Prophylactic low-molecular-weight heparin in women with thrombophilia undergoing in vitro fertilization.

OBJECTIVE: To verify whether low-molecular-weight heparin (LMWH) could increase pregnancy rates and/or decrease abortion rates in women with thrombophilia undergoing assisted reproduction cycles. METHODS: Cross-sectional study with patients undergoing in vitro fertilization (IVF) (N = 104). Women without thrombophilia (control group, n = 20), women with thrombophilia who did not receive LMWH (untreated group, n = 30), and women with thrombophilia, treated with daily enoxaparin from the day of embryo transfer until week 36 of gestation (treated group, n = 54). All women underwent controlled ovarian hyperstimulation. IVF was performed by intracytoplasmic sperm injection, and embryos were transferred on day 3. Pregnancy was detected by ß-human chorionic gonadotropin (biochemical pregnancy) and fetal heartbeat at week 5 to 6. Ongoing pregnancy was determined by ultrasound on week 12. RESULTS: Patients in the untreated thrombophilia group presented with significantly lower ongoing pregnancy rates and live birth rates and significantly higher early pregnancy loss and abortion rates when compared with the control and the treated thrombophilia groups. CONCLUSIONS: In women with diagnosed coagulation disorders, use of LMWH is important to avoid miscarriages.

Effect of Testosterone on Proliferation Markers and Apoptosis in Breasts of Ovariectomized Rats.

OBJECTIVE: To investigate the action of testosterone (T), isolated or associated with estradiol benzoate (EB), on the proliferation markers and apoptosis of breasts of ovariectomized rats. METHODS: A total of 48 castrated female Wistar rats were divided into 6 groups, and each of them were submitted to one of the following treatments for 5 weeks: 1) control; 2) EB 50 mcg/day + T 50 mcg/day; 3) T 50mcg/day; 4) EB 50 mcg + T 300 mcg/day; 5) T 300 mcg/day; and 6) EB 50 mcg/day. After the treatment, the mammary tissue was submitted to a histological analysis and immunoexpression evaluation of proliferation markers (proliferating cell nuclear antigen, PCNA) and apoptosis (caspase-3). RESULTS: There was a statistically significant difference among the groups regarding microcalcifications and secretory activity, with higher prevalence in the groups treated with EB. There was no difference among the groups regarding atrophy, but a higher prevalence of atrophy was found in the groups that received T versus those that received EB + T. There was a difference among the groups regarding the PCNA (p = 0.028), with higher expression in the group submitted to EB + T 300 mcg/day. Regarding caspase-3, there was no difference among the groups; however, in the group submitted to EB + T 300 mcg/day, the expression was higher than in the isolated T group. CONCLUSION: Isolated T did not have a proliferative effect on the mammary tissue, contrary to EB. Testosterone in combination with EB may or may not decrease the proliferation, depending on the dose of T.

OBJETIVO: Investigar a ação da testosterona (T) isolada ou associada ao benzoato de estradiol (EB) na proliferação e apoptose de mamas de ratas ovariectomizadas. MéTODOS: Um total de 48 ratas Wistar castradas foram divididas em 6 grupos, e cada um foi submetido a um dos seguintes tratamentos durante 5 semanas: 1) controle; 2) BE 50 mcg/dia + T 50 mcg/dia; 3) T 50 mcg/dia; 4) BE 50 mcg + T 300 mcg/dia; e) T 300 mcg/dia; e f) BE 50 mcg/dia. Após o tratamento, o tecido mamário foi submetido a análise histológica e avaliação de imunoexpressão de marcadores de proliferação (antígeno nuclear de células proliferantes, PCNA) e apoptose (caspase-3). RESULTADOS: Houve diferença estatisticamente significante entre os grupos com relação às microcalcificações e à atividade secretora, com maior prevalência nos grupos tratados com BE. Não houve diferença entre os grupos quanto à atrofia, mas houve maior prevalência de atrofia nos grupos que receberam T versus os que receberam BE + T. Houve diferença entre os grupos quanto ao ANCP (p = 0,028), com maior expressão no grupo BE + T 300 mcg/dia. Com relação à caspase-3, não houve diferença entre os grupos, mas, no grupo BE + T 300 mcg/dia, a expressão foi maior do que no grupo de T isolada. CONCLUSãO: A T isolada não apresentou efeito proliferativo do tecido mamário, contrariamente ao EB. A T em associação ao EB pode diminuir ou não a proliferação, a depender da dose de T.

