[Estimate of the costs of osteoporotic fractures of the femur in Spain]. / Aproximación a los costes de la fractura osteoporótica de fémur en España.

To evaluate the economic impact of osteoporosis, the cost of acute attention to the osteoporotic hip fractures recorded in Barcelona during one year was investigated. The hospital records of 8637 beds (85.64% of the overall number in the city) were reviewed and the cases seen in inhabitants aged 45 years or more during 1984 were included. The cost, days of hospital admission, operations and orthopedic material were recorded. Data from 870 fractures were recovered. During the study period 1358 hip fractures took place in Barcelona, with 1269 +/- 21 (mean +/- SEM) operations, 31219 +/- 1550 (mean +/- SEM) days of hospital admission, and 408 +/- 40 (mean +/- SEM) prostheses. Their attention generated a cost amounting to 662.5 +/- 29.5 (mean +/- SEM) million pesetas. The cost of each fracture was 488200 +/- 331700 (mean +/- SD) pesetas, with a hospital stay of 23 +/- 17 (mean +/- SD) days. This represents, for the whole of Spain, 33298 +/- 1769 (mean +/- SEM) fractures, 31160 +/- 2154 (mean +/- SEM) operations, 767853 +/- 78314 (mean +/- SEM) hospital admission days and 10042 +/- 1530 (mean +/- SEM) prostheses every year. The yearly expenditure is 16295 +/- 1598 (mean +/-SEM) million pesetas (confidence interval of the estimation 95%). Thus, osteoporotic hip fracture results in a significant expenditure in this country. The enormous cost of the attention to osteoporosis and its complications warrants a greater effort for its prevention and care.

Raised serum alkaline phosphatase activity in one family.

Eleven members of the same family were studied after an incidental detection of raised serum alkaline phosphatase activity in one of them without any apparent underlying cause. Three other members were found to have the same abnormality; none of them had an associated disease. In the four cases with elevated serum alkaline phosphatase levels, its activity showed a preponderance of the bone isoenzyme. Studies of the erythrocyte and histocompatibility antigens in nine members of the family, as well as idiograms of karyotypes of four of them, did not show any relation between histocompatibility antigens and the raised levels of serum alkaline phosphatase. Also, no chromosomal abnormality is shown from karyotypes. The data suggest a probable autosomal dominant pattern of inheritance.

[Carcinomatous lymphangitis of the lung. Report of 21 cases (author's transl)]. / Linfangitis carcinomatosa pulmonar. Estudio de 21 casos.

Twenty-one cases of carcinomatous lymphangitis of the lung are reported. In diagnosing them clinical, roentgenologic, and histopathologic criteria were used and the clinical, roentgenologic and evolutive findins were considered in order to emphasize the origin of the primitive neoplasm. From this point of view the principal ones turned out to be carcinomas of the breast, stomach, and lung. The absence of carcinoma of the thyroid gland as a source of pulmonary lymphangitis carcinomatosa must be pointed out. The higher incidence of this condition in older people and the clear predominance in the female sex are stressed. From a clinical standpoint the most important data were the existence of cough and dyspnea, which are often associated with the commom presence of enlarged left supraclavicular or axillary lymph nodes. There was a predominant pure interstitial pattern (the most common feature was the presence of Kerley's A or B lines), sometimes coexisting with alveolar impairment and very often with accompanying pleural effusion. The mean survival rate was 2 months, with a maximum of 7 months and a minimum of 3 days. The results of the present series were compared with those of the literature and the most significant and constant fact in both instances was that two thirds of the cases of pulmonary lymphangitis carcinomatosa had their origin in neoplasms of the breast, stomach, and lung.