Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly

ABSTRACT Objective To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Materials and methods Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. Results In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). Conclusion The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects / Prevalência de síndrome metabólica aumenta em quartis de hormônio tireoestimulante em uma amostra de sujeitos eutiroides baseada na população

Objective The aim of the study was to assess the prevalence and characteristics of metabolic syndrome (MetS) and its elements in relation to TSH in euthyroid subjects. Materials and methods In the cross-sectional study, 2,153 euthyroid adults, 47.2 ± 14.5 years (20-94) with no current antithyroid or thyroid replacement therapy were enrolled. All participants filled a questionnaire on past and current morbidities, medication and smoking. Body weight, height, waist circumference, serum TSH, glucose and lipids were measured. The subjects were stratified by quartiles of TSH (QTSH) and the prevalence of the MetS elements was calculated. MetS was determined by the IDF 2005 criteria. Results Overweight prevalence was 37.2% (35.2-39.2), obesity in 25.1% (23.3-26.9), abdominal obesity – 61.4% (59.3-63.5), hypertension – 42.1% (38.9-43.1), diabetes/increased fasting glucose – 13.6% (12.1-15), low HDL-cholesterol – 27.6% (25.7-29.5), hypertriglyceridemia – 24.1% (22.3-25.9), MetS – 32.2% (30.2-34.2). MetS was more prevalent in the highest QTSH (34.9%, 30.9-38.9) than the lowest (27%, 23.3-30.9), p < 0.001, as were low HDL-C (32%, 28-35.9 vs. 25%, 21.3-28.7, p < 0.001) and hypertriglyceridemia (26.8%, 23-30.5 vs. 20.4%, 17-23.8, p = 0.015). Each QTSH increased the risk of MetS by 14%, p < 0.001, of hypertriglyceridemia by 20%, p = 0.001 and of low LDL-C by 9%, p = 0.042. Other significant factors for MetS were age, male gender and obesity. Conclusion The prevalence of MetS increased with higher QTSH within the euthyroid range, mostly by an increase in the dyslipidemia. Arq ...

Objetivo O objetivo deste estudo foi avaliar a prevalência e características da síndrome metabólica (MetS) e seus elementos em relação ao TSH em sujeitos eutireoides. Materiais e métodos Foram analisados, em um estudo transversal, 2.153 adultos eutiroides, de 47,2 ± 14,5 anos (20-94) sem terapia antitiroidiana ou de reposição. Todos os participantes preencheram um questionário sobre doenças atuais e passadas, medicações e tabagismo. O peso corporal, altura, circunferência da cintura, TSH, glicose e lipídios séricos foram medidos. Os sujeitos foram estratificados em quartis de TSH (QTSH) e a prevalência dos elementos da MetS foram calculados. Os critérios da MetS foram determinados pela IDF 2005. Resultados A prevalência de sobrepeso foi de 37,2% (35,2-39,2), de obesidade – 25,1% (23,3-26,9), obesidade abdominal – 61,4% (59,3-63,5), hipertensão – 42,1% (38,9-43,1), diabetes/aumento da glicose de jejum – 13,6% (12,1-15), baixo colesterol HDL – 27,6% (25,7-29,5), hipertrigliceridemia – 24,1% (22,3-25,9), MetS – 32,2% (30,2-34,2). A MetS foi mais prevalente no QTSH mais alto (34,9%; 30,9-38,9) do que no mais baixo (27%; 23,3-30,9), p < 0,001, assim como o baixo HDL-C (32%, 28-35,9 contra 25%, 21,3-28,7; p < 0,001) e hipertrigliceridemia (26,8%; 23-30,5 contra 20,4%, 17-23,8; p = 0,015). Cada QTSH aumentou o risco MetS em 14%, p < 0,001, de hipertrigliceridemia em 20%, p = 0,001 e de baixo LDL-C em 9%, p = 0,042. Outros fatores significativos para a MetS foram idade, sexo masculino e obesidade. ...

