Secular trends in hip fractures in adults over 50 years old: a retrospective analysis of hospital admissions to the Brazilian Public Health System from 2004 to 2013.

This was a retrospective observational study to determine the secular trends in osteoporosis hip fractures in Brazil from 2004 to 2013. The fracture rates were stable for both sexes, and there was not a secular trend. Fractures were predominant in the South and Southeast Regions. The hip fracture rate was lower in this study than in other studies. These regional differences may be considered in the FRAX Brazil calibration. PURPOSE: Hip fractures are well-known osteoporotic fractures with high mortality and morbidity. Epidemiological studies in Brazil on hip fractures are scarce, and the great majority have been performed in small populations from a few cities. None of these studies has analyzed the long-term hip fracture secular trends, which are important data for the promotion of public health actions. METHODS: This was a retrospective observational study with a secular trend analysis in patients over 50 years old who were admitted to the Brazilian Public Health System from 2004 to 2013. We collected hospitalization data according to the ICD-10 for low-trauma hip fractures. The fracture rate was calculated when the patients were stratified by sex, age, and geographic region, and linear regression analysis was performed to evaluate the secular trends. RESULTS: The hip fracture rate per 100,000 inhabitants was 59.69; the rate was 74.72 in females and 42.95 in males. The fracture rates were higher in the South and Southeast Regions and steadily increased with age, and the average ratio of women-to-men was 1.74. No secular trend was detected in the overall population. Surprisingly, the secular trend only increased in the South region from 2004 to 2013, and the secular trends were stable in the other regions. CONCLUSION: Although the secular trend was similar to some worldwide studies, the hip fracture rate was lower than that previously observed in regional studies in Brazil. These regional differences may be considered in the FRAX Brazil calibration.

Fibromyalgia patients' quality of life and pain intensity variation / Variação da intensidade da dor e da qualidade de vida de pacientes com fibromialgia

INTRODUCTION: One of the most reported issues on the Fibromyalgia syndrome is the pain intensity variation and its impact on patients' life quality. OBJECTIVES: 1) to establish the correlation among pain, anxiety and depression intensity perception; 2) to determine whether there is a correlation between pain intensity variation and the impact of fibromyalgia on patients' quality of life. MATERIAL AND METHODS: A study was carried out with 21 patients, who received a diary to register their perceptions on pain, anxiety and depression intensity. The patients have made this procedure three times a day, for a fifteen-day period. The impact on life quality was measured by the the Fibromyalgia Impact Questionaire (FIQ). RESULTS: It was observed a significant variation on pain intensity during the day periods. There was not a significant variation for anxiety and depression through the day periods. It was not observed any significant correlation between pain and depression or pain and anxiety intensity perception at any time of the day, during the study period. When considering the whole study period, it was observed that there was a correlation between pain and anxiety and pain and depression in the morning. CONCLUSION: It is concluded that there is a significant pain variation through the day periods and there is a correlation between pain and anxiety and pain and depression in the morning. There is a significant correlation of life quality with pain in the morning, anxiety in the afternoon and evening; and depression in all periods of the day.

INTRODUÇÃO: Uma das questões mais relatadas é a variação da intensidade da dor no decorrer do dia e seu impacto na qualidade de vida. OBJETIVOS: Estabelecer a correlação entre a percepção da intensidade da dor, da ansiedade e da depressão e determinar a correlação entre a variação da intensidade da dor e o impacto na qualidade de vida. MATERIAL E MÉTODOS: Estudou-se 21 pacientes com fibromialgia. As pacientes receberam um diário para registrar suas percepções sobre a intensidade da dor, a ansiedade e a depressão por meio de escalas visuais analógicas. Esse procedimento foi realizado três vezes por dia durante o período de 15 dias. A qualidade de vida foi medida pelo questionário de impacto da fibromialgia (FIQ). RESULTADOS: Observou-se variação significativa da intensidade da dor nos vários períodos do dia (manhã, tarde e noite) por meio do teste de Kruskal-Wallis. Não houve variação significativa para ansiedade e depressão ao longo do dia. Não foi observada correlação significativa entre dor e depressão ou dor e ansiedade em qualquer período do dia durante a duração do estudo. Quando se considera todo o período de estudo, observou-se correlação entre dor e ansiedade e dor e depressão pela manhã. Não se observou tal correlação nos períodos da tarde e da noite. CONLUSÃO: Conclui-se que há variação significativa da intensidade da dor ao longo do dia e há correlação entre dor e ansiedade e dor e depressão no período da manhã durante o tempo do estudo. Há correlação significativa entre a qualidade de vida com dor durante a manhã, ansiedade à tarde e à noite e depressão em todos os períodos.