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  • Original Article

    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women

    Rev Bras Ginecol Obstet. 2022;44(1):32-39

    Summary

    Original Article

    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women

    Rev Bras Ginecol Obstet. 2022;44(1):32-39

    DOI 10.1055/s-0041-1741408

    Views1

    Abstract

    Objective

    To evaluate the improvement in screening accuracy of the Fracture Risk Assessment Tool (FRAX) for the risk of developing osteoporosis among young postmenopausal women by associating with it clinical muscle mass measures.

    Methods

    A sample of postmenopausal women was submitted to calcaneal quantitative ultrasound (QUS), application of the FRAX questionnaire, and screening for the risk of developing sarcopenia at a health fair held in the city of São Bernardo do Campo in 2019. The sample also underwent anthropometric measurements, muscle mass, walking speed and handgrip tests. A major osteoporotic fracture (MOF) risk ≥ 8.5% on the FRAX, a classification of medium risk on the clinical guideline of the National Osteoporosis Guideline Group (NOGG), and a QUS T-score ≤ -1.8 sd were considered risks of having low bone mass, and QUS T-score ≤ -2.5sd, risk of having fractures.

    Results

    In total, 198 women were evaluated, with a median age of 64±7.7 years, median body mass index (BMI) of 27.3±5.3 kg/m2 and median QUS T-score of -1.3±1.3 sd. The accuracy of the FRAX with a MOF risk ≥ 8.5% to identify women with T-scores ≤ -1.8 sd was poor, with an area under the curve (AUC) of 0.604 (95% confidence interval [95%CI]: 0.509-0.694) for women under 65 years of age, and of 0.642 (95%CI: 0.571-0.709) when age was not considered. Including data on muscle mass in the statistical analysis led to a significant improvement for the group of women under 65 years of age, with an AUC of 0,705 (95%CI: 0.612-0.786). The ability of the high-risk NOGG tool to identify T-scores ≤ -1.8 sd was limited.

    Conclusion

    Clinical muscle mass measurements increased the accuracy of the FRAX to screen for osteoporosis in women aged under 65 years.

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    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women
  • Original Article

    A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic

    Rev Bras Ginecol Obstet. 2023;45(7):377-383

    Summary

    Original Article

    A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic

    Rev Bras Ginecol Obstet. 2023;45(7):377-383

    DOI 10.1055/s-0043-1772181

    Views7

    Abstract

    Objective

    To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo.

    Methods

    Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period.

    Results

    A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency.

    Conclusion

    The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

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    A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic

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