Effect of testosterone on proliferation markers and apoptosis in breasts of ovariectomized rats / Efeito da testosterona em marcadores de proliferação e apoptose em mamas de ratas ovariectomizadas

Abstract Objective To investigate the action of testosterone (T), isolated or associated with estradiol benzoate (EB), on the proliferation markers and apoptosis of breasts of ovariectomized rats. Methods A total of 48 castrated female Wistar rats were divided into 6 groups, and each of them were submitted to one of the following treatments for 5 weeks: 1) control; 2) EB 50 mcg/day + T 50 mcg/day; 3) T 50mcg/day; 4) EB 50 mcg +T 300 mcg/day; 5) T 300 mcg/day; and 6) EB 50 mcg/day. After the treatment, the mammary tissue was submitted to a histological analysis and immunoexpression evaluation of proliferation markers (proliferating cell nuclear antigen, PCNA) and apoptosis (caspase-3). Results There was a statistically significant difference among the groups regarding microcalcifications and secretory activity, with higher prevalence in the groups treated with EB. There was no difference among the groups regarding atrophy, but a higher prevalence of atrophy was found in the groups that received T versus those that received EB +T. There was a difference among the groups regarding the PCNA (p = 0.028), with higher expression in the group submitted to EB +T 300 mcg/day. Regarding caspase-3, there was no difference among the groups; however, in the group submitted to EB +T 300 mcg/day, the expression was higher than in the isolated T group. Conclusion Isolated T did not have a proliferative effect on the mammary tissue, contrary to EB. Testosterone in combination with EB may or may not decrease the proliferation, depending on the dose of T.

Resumo Objetivo Investigar a ação da testosterona (T) isolada ou associada ao benzoato de estradiol (EB) na proliferação e apoptose de mamas de ratas ovariectomizadas. Métodos Um total de 48 ratas Wistar castradas foram divididas em 6 grupos, e cada um foi submetido a um dos seguintes tratamentos durante 5 semanas: 1) controle; 2) BE 50 mcg/dia + T 50mcg/dia; 3) T 50 mcg/dia; 4) BE 50 mcg + T 300mcg/dia; e) T 300 mcg/dia; e f) BE 50 mcg/dia. Após o tratamento, o tecido mamário foi submetido a análise histológica e avaliação de imunoexpressão de marcadores de proliferação (antígeno nuclear de células proliferantes, PCNA) e apoptose (caspase-3). Resultados Houve diferença estatisticamente significante entre os grupos com relação às microcalcificações e à atividade secretora, com maior prevalência nos grupos tratados com BE. Não houve diferença entre os grupos quanto à atrofia, mas houve maior prevalência de atrofia nos grupos que receberam T versus os que receberam BE+ T. Houve diferença entre os grupos quanto ao ANCP (p= 0,028), com maior expressão no grupo BE+ T 300 mcg/dia. Com relação à caspase-3, não houve diferença entre os grupos, mas, no grupo BE+ T 300 mcg/dia, a expressão foi maior do que no grupo de T isolada. Conclusão A T isolada não apresentou efeito proliferativo do tecido mamário, contrariamente ao EB. A T em associação ao EB pode diminuir ou não a proliferação, a depender da dose de T.

Association of IGF-1 CA(n) and IGFBP3 rs2854746 Polymorphisms with Endometrial Polyp Risk.

