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P0158 EXTENSIVE NECROBIOTIC XANTHOGRANULOMA
S58
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
Keywords: Polarised Light, Coenzyme Q10, Alpha-lipoic Acid, Alphatocopherol, Neuropathic Diabetic Ulcers, Left Ventricular Diastolic Dysfunction
P0155 LIFE’S QUALITY AND PREVALENCE OF RURAL WOMEN’S URINARY INCONTINENCE IN SPAIN
Maria Del Carmen Lopez Silva, Enrique Vázquez Seijas, Miguel Sánchez De Enciso Ruiz, Concepción Rodríguez Fernández, Juan Carlos Prados Moreno, Mercedes Novo López. Sergas Introduction: Urinary incontinence (UI) can be defined like the involuntary urine loss through the urethra, in sufficient degree wich we could see and it could represents a social or hygienic problem. Its prevalence in different studies worldwide is between 3 and over 50%, there is great variability. The most common clinical forms of UTI are: 1. UI of effort or stress, it would be the loss of urine for increased intra-abdominal pressure, the most frequent and common in women. 2. IU emergency would be the inability to hold urine long enough to go to the bathroom, the most common in older people. mixed UI would be the loss of urine so much as emergency or effort. 3. Other less frequent as IU overflow (frecuent in prostatic obstruction in males), functional UI (environmental barriers, physical disability) and IU transient (less than four weeks). Today, the IU is considered a health problem often forgotten and perfectly manageable from primary care. Objectives: 1. To determine the prevalence of urinary incontinence (UI) (and subtypes) in the women who often go to four health centers. 2. Analise if the UI affects in the life’s quality. Materials & methods: It is about a descriptive cross-sectional study. The inquiry "International consultation on incontinence questionnaire short-form" (in Spanish only validated for that purpose by Espuna M. Pons and H) was carried out to all women who sued administrative inquiry or four general doctors from rural areas of Lugo’s province (Spain) during the month of June 2008. The study variables were anthropometric dates and the derived from the inquiry Results: The proof is compose of 452 cases with an average age of 62.6 (± 34) years. The overall prevalence of urinary incontinence was 39.8% (180 cases), constitutes the effort UI 38.3%, UTI urgent 21.3% and 40.4% mixed UI. The life’s quality was affected in 51.7% of incontinent women, being significantly reduced in cases of emergency and UTI mixed (p <0.0001). Statistical analysis carried out with the software package G-Sta.t Discussion & conclusion: Four in ten women who visit their doctor present UI. The most common type of UTI is the mixed, followed by the effort and urgency’s type. Half of women with UI have reduced their life’s quality. Keywords: Life’s quality, urinary incontinence, women.
considered at this time by the scientific community as the three main types of structural changes vertebral (Acuna biconcavismo and crushing). Statistical analysis was carried out with the software package G-Stat. Results: The proof is composed of 136 cases (24% male, 76% women) with a mean age of 67.54 (± 18.1). The prevalence of risk factors was 13.51% (hip fracture of the mother), 19.8 (fragility fracture), 20.72 (smoking), 0.9% (BMI 19) and 53.15 (high risk of falls, according to Tinetti’s Scale). The biconcavism was found in 56.76%, the wedging in 24.32% of the cases, and 12.61% in the crush. Discussion & conclusion: 1) More than half the study population have a high risk of falls and a quarter had two major risk factors for osteoporosis. 2) The most frecuent vertebral structural alteration is the biconcavism. Keywords: Osteoporosis, risk factors, primary care.
