Resumen La Sociedad Argentina de Osteoporosis convocó a especialistas reconocidos en la atención de personas transgénero para la elaboración del primer posiciona miento local sobre la evaluación de la salud ósea en esta población. La ley 26.743 de “Identidad de género” reco noce todas las identidades y garantiza su atención de manera gratuita en el sistema de salud. El impacto de los diferentes tratamientos de afirmación de género sobre la masa ósea ha sido tópico de debate internacional. Hasta la fecha la evidencia sigue siendo limitada y diferentes sociedades han emitido sugerencias y recomendaciones. Por tal motivo, creemos relevante mencionar nuestra experiencia plasmando mediante este documento una serie de sugerencias para ser utilizadas en la atención médica.

Abstract The Argentine Osteoporosis Society convened renowned specialists in the care of transgender people to prepare the first local position on the evaluation of bone health in this population. Law 26.743 on “Gender Identity” recognize all identities and guarantees free care throughout the health system. The impact of different gender affirmation treatments on bone mass has been topic of international debate. To date the evidence remains limited and different societies have issued suggestions and recommendations. For this reason, we believe it is relevant to mention our experience, capturing through this document a series of suggestions to be used in medical care.

Resumen El artículo propone un recorrido reflexivo que posibilite la co-construcción de prácticas educativas mediatizadas considerando procesos de socialización del patrimonio cultural. Su objetivo es proponer la noción “Presencialidad-DHD” (Presencialidad en el Dispositivo Hipermedial Dinámico) como clave de dichas prácticas. Desde un recorrido filosófico que vincula los términos Identidad, Memoria y Patrimonio, y la noción de redes socio-técnicas-culturales, se argumenta desde una propuesta realizada en el dispositivo digital Creativa Monumento por estudiantes de nivel secundario. Finalmente, frente a quienes entienden lo presencial sólo como asistencia física de los cuerpos en un lugar común, considerar la presencialidad como acontecimiento, invita al ejercicio del saber ha-ser.

Abstract The article proposes a reflective journey that enables the co-construction of mediated educational practices considering processes of socialization of cultural heritage. Its objective is to propose the notion "Presence-DHD" (Presence in the Dynamic Hypermedia Device) as a key to these practices. From a philosophical journey that links the terms Identity, Memory and Heritage, and the notion of socio-technical-cultural networks, it is argued from a process carried out in the Creative Monument digital device by secondary school students. Finally, for those who understand face to face only as physical assistance of bodies in a common place, considering presence as an event invites the exercise of knowing how to be.

This article deals the problematic of the sustainability of cultural landscape from a socio-technical-cultural approach, within the framework of the Sustainable Development Goals formulated by United Nations. As a theoretical perspective, it is postulated -from Charles Peirce's theory- a semio-anthropological conceptual convergence, what includes the mediatization, the info-communication technologies and the cultural heritage. It is argued that in the current physical-virtual context it is possible to enhance the emerging expressive forms, languages and technicities, to strengthen raising awareness towards cultural landscapes. In this direction, it is presented aspects of the proposal “Creativa Monumento”, which synthesizes a series of citizen participation projects linked to “Monumento Histórico Nacional a la Bandera” located in Rosario city (Argentina). Respect to this, it is mentioned some of the contents provided by interested people in exploring and recreating this cultural landscape of high symbolic content at the regional level. Finally, it is postulated the need to conform an intersectoral community alliance to treat problems of sustainability of cultural landscapes, from a working modality that links diverse knowledge and disciplines, and articulate different technological supports and formats.

Este artículo aborda la problemática de la sostenibilidad del paisaje cultural desde un enfoque socio-técnico-cultural, en el marco de las metas formuladas por la Organización de Naciones Unidas en la Agenda 2030 para el desarrollo sostenible. Como perspectiva teórica, se postula -desde la semiótica general de Charles Peirce- una convergencia conceptual semio-antropológica, que incluye la mediatización, las tecnologías infocomunicacionales y los patrimonios culturales. Se sostiene que en el actual contexto físico-virtual es posible potenciar las formas expresivas, los lenguajes y las tecnicidades emergentes para fortalecer la sensibilización hacia los paisajes culturales. En esta dirección, se presentan aspectos significativos de la propuesta “Creativa Monumento”, la cual sintetiza una serie de proyectos de participación ciudadana vinculados al “Monumento Histórico Nacional a la Bandera” ubicado en la ciudad de Rosario (Argentina). Al respecto, se mencionan algunos de los contenidos aportados por quienes se han interesado en explorar y recrear este paisaje cultural de alto contenido simbólico a nivel regional. Finalmente, se postula la necesidad de conformar una alianza intersectorial comunitaria para el tratamiento de problemáticas de sostenibilidad de los paisajes culturales, desde una modalidad de trabajo que vincule diversos saberes y disciplinas, y articule distintos soportes y formatos tecnológicos.

