Dissertação
Diferenças no reconhecimento de osteoporose e da síndrome dos ovários policísticos entre os endocrinologistas e ginecologistas na cidade de Santa Maria – RS
Autor
Beber, Carla Costa
Institución
Resumen
Chronic diseases such as systemic arterial hypertension, type 2 diabetes mellitus,
osteoporosis and polycystic ovarian syndrome are prevalent in Brazil and are
responsible not only for considerable morbidity and mortality in specific segments of
the population, but also for high financial costs. Despite all their relevance, the
diagnosis of these health problems in our country is not performed in an ideal way.
As a consequence, there is a difficulty to act preventively in these pathologies,
generating unwanted clinical complications. The difficulty of establishing diagnoses
uniformly in common pathologies is not unique to our country. There are studies that
demonstrate that the recognition of polycystic ovary syndrome is under-registered in
developed countries such as Australia, as well as osteoporosis in China. At these
sites, a variation in the identification of these pathologies has been demonstrated
according to the physician's specialty. The objective of this study was to evaluate,
through a questionnaire, the awareness regarding the diagnosis and management of
polycystic ovarian syndrome and osteoporosis among the specialized physicians
whom works in these areas (gynecologists and endocrinologists) in the city of Santa
Maria, southern Brazil, where has a population of about 300,000 inhabitants. To
improve this comparison, two other prevalent diseases (type 2 diabetes mellitus and
systemic arterial hypertension) were included in the same questionnaire. A crosssectional
study was carried out between July and August 2015 (Approval of CAAE
43401415.3.0000.5346). In total, 90% of endocrinologists and 75% of gynecologists
out of a total of 97 physicians registered in the Regional Council of Medicine
completed the questionnaire that was applied by a trained interviewer. No differences
related to age, gender and time of work experience were observed among these
specialists. In general, the responses of endocrinologists and gynecologists were
consistent. Considering the questions about polycystic ovarian syndrome, the
decision to include total testosterone, 17OHP, and prolactin was significantly higher
in the group of endocrinologists than gynecologists. Regarding osteoporosis, the
inclusion of the history of low-impact fractures in the diagnosis of osteoporosis was
significantly more reported by gynecologists than endocrinologists. As expected,
sequential identification of secondary causes of osteoporosis was more frequently
performed by endocrinologists than gynecologists, who also identified a greater
number of drug treatment options. To our knowledge, this is the first initiative to
estimate differences in the recognition of polycystic ovarian syndrome and
osteoporosis among gynecologists and endocrinologists using a medium-sized
Brazilian city. It is believed that the information coming from this study will enable in
the future the development of strategies and production of technical support
materials directed to an improvement in the quality of the health care service.