P0157 HUMAN LEUKOCYTE ANTIGEN B, DRB1 AND DQB1 IN SYSTEMIC LUPUS ERYTHEMATOSUS AND FIRST DEGREE RELATIVES
Hamzaoui Amira 1 , Boumiza Radhia 1 , Harzallah Olfa 1 , Sakly Nabil 1 , Mahjoub Silvia 1 . 1 Departement Internal Medecine-monastir-tunisia; 2 Departement of Immunology- Monastir-tunisia Introduction: Systemic lupus erythematosus (SLE) is a prototype of autoimmune systemic diseases affecting predominately woman, characterized by a multisystem organ involvement. The genetic factors play a major role in the development of lupus. More than 5% cases are familial. Genetic studies in humans have identified nearly 50 chromosomal areas possibly involved in lupus transmission. Several studies have found an association between SLE and different human leukocyte antigen (HLA) proposing a role of Major Histocompatibility Complex (MCH) in SLE etiology. Objective: To estimate the prevalence of HLA –B, HLA-DRB1 and HLADQA1 in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. HLA typing was done by reverse dot-blot hybridization of the PCR product. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The global distribution between patients and relatives did not show significant differences for DRB1 and DQA1. The different genotypes (HLA-B*51, HLA-B*07 and HLA-DRB1*08) were found in respectively: 50, 25 and 16, 6% in the patients with SLE and in 28,6, 14,2 and 10,7% in their relatives. The HLA DRB1*15 was the most present genotype in 2 families. In the Tunisian general population, the more frequent phenotype are: HLA-A2, -A3, -B51, -B5O (CMH 1) and HLA-DR7, -DR17, -DR1, -DQ2,- DQ6 and -DQ7 (CMH 2). Conclusion: Genetic factors have a role in the development and expression of SLE. Environmental factors may trigger the disease in genetically susceptible hosts.
P0158 EXTENSIVE NECROBIOTIC XANTHOGRANULOMA
P0156 RISK FACTORS FOR OSTEOPOROSIS AND VERTEBRAL ALTERATIONS IN RURAL AREAS OF SPAIN
Enrique Vázquez Seijas, Maria Del Carmen López Silva, Concepción Rodríguez Fernández, Miguel Sánchez De Enciso Ruiz, Juan Carlos Prados Moreno. Sergas Introduction: Osteoporosis is a silent disease, which is usually detected late when it compounded by the appearance of fractures, or when the suspect makes a size decrease or a chronic back pain. Early detection and adecuate treatment of risk subjects are essential components for the clinical approach of the disease. In this process, primary attention doctors have a key role, especially if one takes into account the increase of its diagnostic and awareness people’s about this disease. Objectives: 1) Know the risk factors for osteoporosis in a proof procedent of rural areas. 2) Determine what are the most common vertebral structural changes in the proof. Materials & methods: It is about a descriptive and cross-sectional study which included all persons who demanded medical attention for any reason during the month of May 2008 in four consultations of General Medical Council’s of the rural gallician environment. As a criterion of inclusion: Men aged less than 65 years and postmenopausal women who agree to participate in the project. The main variables to study were the osteoporosis risk factors
Elena Sanchez Ruiz Granados, Isabel Melguizo Moya, Salvador Vergara López, Luis Torres Palazón, Antonio Grilo Reina. Valme Universitary Hospital We report de case of a 50-year-old woman with a 4-year history of pruritic indurated yellow-red plaques on the bilateral periorbital region, trunk and thorax was referred from Dermatology Departament. Two biopsies were performed in these years and histology revealed histiocytic granulomatous infiltrate and areas of hyaline necrobiosis with multiple large multinucleated giant cells, Touton gigant cells, epithelioid cells and lymphocytes compatible with Necrobiotic Xanthogralunoma. Laboratory studies showed hiperlipidemia, increase arthrocyte sedimentation rate, anemia of chronic disease and monoclonal type on serum protein inmunoelectrophoresisκgammopathy of the Ig G but with no signs of multiple myeloma (plasma cells in bone marrow < 10%). Symptoms were discarded after of multiples studies did not reveal any pathologic finding. She was treated with systemic glucocorticoides for 4 years and surgery of the eyelid skin but the plaques were progressively increased in the periorbital region with central bilateral ulcerations impeding the ocular opening and she had oculars conjunctivitis (Panel B). The patient was treated with chlorambucil which healed the ulcerations and stabilized to progression of the plaques. Necrobiotic xanthogranuloma (NXG) is an uncommon granulomatous disease involving the skin and extracutaneous tissues. In its typical clinical presentation, it consists of multiple indurate yellow–brownish plaques or
