Abstract Introduction: The nursing process is the method that allows us to administer care to people with chronic diseases through the disease stages, that is, assessment, diagnostic reasoning, nursing care plan and evaluation. Objective: Evaluate a nursing care plan for an older adult with type 2 diabetes mellitus and osteoporosis with a focus on therapeutic health education. Methodology: Observational, descriptive, and longitudinal clinical case study of a 63-year-old patient with diabetes mellitus and osteoporosis; the Marjory Gordon instrument was used for assessment, and standardized language was used for diagnostic reasoning, planning, execution and evaluation. Under bioethical principles, this is a minimal risk research, and the privacy and data of the elderly are protected. Results: Alteration was found in the pattern of perception/maintenance of health, nutritional/metabolic, exercise activity and coping with stress; with the establishment of activities to control glucose, priority was given to prescribed diet, exercise, adherence to treatment and coping with stress. Acceptance of the disease, learning to take capillary glucose and glycemic control was achieved, as well as adherence to the prescribed diet and exercise. Conclusions: Therapeutic health education achieved adherence to pharmacological and non-pharmacological treatment, as well as the acceptance of the health status, which allows acquiring self-control of the disease. Continuous and long-term follow-up is important due to the pathological progress, age and general deterioration of the patient.

Abstrato Introdução. O processo de enfermagem é o método que nos permite administrar a assistência a pessoas com doenças crônicas por meio dos estágios da doença, ou seja, avaliação, raciocínio diagnóstico, plano de assistência de enfermagem e avaliação. Objetivo: Avaliar um plano de cuidados de enfermagem para um adulto mais velho com diabetes mellitus tipo 2 e osteoporose com foco na educação terapêutica em saúde. Metodologia: Estudo de caso clínico observacional, descritivo e longitudinal de uma paciente de 63 anos com diabetes mellitus e osteoporose; para a avaliação foi utilizado o instrumento Marjory Gordon para raciocínio diagnóstico, planejamento, execução e avaliação, para raciocínio diagnóstico, planejamento, execução e avaliação, foi utilizada a linguagem padronizada. De acordo com os princípios bioéticos, essa é uma pesquisa de risco mínimo, e a privacidade e os dados dos idosos são protegidos. Resultados: Foi encontrada alteração no padrão de percepção/manutenção da saúde, nutricional/metabólico, atividade física e enfrentamento do estresse; com o estabelecimento de atividades para controlar a glicose, a prioridade foi dada à dieta prescrita, aos exercícios, à adesão ao tratamento e ao enfrentamento do estresse. Houve aceitação da doença, aprendizado da medição da glicose capilar e controle glicêmico, além de adesão à dieta e aos exercícios prescritos. Conclusões: A educação terapêutica em saúde conseguiu a adesão ao tratamento farmacológico e não farmacológico, bem como a aceitação do estado de saúde, que permite adquirir o autocontrolo da doença, sendo importante a monitorização contínua e a longo prazo da evolução patológica, da idade e da deterioração geral do paciente.

Resumen Introducción: El proceso de enfermería es el método que nos permite administrar los cuidados a personas con enfermedades crónicas a través de sus etapas: valoración, razonamiento diagnóstico, plan de cuidados de enfermería y evaluación. Objetivo: Evaluar un plan de cuidados de enfermería a una adulta mayor con diabetes mellitus tipo 2 y osteoporosis con enfoque a la educación para la salud terapéutica. Metodología: Estudio de caso clínico, observacional, descriptivo y longitudinal, a paciente de 63 años con diabetes mellitus y osteoporosis; para la valoración se empleó el instrumento de Marjory Gordon, para el razonamiento diagnóstico, planeación, ejecución y evaluación se utilizó el lenguaje estandarizado de enfermería. Bajo los principios bioéticos es una investigación de riesgo mínimo, se protege la privacidad y datos del adulto mayor. Resultados: Se encontró alteración en el patrón percepción / mantenimiento de la salud, nutricional / metabólico, actividad ejercicio y afrontamiento del estrés; estableciendo actividades para el control de su glucosa, se priorizó en dieta prescrita, ejercicio, adherencia al tratamiento y afrontamiento al estrés. Se logró aceptación de la enfermedad, aprendizaje de toma de glucosa capilar y control glucémico, además del apego a dieta y ejercicio prescrito. Conclusiones: La educación para la salud terapéutica logró el apego al tratamiento farmacológico y no farmacológico, así como la aceptación del estado de salud le permite adquirir el autocontrol de su enfermedad, es importante el seguimiento continuo y a largo plazo por el avance patológico, edad y deterioro general de la paciente.

