RESUMO
OBJECTIVE: To determine de sensitivity and specificity of a questionnaire of osteoporosis risk factors. MATERIAL AND METHODS: In 1,088 files of postmenopausal women, osteoporosis risk factors such as age, time since menopause, former hormone replacement therapy (HRT) use, current use of HRT, former and current HRT use, fractures after 45 years age, actual weight, corticosteroid use and hyperthyroidism were analyzed, giving them different punctuation. Every punctuation was added in each patient. In all of them a dual emission X ray (DEXA) absorptiometry was done from lumbar column and hip (femoral neck, trochanter and Ward's triangle). Odds ratio, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for every one of the variables and DEXA T score as well as Spearman correlation coefficient. RESULTS: Odds ratio increased as the punctuation of the questionnaire increased. With four points in the questionnaire the PPV was 41%, the NPV 86%, the sensitivity 16% and the specificity 96%. A significant negative correlation was found between age, time since menopause, current use of HRT, former and current use of HRT and column and hip T scores, and with the punctuation for all the regions. A positive correlation was found between former fracture and column and femoral neck T scores, and with actual weight in all regions. CONCLUSIONS: This study showed that the questionnaire can be a useful instrument to identify patients at high risk of osteoporosis.
Assuntos
Osteoporose Pós-Menopausa/epidemiologia , Inquéritos e Questionários , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Colo do Fêmur/diagnóstico por imagem , Fraturas Ósseas/epidemiologia , Terapia de Reposição Hormonal , Humanos , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Razão de Chances , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/prevenção & controle , Valor Preditivo dos Testes , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
The objective was to know the characteristics of presentation, its clinical aspects and the modification in the diagnostic tools in a selected population of Mexican women with spontaneous menopause. The age at menarche, age at menopause, marital status, age at marriage, number of pregnancies and occupation of 1,099 women with spontaneous menopause were studied. In 619 women which were not receiving nor had received hormone replacement therapy the clinical, laboratory such as glucose, lipids, hormones, bone remodeling biochemistry; and X ray studies such as densitometry and mammography were analyzed. The age average of menarche presentation was at 13 years, and that of spontaneous menopause at 48.1 years 78% were married, with an age at marriage of 23 years, 66% had home duties. The screening tests showed that 30% of patients required cardiovascular evaluation, 40% showed alterations on lipids levels and at least 40% had some alteration on bone remodeling biochemistry or in densitometry. The mammography was normal in 81%. This study showed that most of the data in these group of women were similar to those of other populations, and many of them need intensive surveillance and adequate therapeutic prescriptions to diminish risk factors.
Assuntos
Pós-Menopausa , Adolescente , Adulto , Fatores Etários , Análise de Variância , Densidade Óssea , Calcificação Fisiológica , Feminino , Humanos , Estado Civil , Menarca , Pessoa de Meia-Idade , Osteoporose/etiologia , Osteoporose/prevenção & controle , ParidadeRESUMO
The purpose of this trial is to demonstrate that a women with high body mass index (BMI > or = 28) has greater bone mineral density (BMD) from that with lower BMI. We studied 922 healthy women who met the inclusion criteria. They were classified into four groups according to their BMI (> or = 28 and < 28) and age (> or = 35 and < 35 years). Bone mineral measurement was performed by dual-energy X-ray absorptiometry (DEXA) in the hip and at the lumbar region. BMD in overweight women older than 35 years was significantly higher in comparison with that of women with lower BMI, both in the hip and the lumbar spine. In overweight women younger than 35 years, we found greater BMD in the hip reaching statistical significance, but not at the lumbar spine. We conclude that obesity is associated with greater BMD (4% at the lumbar spine; 11% at the hip) probably due to both greater physical stress and higher estrogen levels.
Assuntos
Índice de Massa Corporal , Densidade Óssea , Calcificação Fisiológica , Obesidade/metabolismo , Adulto , Estrogênios/análise , Feminino , Articulação do Quadril/química , Humanos , Vértebras Lombares/química , México , Estudos de AmostragemRESUMO
The objective was to identify climateric woman with cardiovasculary risk by the relation between size and weight, known as corporal mass index. Seven hundred and ninety seven postmenopausal patients, were studied; they attended the CECLIMEN, with one or two years of spontaneous menopause, and they were not receiving, nor had received replacement hormonal therapy (RHT). In all of them clinical history was taken, and blood pressure, weight, size and corporal mass index (CMI) (weight/(size)2), were evaluated; considering normal weight when CMI was < or = 27, and obesity when this index was greater than 27. Fastening and postprandial glucose at two hours, was determined, as well as total cholesterol, HDL-C, cholesterol of low density lipoproteins (LDL-C), triglicéridos (Tg), and aterogenic index was calculated by CtHDL-C. Besides, estradiol (E2) and follicle stimulating hormone (FSH) were measured in serum by radioimmunoanalysis RIA. Results were considered in the two groups, according to CMI: Group I with CMI < or = 27 (n = 566); and group II, with CMI > 27 (n = 231). Blood pressure, systolic and diastolic, triglicerides and aterogenic index were significantly greater in group II. There were higher levels of glucose in group II (tendency). CMI > 27 is useful to differentiate the postmenopausal women with a higher cardiovasculary risk.
Assuntos
Índice de Massa Corporal , Climatério/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Climatério/fisiologia , Feminino , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Pós-Menopausa , Fatores de RiscoRESUMO
Many conditions have an abnormal development of the vagina, which impair satisfactory sexual activity. Non-surgical and surgical procedures have been developed to correct this situation, the Abbe-Wharton-McIndoe operation is one with the best results, but it has the disadvantage that the scar produced in the place where the skin graft is taken has an awful appearance. Although the oxidized regenerated cellulose (ORC) has been extensively used in pelvic surgery to avoid or diminish the adhesion formation, no other uses have been described for this material; we decided to use ORC instead of skin graft at the moment of the Abbe-Wharton-McIndoe procedure, in order to achieve rapid epithelization of the recently created cavity and avoiding skin graft taken. This is the report of four cases with Rokitansky syndrome in which a vagina was created using the McIndoe procedure and ORC was used instead of skin graft. At 12 weeks after surgery a complete epithelization of the new open cavity was achieved with the presence of mature vaginal epithelium. The conclusion is that ORC is an alternative instead of skin graft, with the advantage of avoiding the skin graft taken as well as the scar obligatorily produced with that procedure, and also achieving a complete and quick epithelization of the new cavity.
Assuntos
Celulose Oxidada/administração & dosagem , Pele Artificial , Vagina/anormalidades , Administração Tópica , Adulto , Feminino , Humanos , Vagina/patologia , Vagina/cirurgia , Esfregaço VaginalRESUMO
Menopause is the physiologic state that is consequence of ovarian function cessation and everyday more women reach it. In this article is reviewed the pathophysiology of menopause and treatment of osteoporosis.