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
S59
P0160 SEVERITY INDEXES IN AN INTERMEDIATE CARE UNIT
Patricia Freitas 1 , Joana Silvestre 1 , Sofia Duque 1 , Diana Fernandes 1 , Alice Sousa 1 , João Pereira 2 , Vitor Batalha 1 , Luis Campos 1 . 1 Unidade De Cuidados Intermédios Médicos, Serviço De Medicina Iv, Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal; 2 Unidade De Cuidados Intensivos Médicos; Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal
nodules, usually located on the periorbital area. The lesions frequently show tendency to atrophy and ulceration. Most cases are asymptomatic, and oral mucosal erosions are sometimes present. Ophthalmologic complications are observed in many patients, and NXG may involve other extracutaneous sites. NXG may involve other extracutaneous sites, including the heart, lungs, kidneys, liver, spleen, intestines, skeletal muscle, and central nervous system. Paraproteinemia is closely associated with NXG, with approximately 80 percent of patients demonstrating a monoclonal gammopathy on serum protein electrophoresis; furthermore, 10 percent of these patients develop multiple myeloma.Other lymphoproliferative disorders such as Hodgkin’s lymphoma have been associated with NXG. Hepatosplenomegaly, an increased erythrocyte sedimentation rate, leukopenia, hypocomplementemia, and cryoglobulinemia are other common findings. Large areas of degenerated collagen alternating with granulomatous inflammation, multinucleate giant cells, cholesterol clefts, and lymphoid follicles are the most outstanding histopathologic characteristics of NXG. The prognosis for NXG is good, but no curative treatment is available. Chemotherapy with alkylating agents is the most frequently administered treatment, but oral and intralesional corticosteroids, interferon alpha, plasmapheresis, surgical excision, and radiation therapy also have been used for this disorder with variables result.
P0159 CONSULTING OF INTERNAL MEDICINE, A RETROSPECTIVE STUDY OF 36 MONTHS
Leonor Viegas, António Sousa, Francisco Azevedo. Hospital Espírito Santo E.p.e Internal Medicine is a specialty which integrates knowledge and experiences, while evaluating the patient as a whole. The Internist, with his thorough knowledge of the patient as a whole, is the specialist with natural talent for the consult of other medical specialties. The authors present a retrospective study, done in an average sized hospital, during 36 months, where the Internal Medicine Consulting to patients of three specialties, medical and surgical, was evaluated. A total of 369 patients were observed in 556 consults, 229 of which were female and 140 male. The authors present the data concerning the age average and its distribution, characterization of the reasons for consult and its nosological framing as well as their final outcome. Even though there are no indicators that evaluate the impact of Internal Medicine Consulting, its utility cannot be denied in the reduction of patients’ complications, length of stay and mortality. Being an almost unknown activity, with scarce recognition and in need of proper placement, the growth in Medical subspecialties will lead, nonetheless, to an important growth of consulting in Internal Medicine. Keywords: consulting, internist, internal medicine.
Background: There are no severity indexes validated to evaluate the prognosis of patients in Intermediate Care Units (ICU). The severity indexes Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) are used to identify patients with a higher risk of mortality in Intensive Care. Aims: Evaluate the mortality in ICU and in hospital, of patients with UCI admission and assess mortality predictors in the first 24 hours, through the indexes APACHE II, SAPS II e SOFA. Methods: Prospective, observational study in an UCI of a University Hospital for an 8 months period (April to November 2008). Results: 92 patients where included, with an average age of 64, 59 being females (64,1%). The mortality rate in UCI was 5,9% and in hospital 10,8%. The areas under the receiver operating characteristic (AUROC) to evaluate the mortality in UCI from APACHE II, SAPS II e SOFA, where respectively 0,85 (95% confidence interval (CI): 0,76-0,96); 0,78 (95% CI: 0,59-0,97); 0,77 (95% CI: 0,61-0,92). In what concerns to mortality in hospital, and for the same indexes, the next results where found for the AUROC: 0,76 (95% CI: 0,61-0,90); 0,80 (95% CI: 0,66-0,93); 0,77 (95% CI: 0,64-0,90). Conclusions: In patients admitted in UCI the APACHE II was the best prognosis index for mortality. In the assessment of hospital mortality no significant differences where found between the studied indexes.