SUMMARY OBJECTIVE: This study was conducted to determine the relationship between bone mineral density, vitamin D level, and sleep quality in female patients with osteoporosis. METHODS: This descriptive correlational study included a total of 318 women diagnosed with osteoporosis. The data were collected using a patient identification form, including items for the plasma vitamin D level and bone mineral density score obtained by the dual-energy X-ray absorptiometry method, and the Pittsburgh Sleep Quality Index. RESULTS: The mean age of the women was 56.49±5.68 years, and their femoral neck T mean score, an indicator of bone mineral density, was −2.94±0.31. Only 6.3% of the women had adequate vitamin D levels. In addition, according to their Pittsburgh Sleep Quality Index scores, 85.8% of the women had poor sleep quality. In the study, no significant difference was found between the women's bone mineral densities and vitamin D levels according to sleep quality (p>0.05). However, there was a weak negative correlation between the duration of osteoporosis, body mass index, and sleep quality (p<0.05). CONCLUSION: There was no association between the vitamin D level, bone mineral density, and sleep quality, but the duration of osteoporosis was negatively associated with sleep quality. Accordingly, it may be recommended to provide education and counseling to postmenopausal women diagnosed with osteoporosis on issues such as sunbathing, vitamin D and calcium preparation intake, weight control, and non-pharmacological treatment approaches by making necessary individual-specific plans to improve sleep quality. OBJECTIVE METHODS 31 form dualenergy dual energy Xray X ray method RESULTS 5649568 56 49 5 68 56.49±5.6 years 294031 2 94 0 −2.94±0.31 63 6 3 6.3 addition scores 858 85 8 85.8 womens s p>0.05. p005 p p>0.05 . 05 (p>0.05) However index p<0.05. p<0.05 (p<0.05) CONCLUSION Accordingly sunbathing intake control nonpharmacological non pharmacological individualspecific individual specific 564956 4 56.49±5. 29403 9 −2.94±0.3 6. 85. p00 p>0.0 (p>0.05 p<0.0 (p<0.05 56495 56.49±5 2940 −2.94±0. p0 p>0. (p>0.0 p<0. (p<0.0 5649 56.49± 294 −2.94±0 p>0 (p>0. p<0 (p<0. 564 56.49 29 −2.94± p> (p>0 p< (p<0 56.4 −2.94 (p> (p< 56. −2.9 (p −2. −2 −

Abstract Vertebral compression fractures are one of the most frequent types of fractures in postmenopausal women. However, there are few studies on these fractures carried out directly on osteological material. Therefore, the objective of this article is to determine the prevalence of these fractures in a contemporary population through an osteological analysis. For this purpose, 39 skeletons belonging to the Lambre Collection (Faculty of Medical Sciences, National University of La Plata) were analyzed. The mean age was 56.1 years. For the diagnosis of fractures, the vertebrae were macroscopically inspected in search of changes in body height, and then a semiquantitative morphometric approximation was carried out. These results were related to the bone quality of the individuals estimated from X-rays of the calcaneus and femur. The results obtained from the morphometric analysis revealed four individuals with vertebral fractures, which comprised 10.25% of the sample. Two of the observed cases corresponded to males (11.1%), and the remaining two to females (9.52%), with a mean age at death of 68.5 years. The eight fractured vertebrae found correspond to the lower thoracic and upper lumbar segment, while no direct relationship was observed between the fractures and the bone quality of the affected individuals. The estimated prevalence could be affected by sample bias and the effect of resorptive drugs. The low dimorphic expression of the trait might be related to the physical activity performed by the male individuals in the population, while corroborating that bone quality is not the only determinant of an osteoporotic vertebral fracture. Rev Arg Antrop Biol 26(1), 070, 2024. https://doi.org/10.24215/18536387e070

