ABSTRACT
BACKGROUND: Osteoarthritis (OA) is a health problem affecting millions of individuals worldwide. Aim: To evaluate risk factors for hip and knee osteoarthritis (OA) in women aged 40 to 59 years. MATERIAL AND METHODS: Analysis of a prospective cohort of 1159 women attending preventive health care programs and followed during 28 years. They underwent a clinical and laboratory evaluation from 1990 to 1993. The diagnosis of OA was retrieved from registries of a special program for osteoarthritis in 2020. RESULTS: Twenty four percent of participants developed osteoarthritis during the follow-up. At the beginning of the study and compared with women without OA, they were older (median [interquartile range or IQR]: 49.6 [8.5] and 47.2 [8.2] years respectively), had a higher body mass index (26.3 [5.3] and 25.1 [5.3] respectively), and a higher frequency of jobs with low qualification (76 and 62% respectively). The presence of type 2 diabetes mellitus, chronic hypertension, a previous history of alcohol or cigarette consumption, postmenopausal status and lipid and glucose blood levels did not differ between women with or without OA. Cox regression showed a final model that incorporates body mass index (hazard ratio (HR): 1.04; 95% confidence intervals (CI): 1.01-1.07), age (HR: 1.05; 95% CI: 1.03-1.08) and having an unqualified job (HR: 1.88; 95% CI: 1.43-2.47) as risk factors for OA. CONCLUSIONS: Obesity and the type of job are the most relevant risk factors found for OD: both may be modified with proper care.
Subject(s)
Humans , Female , Middle Aged , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/etiology , Osteoarthritis, Hip/epidemiology , Osteoarthritis, Knee/etiology , Osteoarthritis, Knee/epidemiology , Diabetes Mellitus, Type 2/complications , Prospective Studies , Risk FactorsABSTRACT
Resumen Introducción Las cárceles constituyen un foco de violencia inherente y un ambiente propicio de lesiones traumáticas. Objetivo Describir el perfil de ingreso y evolución de personas privadas de libertad hospitalizadas en nivel terciario por trauma acontecido en 2 complejos penitenciarios, que ingresan a nuestro Servicio. Materiales y Método Estudio descriptivo, incluyó la revisión de fichas clínicas en nuestro hospital (HUAP), durante el periodo entre agosto de 2009 y diciembre de 2016. Resultados 88 consultas de personas privadas de libertad, donde se obtuvieron 46 consultas por lesiones traumáticas. Se observó una distribución simétrica para las variables edad, presión arterial media, frecuencia cardíaca, hematocrito, hemoglobina y recuento de leucocitos. El sitio del trauma más frecuente fue el tórax y el abdomen (incluyendo cara anterior y posterior completa), cada uno con 18 pacientes (39,13% cada uno). El diagnóstico de ingreso más frecuente fue neumotórax en doce sujetos. Los principales tratamientos efectuados fueron 16 laparotomías exploradoras (34,78; IC 95%: 22,68 a 49,23) y 12 pleurostomías (26,09; IC 95%: 15,60 a 40,26). La duración de la hospitalización distribuyó en forma asimétrica, con mediana de 3 días. Tuvimos 6 reingresos (13,04%) en los primeros 30 días posteriores al alta y una mortalidad. Conclusiones Los hechos de violencia en estos 2 centros penitenciarios en Santiago, son un diagnóstico que se presenta en la urgencia de nuestro hospital, con lesiones de distinta gravedad y tratamiento. Resulta necesario adelantarse a estos escenarios, donde ahora sabemos que gran parte de ellos necesitará algún procedimiento o intervención.
Background Prisons are a source of inherent violence and an environment conducive to traumatic injuries. Aim The objective of this paper is to describe the income and evolution profile of hospitalized people deprived of liberty at the tertiary level due to trauma that occurred in two prison detention centers in Santiago, that enters our service. Materials and Method Descriptive study, included the review of clinical records in our hospital, during the period between August 2009 and December 2016. Results 88 consultations of people deprived of liberty, where 46 consultations for traumatic injuries were obtained. A symmetric distribution was observed for the variables age, mean arterial pressure, heart rate, hematocrit, hemoglobin and leukocyte count. The most frequent trauma site was the thorax and abdomen (including front face and full back), each with 18 patients (39.13% each). The most frequent diagnosis of admission was pneumothorax in twelve subjects. The main treatments were 16 exploratory laparotomies (34.78, 95% CI: 22.68 to 49.23) and 12 pleurostomies (26.09, 95% CI: 15.60 to 40.26). The duration of hospitalization distributed asymmetrically, with a median of 3 days. We had 6 readmissions (13.04%) in the first 30 days after discharge and one mortality. Conclusions The violence in this two prison detention centers, in Santiago, is a diagnosis that appears in the urgency of our hospital, with lesions of different severity and treatment. It is necessary to anticipate these scenarios, where we now know that a large part of them will need some procedure or intervention.
