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Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):152-158
DOI 10.1590/SO100-720320150005282
To determine the average age at the onset of menopause and to investigate menopausal symptoms in women in a metropolitan region in Southeastern Brazil.
A descriptive, exploratory, cross-sectional study was conducted with 749 women (a population-based household survey). The dependent variable was the intensity of menopausal symptoms assessed by th Menopause Rating Scale (MRS). The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by the χ2 test and Poisson regression using the backward selection criteria.
The mean age of the women was 52.5 (±4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The mean age at the onset of menopause was 46.5 (±5.8) years. The intensity of menopausal symptoms was defined according to the median MRS score and was considered severe for values above 8. Depression/anxiety (PR=1.8; 95%CI 1.5-2.2; p<0.01), rheumatic diseases (PR 1.5; 95%CI 1.2-1.7; p<0.01), self-perception of health as fair/poor/very poor (PR 1.4; 95% CI 1.2-1.7; p<0.01), history of abortion (PR 1.3; 95%CI 1.1-1.4; p<0.01), current or previous treatment for menopausal symptoms (PR 1.2; 95%CI 1.1-1.4; p<0.01), peri- or postmenopausal status (PR 1.4; 95%CI 1.1-1.7; p<0.01), number of normal deliveries >1 (PR 1.2; 95%CI 1.02-1.4; p<0.01) and asthma (PR 1.2; 95%CI 1.01-1.4; p<0.01) were associated with more severe menopausal symptoms. Older age (PR 0.96; 95%CI 0.96-0.97; p<0.01) was associated with less severe symptoms.
The severity of menopausal symptoms was related to a wild range of factors, especially presence of chronic diseases, a larger number of pregnancies, use of hormone therapy, and worse self-rated health. A better understanding of these factors can help to reduce the impact of symptoms on quality of life, and to identify groups of women who are likely to need more care during and beyond menopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):152-158
DOI 10.1590/SO100-720320150005282
To determine the average age at the onset of menopause and to investigate menopausal symptoms in women in a metropolitan region in Southeastern Brazil.
A descriptive, exploratory, cross-sectional study was conducted with 749 women (a population-based household survey). The dependent variable was the intensity of menopausal symptoms assessed by th Menopause Rating Scale (MRS). The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by the χ2 test and Poisson regression using the backward selection criteria.
The mean age of the women was 52.5 (±4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The mean age at the onset of menopause was 46.5 (±5.8) years. The intensity of menopausal symptoms was defined according to the median MRS score and was considered severe for values above 8. Depression/anxiety (PR=1.8; 95%CI 1.5-2.2; p<0.01), rheumatic diseases (PR 1.5; 95%CI 1.2-1.7; p<0.01), self-perception of health as fair/poor/very poor (PR 1.4; 95% CI 1.2-1.7; p<0.01), history of abortion (PR 1.3; 95%CI 1.1-1.4; p<0.01), current or previous treatment for menopausal symptoms (PR 1.2; 95%CI 1.1-1.4; p<0.01), peri- or postmenopausal status (PR 1.4; 95%CI 1.1-1.7; p<0.01), number of normal deliveries >1 (PR 1.2; 95%CI 1.02-1.4; p<0.01) and asthma (PR 1.2; 95%CI 1.01-1.4; p<0.01) were associated with more severe menopausal symptoms. Older age (PR 0.96; 95%CI 0.96-0.97; p<0.01) was associated with less severe symptoms.
The severity of menopausal symptoms was related to a wild range of factors, especially presence of chronic diseases, a larger number of pregnancies, use of hormone therapy, and worse self-rated health. A better understanding of these factors can help to reduce the impact of symptoms on quality of life, and to identify groups of women who are likely to need more care during and beyond menopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):315-319
DOI 10.159/S0100-720320140004977
To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease.
This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software.
In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification.
The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):315-319
DOI 10.159/S0100-720320140004977
To analyze associations between mammographic arterial mammary calcifications in menopausal women and risk factors for cardiovascular disease.
This was a cross-sectional retrospective study, in which we analyzed the mammograms and medical records of 197 patients treated between 2004 and 2005. Study variables were: breast arterial calcifications, stroke, acute coronary syndrome, age, obesity, diabetes mellitus, smoking, and hypertension. For statistical analysis, we used the Mann-Whitney, χ2 and Cochran-Armitage tests, and also evaluated the prevalence ratios between these variables and mammary artery calcifications. Data were analyzed with the SAS version 9.1 software.
In the group of 197 women, there was a prevalence of 36.6% of arterial calcifications on mammograms. Among the risk factors analyzed, the most frequent were hypertension (56.4%), obesity (31.9%), smoking (15.2%), and diabetes (14.7%). Acute coronary syndrome and stroke presented 5.6 and 2.0% of prevalence, respectively. Among the mammograms of women with diabetes, the odds ratio of mammary artery calcifications was 2.1 (95%CI 1.0-4.1), with p-value of 0.02. On the other hand, the mammograms of smokers showed the low occurrence of breast arterial calcification, with an odds ratio of 0.3 (95%CI 0.1-0.8). Hypertension, obesity, diabetes mellitus, stroke and acute coronary syndrome were not significantly associated with breast arterial calcification.
The occurrence of breast arterial calcification was associated with diabetes mellitus and was negatively associated with smoking. The presence of calcification was independent of the other risk factors for cardiovascular disease analyzed.