Resumen Las fracturas vertebrales por compresión se encuentran entre las más frecuentes en mujeres postmenopáusicas. Sin embargo, son escasos los estudios sobre las mismas realizados de manera directa sobre el material esquelético. A partir de esto es que nos propusimos como objetivo determinar la prevalencia de estas fracturas en una población contemporánea a través del análisis osteológico. Fueron observados 39 esqueletos de la Colección Lambre (Argentina), con una media de edad de 56,1 años. Se relevaron macroscópicamente las vértebras en búsqueda de modificaciones de la altura del cuerpo, para luego realizar una aproximación morfométrica semicuantitativa. Estos resultados se relacionaron con la calidad ósea de los individuos estimada a partir de radiografías de calcáneo y fémur. Los resultados obtenidos evidenciaron cuatro individuos con fracturas vertebrales (10,25% de la muestra), correspondiendo dos al sexo masculino (11,1%) y dos al sexo femenino (9,52%), con una media de edad de muerte de 68,5 años. Las ocho vértebras fracturadas corresponden al segmento torácico inferior y lumbar superior, al tiempo que no se observó una relación directa entre las fracturas y la calidad ósea de los individuos. La prevalencia estimada podría estar afectada por sesgos muestrales y por el efecto de medicamentos resortivos. La baja expresión dimórfica del rasgo se relacionaría con la actividad laboral de los individuos masculinos de la población, a la vez que se corrobora que la calidad ósea no es el único determinante de una fractura vertebral osteoporótica. Rev Arg Antrop Biol 26(1), 070, 2024. https://doi.org/10.24215/18536387e070

RESUMEN Objetivo. Proporcionar un marco para profesionales de la salud que tratan a pacientes pediátricos bajo terapia con glucocorticoides (GC) y desarrollar recomendaciones para la prevención y el tratamiento de la osteoporosis inducida por GC en la población pediátrica. Métodos. Un panel de expertos en enfermedades óseas y pediátricas generó una serie de preguntas PICO que abordan aspectos relacionados con la prevención y el tratamiento de osteoporosis en pacientes bajo tratamiento con GC. Siguiendo la metodología GRADE, se realizó una revisión sistemática de la literatura, se resumieron las estimaciones del efecto y se calificó la calidad de la evidencia. Luego se procedió a la votación y a la formulación de las recomendaciones. Resultados. Se desarrollaron 7 recomendaciones y 6 principios generales para osteoporosis inducida por GC en población pediátrica. Conclusión. Estas recomendaciones proporcionan orientación para los médicos que deben tomar decisiones en pacientes pediátricos bajo tratamiento con GC.

Abstract Background: Non-communicable diseases occur earlier in people living with HIV (PLWH) than in general population. Objective: The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer. Material and methods: In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to the National Cancer Institute, between 2010 and 2019. Data collected included cancer type, comorbidities, frequency of polypharmacy, Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Results: Of 125 patients, 69 % had at least one comorbidity; 32 % had two or more. Common comorbidities were dyslipidemia (54 %), hypertension (19 %), obesity (14 %), and diabetes (12 %). In patients ≥ 50 years, 29 (62 %) had a densitometry and 9 (31 %) had osteoporosis; 56 depression questionnaires were applied: 30 % had mild to severe depression. Being ≥ 50 years was associated with multimorbidity (p = 0.017). Conclusions: We report PLWH and cancer with a high prevalence of multimorbidity and poor screening of bone disease and mental health. An integrated approach to the PLWH is needed to improve the detection and management of non-communicable diseases.

Resumen Antecedentes: En las personas mayores que viven con VIH, las enfermedades no transmisibles se presentan antes que en la población general. Objetivo: Estimar la prevalencia de comorbilidades en personas mayores que viven con VIH y cáncer. Material y métodos: Estudio retrospectivo de todas las personas > 40 años que viven con VIH y cáncer, quienes entre 2010 y 2019 acudieron al Instituto Nacional de Cancerología. Se incluyeron datos sobre tipo de cáncer, comorbilidades y polifarmacia. Se aplicó el Inventario de Depresión de Beck-II. Resultados: De 125 pacientes, 69 % tenía al menos una comorbilidad y 32 %, dos o más; las comorbilidades más comunes fueron dislipemia (54 %), hipertensión (19 %), obesidad (14 %) y diabetes (12 %); 29 % de los pacientes ≥ 50 años disponía de densitometría ósea, de los cuales en 31 % se diagnosticó osteoporosis. Se aplicaron 56 cuestionarios; en 30 % se identificó depresión. La edad ≥ 50 años se asoció a multimorbilidad (p = 0.017). Conclusiones: Se reportó alta prevalencia de multimorbilidad en personas mayores que viven con VIH y cáncer, con escaso escrutinio de enfermedad ósea y salud mental. Se requiere un enfoque integral para mejorar el manejo de las enfermedades no transmisibles.