Subject(s)
Humans , Wounds and Injuries/surgery , Wounds and Injuries/etiology , Wounds and Injuries/therapy , Prisons , Thoracic Injuries/epidemiology , Chile , Epidemiology, Descriptive , Abdominal Injuries/epidemiologyABSTRACT
Introduction: To determine the etiology of invasive bacterial infection in high risk febrile neutropenia (HRFN) episodes in children with cancer is essential because of the favorable impact on mortality of the early empiric antibiotic treatment. Objective: To determine the etiology of bacteremia in pediatric patients with cancer and HRFN in the National Child Program of Antineoplastic Drugs during the 2004-2009 period, and compare these agents and their antimicrobial susceptibility with the period 1994-1998 described in a previous study. Methods: The causative agents of bacteremia were prospectively recorded in patients less than 18 years of age receiving chemotherapy for cancer with HRFN and positive blood cultures admitted to one of the six hospitals from the Child Program of Antineoplastic Drugs network during the period 2004-2009. Results: 839 episodes of HRFN were identified; 181 blood cultures were positive in the following proportion: gram positive cocci (56%), gram negative bacilli (42%) and yeast (2%).The most common etiologic agents were Staphylococcus coagulase negative (25%), Escherichia. coli (20%), group viridans Streptococcus (14%), Staphylococcus aureus (13%) and Pseudomonas aeruginosa (9%). Comparing the two periods, the relative frequency of Streptococcus spp increased from 4 to 17%, coagulase negative Staphylococcus decreased from 44 to 25%, showing an increase in their resistance to oxacillin from 55% to 77%. Conclusions: We describe the main etiological agents from HRFN episodes in children with cancer in a 5 years period. This information could help for a better approach in the empirical antimicrobial therapy in this population.
Introducción: Conocer la etiología de los episodios de neutropenia febril de alto riesgo (NFAR) en pacientes con cáncer tiene importancia para implementar tratamientos antimicrobianos ajustados a la epidemiología local, lo que tiene impacto en la morbilidad y mortalidad. Objetivo: Describir la etiología de las bacteriemias en niños con cáncer y NFAR en el período 2004-2009, en la red PINDA de Santiago (Región Metropolitana), Chile, y comparar estos agentes y su susceptibilidad antimicrobiana con un estudio previo realizado en el período 1994-1998. Material y Métodos: Se registraron prospectivamente los agentes causantes de bacteriemia y su susceptibilidad a antimicrobianos de los pacientes bajo 18 años de edad en tratamiento quimioterápico por cáncer, ingresados con diagnóstico de NFAR a los seis hospitales de la red, durante el período 2004-2009. Resultados: De 839 episodios de NFAR, 181 tuvieron hemocultivos positivos, correspondientes a cocáceas grampositivas (56%), bacilos gramnegativos (42%) y levaduras (2%). Los agentes más frecuentemente aislados fueron: Staphylococcus coagula-sa negativa (25%), Escherichia coli (20%), Streptococcus grupo viridans (14%), Staphylococcus aureus (13%) y Pseudomonas spp (9%). Al comparar los dos períodos de tiempo, destacan los siguientes cambios significativos: disminución en frecuencia relativa de Staphylococcus coagulasa negativa (desde 44 a 25%), aumento de Streptococcus spp (desde 4 a 17%), y aumento de la resistencia de Staphylococcus coagulasa negativa a oxacilina (desde 55 a 77%). Conclusiones: Se dan a conocer los principales agentes etiológicos de los episodios de NFAR y la susceptibilidad a antimicrobianos en un período de cinco años. Esto permite racionalizar el manejo antimicrobiano empírico de los episodios de NFAR en esta población.