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Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):439-441
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Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):439-441
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Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):592-597
DOI 10.1590/S0100-72032009001200003
PURPOSE: The adaptation into Portuguese and evaluation of the Index of Scientific Quality (ISQ) questionnaire applicability's in texts presented by Brazilian magazines on woman's health. METHODS: A transversal cohort study. Texts published from August 2005 to July 2007, in the main weekly magazines Veja, Época and Isto é, were collected. The questionnaire used is composed of eight items, with five alternatives each, measuring the applicability, opinion degree, validity and implications of the finding, precision, coherence and relevance of the data, besides a global item summarizing all the other items. ISQ was translated, retro-translated and submitted to a pilot test till the final version, which was used by two medical doctors and two journalists. After the texts analysis', the internal consistency of the questionnaire items was checked through Cronbach's alpha coefficient, and the inter and intra-observer agreement, for each item, by Kappa's index. RESULTS: The sample was composed by 80 articles. The internal consistency of items has varied from 0.81 to 0.96. The inter-evaluators' agreement ranged from -0.03 to 0.48, and the intra-observer varied from 0.27 to 0.34 (CI 95%). CONCLUSION: The questionnaire items have adequately measured the scientific quality of the texts, but the low agreement inter and intra-observers points to the need for further studies to assess the Brazilian version of ISQ.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):592-597
DOI 10.1590/S0100-72032009001200003
PURPOSE: The adaptation into Portuguese and evaluation of the Index of Scientific Quality (ISQ) questionnaire applicability's in texts presented by Brazilian magazines on woman's health. METHODS: A transversal cohort study. Texts published from August 2005 to July 2007, in the main weekly magazines Veja, Época and Isto é, were collected. The questionnaire used is composed of eight items, with five alternatives each, measuring the applicability, opinion degree, validity and implications of the finding, precision, coherence and relevance of the data, besides a global item summarizing all the other items. ISQ was translated, retro-translated and submitted to a pilot test till the final version, which was used by two medical doctors and two journalists. After the texts analysis', the internal consistency of the questionnaire items was checked through Cronbach's alpha coefficient, and the inter and intra-observer agreement, for each item, by Kappa's index. RESULTS: The sample was composed by 80 articles. The internal consistency of items has varied from 0.81 to 0.96. The inter-evaluators' agreement ranged from -0.03 to 0.48, and the intra-observer varied from 0.27 to 0.34 (CI 95%). CONCLUSION: The questionnaire items have adequately measured the scientific quality of the texts, but the low agreement inter and intra-observers points to the need for further studies to assess the Brazilian version of ISQ.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):45-52
DOI 10.1590/S0100-72032004000100007
PURPOSE: to evaluate the relationship between epidemiologic, anthropometric, reproductive and hormonal factors and mammographic density in postmenopausal women. METHODS: this is a retrospective, cross-sectional study, including 144 women aged 45 years or more, with at least 12 months of amenorrhea and who were non users of hormone replacement therapy during the last six months. Medical charts were reviewed to evaluate age, weight, body mass index (BMI), parity, age at menarche, age at menopause and levels of estradiol, follicle stimulating (FSH) and luteinizing hormones. Mammograms were analyzed by two blinded investigators. The films were taken in the craniocaudal and mediolateral views and mammography was classified as dense and nondense, according to the Wolfe criteria. For statistical analysis, the frequency, median, minimum and maximum values, the Wilcoxon test and the odds ratio were used. Multiple logistic regression was performed, using the stepwise selection, with a 5% significance level. RESULTS: the frequency of dense breasts was 45%. Women with dense breasts were of lower weight (60.5 vs. 71.9 kg - p<0.01), had a lower BMI (25.9 vs 31.0 kg/m² - p<0.01), a shorter time since onset of menopause (6.0 vs 10 years - p<0.01) and higher levels of FSH (75.2 vs 60.3 mU/mL - p<0.01). The probability of having dense breasts decreased in women whose weight was 67 kg or more (OR = 4.0, CI 95% = 1.50-10.66), BMI was higher than 30 kg/m² (OR = 6.69, CI 95% = 1.67-36.81), time since onset of menopause was superior or equal to seven years (OR = 2.05, CI 95% = 1.05-3.99) and FSH levels were lower than 134.8 mU/mL. CONCLUSION: weight, BMI, parity, time since menopause and FSH levels were significantly associated with mammographic density patterns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):45-52
DOI 10.1590/S0100-72032004000100007
PURPOSE: to evaluate the relationship between epidemiologic, anthropometric, reproductive and hormonal factors and mammographic density in postmenopausal women. METHODS: this is a retrospective, cross-sectional study, including 144 women aged 45 years or more, with at least 12 months of amenorrhea and who were non users of hormone replacement therapy during the last six months. Medical charts were reviewed to evaluate age, weight, body mass index (BMI), parity, age at menarche, age at menopause and levels of estradiol, follicle stimulating (FSH) and luteinizing hormones. Mammograms were analyzed by two blinded investigators. The films were taken in the craniocaudal and mediolateral views and mammography was classified as dense and nondense, according to the Wolfe criteria. For statistical analysis, the frequency, median, minimum and maximum values, the Wilcoxon test and the odds ratio were used. Multiple logistic regression was performed, using the stepwise selection, with a 5% significance level. RESULTS: the frequency of dense breasts was 45%. Women with dense breasts were of lower weight (60.5 vs. 71.9 kg - p<0.01), had a lower BMI (25.9 vs 31.0 kg/m² - p<0.01), a shorter time since onset of menopause (6.0 vs 10 years - p<0.01) and higher levels of FSH (75.2 vs 60.3 mU/mL - p<0.01). The probability of having dense breasts decreased in women whose weight was 67 kg or more (OR = 4.0, CI 95% = 1.50-10.66), BMI was higher than 30 kg/m² (OR = 6.69, CI 95% = 1.67-36.81), time since onset of menopause was superior or equal to seven years (OR = 2.05, CI 95% = 1.05-3.99) and FSH levels were lower than 134.8 mU/mL. CONCLUSION: weight, BMI, parity, time since menopause and FSH levels were significantly associated with mammographic density patterns.