Abstract A case of pulmonary embolism is presented after vertebroplasty, performed for a vertebral fracture due to osteoporosis. Embolism was confirmed by complementary methods. Attention to respiratory symptoms and a chest x-ray after vertobroplasty are suggested in order to improve patient safety after the procedure.

Resumen Se presenta un caso de embolismo pulmonar luego de vertebroplastia, realizada por fractura vertebral por osteoporosis. El embolismo se confirmó por métodos complementarios. Se sugiere atención a los síntomas respiratorios y radiografía de tórax posterior a la vertobroplastia a los efectos de mejorar la seguridad del paciente luego del procedimiento.

Resumen Introducción: El denosumab es un anticuerpo monoclonal humano que actúa contra el RANKL, inhibiendo la destrucción ósea mediada por los osteoclastos, así evitando la pérdida de stock óseo; por este motivo, se lo utiliza en el tratamiento de la osteoporosis como agente antiresortivo y está autorizado para el tratamiento del tumor de células gigantes y el mieloma múltiple. Nuestro objetivo fue conocer las indicaciones y contraindicaciones para la pérdida de stock óseo de causa no osteoporótica. Materiales y Métodos: Revisión sistemática de artículos en inglés publicados en el período 2009-2023. Se incluyeron artículos que indicaran o contraindicaran el uso del denosumab. Resultados: De un total inicial de 4306 artículos, se analizaron 18 artículos que mostraban consenso en la dosis y los controles con tomografía e indicaban o contraindicaban el uso del denosumab. Conclusiones: El denosumab está indicado como una buena opción de tratamiento preferente de tumores vertebrales primarios inoperables, para evitar recidivas o demorar las metástasis de tumores primarios o de tumores sólidos, principalmente de mama, próstata y pulmón, y para el compromiso vertebral del mieloma múltiple. El denosumab está contraindicado, por el momento, para las lesiones infecciosas.

Abstract Background: Denosumab is a human monoclonal antibody that acts against RANKL, inhibiting bone destruction mediated by osteoclasts, thus avoiding bone loss. For this reason, it is used in the treatment of osteoporosis as an antiresorptive and is authorized for the treatment of giant cell tumor and multiple myeloma. Our objective is to understand its indications and contraindications for the treatment of non-osteoporotic bone loss. Materials and Methods: A systematic review of English-language articles published between 2009 and 2023, using PRISMA criteria. Articles indicating or contraindicating the use of denosumab were considered for inclusion. Results: From a total of 4306 articles, 18 articles were analyzed, which showed consensus on the dose and controls with tomography and indicated or contraindicated the use of denosumab. Conclusions: Denosumab is recommended as a primary therapeutic option for unresectable spinal tumors, to prevent recurrences or to delay the formation of metastases from primary tumors or solid tumors, primarily breast, prostate, and lung, as well as for multiple myeloma spinal involvement. Denosumab is currently contraindicated in infectious lesions.

ABSTRACT Objetive: To analyze the sociodemographic characteristics and bone health in adult consumers of plant-based diets (PBL). Method: Individuals between 18 and 75 years old were invited to complete a self-administered survey through a digital platform. Results: A total of 1,151 participants completed the survey; the majority were women [n=958 (83.2%)], young [age (years): 18-25: 35.8%; 26-35:39.8% and 36-45:17.4%] and single (67.1%). The ABP consumption pattern was mainly represented by vegans (54.0%) followed by lacto-ovo-vegetarians (27.7%), the main reason for their food choice was the care of animal life (83, 5%). Adherence to ABP, as a function of time (years), was <1: 12.3%; 1-5: 67.4%; 10-15:14.8% and>15:5.5%. 16% of vegans reported having suffered fractures and 5.1% reported having had a densitometry. Of them, 88.1% responded with normal results and 11.8% presented osteopenia. No cases of osteoporosis were recorded in the survey. Vitamin B12 was the predominant supplement among ABP consumers (61.4%). Conclusions: PBL consumers constitute an important minority in our country, predominantly composed of women under 35 years of age, with a projection to increase in the coming years.