P0161 AUTOANTIBODIES IN THREE FAMILY SYSTEMIC LUPUS ERYTHEMATOSUS
Hamzaoui Amira 1 , Boumiza Radhia 2 , Harzallah Olfa 1 , Sakly Nabil 2 , Mahjoub Silvia 1 . 1 Departement of Internal Medicine; 2 Departement of Immunology Introduction: Systemic lupus erythematosus (SLE) is an auto-immune disease of unknown pathogenesis. Familial studies and concordance rate among affected and relatives suggest that human SLE has a strong genetic and auto-immune basis. Objective: To describe the immunological features in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. Auto-antibodies were search by ELISA: Antinuclear antibodies (ANA), anti-DNA, anti Ro, anti La, anti-Sm, anti-Sm- RNP, anti-SCL 70 and anti-JO1. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The 4 affected patients shared: ANA (4 cases), anti-DNA (3 cases), anti-Ro (3 cases), anti –La (1 case) and anti- Sm/RNP (2 cases). Among the 16 relatives, 6 (37, 5%) had positive ANA (1/100). One of them had a diagnosis of primary Sjögren syndrome. No correlation with clinical manifestations was found. Conclusion: The higher rate of auto-immunity among blood relatives found in our study suggests a complex interaction of genetic, auto-immune and environmental factors contributing to disease.
P0162 NURSES’ KNOWLEDGE ABOUT FOOD-DRUG INTERACTION
Güler Balcı Alparslan. Dumlupınar University School of Health Nursing Department Background: Giving information which focus on interaction food-drug to patients by nurse could increase effects of treatment. However it is observed that the patients weren’t given information about food-drug interaction. It is hypothesized that the nurses haven’t enough knowledge about this as reason. Nurses could revise their knowledge by conducting this study which hadn’t been conducted in our country. In addition, its results could encourage the nurses to give information to patients about food-drug interaction. Aim: Aim of this study is to determine nurses’ knowledge about food-drug interaction and whether knowledge food-drug interaction is associated with nurse characteristics.
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
Keywords: Polarised Light, Coenzyme Q10, Alpha-lipoic Acid, Alphatocopherol, Neuropathic Diabetic Ulcers, Left Ventricular Diastolic Dysfunction
P0155 LIFE’S QUALITY AND PREVALENCE OF RURAL WOMEN’S URINARY INCONTINENCE IN SPAIN
Maria Del Carmen Lopez Silva, Enrique Vázquez Seijas, Miguel Sánchez De Enciso Ruiz, Concepción Rodríguez Fernández, Juan Carlos Prados Moreno, Mercedes Novo López. Sergas Introduction: Urinary incontinence (UI) can be defined like the involuntary urine loss through the urethra, in sufficient degree wich we could see and it could represents a social or hygienic problem. Its prevalence in different studies worldwide is between 3 and over 50%, there is great variability. The most common clinical forms of UTI are: 1. UI of effort or stress, it would be the loss of urine for increased intra-abdominal pressure, the most frequent and common in women. 2. IU emergency would be the inability to hold urine long enough to go to the bathroom, the most common in older people. mixed UI would be the loss of urine so much as emergency or effort. 3. Other less frequent as IU overflow (frecuent in prostatic obstruction in males), functional UI (environmental barriers, physical disability) and IU transient (less than four weeks). Today, the IU is considered a health problem often forgotten and perfectly manageable from primary care. Objectives: 1. To determine the prevalence of urinary incontinence (UI) (and subtypes) in the women who often go to four health centers. 2. Analise if the UI affects in the life’s quality. Materials & methods: It is about a descriptive cross-sectional study. The inquiry "International consultation on incontinence questionnaire short-form" (in Spanish only validated for that purpose by Espuna M. Pons and H) was carried out to all women who sued administrative inquiry or four general doctors from rural areas of Lugo’s province (Spain) during the month of June 2008. The study variables were anthropometric dates and the derived from the inquiry Results: The proof is compose of 452 cases with an average age of 62.6 (± 34) years. The overall prevalence of urinary incontinence was 39.8% (180 cases), constitutes the effort UI 38.3%, UTI urgent 21.3% and 40.4% mixed UI. The life’s quality was affected in 51.7% of incontinent women, being significantly reduced in cases of emergency and UTI mixed (p <0.0001). Statistical analysis carried out with the software package G-Sta.t Discussion & conclusion: Four in ten women who visit their doctor present UI. The most common type of UTI is the mixed, followed by the effort and urgency’s type. Half of women with UI have reduced their life’s quality. Keywords: Life’s quality, urinary incontinence, women.