Abstract Background: The Hand Mobility in Scleroderma (HAMIS) test was created to measure the degree of dysfunction of hand movements imposed by systemic sclerosis (SSc). The modified version (mHAMIS), with 4 of the 9 original items, was developed later. The goal of the present study was to translate and validate HAMIS and mHAMIS into Brazilian Portuguese and culture. Methods: After direct and reverse translation and comprehension test in 10 SSc patients, HAMIS-Br was applied to another 32 patients with SSc. To evaluate internal consistency, intraobserver and interobserver agreement, and intraobserver and interobserver reliability, we used respectively the Cronbach's α coefficient, kappa concordance and intraclass correlation (ICC). The correlation between HAMIS-Br and mHAMIS-Br was evaluated and a factorial analysis was performed. Results: HAMIS-Br showed excellent internal consistency (Cronbach's α = 0.997), good intraobserver agreement (kappa between 0.78 [95%CI =0.57-0.99] and 1) and intraobserver and interobserver reliability (ICC = 0.993, 95% CI = 0.973-0.993 and ICC = 0.994, 95% CI = 0.987-0.997, respectively). The mHAMIS-Br presented similar results and excellent correlation with HAMIS-Br (r = 0.923). The factorial analysis extracted three groups of questions that explain 84.4% of the total variance, and that can be understood through the influence of certain movements in the interpretation of others: [1] questions whose interpretation is influenced by the extension of the fingers, [2] questions whose interpretation is influenced by flexion of the fingers, [3] volar flexion of the fingers, with similar correlation with both other factors. Conclusions: HAMIS-Br and mHAMIS-Br showed good agreement, intraobserver and interobserver reliability, and internal validity. It is necessary to be attentive to the influence of certain limitations of movements in the interpretation of others.

Introdução: Estudos recentes mostram associação entre tireoidites autoimunes e esclerose sistêmica (ES), e sugerem que essa condição pode interferir no fenótipo da ES. Entretanto, esses estudos avaliam as tireoidites autoimunes como um todo e nenhum deles aborda especificamente a tireoidite de Hashimoto (TH) na ES. Objetivo: Investigar a presença de TH em pacientes com ES e sua possível associação com as manifestações da doença. Casuística e métodos: Manifestações clínicas de hipotireoidismo, TSH, T4 livre e anticorpos antitireoidanos (anti-TPO, anti TBG e TRAb) foram pesquisados em 56 pacientes com ES. Pacientes com ES e TH foram comparados com pacientes com ES sem tireoidite. Resultados: TH foi observada em 19,64% dos pacientes com ES. Não foi encontrada associação entre a TH e as diferentes formas de doença ou com o perfil de autoanticorpos. Da mesma forma, não houve diferença entre a média do escore de Rodnan modificado e entre a presença de fenômeno de Raynaud, cicatrizes estelares, necrose digital, miosite, artrite, sintomas sicca, dismotilidade esofágica ou crise renal esclerodérmica quando os grupos foram comparados. Por outro lado, pacientes com TH apresentaram maior frequência de hipertensão pulmonar quando comparados a pacientes sem TH (66,6% vs 22,5%; p = 0,016). Conclusões: Na amostra de ES estudada, a TH está associada a uma maior prevalência de hipertensão pulmonar. Estudos de seguimento a longo prazo, englobando um número maior de pacientes com ES e TH, são necessários para confirmar esses dados.

Introduction: Recent studies show an association between autoimmune thyroiditis and systemic sclerosis (SSc) and suggest that this condition may interfere with the ES phenotype. However these studies evaluate the autoimmune thyroiditis as a whole and none of them specifically addresses Hashimoto's thyroiditis (HT) in SSc. Objective: To investigate the presence of HT in SSc patients and its possible association with disease manifestations. Methods: Clinical manifestations of hypothyroidism, TSH and anti-thyroid auto antibodies (anti-TPO. anti TBG and TRAb) were studied in 56 patients with SSc. SSc patients with HT were compared with SSc patients without thyroiditis. Results: HT was observed in 19.64% of patients with SSc. No association was observed between HT and the different forms of disease or profile of autoantibodies. Likewise, there was no difference between the mean modified Rodnan score and presence of Raynaud's phenomenon, scars, digital necrosis, myositis, arthritis, sicca symptoms, esophageal dysmotility and scleroderma renal crisis when the groups were compared. On the other hand, patients with HT had higher frequency of pulmonary hypertension in relation to patients without HT (66.6% vs 22.5%, p = 0.016). Conclusions: In the studied sample patients with ES and HT had higher prevalence of pulmonary hypertension. Long-term follow-up studies with a larger number of TH and SSc patients are needed to confirm these data.