Summary Adherence to anti-osteoporosis medications is currently low and is associated with poor anti-fracture efficacy. This manuscript reviews the potential design of clinical studies that aim to demonstrate improved adherence, with new chemical entities to be used in the management of osteoporosis.

Risedronate treatment reduces the risk of vertebral fracture in women with existing vertebral fractures, but its efficacy in prevention of the first vertebral fracture in women with osteoporosis but without vertebral fractures has not been determined. We examined the risk of first vertebral fracture in postmenopausal women who were enrolled in four placebo-controlled clinical trials of risedronate and who had low lumbar spine bone mineral density (BMD) (mean T-score = -3.3) and no vertebral fractures at baseline. Subjects received risedronate 5 mg ( n = 328) or placebo ( n = 312) daily for up to 3 years; all subjects were given calcium (1000 mg daily), as well as vitamin D supplementation (up to 500 IU daily) if baseline serum 25-hydroxyvitamin D levels were low. The incidence of first vertebral fracture was 9.4% in the women treated with placebo and 2.6% in those treated with risedronate 5 mg (risk reduction of 75%, 95% confidence interval 37% to 90%; P = 0.002). The number of patients who would need to be treated to prevent one new vertebral fracture is 15. When subjects were stratified by age, similar significant reductions were observed in patients with a mean age of 64 years (risk reduction of 70%, 95% CI 8% to 90%; P = 0.030) and in those with a mean age of 76 years (risk reduction of 80%, 95% CI 7% to 96%; P = 0.024). Risedronate treatment therefore significantly reduces the risk of first vertebral fracture in postmenopausal women with osteoporosis, with a similar magnitude of effect early and late after the menopause.

Background: Women make up half of the world's population, and comprise 20% of the world's one billion smokers. The aim of this study was to assess the prevalence of smoking among female medical students in comparison to female non-medical students, and to assess the importance of medical education and knowledge in decreasing the prevalence of smoking among female university students in Saudi Arabia. Method: We used a self-administered questionnaire to collect cross-sectional data from a randomly selected sample of 320 female students attending King Abdul-Aziz University, Jeddah. Medical students comprised 50% of the sample. Results: A total of 310 students (96.9%) completed and returned the questionnaire. The prevalence of smoking was higher in non-medical female students (4.2%) compared to medical female students (0.32%) (P < 0.001). Conclusion: The prevalence of smoking is low among female medical students compared to female non-medical students, presumably because of their awareness, level of education, and knowledge of the risks to health associated with smoking. Our study highlights the need for increased knowledge, health education, and awareness of the risks of smoking to reduce smoking among female university students.

Interns in King Abdulaziz University Faculty of Medicine have a positive attitude towards research; however, few students submit papers for publication. Lack of time and training in research methods were the main obstacles cited by the interns for conducting and publishing research. Interns welcome training in research, scientific writing and publication practice. These requirements will be issued to the main curriculum committee at the faculty of medicine and recommendations on possible actions will be discussed with the administration.