[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.

Identification of a new genotype of canine distemper virus circulating in America.

Canine Distemper is a highly contagious viral systemic disease that affects a wide variety of terrestrial carnivores. Canine Distemper virus (CDV) appears genetically heterogeneous, markedly in the hemagglutinin protein (H), showing geographic patterns of diversification that are useful to monitor CDV molecular epidemiology. In Mexico the activity of canine distemper remains high in dogs, likely because vaccine prophylaxis coverage in canine population is under the levels required to control effectively the disease. By phylogenetic analysis based on the nucleoprotein (N) and on the H genes, Mexican CDV strains collected between 2007 and 2010 were distinguished into several genovariants, all which constituted a unique group, clearly distinct from field and vaccine strains circulating worldwide, but resembling a CDV strain, 19876, identified in Missouri, USA, 2004, that was genetically unrelated to other North-American CDV strains. Gathering information on the genetic heterogeneity of CDV on a global scale appears pivotal in order to investigate the origin and modalities of introduction of unusual/novel CDV strains, as well as to understand if vaccine breakthroughs or disease epidemics may be somewhat related to genetic/antigenic or biological differences between field and vaccine strains.

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.

Valor predictivo positivo de test de screening para drogas en orina / Positive predictive value for drugs in urine screening tests

Con el objeto de conocer el Valor Predictivo Positivo (VPP) del test de screening para canabinoides y cocaína, a 3049 trabajadores pertenecientes a una empresa del rubro comercio se les realizó una muestra de orina entre el 28 de noviembre de 1999 y el 28 de agosto de 2000. En una primera instancia, la muestra fue sometida a un test de screening (Enzimoinmunoensayo Rapid test d.a.u. de DADE BEHRING). Los test de screening con resultado positivo, en una segunda instancia fueron sometidos a un examen de confirmación con la técnica cromatografía gaseosa acoplada a espectrofotometría de masas (CG/MSD). Se realizaron 6098 test de screening para canabinoides y cocaína. 46 test de screening resultaron positivos para canabinoides, cocaína o ambas. El examen de confirmación fue positivo en 35 de 46 test de screening (76 por ciento). El porcentaje de confirmación para canabinoides y cocaína fue de 75,7 por ciento (25 de 33) y 76,9 por ciento (10 de 13), respectivamente; es decir, aproximadamente 1 de cada 4 test de screening positivo para canabinoides o cocaína no permite hacer el diagnóstico de consumo con certeza, para lo cual es necesario realizar una confirmación, la que puede ser instrumental (CG/MSD, por ejemplo) o preguntándole directamente al trabajador (verbal). En general, en el ámbito laboral propiciamos la confirmación verbal

Evaluaciones de aptitud laboral para trabajos en gran altitud / Evaluations of labor aptitude for works in great altitude

La hipoxia hipobárica es una causa frecuente de morbilidad y mortalidad ocasional en personas que ascienden sobre 3.000 metros sobre el nivel del mar (m.s.n.m). Muchos de estos problemas son evitables con una evaluación adecuada antes del ascenso. El Servicio de exámenes preventivos del Hospital del Trabajador de Santiago realiza 4.000 evaluaciones de altitud geográfica anualmente. Esta consiste en control médico, radiografía de tórax, espirometría, hemoglobinemia, glicemia, creatininemia, perfil lipídico y ECG. Con el objeto de describir algunos resultados se analizaron 1.646 casos, correspondientes al período 01/01 al 27/01 de 2000. El 97 por ciento correspondió al sexo masculino, con un promedio de edad de 36 años. 96.2 por ciento fueron considerados aptos, es decir, no presentaban contraindicaciones para trabajar en altitud, 0.6 por ciento resultaron no aptos y 1.5 por ciento se consideró apto, pero sujeto a alguna restricción. El 1.8 por ciento quedó pendiente a la espera de examen adicional a la batería aplicada o compensación de alguna patología. Globalmente las causales de no aptitud y aptitud con restricción más frecuentes fueron obesidad (47 por ciento, hipertensión arterial descompensada (41.1 por ciento) y dislipidemia (17.6 por ciento). Otras causas fueron diabetes mellitus descompensada, epilepsia, asma bronquial descompensada, etc. Creemos que la batería de exámenes utilizada es adecuada para identificar trabajadores susceptibles de padecer problemas graves asociados a la altitud. Estudios prospectivos serían necesarios para precisar el real valor predictivo de estas evaluaciones

Infección intestinal por parásitos y/o comensales en escolares de la IX región, Chile / Intestinal infection by parasites and/or commensals in school children from the IX region, Chile

Se estudió la prevalencia de enteroparasitosis en 135 escolares de Lautaro, IX región. Del total, 68 eran de procedencia rural y 67 urbana. La metodología usada consistió en examen seriado de deposiciones empleando el método de Telemann (MTM); técnica de Ziehl-Neelsen (pesquisa de Cryptosporidium sp.) y test de Graham. Los resultados obtenidos reflejan un alto índice de infección por protozoos y helmintos intestinales con un 87,4% de positividad, no observándose diferencias estadísticamente significativas entre los escolares de procedencia rural y urbana, sexo ni nivel de escolaridad. Sólo es destacable el porcentaje de infección significativamente superior entre los escolares de segundo ciclo de enseñanza, de procedencia rural comparados con sus similares del primer ciclo (95,5% y 79,2%). El parásito más frecuente fue G. lamblia (37,8%) en el total de examinados y entre escolares del primer ciclo con un 60,7%. El segundo lugar por frecuencia correspondió a T. trichiura (22,2%), seguido de A. lumbricoides. Entre los comensales más frecuentes estuvieron E. coli (45,2%) y E. nana (33,3%). Se concluye que en la IX región los índices de infección por protozoos y helmintos intestinales siguen siendo altos, debido a que las condiciones del ecosistema favorecen su persistencia y transmisión, especialmente en estratos de condiciones de vida deficitarias

Perfil del personal auxiliar en odontología / Profile from auxiliar dentistry personnel

En Venezuela, la formación del personal auxiliar en Odontología la realizan diversas instituciones aficiales tales como Universidades, MSAS, INCE. Es preocupación del Colegio de odontológos de Venezuela conociendo a fondo la problemática odontológica que sea un solo organismo el que encauce y coordine la formación del personal, enmarcado en lo que la profesión y la comunidad exigen