The results of our study suggest that the administration of aprotinin is a safe and effective method to reduce blood loss and to decrease the need for transfusions without increasing risk of complication in the younger patients in relatively good general health undergoing spinal deformity surgery requiring 6 or more levels of fusion.

These blood conservation techniques allow satisfactory completion of deformity surgery on those patients not willing to be transfused and without major anesthetic or medical complications.

SummaryObjectives: This study aims at evaluating the prevalence of rheumatic diseases in the elderly and its evolution over time. Methods:We present a systematic international literature review of the prevalence of rheumatic diseases in the elderly and its evolution over time. Results:The estimated current prevalence of rheumatic diseases among people aged 65 and more varies between 41 % and 53 %, and is similar to estimated prevalence rates in studies performed before 1990 (35 -55 %). The prevalence is high and seems to increase rapidly with age. Furthermore, women suffer more frequently from rheumatic diseases than men. Conclusion:The selected studies included a large range of methods, making comparisons difficult. However, estimates of the prevalence of rheumatic diseases in the elderly appear to be homogeneous in different countries and stable since 1980. Keywords: Rheumatic diseases -Prevalence -Evolution -Elderly - Health -Review.Chronic diseases, such as cancers, heart diseases, and rheumatic diseases have become a new challenge for public health, since the former major problem, mortality due to infectious diseases, largely declined in the last century. Such diseases affect an increasing population of elderly reaching an increasingly advanced age (Blanc et al. 1995). Among pathologies affecting the elderly, rheumatic diseases are particularly frequent. Being the first cause of disability, they have a pronounced impact on the quality of life, they can be painful, and they are at the origin of functional troubles and deformations (CDC 1995;1999;Raina et al. 1998). Despite their importance, few systematic studies of their epidemiology in the elderly have been conducted in the international literature. The aims of our study were to determine the current prevalence of rheumatic diseases in the elderly in different developed countries, to identify possible regional differences, and to study the evolution of the prevalence over time based on a systematic literature review. MethodsWe defined rheumatic diseases by their symptoms (i. e., pain and mobility limitation) rather than by rigorous diagnostic criteria (i. e., validation by health professionals) since most population-based epidemiological data rely on self-reported symptoms from health surveys. Self-reports do not permit differentiation between the various types of rheumatic diseases. First, we studied the prevalence rates of rheumatic diseases found in surveys conducted between 1990 and 2002, which we have considered as the "current prevalence". We did not limit our research to a specific period of prevalence. Second, we studied the evolution of prevalence rates over time. For this purpose, we used epidemiological surveys of rheumatic diseases conducted before 1990 and compared their results with the estimated current prevalences. We excluded surveys conducted in developing countries for the following reasons: (1) Socio-economic conditions in those countries are not comparable with those found in industrial countries (Adebajo 1990); (2) The main rheumatic ...