[Cortical bone mass and risk factors for osteoporosis among postmenopausal women in our environment]. / Masa ósea cortical y factores de riesgo para osteoporosis en mujeres postmenopáusicas en nuestro medio.

OBJECTIVE: To evaluate the relevance of the so called risk factors for osteoporosis among women. MATERIALS AND METHODS: A total of 150 consecutive postmenopausal women who had been enrolled in the gynecology outpatient clinics of the Health Areas affiliated to the Alcalá de Henares University Hospital. Bone mass of these women was calculated as index of metacarpal cortical area/total area (CA/TA) (mm2), measured by radiogrammetry. RESULTS: With the ANOVA test, a late menarchial age and a shorter reproductive life induced a lower bone mass (p < 0.0005 and < 0.05, respectively); also, a history of bone fractures without previous relevant trauma (p < 0.05) was obtained. By correlational studies, there was a negative significance between CA/TA index and chronological age, menarchial age, menopausal age and number of fractures (r = -0.20 to -0.30; p < 0.05 to < 0.0001) and a positive significance with years of reproductive life (r = 0.17; p < 0.05). These values virtually remain unchanged when with partial correlation are weight adjusted, but with the multiple regression model, the CA/TA index is negatively significant only with menopause years (p < 0.005). Taking the average of the metacarpal CA/TA index as value, a sensitivity of 50% and an specificity of 78% were obtained to indicate fractures and a negative predictive value of 92%. CONCLUSION: These results indicate the greater importance of menarchial age, of reproductive life years and therefore of menopausal years, as determinants of postmenopausal bone mass and show a very acceptable specificity of the CA/TA index as predictive for bone fracture.

Masa ósea cortical y factores de riesgo para osteoporosis en mujeres postmenopáusicas en nuestro medio / Cortical bone mass and risk factors for osteoporosis among postmenopausal women in our environment

Objetivo. Valorar la importancia de los denominados factores de riesgo para la osteoporosis en las mujeres. Material y métodos. Se estudian 150 mujeres postmenopáusicas, seleccionadas de forma consecutiva en las consultas ambulatorias de ginecología del área de salud del Hospital Universitario de Alcalá de Henares, cuya masa ósea se calcula como índice área cortical/área total (AC/AT) metacarpiana (mm2) determinada por radiogrametría. Resultados. Por el análisis de varianza ANOVA se determina que una menarquía tardía y una vida reproductiva más corta inducen una menor masa ósea (p < 0,0005 y < 0,05, respectivamente) y también el antecedente de fracturas óseas sin trauma importante previo (p < 0,05). Por estudios de correlación hay una significación negativa entre el índice AC/AT y la edad cronológica, la de la menarquía, la de la menopausia y el número de fracturas (r = -0,20 a -0,30, p < 0,05 a < 0,0001) y positiva con los años de vida reproductiva (r = 0,17, p < 0,05). Estos valores prácticamente no cambian cuando con correlación parcial se ajustan al peso, pero al hacer una regresión múltiple el índice AC/AT es únicamente significativo de forma negativa con los años de menopausia (p < 0,005). Tomando como valor el medio del índice AC/AT metacarpiana del grupo de mujeres con antecedente con fracturas se observa una sensibilidad del 50 por ciento y una especificidad del 78 por ciento para indicar fracturas y un valor predictivo negativo el 92 por ciento. Conclusión. Estos resultados señalan la mayor importancia de la edad de la menarquía, de los años de vida reproductiva y, por ende, de los años de menopausia como determinantes de la masa ósea postmenopáusica y demuestran de muy aceptable especificidad del índice AC/AT como predictivo de fractura ósea (AU)

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[Relationship between anxiety and family dynamics]. / Relación entre ansiedad y dinámica familiar.

OBJECTIVE: In the present study we tried to find the likely association between anxiety and a disturbed family dynamic in patients who attended Primary Care for consultation. DESIGN: An observational, crossover study with 150 patients (64.7% women) chosen by systematised random sampling was performed. Patients were grouped in various bivariable categories: sex, marital status, where from, cultural level, occupation, size of family, stage of their life-cycle, family sub-system and income, which were compared with the results from the Stai Anxiety and the Apgar Family tests. 95% significance level; two months data-gathering. RESULTS: Among the most relevant findings were negative correlation in the value of the Stai Anxiety test vs the Apgar Family test, with r = -0.27 and level of significance between [-0.42 < r < -0.12]. A multivariant study using Dummy type variables found association between Anxiety and being Female, with a Beta coefficient of -6.2172 [CI -10.2044/-2.0342]. There was also association of size of family and disturbed family dynamic, with Beta coeff. = -0.2437 and CI [-0.4706/-0.0168]. CONCLUSIONS: a) There is a correlation between anxiety and disturbed family dynamic. b) Being female is a risk factor, when before anxious patients, of a disturbed family dynamic. c) Family size is also a risk factor, before an anxious patient, of a disturbed family dynamic.