Vertebroplastia percutânea por fractura osteoporótica

A Vertebroplastia Percutânea é uma técnica minimamente invasiva relativamente recente, que tem reconhecidas vantagens e aplicações em fracturas compressivas dos corpos vertebrais. Basicamente, consiste na injecção de um Cimento Acrílico no interior do corpo vertebral, e desse modo, minimizar e estabilizar fracturas compressivas dos corpos vertebrais, que são frequentemente de etiologia osteoporótica. Fortemente indicada no tratamento de fracturas incapacitantes, possui como complicação principal o extravasamento do Cimento. Este artigo pretende abordar a técnica, expondo suas indicações, vantagens e complicações mais frequentes. Esta permite reduzir a elevada taxa de morbilidade e impacto económico-social associado à Osteoporose.

Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk

Introduction: Healthcare improvements have allowed prevention but have also increased life expectancy, resulting in more people being at risk. Our aim was to analyse the separate effects of age, period and cohort on incidence rates by sex in Portugal, 2000–2008. Methods: From the National Hospital Discharge Register, we selected admissions (aged ≥49 years) with hip fractures (ICD9-CM, codes 820.x) caused by low/moderate trauma (falls from standing height or less), readmissions and bone cancer cases. We calculated person-years at risk using population data from Statistics Portugal. To identify period and cohort effects for all ages, we used an age–period–cohort model (1-year intervals) followed by generalised additive models with a negative binomial distribution of the observed incidence rates of hip fractures. Results: There were 77,083 hospital admissions (77.4 % women). Incidence rates increased exponentially with age for both sexes (age effect). Incidence rates fell after 2004 for women and were random for men (period effect). There was a general cohort effect similar in both sexes; risk of hip fracture altered from an increasing trend for those born before 1930 to a decreasing trend following that year. Risk alterations (not statistically significant) coincident with major political and economic change in the history of Portugal were observed around birth cohorts 1920 (stable–increasing), 1940 (decreasing–increasing) and 1950 (increasing–decreasing only among women). Conclusions: Hip fracture risk was higher for those born during major economically/politically unstable periods. Although bone quality reflects lifetime exposure, conditions at birth may determine future risk for hip fractures.

Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

The aim is to examine the temporal trends of hip fracture incidence in Portugal by sex and age groups, and explore the relation with anti-osteoporotic medication. From the National Hospital Discharge Database, we selected from 1st January 2000 to 31st December 2008, 77,083 hospital admissions (77.4% women) caused by osteoporotic hip fractures (low energy, patients over 49 years-age), with diagnosis codes 820.x of ICD 9-CM. The 2001 Portuguese population was used as standard to calculate direct age-standardized incidence rates (ASIR) (100,000 inhabitants). Generalized additive and linear models were used to evaluate and quantify temporal trends of age specific rates (AR), by sex. We identified 2003 as a turning point in the trend of ASIR of hip fractures in women. After 2003, the ASIR in women decreased on average by 10.3 cases/100,000 inhabitants, 95% CI (− 15.7 to − 4.8), per 100,000 anti-osteoporotic medication packages sold. For women aged 65–69 and 75–79 we identified the same turning point. However, for women aged over 80, the year 2004 marked a change in the trend, from an increase to a decrease. Among the population aged 70–74 a linear decrease of incidence rate (95% CI) was observed in both sexes, higher for women: − 28.0% (− 36.2 to − 19.5) change vs − 18.8%, (− 32.6 to − 2.3). The abrupt turning point in the trend of ASIR of hip fractures in women is compatible with an intervention, such as a medication. The trends were different according to gender and age group, but compatible with the pattern of bisphosphonates sales.

TEA: Timing and Energy Aware compression architecture for Efficient Configuration in CGRAs

Coarse Grained Reconfigurable Architectures (CGRAs) are emerging as enabling platforms to meet the high performance demanded by modern applications (e.g. 4G, CDMA, etc.). Recently proposed CGRAs offer time-multiplexing and dynamic applications parallelism to enhance device utilization and reduce energy consumption at the cost of additional memory (up to 50% area of the overall platform). To reduce the memory overheads, novel CGRAs employ either statistical compression, intermediate compact representation, or multicasting. Each compaction technique has different properties (i.e. compression ratio, decompression time and decompression energy) and is best suited for a particular class of applications. However, existing research only deals with these methods separately. Moreover, they only analyze the compaction ratio and do not evaluate the associated energy overheads. To tackle these issues, we propose a polymorphic compression architecture that interleaves these techniques in a unique platform. The proposed architecture allows each application to take advantage of a separate compression/decompression hierarchy (consisting of various types and implementations of hardware/software decoders) tailored to its needs. Simulation results, using different applications (FFT, Matrix multiplication, and WLAN), reveal that the choice of compression hierarchy has a significant impact on compression ratio (up to 52%), decompression energy (up to 4 orders of magnitude), and configuration time (from 33 n to 1.5 s) for the tested applications. Synthesis results reveal that introducing adaptivity incurs negligible additional overheads (1%) compared to the overall platform area.