Holly L. Thacker

Values and beliefs about obesity and weight reduction among African American and Caucasian women

Designing culturally relevant weight-reduction programs requires understanding of ethnic variations and illness beliefs. Preliminary data on the values and beliefs about obesity and weight reduction were obtained from women of different ethnic/racial backgrounds. Purposive sampling was used to recruit African American (AA) and Caucasian (C) women with a body mass index (BMI)[.greaterequal] 30 from the general internal medicine clinics of a large tertiary care facility. Four focus groups (2 with AA women and 2 with C women) consisting of a total of 20 subjects were conducted in a 2-month period. AA women cited culture specific barriers to weight loss more so than did C women. AA women and C women also differed on how health care professionals could help them with weight loss. These findings have implications for nursings role in the design of culturally relevant weight-loss programs.

Coronary artery disease in women: Different, often undertreated

Cardiovascular disease is responsible for more deaths in women each year than all other causes combined. Women have different cardiac presentations than men and are more likely to be underdiagnosed and undertreated for coronary artery disease. This article addresses gender-specific issues in prevention, diagnosis, and treatment of coronary artery disease.

Is long-term bisphosphonate therapy associated with benefits to the periodontium in postmenopausal women?

Objective: The aim of this study was to compare the periodontium of postmenopausal women with known low bone mineral density who are receiving long-term bisphosphonate therapy with those who are not. Methods: The periodontal status of 28 white postmenopausal women with low bone density using bisphosphonate therapy for at least 2 years was compared with that of a matching group not using such therapy. All women underwent a cone-beam CT scan of the jaw and a complete periodontal examination evaluating for plaque score, periodontal probing depth, clinical attachment loss, bleeding on probing, and alveolar bone height. Results: Bisphosphonate users had higher plaque score, lower probing depth, and lesser clinical attachment loss compared with the controls. These differences were determined to be significant by both t test and Wilcoxons tests. Bleeding on probing was lower and the alveolar bone height was higher in the bisphosphonate group than in controls, but these differences were not statistically significant. Linear models showed no significant interactions between plaque score and bisphosphonate use, suggesting that the association of periodontal status and outcome measures was constant across all levels of plaque scores. Bisphosphonate use was a significant factor for probing depth but was not significant for the other parameters when adjusted for plaque score. Conclusions: Long-term bisphosphonate use seems to have some beneficial effects on the periodontium of postmenopausal women with low bone density, across all levels of plaque score.

A need to educate postmenopausal women of their periodontal health.

Background: Postmenopausal women have shown proactive willingness to take responsibility for their changing health care needs. The example of osteoporosis is a model that when educated of their bone health status, this cohort follows through with prevention and treatment regimens. Postmenopausal status is considered to be a risk factor for periodontitis. It is known that up to 50% of periodontal disease goes undiagnosed. The goal of periodontal therapy is to prevent tooth loss. Objective: Is there a need, then to educate and inform postmenopausal women of their periodontal status? Can dentists provide a greater service to this cohort by increasing education and information? Materials and Methods: The current study compares patient perception to actual clinical findings in 94 postmenopausal women. Patients are informed of their diagnosis, and educated about the disease, its risk factors and preventive and treatment modalities. Detailed interviews examine the patient intentions to follow up on preventive and treatment regimens suggested. Results: Although 97.8% of participants reported having “healthy gums”, 36.2% had severe periodontitis in at least one site. Interviews reveal that patients associated disease with abscess, and would be likely to follow prevetive and treatment regimens when they were informed of their diagnosis and educated on the topic. Conclusion: The findings suggest a need to make education a priority when treatment postmenopausal women.

Osteoporosis for the Female Patient

As more women will suffer from an osteoporotic fracture than from myocardial infarction, strokes and cancers combined, providers must be competent with identifying and treating osteoporosis (OP). The diagnostic criteria for OP rests mostly on identification of risk factors, bone mineral density (BMD) results, and a history of fragility fracture. The clinician must differentiate therapeutic strategies for prevention and treatment of osteoporosis. Additional pharmacologic therapy is indicated in all patients with OP, diagnosed either by BMD or clinically by presence of a fragility fracture. For those with low bone density, the Fracture Risk Assessment Tool (FRAX®) is utilized to calculate absolute 10 year fracture risk. Additional pharmacologic therapy is indicated in all patients with OP, diagnosed either by BMD or clinically by presence of a fragility fracture. Fracture Risk Assessment Tool (FRAX®) can be utilized to calculate absolute 10 year fracture risk and help in therapeutic decisions.