considered at this time by the scientific community as the three main types of structural changes vertebral (Acuna biconcavismo and crushing). Statistical analysis was carried out with the software package G-Stat. Results: The proof is composed of 136 cases (24% male, 76% women) with a mean age of 67.54 (± 18.1). The prevalence of risk factors was 13.51% (hip fracture of the mother), 19.8 (fragility fracture), 20.72 (smoking), 0.9% (BMI 19) and 53.15 (high risk of falls, according to Tinetti’s Scale). The biconcavism was found in 56.76%, the wedging in 24.32% of the cases, and 12.61% in the crush. Discussion & conclusion: 1) More than half the study population have a high risk of falls and a quarter had two major risk factors for osteoporosis. 2) The most frecuent vertebral structural alteration is the biconcavism. Keywords: Osteoporosis, risk factors, primary care.
P0157 HUMAN LEUKOCYTE ANTIGEN B, DRB1 AND DQB1 IN SYSTEMIC LUPUS ERYTHEMATOSUS AND FIRST DEGREE RELATIVES
Hamzaoui Amira 1 , Boumiza Radhia 1 , Harzallah Olfa 1 , Sakly Nabil 1 , Mahjoub Silvia 1 . 1 Departement Internal Medecine-monastir-tunisia; 2 Departement of Immunology- Monastir-tunisia Introduction: Systemic lupus erythematosus (SLE) is a prototype of autoimmune systemic diseases affecting predominately woman, characterized by a multisystem organ involvement. The genetic factors play a major role in the development of lupus. More than 5% cases are familial. Genetic studies in humans have identified nearly 50 chromosomal areas possibly involved in lupus transmission. Several studies have found an association between SLE and different human leukocyte antigen (HLA) proposing a role of Major Histocompatibility Complex (MCH) in SLE etiology. Objective: To estimate the prevalence of HLA –B, HLA-DRB1 and HLADQA1 in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. HLA typing was done by reverse dot-blot hybridization of the PCR product. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The global distribution between patients and relatives did not show significant differences for DRB1 and DQA1. The different genotypes (HLA-B*51, HLA-B*07 and HLA-DRB1*08) were found in respectively: 50, 25 and 16, 6% in the patients with SLE and in 28,6, 14,2 and 10,7% in their relatives. The HLA DRB1*15 was the most present genotype in 2 families. In the Tunisian general population, the more frequent phenotype are: HLA-A2, -A3, -B51, -B5O (CMH 1) and HLA-DR7, -DR17, -DR1, -DQ2,- DQ6 and -DQ7 (CMH 2). Conclusion: Genetic factors have a role in the development and expression of SLE. Environmental factors may trigger the disease in genetically susceptible hosts.
