, qualified worker, with low income, and an erosive disease with extraarticular manifestations. At reference Hospitals prevailing patients were young women with a long duration disease and requiring biological therapy. CONCLUSION: There are significant differences in rheumatoid arthritis patient profiles at different health care levels.
RESUMO
OBJECTIVE: To compare the effect of coexisting fibromyalgia in DAS28 in RA female patients. PATIENTS AND METHOD: Fifty-three RA women seen consecutively in an outpatient rheumatology clinic were included and classified according to the presence (9 women) or absence (44 women) of fibromyalgia. ESR, number of tender and swollen joints, and global assessment by the patient through a visual analogue scale were recorded, as well as other functional and emotional variables. RESULTS: There were no differences in age, time since onset of the arthritis, number of swollen joints, ESR, and CRP. Number of tender joints, global assessment by the patient, and functional and emotional aspects were worse in patients with fibromyalgia. DAS28 was higher when fibromyalgia was associated to RA (5.55 ± 0.78 vs 3.39 ± 1.15; P = .000). CONCLUSIONS: Coexistence of fibromyalgia increases DAS28 in women with RA.
RESUMO
OBJECTIVE: To find the number of individuals with indication for Bone Densitometry in Primary Care, according to the criteria of the WHO, the Agency for Evaluating Medical Technology of Catalonia (AETM) and the International Committee on Clinical Guides to Osteoporosis (CIGCO), and the frequency of factors of risk of low osseous mass. DESIGN: Multi-centre, prospective, transversal study. SETTING: Primary care consultations. PARTICIPANTS: Patients over 18 (307 women and 139 men) with mean age of 54.3+/-16.8, who attended for consultation with an appointment. MAIN MEASUREMENTS: Presence or absence of factors relating to each of the indication criteria for bone densitometry. RESULTS: A 36.3% of individuals had indication of densitometry under the AETM criteria, 76.7% with the WHO criteria, and 50.5% with the CIGCO criteria (applicable only to women). Percentages increased with age and were higher for women. Concordance between the various criteria was under 37%. CONCLUSIONS: The percentage of individuals with indication for bone densitometry was highly variable under different criteria. It was greater in women and increased with age. Concordance between different criteria was low.
Assuntos
Densidade Óssea , Osteoporose/diagnóstico , Absorciometria de Fóton , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Espanha/epidemiologiaRESUMO
OBJECTIVE: Although there is relevant information on frequency of osteoporosis in women with rheumatoid arthritis (RA), data about male patients are limited. We evaluated the frequency of osteoporosis in a group of Spanish men with RA followed in a university hospital. METHODS: From the database of our bone densitometry unit, we searched for men with RA evaluated between January 1991 and December 2004 and identified 187 patients, 156 of whom were older than 50 years. Previously recorded demographic, disease, and treatment-related variables were collected. Bone mineral density (BMD) was measured by dual x-ray absorptiometry (DEXA). Osteoporosis was defined according to the criteria of the World Health Organization (WHO), recommended for postmenopausal Caucasian women, as a T score Assuntos
Artrite Reumatoide/epidemiologia
, Hospitais Universitários
, Osteoporose/epidemiologia
, Absorciometria de Fóton
, Adulto
, Idoso
, Idoso de 80 Anos ou mais
, Artrite Reumatoide/metabolismo
, Artrite Reumatoide/fisiopatologia
, Densidade Óssea
, Comorbidade
, Colo do Fêmur/diagnóstico por imagem
, Colo do Fêmur/metabolismo
, Humanos
, Vértebras Lombares/diagnóstico por imagem
, Vértebras Lombares/metabolismo
, Masculino
, Pessoa de Meia-Idade
, Osteoporose/metabolismo
, Índice de Gravidade de Doença
, Espanha/epidemiologia