[Management of osteoporosis at a primary care center]. / Abordaje de la osteoporosis en un centro de atención primaria.

OBJECTIVES: To find how suitable a semFYC guide is for the indication of bone densitometry in menopausal women; and how appropriate their Osteoporosis treatment is. DESIGN: Cross-sectional study.Setting. Girona-3 Health District. PARTICIPANTS: Women between 50 and 80 allocated to the Girona-3 Health District. Suffering a grave psychiatric disorder or a terminal illness were considered criteria for exclusion. 409 out of the 420 women envisaged were included, to achieve a 5% accuracy and a 0.05% alpha error. MAIN MEASUREMENTS: Whether bone densitometry took place or otherwise, other diagnostic tests, risk factors for osteoporosis recorded and drug treatment prescribed. RESULTS: Of the 125 women with risk factors for osteoporosis, 12 (9.6%) had had a bone densitometry. 20% of all bone densitometries done showed pathology. Only in 3 cases (0.7%) of the pathological cases was any recommendation on life-style recorded. 19.8% of the women took drug treatment. In 8% this was justified. The most common treatment prescribed was calcium, on its own or linked to vitamin D. 20% of cases had a bone densitometry to monitor them after 2 years. CONCLUSIONS: The indication for bone densitometry is low and its use could be improved. In those cases in which bone densitometry is requested, a pharmacological intervention is more common than a life-style one.

[Prevalence of Helicobacter pylori infection in primary health care]. / Prevalencia de la infección por Helicobacter pylori en atención primaria de salud.

OBJECTIVES: To find the prevalence of Helicobacter pylori (Hp) infection in the population as a whole. To assess its relationship with the associated factors described in other studies. DESIGN: Transversal study of an urban population of 20,000. PARTICIPANTS: Between 14 and 80 years old. Randomised sampling of the computerised records (640 clinical histories). Necessary sample n = 384 (alpha = 0.05, prior prevalence = 50%, precision 0.05). MEASUREMENTS: Breath test with urea marked (13C), age, sex, alcohol and tobacco consumption, social class and dyspepsia and/or gastro-duodenal pathology. RESULTS: 123 exclusions. 122 losses (23%). 397 people screened, 43.6% male. Average age: 42.6. 41.6% consumed alcohol. 30.5% smoked. Prevalence of dyspepsia, gastritis, gastric ulcer and duodenal ulcer, 14%, 2.8%, 2.8% and 2.0%, respectively. Hp prevalence: 56.1% (95% CI, 51.2-60.1). There were no significant differences between prevalence of Hp+ and sex, dyspepsia, peptic ulcer history, gastritis, alcohol consumption and tobacco consumption. Greatest prevalence of Hp+ in over-70s (73%). Significant linear tendency between presence of Hp+ and age (p < 0.05) and low social class (p < 0.05). The logistic regression analysis found a statistically significant relationship only between the presence of H. pylori and age and social class. CONCLUSIONS: Prevalence was similar to that in other studies. The relationship between low social class and age and greater Hp prevalence was confirmed. Dyspepsia is not a justification for empirical treatment of Hp. Patients with and without the infection must be followed to evaluate morbidity longitudinally.

Prevalencia de la infección por Helicobacter pylori en atención primaria de salud / Prevalence of helicobacter pylori infection in primary health care

Objetivos. Conocer la prevalencia de infección por Helicobacter pylori (Hp) en población general. Valorar la relación con los factores asociados descritos en otros ámbitos. Diseño y ámbito. Estudio transversal. Población urbana: 20.000 personas. Sujetos. Edad de 14-80 años. Muestreo aleatorio del registro informatizado (640 historias clínicas). Muestra necesaria, 384 (alfa, 0,05; prevalencia previa, 50 por ciento; precisión, 0,05). Mediciones. Prueba del aliento con urea marcada (13C), edad, sexo, consumo de alcohol y tabaco, clase social y dispepsia y/o patología gastroduodenal. Resultados. Exclusiones, 123; pérdidas, 122 (23 por ciento); cribados, 397; varones, 43,6 por ciento; edad media, 42,6 años; consumía alcohol, 41,6 por ciento; fumaba, 30,5 por ciento. Prevalencia de dispepsia, gastritis, ulcus gástrico y duodenal, respectivamente, 14, 2,8, 2,8 y 2,0 por ciento. Prevalencia Hp, 56,1 por ciento (IC del 95 por ciento, 51,2-60,1). No hay diferencias significativas entre prevalencia de Hp+ y sexo, dispepsia, antecedentes de ulcus péptico, gastritis, consumo de alcohol y consumo de tabaco. Máxima prevalencia de Hp+ en mayores de 70 años (73 por ciento). Tendencia lineal significativa entre presencia de Hp+ y edad (p < 0,05) y clase social baja (p < 0,05). El análisis de regresión logística sólo encuentra relación estadísticamente significativa entre presencia de Hp y edad y clase social. Conclusiones. La prevalencia es similar a la de otros estudios. Se confirma la relación entre clase social baja y edad y mayor prevalencia de Hp. La dispepsia no justificaría el tratamiento empírico de Hp. Es necesario el seguimiento de los pacientes con y sin infección para evaluar la morbilidad longitudinalmente (AU)