P0158 EXTENSIVE NECROBIOTIC XANTHOGRANULOMA
P0156 RISK FACTORS FOR OSTEOPOROSIS AND VERTEBRAL ALTERATIONS IN RURAL AREAS OF SPAIN
Enrique Vázquez Seijas, Maria Del Carmen López Silva, Concepción Rodríguez Fernández, Miguel Sánchez De Enciso Ruiz, Juan Carlos Prados Moreno. Sergas Introduction: Osteoporosis is a silent disease, which is usually detected late when it compounded by the appearance of fractures, or when the suspect makes a size decrease or a chronic back pain. Early detection and adecuate treatment of risk subjects are essential components for the clinical approach of the disease. In this process, primary attention doctors have a key role, especially if one takes into account the increase of its diagnostic and awareness people’s about this disease. Objectives: 1) Know the risk factors for osteoporosis in a proof procedent of rural areas. 2) Determine what are the most common vertebral structural changes in the proof. Materials & methods: It is about a descriptive and cross-sectional study which included all persons who demanded medical attention for any reason during the month of May 2008 in four consultations of General Medical Council’s of the rural gallician environment. As a criterion of inclusion: Men aged less than 65 years and postmenopausal women who agree to participate in the project. The main variables to study were the osteoporosis risk factors
Elena Sanchez Ruiz Granados, Isabel Melguizo Moya, Salvador Vergara López, Luis Torres Palazón, Antonio Grilo Reina. Valme Universitary Hospital We report de case of a 50-year-old woman with a 4-year history of pruritic indurated yellow-red plaques on the bilateral periorbital region, trunk and thorax was referred from Dermatology Departament. Two biopsies were performed in these years and histology revealed histiocytic granulomatous infiltrate and areas of hyaline necrobiosis with multiple large multinucleated giant cells, Touton gigant cells, epithelioid cells and lymphocytes compatible with Necrobiotic Xanthogralunoma. Laboratory studies showed hiperlipidemia, increase arthrocyte sedimentation rate, anemia of chronic disease and monoclonal type on serum protein inmunoelectrophoresisκgammopathy of the Ig G but with no signs of multiple myeloma (plasma cells in bone marrow < 10%). Symptoms were discarded after of multiples studies did not reveal any pathologic finding. She was treated with systemic glucocorticoides for 4 years and surgery of the eyelid skin but the plaques were progressively increased in the periorbital region with central bilateral ulcerations impeding the ocular opening and she had oculars conjunctivitis (Panel B). The patient was treated with chlorambucil which healed the ulcerations and stabilized to progression of the plaques. Necrobiotic xanthogranuloma (NXG) is an uncommon granulomatous disease involving the skin and extracutaneous tissues. In its typical clinical presentation, it consists of multiple indurate yellow–brownish plaques or
Abstracts from 8th Congress of the European Federation of Internal Medicine / European Journal of Internal Medicine 20S (2009), S1–S283
S59
P0160 SEVERITY INDEXES IN AN INTERMEDIATE CARE UNIT
Patricia Freitas 1 , Joana Silvestre 1 , Sofia Duque 1 , Diana Fernandes 1 , Alice Sousa 1 , João Pereira 2 , Vitor Batalha 1 , Luis Campos 1 . 1 Unidade De Cuidados Intermédios Médicos, Serviço De Medicina Iv, Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal; 2 Unidade De Cuidados Intensivos Médicos; Hospital De São Francisco Xavier, Centro Hospitalar De Lisboa Ocidental, Epe, Lisboa, Portugal
nodules, usually located on the periorbital area. The lesions frequently show tendency to atrophy and ulceration. Most cases are asymptomatic, and oral mucosal erosions are sometimes present. Ophthalmologic complications are observed in many patients, and NXG may involve other extracutaneous sites. NXG may involve other extracutaneous sites, including the heart, lungs, kidneys, liver, spleen, intestines, skeletal muscle, and central nervous system. Paraproteinemia is closely associated with NXG, with approximately 80 percent of patients demonstrating a monoclonal gammopathy on serum protein electrophoresis; furthermore, 10 percent of these patients develop multiple myeloma.Other lymphoproliferative disorders such as Hodgkin’s lymphoma have been associated with NXG. Hepatosplenomegaly, an increased erythrocyte sedimentation rate, leukopenia, hypocomplementemia, and cryoglobulinemia are other common findings. Large areas of degenerated collagen alternating with granulomatous inflammation, multinucleate giant cells, cholesterol clefts, and lymphoid follicles are the most outstanding histopathologic characteristics of NXG. The prognosis for NXG is good, but no curative treatment is available. Chemotherapy with alkylating agents is the most frequently administered treatment, but oral and intralesional corticosteroids, interferon alpha, plasmapheresis, surgical excision, and radiation therapy also have been used for this disorder with variables result.