INTRODUCTION: Insulin-like growth factor 1 (IGF-1) is a peptide growth factor that promotes cell proliferation and inhibits apoptosis. The bioavailability of IGF-1 is regulated by the insulin-like growth factor binding protein 3 (IGFBP3). Genetic variations influence the levels of IGF-1 and IGFBP3. The purpose of this study was to examine the association of polymorphisms IGF-1 CA(n) and IGFBP3 rs2854746 with risk of endometrial polyps. MATERIALS AND METHODS: Case control observational study, composed of 104 women with antecedent of endometrial polyp (case group) and 81 postmenopausal women without antecedent of endometrial diseases (control group). Genotyping of IGF-1 CA(n) was performed by PCR and fragment analysis by capillary electrophoresis, and genotyping of IGFBP3 rs2854746 was performed by PCR-HRM. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression. RESULTS: The genotype IGF-1 CA(19)/CA(19) was associated with an increased endometrial polyp risk (OR=2,57; IC 95%= 1,09 - 6,01); this was also found when combining it with CA(>19)/CA(n) genotypes (OR=2,18; IC 95%= 1,06-4,47). The IGFBP3 rs2854746 analyses showed the CG genotype having a protective effect for endometrial polyp (OR=0,37; IC 95%= 0,19-0,73), fact also observed when grouping CG and GG carriers (OR=0,51; IC 95%= 0,28-0,93). CONCLUSION: The genotypes CA(19)/CA(19) and CA(19)/CA(19) + CA(>19)/CA(n) of the IGF-1 CA(n) may be considered a risk for endometrial polyp, whereas the genotypes CG and CG + GG of IGFBP3 rs2854746 polymorphism have an inverse effect of endometrial polyp risk.

Effects of an extended flexible regimen of an oral contraceptive pill containing 20 µg ethinylestradiol and 3 mg drospirenone on menstrual-related symptoms: a randomised controlled trial.

OBJECTIVES: The aim of the study was to assess the efficacy for menstrual-related symptoms of an extended flexible regimen of an oral contraceptive pill containing 20 µg ethinylestradiol and 3 mg drospirenone in comparison with a 24/4 d cyclical regimen of the same formulation. METHODS: This randomised, non-inferiority, open-label, multicentre study was conducted in women aged 18-39 years. Their menstrual-related symptoms were assessed using the Penn Daily Symptom Rating (DSR17). Participants were randomised to use an extended flexible regimen of 20 µg ethinylestradiol and 3 mg drospirenone (EE/DRSPe.flex), comprising 168 consecutive days with a 4-d hormone-free interval (HFI, allowing for management of unexpected bleeding) or a conventional 24/4 cyclical regimen of the same pill (EE/DRSP24/4). The primary measure of efficacy was the percentage change in DSR17 total score from baseline to cycle 6. The secondary measures of efficacy were the percentage changes in DSR17 total score from baseline after each 28-d interval throughout the entire study and in the scores for individual DSR17 symptoms. RESULTS: The primary analysis demonstrated that EE/DRSPe.flex was not inferior to EE/DRSP24/4 (Mean DSR17 score 9.1; 95% confidence interval (CI) - 2.5, 20.6; p = 0.123). Analysis at intervals throughout the entire evaluation period showed greater reduction in DSR17 total score for EE/DRSPe.flex than for the 24/4 regimen (p < 0.001). The decreases in individual scores for the symptoms 'poor coordination' and 'depression/feeling sad/down or blue' were greater for the extended flexible regimen than for the cyclical regimen (p < 0.05). CONCLUSION: The extended flexible regimen was not inferior to the 24/4 cyclical regimen in terms of the primary endpoint. It significantly improved symptoms in the interval analysis, and the effects on specific DSR17 symptoms, compared with the cyclical regimen.

Influence of Dyslipidemia on the Quality of Sexual Life in Women in the Menacme using a Combined Oral Contraceptive / Influência da dislipidemia na qualidade de vida sexual de mulheres na menacme usando contraceptivos orais combinados

ABSTRACT Purpose: Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs) . Methods: A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results: After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions: The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.