Gardnerella vaginalis-associated bacterial vaginosis in Bulgarian women

ABSTRACT BACKGROUND: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age. The purpose of this study was to determine the frequency of BV in Bulgarian pregnant and nonpregnant women from several age ranges and to compare three different laboratory methods for Gardnerella vaginalis detection in patents suffering from BV. METHODS: Between September 2011 and June 2012, 809 women of 16-40 years of age separated in two major groups: nonpregnant - 469 (355 with and 114 without symptoms) and pregnant - 340 (213 and 127 respectively) were enrolled for the study. The women underwent three different laboratory tests simultaneously: scoring of Gram staining of vaginal smear, culture, and polymerase chain reaction (PCR) assay for G. vaginalis. RESULTS: The microscopic method detected high frequency of BV in symptomatic (57%) whereas only a minority of asymptomatic subjects (14%) were detected. G. vaginalisassociated BV was diagnosed in approximately equal proportions when evaluated with PCR and microscopic method for both pregnant and nonpregnant women. The comparative analysis of microscopic evaluation, culture and PCR assays demonstrated greater concurrence (about 90%) between Gram staining and PCR detection for BV, than both methods compared to culture. The combination of microscopy and PCR turned out to be very reliable and repeatable for detecting G. vaginalis-associated BV. CONCLUSIONS: This is the first comparative investigation on the epidemiology of G. vaginalisassociated BV in Bulgaria. The established highest frequency in the young Bulgarian women (21-30 years) is alarming and should be considered in prophylaxis and reproductive programmes.

Lucha contra las enfermedades cardiovasculares en el Uruguay / Fight against the cardiovascular diseases in Uruguay

Este trabajo recoge datos preliminares de un estudio comparativo de mortalidad por enfermedad cardiovascular en elaboración. La mortalidad por enfermedades del aparato circulatorio ocupa en Uruguay el primer lugar entre las causas de muerte con una tasa de 352/100.000 h. (1996). Considerando los grupos de enfermedades, el primer lugar lo ocupan las cerebrovasculares con una tasa de 114/100.000 h. y en la que predomina el sexo femenino. En segundo lugar se ubican las isquémicas con una tasa de 101/100.000 h. y predominio del sexo masculino. El tercer lugar corresponde a las enfermedades hipertensivas, con tasas y valores muy inferiores. En la mayoría de los países de la región estas enfermedades ocupan el primer lugar dentro de las causas de muerte. En el presente informe se presentan datos de Uruguay y de otros cuatro países: Argentina, Bulgaria, EE.UU. y Finlandia, según el último año con información disponible. La comparación de las tasas de mortalidad ajustadas por edad, muestra a Uruguay en un nivel bajo (211/100.000 h.) similar a Finlandia (210/100.000 h.) y algo superior a Estados Unidos (192/100.000 h.) con una tasa algo mayor (260/100.000 h.) está Argentina y en un nivel más elevado se encuentra Bulgaria (424/100.000 h.). El análisis de las tendencias en períodos de 7 a 10 años muestra que la mortalidad por enfermedades del aparato circulatorio en Uruguay se comporta entre 1986 y 1993 en forma similar a EE.UU. dentro de un rango que no supera el valor de tasa ajustada de 250/100.000 h. y una tendencia negativa (descendente) con una pendiente de valor de b = -5,4. También es similar la mortalidad en Finlandia aunque la tendencia decreciente es más pronunciada (b= -7,19). Argentina muestra una tendencia decreciente (b = - 5,4) con valores algo superiores. Los valores más elevados y crecientes (b = + 3,7) de la mortalidad por estas causas correspondieron a Bulgaria.

Flúor: bebida aditivada / Fluoride: additived drinks

Países como Chile, China, Bulgária e Inglaterra aplicam flúor no leite para combater a cárie infantil. Alternativa é recomendada pela Organização Mundial da Saúde (OMS) onde não é possível implantar a fluoretação do sal ou até mesmo da água. No Brasil, a água fluorada vem diminuindo drasticamente a incidência de cáries na população