[Prevalence of osteopenia and osteoporosis in postmenopausal women and its relation to risk factors]. / Prevalencia de osteopenia y osteoporosis en mujeres posmenopáusicas y su relación con factores de riesgo.

BACKGROUND: Degenerative diseases are becoming more frequent in adults due to the increase in the average life, among them osteoporosis is with one prevalence higher in women mainly due to the lack of estrogen after menopause. OBJECTIVE: Estimate the prevalence of osteoporosis and osteopenia by effectuate a bone densitometry in postmenopausal women and analyze the possible relationship with some recognized risk factors. MATERIAL AND METHODS: Cross-sectional study with 389 patients analyzing the following variables: age; index of body mass and time of treatment with hormone replacement therapy, crossing the information with the result of bone densitometry. RESULTS: A prevalence rate similar to that reported in our country was obtained. We found that patients with overweight have one higher percentage of osteopenia and osteoporosis than normal weight, which is contrary to what was reported in literature. Also contrary to expectations, untreated patients occupy a higher percentage without bone disorders, while in the leading hormone therapy the lesser percentage was for those whit osteoporosis. We found no differences in terms of age. CONCLUSIONS: Early diagnosis provides an excellent opportunity to address these problems but we must not forget that the best treatment is prevention from an early age.

[Metabolic disorders in women during climacterium]. / Trastornos metabólicos de mujeres en el climaterio.

BACKGROUND: As part of preventive medicine climacteric and menopause clinics should identify the chronic-degenerative diseases that accompany this stage of women and which are increasing as the age increases. OBJECTIVE: To dentify following chronic degenerative diseases that occur during climacteric: diabetes, hypertension, obesity and dyslipidemia. MATERIAL AND METHODS: A descriptive and transversal study was performed with 688 patients in the clinic of the climacteric and menopause, 98 were removed for failing to comply with all the requirements that included: determining serum glucose and lipids, weight, height, diameter of waist and hip. Controls were done every three to four months forming two groups: menopause and perimenopause. RESULTS: The average age of menopause was 47.5 years, in which predominated the chronic degenerative diseases, highlighting the overweight and obesity (66%), dyslipidemia (59%), hypertension (22%) and diabetes (19%). CONCLUSION: The gynecologist must be attentive to identify early risk factors for chronic degenerative diseases from the reproductive stage.

Performance of two questionnaires to measure treatment adherence in patients with Type-2 diabetes.

BACKGROUND: Most valid methods to measure treatment adherence require time and resources, and they are not easily applied in highly demanding Primary Health Care Clinics (PHCC). The objective of this study was to determine sensitivity, specificity, predictive values, likelihood ratios, and post-test probabilities of two novel questionnaires as proxy measurements of treatment adherence in Type-2 diabetic patients. METHODS: Two questionnaires were developed by a group of experts to identify the patient's medical prescription knowledge (knowledge) and their attitudes toward treatment adherence (attitudes) as proxy measurements of adherence. The questionnaires were completed by patients receiving care in PHCC pertaining to the Mexican Institute of Social Security in Aguascalientes (Mexico). Pill count was used as gold standard. Participants were selected randomly, and their oral hypoglycemic prescriptions were studied. The main outcome measures for each questionnaire were sensitivity, specificity, predictive values, likelihood ratios, and post-test probabilities, all as an independent questionnaire test and in a serial analysis. RESULTS: Adherence prevalence was 27.0% using pill count. Knowledge questionnaire showed the highest sensitivity (68.1%) and negative predictive value (82.2%), the lowest negative likelihood ratio (0.58) and post-test probability for a negative result (0.16). Serial analysis showed the highest specificity (77.4%) and positive predictive value (40.1%) as well as the highest positive likelihood ratio (1.8) and post-test probability for a positive result (0.39). CONCLUSION: Medical Prescription Knowledge questionnaire showed the best performance as proxy measurement to identify non-adherence in type 2 diabetic patients regarding negative predictive value, negative likelihood ratio, and post-test probability for a negative result. However, Medical Prescription Knowledge questionnaire performance may change in contexts with higher adherence prevalence. Therefore, more research is needed before using this method in other contexts.