RESUMO Objetivo: Disfunção sexual feminina é uma condição complexa acomete as mulheres, e a relação entre a função sexual e a dislipidemia é muito pouco estudada. Este estudo objetivou avaliar esta relação em mulheres na menacme que fazem uso de contraceptivos orais combinados (COCs). Métodos: Um total de 49 mulheres saudáveis com vida sexual ativa receberam pílulas anticoncepcionais contendo etinilestradiol 30 mcg (EE30) associado a levonorgestrel 150 mcg (LNG150). As mulheres foram divididas em dois grupos, de acordo com o perfil lipídico. Dislipidemia foi definida como nível de lipoproteína de alta densidade (HDL) < 50 mg/dL, ou nível de lipoproteína de baixa densidade (LDL) > 130 mg/dL. A função sexual feminina foi avaliada utilizando o questionário de Índice de Função Sexual Feminina (IFSF). O IFSF e os parâmetros lipídicos e lipoproteicos foram obtidos no início e após o sexto ciclo do estudo. Resultados: Após seis ciclos de uso dos COCs, as mulheres com LDL > 130 mg/dL, tiveram redução dos níveis de colesterol total e colesterol LDL de 14,7% e 22,1% respectivamente. Nas mulheres com níveis HDL < 50 mg/dL no momento basal, o nível de HDL aumentou 15,5% ao final do estudo. Os domínios de excitação, orgasmo e os escores totais do IFSF aumentaram significativamente nas mulheres com e sem dislipidemia. Os domínios de desejo e satisfação aumentaram no final do período de tratamento exclusivamente no grupo sem dislipidemia. Conclusões: A formulação EE30/LNG150 aumentou a função sexual das mulheres, sendo positivamente correlata somente com os níveis de colesterol HDL. Estes achados demonstram baixa correlação entre a função sexual e as alterações no metabolismo lipídico e lipoproteico.

Influence of Dyslipidemia on the Quality of Sexual Life in Women in the Menacme using a Combined Oral Contraceptive.

Purpose Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs). Methods A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.

Attitudes, knowledge and prescribing habits of Brazilian gynecologists regarding extended-cycle oral contraceptives.

Extended-cycle and continuous use combined oral contraceptives (COC) have been widely investigated; however, gynecologists' prescribing habits are largely unknown. This study evaluated the opinions and prescribing habits of Brazilian gynecologists regarding extended/continuous COC. Gynecologists caring for reproductive-age women and used to prescribing COC were recruited to an online survey. Overall, 1097 physicians were included. Of these, 93.0% stated that patients requested extended/continuous COC, with 93.9% of the physicians having already prescribed these regimens at least once. Only 67 physicians reported never having prescribed extended/continuous COC. The most common reasons for prescribing extended/continuous COC were "dysmenorrhea", "endometriosis" and "convenience of menstrual suppression". Physicians reported prescribing extended/continuous regimens for 20.7 ± 17.2% of their patients with an indication for COC, postgraduate degree holders being more likely to prescribe extended/continuous regimens than physicians without postgraduate degree (23.6 ± 19.1% versus 20.0 ± 16.7%; p = 0.014). In conclusion, the vast majority of gynecologists prescribe extended/continuous COC. Women often request information from their doctors on the subject. "Convenience of menstrual suppression" is a common reason given for prescribing extended/continuous COC. According to the physicians, the great majority of extended/continuous COC users are satisfied or very satisfied with the regimen prescribed.

Impact of standardized information provided by gynecologists on women's choice of combined hormonal contraception.

This prospective interventional study was designed to determine the impact of providing standardized information on different methods of combined hormonal contraception on women's selection of which method to use. A total of 952 Brazilian gynecologists were randomly selected. Each gynecologist recruited 15 consecutive patients for whom combined hormonal contraception was indicated. Each patient was asked which contraceptive method she would prefer (pill, patch, vaginal ring or injectable) before and after receiving a standardized explanation on each of these methods provided by her doctor. A total of 9507 women were included in the study. Prior to counseling, 66.5% of the women stated that they would prefer the pill, 17.9% the injectable, 8.9% the patch and 6.7% the vaginal ring. After counseling, 53.7% of the women stated that they would prefer the pill, 16.3% the injectable, 14% the patch and 16% the ring. In conclusion, the combined pill remains the most popular contraceptive method among Brazilian women; however, after receiving information on the various contraceptive methods available, the proportion of women choosing the vaginal ring or patch increased, while preference for the combined pill decreased.

