[Parity and menarche as risk factors for osteoporosis in postmenopausal women]. / Paridad y menarquia como factores de riesgo para osteoporosis en mujeres posmenopáusicas.

BACKGROUND: Worldwide studies, even in our country, have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. OBJECTIVE: To investigate the relation of osteoporosis in postmenopausal mexican women with multiparity and age of menarche. PATIENTS AND METHOD: Transversal, retrospective and analytical study. Non-probabilistic sampling technique was performing with users women of the IMSS in San Luis Potosí. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (before the age of 13) and late menarche (at 13 years of age or after). It was measured bone mineral density with dual distal forearm x-ray absorptiometry to all patients. RESULTS: 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria, of the World Health Organization, 18% of posmenopausal women had osteoporosis, 39% had osteopenia and 41% had bone normality. No association was found between the number of deeds and osteoporosis. Additionally we observed that the women who had 4 or more children were older than the other women. average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. In addition we found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46; p = 0.035). CONCLUSIONS: In posmenopausal women a menarche at the age of 13 years or after is a risk factor for osteoporosis.

[Parity and menarche as risk factors of osteoporosis in postmenopausal Mexican women]. / Paridad y menarquia como factores de riesgo de osteoporosis en mujeres posmenopáusicas mexicanas.

BACKGROUND: At the moment the studies lead at world-wide level and even in our country have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. OBJECTIVE: To investigate the relation of osteoporosis in postmenopausal Mexican women with multiparity and age of menarche. PATIENTS AND METHOD: A retrospective and analytical cross-sectional study, with a non-probabilistic sampling technique in women rightful claimants of the IMSS, San Luis Potosi. In all of them the bone mineral density was measured with X-ray dual absorptiometry in the distal forearm. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (< 13 yrs) and late menarche (> or = 13 yrs). RESULTS: 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria of the World Health Organization, 18% of postmenopausal women had osteoporosis, 39% had osteopenia and 43% had bone normality. No association was found between the number of pregnancies and osteoporosis. Additionally we observed that the women who had four or more children were older than the other women, average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. We found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46, p: 0.035). CONCLUSIONS: In postmenopausal women a menarche older than 13 years is a risk factor for osteoporosis.

[Sensitivity and specificity of a utility model of the detection of diabetic neuropathy]. / Sensibilidad y especificidad de un modelo de utilidad para la detección de neuropatía diabética.

OBJECTIVE: To determine whether a utility model can be used with acceptable sensitivity and specificity for the diagnosis of diabetic peripheral neuropathy (DPN). METHODS: Cross sectional study, non-probability sampling, in 381 type 2 diabetic patients with diabetic foot risk. To determine the DPN, it was evaluated the protective sensation in 10 sites on the foot. It was a positive diagnosis if three or more points showed insensitivity at the touch of the skin with Semmes-Weinstein monofilament (SWM). Monofilament was compared to the utility model (MMU); the diagnostic methods of application were the same for both. RESULTS: Mean age was 62 years, 11 years of development of DM, mean body mass index of 29 kg/m2, average glucose 129 mg/dL (78-264 mg/dL). With sensitivity of 73.68%, 97.67% of specificity, positive predictive value 77.78%, negative predictive value 97.10%, the positive likelihood ratio was 31.59 and the negative likelihood ratio 0.27. CONCLUSION: Currently, diagnostic devices for tactile sensory loss are not readily available in our country; therefore, the results of this research will help to make the diagnosis of the MMU timely, inexpensive and easily accessible.

[Correlation of metabolic syndrome components in older Mexican women]. / Correlación de los componentes del síndrome metabólico en mujeres Mexicanas mayores de 60 años.

BACKGROUND: In woman aged over 60 years, body changes occur and might cause insulin resistance and metabolic syndrome. OBJECTIVE: To determine the relationship between the components of metabolic syndrome, insulin resistance and body mass index in women over 60 years, attended at the Geriatric Services in the Dr. Ignacio Morones Prieto Hospital in San Luis Potosi, Mexico. MATERIAL AND METHOD: We performed an observational, descriptive and transversal study with non-probability sampling, selecting 61 women aged 60 years attended from 2006 to 2008, who have measured the body mass index (BMI), insulin resistance and homeostasis model (HOMA2), and identifying the components of metabolic syndrome according to the criteria of the World Health Organization. We used descriptive and inferential statistics with r Pearson and Chi Square. RESULTS: The mean age was 68 years. The average HOMA2 were 1.4 and 75 percentile 1.9. The prevalence of metabolic syndrome was present in 23%. The association test with a p < 0.05 was considered significant for metabolic syndrome dysglucemia and obesity, but not for other components of metabolic syndrome. The triglycerides level correlated with insulin resistance (r = 0.325, p = 0.011), insulin resistance with glucose (r = 0.535, p = 0.000) and insulin resistance with BMI (r = 0.282, p = 0.28). CONCLUSIONS: It is important to properly define the components for the presence of metabolic syndrome in older women due to not all who qualify as obese have metabolic syndrome, and neither all the metabolic syndrome are associated with insulin resistance. The single alteration of one of the components of metabolic syndrome is not sufficient to cause insulin resistance.

[Reliability of the modified albrand questionnaire to diagnose osteoporosis]. / Confiabilidad del cuestionario de Albrand modificado para el diagnóstico de osteoporosis.

