Aims The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals. Patients and Methods A total of 24 patients (mean age 14.9 years (sd 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015. In situ epiphysiodesis was performed in seven contralateral hips with mild slip. A control cohort was composed of 15 healthy individuals (mean age 16.5 years (sd 2.5); six male and nine female patients). The abductor function was assessed using isokinetic dynamometry and range of abduction, with a minimum one-year follow-up. Results We found no differences in mean peak abductor torque between the hips that underwent osteotomy and those that received in situ epiphysiodesis (p = 0.63), but the torque was inferior in comparison with contralateral hips without a slip (p < 0.01) and hips from control individuals (p < 0.001). The abduction strength was positively correlated with the range of hip abduction (R = 0.36; p < 0.001). Conclusion Although the abductor strength was not restored to normal levels, moderate and severe SCFE treated with osteotomy at the base of the femoral neck and osteoplasty showed abductor function similar to in situ epiphysiodesis in hips with less severe displacement. Cite this article: Bone Joint J 2018;100-B:1524–32.

The association between pet ownership and the development of allergic and respiratory diseases has been the aim of several studies, however, the effects of exposure in adults remain uncertain. The aims of the present study were to investigate the prevalence of asthma and lung function status among dog and cat owners. This cross-sectional study was performed at two universities with students and workers who were allocated into 3 groups according to pet ownership in the previous year: cat owners, dog owners, and no pets (control group). Subjects underwent spirometry, bronchial challenge test with mannitol, skin prick tests, and questionnaires about animal exposures and respiratory symptoms. Control group comprised 125 subjects; cat owner group, 51 subjects; and dog owner group, 140 subjects. Cat owners had increased asthma prevalence (defined by symptoms and positive bronchial challenge test), but no changes in lung function compared to the control group. The dog owner group had lower spirometry values (forced expiratory volume in one second and lower forced vital capacity), but similar asthma prevalence, compared to the control group. In the cat owner group, excess of asthma may have an immunological basis, since we found an association with atopy. Although we did not have endotoxin data from volunteers' households, we postulated that low values of lung function were associated to exposure to endotoxins present in environments exposed to dogs.

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Resumo O objetivo deste estudo foi analisar o uso e o acesso aos medicamentos para o diabetes mellitus tipo 2 em idosos atendidos na Estratégia Saúde da Família de Ribeirão Preto, São Paulo. Trata-se de um inquérito domiciliar de base populacional realizado com 338 idosos, em amostragem por conglomerados. Investigou-se a farmacoterapia do diabetes e o acesso por meio de um questionário estruturado em entrevistas face a face. O número de medicamentos usados no tratamento do diabetes variou de um a quatro. Observou-se o predomínio de antidiabéticos orais, sendo o uso de apenas metformina autorreferido por 37,9% dos idosos, e 9,8% usavam sulfonilureia isoladamente. No grupo de idosos com idade igual ou superior a 80 anos, percebeu-se maior frequência (38,9%) no uso de insulina do que nos outros grupos etários. O acesso total foi estimado em 96,4%, a forma de financiamento gratuita correspondeu a 78,1% e as farmácias do Sistema Único de Saúde foram os principais locais de provisão dos medicamentos (74,8%). A metformina foi o antidiabético oral mais usado pelos idosos, em conformidade com as atuais recomendações para o tratamento da doença. Contudo, verificou-se usos inapropriados, especificamente na utilização isolada de sulfonilureia. Além disso, evidenciou-se a importância do sistema público de saúde para o fornecimento dos medicamentos.