RESUMEN Objetivo: Analizar las características sociodemográficas y salud ósea en consumidores adultos de alimentación basada en plantas (ABP). Método: Se invitó a individuos entre 18 a 75 años a realizar una encuesta autoadministrada a través de una plataforma digital. Resultados : Un total de 1151 participantes completaron la encuesta; la mayoría fueron mujeres [n=958 (83,2%)], jóvenes [edad (años): 18-25: 35,8%; 26-35:39,8% y 36-45:17,4%] y solteras (67,1%). El patrón de consumo de ABP estuvo representado, principalmente, por vegano (54,0%) seguido por lacto-ovo-vegetariano (27,7%), la principal razón de su elección alimentaria fue el cuidado de la vida animal (83,5%). La adherencia a la ABP, en función del tiempo (años), fue <1: 12,3%; 1-5: 67,4%; 10-15:14,8% y>15:5,5%. 16 % de los veganos refirió haber sufrido fracturas y el 5,1 % refirió haberse realizado una densitometría. De ellos el 88,1 % respondió resultados normales y el 11,8 % presentó osteopenia. No se registró en la encuesta ningún caso de osteoporosis. La vitamina B12 fue el suplemento predominante entre los consumidores de ABP (61,4%). Conclusiones: Los consumidores de ABP constituyen una minoría importante en nuestro país, compuesta predominantemente por mujeres menores de 35 años, con proyección a aumentar en los próximos años.

ABSTRACT Objective: To analyze the bone health of pediatric patients with short bowel syndrome intestinal failure (SBS-IF). Data source: An integrative literature review was performed using the data published in the MEDLINE-PubMed and Scientific Electronic Library Online (SciELO) databases between January 2010 and April 2021, and through a manual search of the reference lists of relevant studies. Studies were included if they assessed bone mineral density by the Dual X-Ray Absorptiometry (DXA) technique, incorporated pediatric patients (up to 20 years of age) with SBS under parenteral nutrition (PN) and were written in English. Eleven primary sources met the inclusion criteria for this study. Data synthesis: Pediatric patients with SBS-IF under long-term parenteral nutrition experienced frequent changes in bone metabolism, leading to osteoporotic fractures and growth failure. These patients have deficiencies in multiple nutrients, such as calcium, magnesium, phosphorus, and vitamin D. Consequently, there are variations in the secretion and regulation of the parathyroid hormone. In addition, the pharmacotechnical limitations related to calcium and phosphorus in the PN solution, use of glucocorticoids, and difficulty performing physical activity are risk factors for the development of metabolic bone disease in pediatric patients with SBS-IF. Conclusions: Low bone mineral density was associated with a high risk of developing osteoporosis, fractures, and growth deficiency in pediatric patients with SBS-IF on PN therapy in the long term. Objective SBSIF. SBSIF IF . (SBS-IF) source MEDLINEPubMed MEDLINE PubMed SciELO (SciELO 201 2021 studies XRay X Ray DXA (DXA technique up 2 age (PN English study synthesis longterm term metabolism nutrients magnesium D Consequently hormone addition solution glucocorticoids IF. Conclusions osteoporosis (SBS-IF 202

Objetivo: Analisar a saúde óssea de pacientes pediátricos com síndrome do intestino curto — falência intestinal (SIC-FI). Fontes de dados: Revisão integrativa da literatura usando os dados publicados nas bases de dados Medical Literature Analysis and Retrieval System Online/ United States National Library of Medicine (MEDLINE/PubMed) e Scientific Electronic Library Online (SciELO) entre janeiro de 2010 e abril de 2021 e por meio de busca manual nas listas de referências de estudos relevantes. Foram incluídos estudos em inglês que avaliaram a densidade mineral óssea pela técnica de absorciometria de raio X duplo (DXA), incluíram pacientes pediátricos (até 20 anos de idade) com SIC sob terpia nutricional parenteral. Onze fontes primárias preencheram os critérios de inclusão para este estudo. Síntese dos dados: A pesquisa revelou que pacientes pediátricos com SIC-FI sob nutrição parenteral (NP) de longo prazo tiveram alterações frequentes no metabolismo ósseo, levando a fraturas osteoporóticas e falha de crescimento. Esses pacientes apresentam deficiências de múltiplos nutrientes, como cálcio, magnésio, fósforo e vitamina D. Consequentemente, houve variações na secreção e regulação do hormônio da paratireoide. Além disso, as limitações farmacotécnicas relacionadas ao cálcio e fósforo na solução de NP, o uso de glicocorticoides e dificuldade para realizar atividade física são fatores de risco para o desenvolvimento de doença óssea metabólica em pacientes pediátricos com SIC-FI. Conclusões: A baixa densidade mineral óssea foi associada a um alto risco de desenvolver osteoporose, fraturas e deficiência de crescimento em pacientes pediátricos com SIC-FI sob terapia nutricional parenteral em longo prazo. Objetivo SICFI. SICFI FI . (SIC-FI) MEDLINE/PubMed MEDLINEPubMed MEDLINE PubMed (MEDLINE/PubMed SciELO (SciELO 201 202 relevantes DXA, DXA , (DXA) até 2 idade estudo NP (NP ósseo nutrientes magnésio D Consequentemente paratireoide disso FI. Conclusões osteoporose (SIC-FI (DXA

