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Biomedical subjects

S Schrager

Publications and source records attributed to S Schrager.

4 recordsLinked to original sources
PubMed2000

Osteoporosis prevention counseling during health maintenance examinations.

OBJECTIVE: Our goal was to determine how often primary care providers discussed osteoporosis prevention and calcium intake with women during their health maintenance examinations. METHODS: A total of 449 women aged 18 to 65 years participated in exit interviews immediately following a health maintenance examination at 1 of 8 Wisconsin family practice clinics. RESULTS: Forty-six percent of these women reported discussing osteoporosis with their providers during their visit, and 51% reported discussing calcium intake. A total of 61% reported discussing either osteoporosis or calcium intake during the visit. Some providers were able to discuss these topics with more than 90% of their patients. A logistic regression model showed that providers were less likely to discuss either of these issues with women younger than 40 years (P=.019); they were more likely to discuss them with women older than 60 years (P=.002) than with women aged 40 to 60 years; and women providers were significantly more likely to discuss either issue (P=.004). CONCLUSIONS: Primary care providers are in a good position to counsel women of all ages about their potential for avoiding osteoporosis and to recommend prevention strategies. The United States Preventive Services Task Force recommends that all women be counseled on adequate calcium intake yearly after the age of 18 years. Provider education and institutional changes may increase the frequency of this counseling for all primary care physicians.

Adolescent↗
PubMed1999

Abnormal uterine bleeding.

The most probable etiology of abnormal uterine bleeding relates to the patient's reproductive age, as does the likelihood of serious endometrial pathology. The specific diagnostic approach depends on whether the patient is premenopausal, perimenopausal or postmenopausal. In premenopausal women with normal findings on physical examination, the most likely diagnosis is dysfunctional uterine bleeding (DUB) secondary to anovulation, and the diagnostic investigation is targeted at identifying the etiology of anovulation. In perimenopausal patients, endometrial biopsy and other methods of detecting endometrial hyperplasia or carcinoma must be considered early in the investigation. Uterine pathology, particularly endometrial carcinoma, is common in postmenopausal women with abnormal uterine bleeding. Thus, in this age group, endometrial biopsy or transvaginal ultrasonography is included in the initial investigation. Premenopausal women with DUB may respond to oral contraceptives, cyclic medroxyprogesterone therapy or cyclic clomiphene. Perimenopausal women may also be treated with low-dose oral contraceptives or medroxyprogesterone. Erratic bleeding during hormone replacement therapy in postmenopausal women with no demonstrable pathology may respond to manipulation of the hormone regimen.

Algorithms↗
PubMed1999

Osteoporosis risk assessment by family practice faculty and residents: a chart review.

OBJECTIVE: To assess the frequency of osteoporosis risk assessment of postmenopausal women by family practice faculty and residents. METHODS: Review of 263 charts of women over 50 from 3 residency clinics. Charts were evaluated for evidence of osteoporosis risk assessments or discussion of prevention strategies during the past 2 years. RESULTS: Overall, 35% of the charts contained documentation of some discussion of osteoporosis. Female physicians discussed osteoporosis more than their male colleagues (p < 0.05). Documentation of osteoporosis discussions decreased as women aged (p < 0.05). There was no difference in rates among clinics or between residents and faculty. CONCLUSIONS: The documentation of osteoporosis discussions with high risk women was low in this sample. Strategies to improve osteoporosis screening are necessary.

Aged↗