Introduction: The present study aims to evaluate the association between nocturia and falls in a group of community-living elderly men in the city of São Paulo (Brazil). Material and methods: Under the coordination of the Pan American Health Organization and World Health Organization, a multicenter study named Health, Welfare and Aging (SABE Study) is being conducted to evaluate the living and health conditions of older people in Latin America and Caribbean. In Brazil, this study is evaluating the elderly population (60 years or more) in São Paulo since 2000. The presence of nocturia was taken as the response "yes" to the question "Do you need to void three times or more at night?". The presence of falls was also taken as the response "yes" to the question "Did you have any fall during the last 12 months?" The intergroup analysis used was the logistic regression. Results: Total of 865 men was interviewed, mean age 68 years. It was observed high prevalence of nocturia and falls in all groups, with higher prevalence of both in the eldest group (p<0.001), however, the association of nocturia and falls was not statistically significant in any of the groups (p=0.45). Conclusion: This is one of the pioneering studies that assess only the male population, showing that nocturia was not significantly associated with falls. Nocturia and falls are highly prevalent conditions in the elderly, but no association was found between both, so that these variables may be correlated to age and other clinical conditions.

Introducción: el propósito de este estudio es evaluar la relación entre nictura y caídas en un grupo de hombres ancianos que viven en comunidad en la ciudad de São Paulo (Brasil). Materiales y métodos: Bajo la coordinación de la Organización Panamericana de Salud y la Organización Mundial de la Salud, un estudio multicéntrico denominado Salud, Bienestar y Envejecimiento (Estudio SABE) se está llevando a cabo para evaluar las condiciones de vida y salud de los ancianos en América Latina y el Caribe. En Brasil este estudio evalúa la población anciana (60 años o más) en São Paulo desde 2000. La presencia de nicturia se tomó como la respuesta "sí" a la pregunta "¿Necesita orinar tres veces o más por la noche?" La presencia de caídas también se tomó como la respuesta "sí" a la pregunta "¿Ha sufrido una caída en los últimos 12 meses?" Se aplicó la regresión logística para el análisis intergrupal. Resultados: Se entrevistó a un total de 865 hombres con una edad media de 68 años. Se identificó una alta prevalencia de nicturia y caídas en todos los grupos, con una mayor prevalencia de ambas en el grupo de los más mayores (p<0,001); sin embargo, la asociación de nicturia y caídas no fue estadísticamente significativa en ninguno de los grupos (p=0,45). Conclusión: Éste es uno de los estudios pioneros que solamente evalúa la población masculina, demostrando que la nicturia no está asociada con caídas de manera significativa. La nicturia y las caídas son condiciones altamente prevalentes en los ancianos, pero no se encontró ninguna relación entre ambas, por lo tanto estas variables se podrían correlacionar con la edad y otras condiciones clínicas.

São ainda mal estabelecidos os fatores prognósticos para a ocorrência de óbito nos envenenamentos por serpentes e as causas que o determinam. OBJETIVO: Determinar, no envenenamento ofídico, os fatores prognósticos e as causas mais prováveis do óbito. MÉTODOS: No período de 1988 a 1993 foram notificados 12.639 casos de acidentes por serpentes peçonhentas no Estado de São Paulo, com 43 óbitos (0,34%). Foram comparadas as variáveis obtidas das fichas de notificação dos acidentes com aquelas dos prontuários e/ou dos relatórios médicos dos casos de óbito. RESULTADOS: O diagnóstico quanto ao gênero da serpente foi realizado em 11.297 acidentes, sendo 9.828 (87%) por Bothrops, 1.359 (12%) por Crotalus e 110 (1%) por Micrurus, e em 41 casos de óbito, sendo 28 (68,3%) por Bothrops e 13 (31,7%) por Crotalus (p<0,05). Informação quanto a sexo e idade dos pacientes foi fornecida em, respectivamente, 12.620 e 12.527 acidentes. Pertenciam ao sexo masculino 9.783 (77,5%) pacientes picados e 35 (81,4%) que faleceram (p>0,05). Tinham 50 anos ou mais 15,9% dos pacientes picados e 41,8% daqueles que faleceram (p<0,05). As regiões anatômicas mais freqüentemente picadas foram: pé (42,2%), mão (20,6%), perna (17,6%) e tornozelo (13,1%), nos acidentes, e pé (35,7%) e perna (35,7%), nos casos de óbito (p<0,05). A alteração da coagulação ocorreu em 34 (91,9%) de 37 pacientes que evoluíram para o óbito. As manifestações e complicações mais referidas como possíveis causas de óbito foram: insuficiência renal (34-79,1%), insuficiência respiratória (28- 65,1%), choque (18-41,9%) e septicemia (18- 41,9%). Dentre os pacientes que evoluíram para óbito, excluindo-se um caso sem informação, 29,4% faleceram dentro dos primeiros dois dias após a picada. A insuficiência respiratória foi mais comum entre os que faleceram devido ao envenenamento crotálico e a septicemia só foi referida para o envenenamento botrópico. CONCLUSÃO: A maioria dos acidentes e dos óbitos é causada por Bothrops; são mais freqüentemente letais os envenenamentos por Crotalus, as picadas na perna e em pessoas com mais de 50 anos; a complicação mais comum nos casos fatais é a insuficiência renal.

The prognostic factors and the causes for obit occurrence in ophidian envenoming are yet not completely clear. PURPOSE: To determine the prognostic factors and the most probable causes for obit occurrence in ophidian envenoming. METHODS: In the State of São Paulo were notified 12,639 cases of accidents by venomous snakes from 1988 to 1993. There were 43 deaths (0.34%). The variables from the accident notification reports were compared with the promptuary notes and/or with the death records (in lethal cases). RESULTS: The snake genus was classified in 11,297 accidents and in 41 from the lethal ones. Bothrops was responsible for 9,828 (87%) accidents and 28 (68.3%) deaths, Crotalus for 1,359 (12.0%) accidents and 13 deaths (31.7%) and Micrurus for 110 (1%) accidents and no death (p<0.05). The information regarding to sex and age of the patients was available, respectively, in 12,620 and 12,527 accidents and in all lethal ones. There were 9,783 (77.5%) male patients in the accidents and 35 (81.4%) in the lethal cases (p> 0.05). Regarding to age, 15.9% of the patients and 41.8% of the ones who died were 50 years-old or more (p<0.05). The most frequently bitten anatomic regions were: foot (42.2%), hand (20.6%), leg (17.6%), and ankle (13.1%) in the accidents, and foot (35.7%) and leg (35.7%) in the lethal cases (p<0.05). Coagulation disorders occurred in 34 (91.9%) from 37 patients who died (those where this datum was available). The information above was not available in non lethal cases. The most common manifestations and complications implicated as possible death causes were: acute renal failure (34- 79.1%), acute respiratory failure (28- 65.1%), shock (18- 41.9%), and sepsis (18- 41.9%). Among all lethal cases but one without information, 29.4% of the patients died within the first two days after bite and 67.6% within the first 5 days. Acute respiratory failure was most common among the patients who died owing to crotalic envenoming, and sepsis was only seen in bothropic envenoming. CONCLUSION: Most of the accidents and obits are caused by Bothrops; Crotalus envenoming, leg bites, and accidents in 50 year-old patients (or more) are frequently lethal; the most common complication in lethal cases is acute renal failure.