ABSTRACT Bisphosphonates (BPs) are medications widely used in clinical practice to treat osteoporosis and reduce fragility fractures. Its beneficial effects on bone tissue have been consolidated in the literature for the last decades. They have a high affinity for bone hydroxyapatite crystals, and most bisphosphonates remain on the bone surface for a long period of time. Benefits of long-term use of BPs: Large and important trials (Fracture Intervention Trial Long-term Extension and Health Outcomes and Reduced Incidence with Zoledronic acid Once Yearly-Pivotal Fracture Trial) with extended use of alendronate (up to 10 years) and zoledronate (up to 6 years) evidenced significant gain of bone mineral density (BMD) and vertebral fracture risk reduction. Risks of long-term use of BPs: The extended use of antiresorptive therapy has drawn attention to two extremely rare, although severe, adverse events. That is, atypical femoral fracture and medication-related osteonecrosis of the jaw are more common in patients with high cumulative doses and longer duration of therapy. BPs have demonstrated safety and effectiveness throughout the years and evidenced increased BMD and reduced fracture risks, resulting in reduced morbimortality, and improved quality of life. These benefits overweight the risks of rare adverse events. (BPs fractures decades crystals time longterm term Longterm Long YearlyPivotal Yearly Pivotal up 1 (BMD reduction severe events is medicationrelated medication related morbimortality life

ABSTRACT Objective: To investigate the impact of tenofovir disoproxil fumarate on bone mineral density and bone mineral content in children and adolescents infected with the human immunodeficiency virus. Data source: The search procedure was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. The search was carried out until April 2022 in Medical Literature Analysis and Retrieval System Online (Medline), Embase, Cochrane Central, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, and MedRxiv. The combination of terms used was: (Children OR Youth OR Teenagers) AND HIV AND (Tenofovir OR “Antiretroviral therapy”) AND (“Bone density” OR Osteoporosis OR Osteopenia). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42022312851) Data synthesis: The initial searches resulted in 1156 papers. After the exclusion of duplicate studies, three blinded reviewers analyzed the title and abstract of 563 papers, of which 57 remained to be read in full. Only nine papers met the eligibility criteria and were included in descriptive and risk-of-bias analyses. Regarding study design, four were cross-sectional, three were longitudinal before-after studies without a control group, and two were prospective cohorts. Among these nine papers, seven showed no significant association between tenofovir disoproxil fumarate use and reduced bone mass in young people. However, these papers did not have high methodological quality. Conclusions: Although most of the selected papers found no harmful effect of tenofovir disoproxil fumarate on bone mass, further primary research with higher methodological quality is needed so robust scientific evidences can be obtained. Objective virus source MetaAnalyses Meta Analyses Statement 202 Medline, Medline , (Medline) Embase Central Science Scopus MedRxiv Children Teenagers Tenofovir Antiretroviral therapy therapy” Bone Osteopenia. Osteopenia . Osteopenia) PROSPERO, PROSPERO (PROSPERO CRD42022312851 CRD synthesis 115 56 5 full riskofbias risk bias analyses design crosssectional, crosssectional cross sectional, sectional cross-sectional beforeafter before after group cohorts people However Conclusions obtained 20 (Medline CRD4202231285 11 2 CRD420223128 1 CRD42022312 CRD4202231 CRD420223 CRD42022 CRD4202 CRD420 CRD42 CRD4