P0159 CONSULTING OF INTERNAL MEDICINE, A RETROSPECTIVE STUDY OF 36 MONTHS
Leonor Viegas, António Sousa, Francisco Azevedo. Hospital Espírito Santo E.p.e Internal Medicine is a specialty which integrates knowledge and experiences, while evaluating the patient as a whole. The Internist, with his thorough knowledge of the patient as a whole, is the specialist with natural talent for the consult of other medical specialties. The authors present a retrospective study, done in an average sized hospital, during 36 months, where the Internal Medicine Consulting to patients of three specialties, medical and surgical, was evaluated. A total of 369 patients were observed in 556 consults, 229 of which were female and 140 male. The authors present the data concerning the age average and its distribution, characterization of the reasons for consult and its nosological framing as well as their final outcome. Even though there are no indicators that evaluate the impact of Internal Medicine Consulting, its utility cannot be denied in the reduction of patients’ complications, length of stay and mortality. Being an almost unknown activity, with scarce recognition and in need of proper placement, the growth in Medical subspecialties will lead, nonetheless, to an important growth of consulting in Internal Medicine. Keywords: consulting, internist, internal medicine.
Background: There are no severity indexes validated to evaluate the prognosis of patients in Intermediate Care Units (ICU). The severity indexes Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA) are used to identify patients with a higher risk of mortality in Intensive Care. Aims: Evaluate the mortality in ICU and in hospital, of patients with UCI admission and assess mortality predictors in the first 24 hours, through the indexes APACHE II, SAPS II e SOFA. Methods: Prospective, observational study in an UCI of a University Hospital for an 8 months period (April to November 2008). Results: 92 patients where included, with an average age of 64, 59 being females (64,1%). The mortality rate in UCI was 5,9% and in hospital 10,8%. The areas under the receiver operating characteristic (AUROC) to evaluate the mortality in UCI from APACHE II, SAPS II e SOFA, where respectively 0,85 (95% confidence interval (CI): 0,76-0,96); 0,78 (95% CI: 0,59-0,97); 0,77 (95% CI: 0,61-0,92). In what concerns to mortality in hospital, and for the same indexes, the next results where found for the AUROC: 0,76 (95% CI: 0,61-0,90); 0,80 (95% CI: 0,66-0,93); 0,77 (95% CI: 0,64-0,90). Conclusions: In patients admitted in UCI the APACHE II was the best prognosis index for mortality. In the assessment of hospital mortality no significant differences where found between the studied indexes.
P0161 AUTOANTIBODIES IN THREE FAMILY SYSTEMIC LUPUS ERYTHEMATOSUS
Hamzaoui Amira 1 , Boumiza Radhia 2 , Harzallah Olfa 1 , Sakly Nabil 2 , Mahjoub Silvia 1 . 1 Departement of Internal Medicine; 2 Departement of Immunology Introduction: Systemic lupus erythematosus (SLE) is an auto-immune disease of unknown pathogenesis. Familial studies and concordance rate among affected and relatives suggest that human SLE has a strong genetic and auto-immune basis. Objective: To describe the immunological features in 3 Tunisian families of 4 SLE affected patients. The diagnosis was made according to the revised American College of Rheumatology criteria. Auto-antibodies were search by ELISA: Antinuclear antibodies (ANA), anti-DNA, anti Ro, anti La, anti-Sm, anti-Sm- RNP, anti-SCL 70 and anti-JO1. Results: We identified 3 families with 4 SLE patients and 16 first degree relatives. The 4 affected patients shared: ANA (4 cases), anti-DNA (3 cases), anti-Ro (3 cases), anti –La (1 case) and anti- Sm/RNP (2 cases). Among the 16 relatives, 6 (37, 5%) had positive ANA (1/100). One of them had a diagnosis of primary Sjögren syndrome. No correlation with clinical manifestations was found. Conclusion: The higher rate of auto-immunity among blood relatives found in our study suggests a complex interaction of genetic, auto-immune and environmental factors contributing to disease.
P0162 NURSES’ KNOWLEDGE ABOUT FOOD-DRUG INTERACTION
Güler Balcı Alparslan. Dumlupınar University School of Health Nursing Department Background: Giving information which focus on interaction food-drug to patients by nurse could increase effects of treatment. However it is observed that the patients weren’t given information about food-drug interaction. It is hypothesized that the nurses haven’t enough knowledge about this as reason. Nurses could revise their knowledge by conducting this study which hadn’t been conducted in our country. In addition, its results could encourage the nurses to give information to patients about food-drug interaction. Aim: Aim of this study is to determine nurses’ knowledge about food-drug interaction and whether knowledge food-drug interaction is associated with nurse characteristics.