Anticoncepcionais orais combinados em regime estendido / Combined oral contraceptives in extended regimen

Denominam-se regimes estendidos em contracepção oral combinada a utilização de pílulas por mais de 28 dias sem pausa, visando a supressão da menstruação. Incluem o uso contínuo dos contraceptivos, bem como de regimes com intervalos trimestrais. Os questionamentos acerca da necessidade da menstruação, bem como dos intervalos mensais entre as usuárias de anticoncepcionais hormonais, motivou, nos últimos anos, o interesse crescente por regimes contraceptivos não convencionais. Nesse sentido, a conveniência e a melhora dos sintomas como cólicas, cefaleia e inchaço figuram entre as principais indicações dos regimes estendidos, além do possível efeito sobre doenças menstruais relacionadas. O propósito deste estudo foi identificar os principais aspectos referentes ao uso dos anticoncepcionais em regime estendido, com ênfase sobre as indicações, formulações disponíveis, padrão de sangramento, efeitos adversos e perfil metabólico

Extended regimens in combined oral contraception mean continuous administration, greater than 28 days of active hormone, in order to avoid menstruation. Extended regimens include some kind of contraception with no interval (as continuous) and with intervals every three months. Questions about the necessity of menstruation, as well as monthly intervals between hormonal contraceptive has motivated the growing interest in unconventional contraceptives regimens. Convenience and improved symptoms such as cramping, bloating and headache are among the main indications for extended regimens, in addition to the possible effect on menstrual-related diseases. The purpose of this study was to identify the main aspects regarding the use of contraceptives in extended regimens, with emphasis on indications, formulations available, bleeding patterns, adverse effects and metabolic profile

Accuracy study on "Osteorisk": a new osteoporosis screening clinical tool for women over 50 years old.

CONTEXT AND OBJECTIVE: Osteoporosis is the greatest cause of quality-of-life reductions, morbidity and mortality among postmenopausal women, with growing incidence as populations age. Clinical tools like Osteorisk provide an easy-access and low-cost alternative method that helps physicians to reduce the need for dual-energy X-ray absorptiometry (DXA), the expensive gold standard examination for diagnosing osteoporosis. The aim here was to study the accuracy of Osteorisk using heel ultrasonography for bone mineral density (BMD). DESIGN AND SETTING: Cross-sectional study, at Faculdade de Medicina do ABC. METHODS: A structured questionnaire was applied to 615 postmenopausal women, with anthropometric measurements, Osteorisk calculations and quantitative ultrasound on the heel using Sonost 2000 equipment. RESULTS: 461 women were included, with mean age 60 +/- 9 years, weight 67.6 +/- 12.9 kg and body mass index (BMI) 28.8 +/- 5.0 kg/m(2). Their Osteorisk classifications were: 61.0% low-risk, 28.4% medium-risk and 10.6% high-risk. Quantitative ultrasound showed 81.3% low-risk, 10.0% medium-risk and 8.7% high-risk regarding osteoporosis. Statistically significant results were observed (p < 0.001) when Osteorisk was correlated with age, years since menopause and BMI. Correlating these same variables with quantitative ultrasound, statistically significant results were observed for age (p < 0.001), years since menopause (p < 0.001) and BMI (p < 0.006). The sensitivity, specificity, negative predictive value and positive predictive value for Osteorisk were 64%, 6.7%, 89% and 30.6%, respectively. CONCLUSION: Osteorisk is a valid tool for screening for women at low risk of osteoporosis, making it possible for these women not to have to undergo densitometry.

Knowledge, attitude and practice of breast self-examination in a female population of metropolitan São Paulo.

OBJECTIVE: Evaluation of the knowledge, attitude and practice of breast self-examination in different groups of women in São Paulo. METHODS: Application of a questionnaire to 392 women divided in four groups. Group one: 101 patients of the National Health Service, Group two: 95 female physicians; Group three: 95 female medical students; and Group four: 101 wives of gynecologists. RESULTS: Self-examination was performed by 90.3% of women, Group 1 having the lowest rate, 69.3%. However, proper self-examination (performed monthly or once per cycle, after menstrual period, with at least one stage in standing or sitting up position) was performed by only 30.4%, the poorest performance being found in Group 1 (15.7%) and the best one in Group 2 (43.6%). For women in Group 1, "mass media" was the most important source of information on breast self-examination, whereas for the other groups, it was "medical sources". CONCLUSION: The majority of women are knowledgeable about breast self-examination but perform it improperly, this finding being more common among women who depend on the National Health Service, who represent a section of the general population. As breast self-examination remains an important tool in countries with limited resources, this study confirms the importance of disseminating proper information, and that more investment should be made in awareness campaigns.