RESUMO Objetivo: Investigar o impacto do tenofovir disoproxil fumarato sobre a densidade mineral óssea e o conteúdo mineral ósseo em crianças e adolescentes infectados pelo vírus da imunodeficiência humana. Fontes de dados: O procedimento de busca foi executado de acordo com o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. A busca foi realizada até abril de 2022 nas seguintes bases de dados: Medical Literature Analysis and Retrieval System Online (Medline), Embase, Cochrane Central, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Web of Science, Scopus, and MedRxiv. A combinação de termos utilizada foi: (Children OR Youth OR Teenagers) AND HIV AND (Tenofovir OR “Antiretroviral therapy”) AND (“Bone density” OR Osteoporosis OR Osteopenia). O protocolo foi registrado na base International Prospective Register of Systematic Reviews — PROSPERO (CRD42022312851). Síntese dos dados: As pesquisas iniciais resultaram em 1.156 artigos. Após a exclusão dos estudos duplicados, três revisores cegos analisaram título e resumo de 563 estudos, dos quais 57 permaneceram para leitura na íntegra. Somente nove artigos atenderam aos critérios de elegibilidade e foram incluídos para análises descritivas e de risco de viés. Com relação ao desenho dos estudos, quatro foram transversais, três foram estudos longitudinais antes-depois sem grupo controle e dois foram coortes prospectivas. Dos nove artigos, sete não mostraram associação significativa entre uso de TDF e redução de massa óssea em pessoas jovens. Entretanto, esses estudos não tiveram alta qualidade metodológica. Conclusões: Embora a maioria dos estudos selecionados não tenha encontrado efeito prejudicial do TDF sobre massa óssea, novas pesquisas primárias com maior qualidade metodológica são necessárias para que sejam obtidas evidências científicas robustas. Objetivo humana dados MetaAnalyses Meta Analyses PRISMA (PRISMA Statement 202 Medline, Medline , (Medline) Embase Central LatinoAmericana Latino Americana Lilacs, Lilacs (Lilacs) Science Scopus MedRxiv Children Teenagers Tenofovir Antiretroviral therapy therapy” Bone density Osteopenia. Osteopenia . Osteopenia) CRD42022312851. CRD42022312851 CRD (CRD42022312851) 1156 1 156 1.15 duplicados 56 5 íntegra viés transversais antesdepois antes depois prospectivas jovens Entretanto Conclusões robustas 20 (Medline (Lilacs CRD4202231285 (CRD42022312851 115 15 1.1 2 CRD420223128 (CRD4202231285 11 1. CRD42022312 (CRD420223128 CRD4202231 (CRD42022312 CRD420223 (CRD4202231 CRD42022 (CRD420223 CRD4202 (CRD42022 CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD

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 envejecimiento poblacional es un fenómeno que ocurre en todos los países en mayor o menor grado, lo que provoca un incremento en el número y proporción de las personas ancianas. En Cuba esta proporción ha tenido un crecimiento progresivo, que sobrepasa el 18%, o sea, casi la quinta parte de los cubanos ya superan las seis décadas. Cada vez son más las investigaciones enfocadas al estudio de factores de riesgo, manifestaciones clínicas y enfermedades presentes en esta población; la osteoporosis, la osteoartritis, el climaterio y la menopausia, son algunos de ellas, y mucho más las investigaciones enfocadas al estudio de terapéuticas farmacológicas y no farmacológicas para prevenirlas o tratarlas, con el propósito de mejorar la calidad de vida de la población afectada. El Prevenox es una mezcla de ácidos primarios alifáticos de alto peso molecular obtenida de la cera de caña de azúcar, con efectos antioxidantes, hipolipemiantes, antiagregantes plaquetarios, y osteoprotectores, demostrados en estudios preclínicos y clínicos, además de resultar seguro y muy bien tolerado. El objetivo de esta revisión es abordar al Prevenox y sus efectos beneficiosos en la prevención o el tratamiento de afecciones osteomioarticulares frecuentes en personas de edad media y avanzada. Se expusieron, detallaron y analizaron las principales evidencias preclínicas y clínicas de los efectos del Prevenox sobre la osteoporosis y osteoartritis. Se concluye que el Prevenox constituye una alternativa para el manejo de afecciones osteomioarticulares en personas de edad media y avanzada, contribuyendo a mejorar la calidad de vida de las mismas para que puedan llegar a un envejecimiento más saludable.