BACKGROUND: A considerable amount of Mexican women will be in menopausal status, though it won't be possible to carry out densitometry to all of them. Developing a risk-factor--based instrument to screen those who would need it is advisable. OBJECTIVE: To ascertain the sensitivity and specificity of the Albrand questionnaire, which could be used to identify risk factors for osteoporosis. MATERIAL AND METHOD: A cross-sectional study with a non-probabilistic sampling technique was used to include 906 menopausal women. All women answered a modified and previously validated version of Albrand questionnaire; Cronbach's alpha was 0.83. Eight risk factors for osteoporosis were analyzed; each risk factor had a different weight and the total score per patient was calculated. All underwent lower arm densitometry. RESULTS: Peripheral densitometry revealed that 166 patients had osteoporosis and 740 did not. The global prevalence of osteoporosis was 18.3%; the cut-off value was set in > or =4 points. The Albrand questionnaire had 55% sensitivity and 79% specificity; the positive predictive value was 39% and the negative predictive value was 90%. CONCLUSION: Albrand questionnaire has acceptable sensitivity and specificity and it could be useful for screening menopausal women who would need densitometry tests. Applying the instrument would reduce costs of osteoporosis detection.

Correlación del monitoreo glucémico entre el método visual y computarizado pre y post capacitación / Correlation ot blood glucose monitoring with reactive strips and central laboratory after and before training

Introducción: El monitoreo de la glucosa se obtiene del cambio en la tinción de la zona de una tira reactiva. La educación en diabetes incluye el conocimiento de las mediciones en sangre capilar. Objetivo: Conocer si la capacitación a enfermeras influye en la precisión del monitoreo de glucemia en ayunas. Material y método: Estudio transversal, observacional, descriptivo, comparativo, de intervención educativa en 116 pacientes diabéticos hospitalizados. Las determinaciones se realizaron en forma ciega por enfermería, antes y después de la capacitación en días diferentes, y las muestras de sangre venosa por el personal del laboratorio. Resultados: Su distribución por sexo fue 22 mujeres y 25 hombres en el grupo pre-intervención y 30 mujeres y 39 hombres en el grupo post-intervención. El coeficiente de correlación fue de 0.45 entre las muestras de glucosa por tira reactiva y las de laboratorio antes de la intervención educativa y de 0.77 después de la intervención educativa. El 11% de los pacientes descontrolados metabólicamente quedaban sin diagnosticarse por imprecisión del método con tira visual; después de la intervención educativa disminuyó a 8%. La diferencia de los valores promedios obtenidos por laboratorio y por tira reactiva fue significativa (p<0.05) en los dos grupos. Conclusiones: Los resultados de la correlación que existe entre los resultados de glucemia por laboratorio y con tira reactiva visuales baja y coincide con lo reportado en la literatura, pero mejora con la intervención educativa hacia el personal involucrado en su determinación.

Introduction: The results of capillary glucose testing are obtained by especific zone strip tincture. The current use of accurate blood glucose monitor are even more used nowadays, so, health diabetes team education is a priority. Frequently on clinical practice there are not correlation between visual test strips and reference laboratory. Objective: To know the correlation between different glucose monitoring according hospital educational intervention program training. Methods: Transversal, comparative, intervention study Visual testing monitoring before and after educational intervention program were compared with central laboratory results. We use t-student and Parson's "r" correlation test. Results: 116 hospitalized subjects were studied. 52 women and 64 male correlation coefficient was 0.45 between visual strips and referral laboratory and 0.77 after education intervention. Difference in values obtained from reactive strip and laboratory tests was significative (<0.05) in both groups. Conclusions: This study shows that correlation between results of both tests is low and it is related to the existing evidence found in the literature review, and it is improved after the introduction of the education (training) program.

Características y manejo de la urolitiasis en pacientes que acuden a un hospital general / Characteristic and managing of the urolitiasis in patient that attend to a general hospital

Introducción: la urolitiasis es un padecimiento común en la práctia clínica diaria, cuyo tratamiento médico puede dirigirse a la disolución del cálculo existente y a la prevención de la formación de otros nuevos. En nuestro medio, la litiasis representa una causa importante de atención con aproximadamente mil consultas por año. Objetivo: reconocer las características de la litiasis, así como el tratamiento utilizado con más frecuencia en los pacientes con esta afección. Material y método: estudio retrospectivo, transversal, observacional y descriptivoárealizado en un hospital general. Resultados: se incluyeron 64 pacientes: 37 hombres y 27mujeres, la edad promedio: 4l.9 años. El 6 por ciento de los sujetos del estudio tenía antecedentes familiares de urolitiasis. El dolor fue el síntoma principal; se localizaba en el abdomen y pelvis en 29 pacientes (45 por ciento). Los síntomas secundarios más frecuentes fueron: hematuria y disuria. La localización del lito predominó en el uréter izquierdo (55 por ciento). Del grupo de pacientes, 19 (30 por ciento) tuvieron recidivas. Conclusiones: la tercera parte de los pacientes ingresó debido a urolitiasis recidivante y a ninguno se le habían realizado pruebas o exámenes del metabolismo del calcio, físicos ó químicos del lito. Su tratamiento fue exclusivamente quirúrgico, sin ninguna forma de intervención médica en un problema esencialmente metabólico. Se propuso el abordaje multidisciplinario por parte de los servicios de: endocrinología, urología, medicina interna. En la actualidad está en proceso un protocolo de manejo conjunto que se reportar en el año 2002.