Accuracy study on "Osteorisk": a new osteoporosis screening clinical tool for women over 50 years old

CONTEXT AND OBJECTIVE: Osteoporosis is the greatest cause of quality-of-life reductions, morbidity and mortality among postmenopausal women, with growing incidence as populations age. Clinical tools like Osteorisk provide an easy-access and low-cost alternative method that helps physicians to reduce the need for dual-energy X-ray absorptiometry (DXA), the expensive gold standard examination for diagnosing osteoporosis. The aim here was to study the accuracy of Osteorisk using heel ultrasonography for bone mineral density (BMD). DESIGN AND SETTING: Cross-sectional study, at Faculdade de Medicina do ABC. METHODS: A structured questionnaire was applied to 615 postmenopausal women, with anthropometric measurements, Osteorisk calculations and quantitative ultrasound on the heel using Sonost 2000 equipment. RESULTS: 461 women were included, with mean age 60 ± 9 years, weight 67.6 ± 12.9 kg and body mass index (BMI) 28.8 ± 5.0 kg/m². Their Osteorisk classifications were: 61.0 percent low-risk, 28.4 percent medium-risk and 10.6 percent high-risk. Quantitative ultrasound showed 81.3 percent low-risk, 10.0 percent medium-risk and 8.7 percent high-risk regarding osteoporosis. Statistically significant results were observed (p < 0.001) when Osteorisk was correlated with age, years since menopause and BMI. Correlating these same variables with quantitative ultrasound, statistically significant results were observed for age (p < 0.001), years since menopause (p < 0.001) and BMI (p < 0.006). The sensitivity, specificity, negative predictive value and positive predictive value for Osteorisk were 64 percent, 6.7 percent, 89 percent and 30.6 percent, respectively. CONCLUSION: Osteorisk is a valid tool for screening for women at low risk of osteoporosis, making it possible for these women not to have to undergo densitometry.

CONTEXTO E OBJETIVO: Osteoporose é a principal causa de redução de qualidade de vida, morbidade e mortalidade entre as mulheres no climatério, com aumento na incidência conforme o envelhecimento da população. Ferramentas clínicas como Ostorisk fornecem uma alternativa de acesso fácil e de baixo custo que ajudam o clínico a melhorar a eficácia da solicitação da densitometria óssea, exame padrão ouro, porém caro para o diagnóstico de osteoporose. O objetivo deste artigo foi estudar a acurácia do Ostorisk tendo a ultrassonometria de calcâneo como método de avaliação da densidade mineral óssea. TIPO DE ESTUDO E LOCAL: Estudo transversal, na Faculdade de Medicina do ABC. MÉTODO: Um questionário estruturado foi aplicado em 615 mulheres menopausadas, com medidas antropométricas, cálculo do Osteorisk e realização de ultrassonometria quantitativa do calcâneo com o aparelho Sonost 2000. RESULTADOS: 461 mulheres foram incluídas, com uma idade média de 60 ± 9 anos, peso de 67,6 ± 12,9 kg e índice de massa corpórea (IMC) 28,8 ± 5.0 kg/ m². A classificação do Osteorisk para o grupo estudado foi: 61,0 por cento baixo risco, 28,4 por cento médio risco, e 10,6 por cento alto risco. A ultrassonometria de calcâneo mostrou 81,3 por cento baixo risco, 10,0 por cento médio risco e 8,7 por cento alto risco para osteoporose. Os resultados estatisticamente significantes foram observados (p < 0,001) quando o Osteorisk foi correlacionado com idade, anos de menopausa e índice de massa corpórea (IMC). Correlacionando essas mesmas variedades com a ultra-sonometria, resultados estatisticamente significantes foram observados para idade (p < 0,001), anos de menopausa (p < 0,001) e IMC (p < 0,006). A sensibilidade, especificidade, o valor preditivo negativo e o valor preditivo positivo para o Osteorisk foram 64 por cento, 6,7 por cento, 89 por cento e 30,6 por cento, respectivamente. CONCLUSÃO: Osteorisk é uma ferramenta válida para o rastreamento...