ABSTRACT Population aging is a phenomenon that occurs in all countries to a greater or lesser degree, which causes an increase in the number and proportion of elderly people. In Cuba this proportion has had a progressive growth, which exceeds 18%, that is, almost a fifth of Cubans are now over six decades old. More research is focused on the study of risk factors, clinical manifestations and diseases present in this population; osteoporosis, osteoarthritis, climacteric and menopause are some of them, and much more research focused on the study of pharmacological and non-pharmacological therapies to prevent or treat them, with the purpose of improving the quality of life of the affected population. Prevenox is a mixture of high molecular weight aliphatic primary acids obtained from sugar cane wax, with antioxidant, lipid-lowering, antiplatelet, and osteoprotective effects, demonstrated in preclinical and clinical studies, in addition to being safe and very well tolerated. The objective of this review is to address Prevenox and its beneficial effects in the prevention or treatment of common osteomyoarticular conditions in middle-aged and elderly people. The main preclinical and clinical evidence of the effects of Prevenox on osteoporosis and osteoarthritis were presented, detailed and analyzed. It´s concluded that Prevenox constitutes an alternative for the management of osteomyoarticular conditions in middle-aged and elderly people, contributing to improving their quality of life so that they can achieve healthier aging.

Abstract Objective the aim of this study was to analyze the influence of ozone therapy (OZN) on peri-implant bone repair in critical bones by installing osseointegrated implants in the tibia of ovariectomized rats. Methodology ovariectomy was performed on 30 Wistar rats, aged six months (Rattus novergicus), and, after 90 days, osseointegrated implants were installed in each tibial metaphysis. The study groups were divided into the animals that received intraperitoneal ozone at a concentration of 700 mcg/kg — OZ Group (n=15) — and a control group that received an intraperitoneal saline solution and, for this reason, was named the SAL group (n=15). The applications for both groups occurred during the immediate post-operative period on the 2nd, 4th, 6th, 8th, 10th, and 12th day post-surgery. At various stages (14, 42, and 60 days), the animals were euthanized, and tests were performed on their tibiae. These tests include histomorphometric and immunohistochemical analyses, computerized microtomography, sampling in light-cured resin for calcified sections, and confocal microscopy. The obtained data were then analyzed using One-way ANOVA and the Shapiro-Wilk, Kruskal-Wallis, and student t-tests (P<0.05). Results our findings indicate that the OZ group (3.26±0.20 mm) showed better cellular organization and bone neoformation at 14 days (SAL group, 0.90±1.42 mm) (P=0.001). Immunohistochemistry revealed that osteocalcin labeling was moderate in the OZ group and mild in the SAL group at 14 and 42 days post-surgery. The data from the analysis of calcified tissues (microtomography, histometric, and bone dynamism analysis) at 60 days showed no statistically significant differences between the groups (P=0.32). Conclusion it was concluded that ozone therapy anticipated the initial phases of the peri-implant bone repair process. OZN (OZN periimplant peri implant rats 3 Rattus novergicus, novergicus , novergicus) 9 metaphysis 70 mcgkg mcg kg n=15 n15 n 15 (n=15 reason n=15. . postoperative post operative 2nd nd 4th th 6th 8th 10th postsurgery. postsurgery surgery. surgery post-surgery 14, (14 6 days) euthanized tibiae analyses microtomography lightcured light cured sections microscopy Oneway One way ShapiroWilk, ShapiroWilk Shapiro Wilk, Wilk Shapiro-Wilk KruskalWallis, KruskalWallis Kruskal Wallis, Wallis Kruskal-Wallis ttests t P<0.05. P005 P P<0.05 0 05 (P<0.05) 3.26±0.20 326020 26 20 (3.26±0.2 mm 1 090142 0.90±1.4 P=0.001. P0001 P=0.001 001 (P=0.001) 4 (microtomography histometric P=0.32. P032 P=0.32 32 (P=0.32) process 7 n=1 n1 (n=1 (1 P00 P<0.0 (P<0.05 3.26±0.2 32602 2 (3.26±0. 09014 0.90±1. P000 P=0.00 00 (P=0.001 P03 P=0.3 (P=0.32 n= (n= ( P0 P<0. (P<0.0 3.26±0. 3260 (3.26±0 0901 0.90±1 P=0.0 (P=0.00 P=0. (P=0.3 (n P<0 (P<0. 3.26±0 326 (3.26± 090 0.90± (P=0.0 P=0 (P=0. P< (P<0 3.26± (3.26 09 0.90 P= (P=0 (P< 3.26 (3.2 0.9 (P= (P 3.2 (3. 0. 3. (3