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.

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 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 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 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

ABSTRACT BACKGROUND: Osteoporosis, characterized by decreased bone density and increased fracture risk, imposes significant physical, psychosocial, and financial burdens. Early detection and prevention are crucial for managing osteoporosis and reducing the risk of fractures. OBJECTIVES: To investigate the relationship between Hepatitis A seropositivity and bone mineral density (BMD) in adolescents and adults and to explore the potential link between Hepatitis A infection and osteoporosis risk. DESIGN AND SETTING: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 to evaluate the association between hepatitis A seropositivity and BMD in 15,693 participants. METHODS: Multivariable regression analysis was used to calculate the mean BMD and standard error for adolescents and adults, followed by an independent z-test to determine whether there was a significant difference between the seropositive and seronegative groups. RESULTS: Hepatitis A seropositive adolescents and adults had lower BMD than their seronegative counterparts, with significant differences in lumber spine (mean difference = -0.03 g/cm2, P < 0.01 for both age groups) and pelvis BMDs (mean difference = -0.02 g/cm2, P < 0.01 for the adult age groups), after adjusting for various covariates. CONCLUSIONS: This study confirmed that both adolescent and adult individuals seropositive for Hepatitis A antibodies had reduced BMD among both adolescents and adults, especially in the adult group. This finding suggests a possible link between Hepatitis A infection and risk of osteoporosis. BACKGROUND Osteoporosis physical psychosocial burdens fractures OBJECTIVES (BMD SETTING crosssectional cross sectional NHANES (NHANES 201 15693 15 693 15,69 participants METHODS ztest z test groups RESULTS counterparts 0.03 003 0 03 -0.0 gcm2 gcm g cm2 cm g/cm2 001 01 0.0 0.02 002 02 groups, , covariates CONCLUSIONS group 20 1569 1 69 15,6 00 -0. g/cm 0. 2 156 6 15, -0 -

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

ABSTRACT Purpose: Osteoporosis is a bone disease which commonly occurred in postmenopausal women. Almost 10 percent of world population and approximately 30% of women (postmenopausal) suffer from this disease. Alternative medicine has great success in the treatment of osteoporosis disease. Bryodulcosigenin, a potent phytoconstituent, already displayed the anti-inflammatory and antioxidant effect. In this study, we made effort to analyze the antiosteoporosis effect of bryodulcosigenin against ovariectomy (OVX) induced osteoporosis in rats. Methods: Swiss albino Wistar rats were grouped into fIve groups and given an oral dose of bryodulcosigenin (10, 20 and 30 mg/kg) for eight weeks. Body weight, uterus, bone mineral density, cytokines, hormones parameters, transforming growth factor (TGF)-β, insulin-like growth factor (IGF), osteoprotegerin (OPG), receptor activator of nuclear factor kappa-Β ligand (RANKL), and its ratio were estimated. Results: Bryodulcosigenin significantly (p < 0.001) suppressed the body weight and enhanced the uterine weight and significantly (p < 0.001) increased the bone mineral density in whole femur, caput femoris, distal femur and proximal femur. Bryodulcosigenin significantly (P < 0.001) altered the level of biochemical parameters at dose dependent manner, significantly (P < 0.001) improved the level of estrogen and suppressed the level of follicle stimulating hormone and luteinizing hormone. Bryodulcosigenin significantly (P < 0.001) improved the level of OPG and suppressed the level of RANKL. Conclusions: Bryodulcosigenin reduced the cytokines level and suppressed the TGF-β and IGF. We concluded that bryodulcosigenin is an antiosteoporosis medication based on the findings. Purpose 1 (postmenopausal phytoconstituent antiinflammatory anti inflammatory study OVX (OVX Methods 10, (10 2 3 mg/kg mgkg mg kg weeks uterus TGFβ, TGFβ TGF β, β (TGF)-β insulinlike insulin like IGF, IGF , (IGF) OPG, (OPG) kappaΒ kappa Β RANKL, RANKL (RANKL) estimated Results p 0.001 0001 0 001 femoris P manner Conclusions findings (1 (IGF (OPG (RANKL 0.00 000 00 ( 0.0 0.

Abstract The osseous vascular endothelium encompasses a vast intricate framework that regulates bone remodeling. Osteoporosis, an age-associated systemic bone disease, is characterized by the degeneration of the vascular architecture. Nevertheless, the precise mechanisms underpinning the metamorphosis of endothelial cells (ECs) with advancing age remain predominantly enigmatic. In this study, we conducted a systematic analysis of differentially expressed genes (DEGs) and the associated pathways in juvenile and mature femoral ECs, utilizing data sourced from the Gene Expression Omnibus (GEO) repositories (GSE148804) and employing bioinformatics tools. Through this approach, we successfully discerned six pivotal genes, namely Adamts1, Adamts2, Adamts4, Adamts14, Col5a1, and Col5a2. Subsequently, we constructed a miRNA-mRNA network based on miRNAs displaying differential expression between CD31hiEMCNhi and CD31lowEMCNlow ECs, utilizing online repositories for prediction. The expression of miR-466i-3p and miR-466i-5p in bone marrow ECs exhibited an inverse correlation with age. Our in vivo experiments additionally unveiled miR-466i-5p as a pivotal regulator in osseous ECs and a promising therapeutic target for age-related osteoporosis. remodeling Osteoporosis ageassociated disease architecture Nevertheless (ECs enigmatic study DEGs (DEGs GEO (GEO GSE148804 GSE (GSE148804 tools approach Adamts1 Adamts Adamts2 Adamts4 Adamts14 Col5a1 Cola Col Col5a2 Subsequently miRNAmRNA miRNA mRNA CDhiEMCNhi CD hiEMCNhi CDlowEMCNlow lowEMCNlow prediction miR466i3p miRip miR 466i 3p i p miR466i5p 5p agerelated related osteoporosis GSE14880 (GSE14880 Col5a GSE1488 (GSE1488 GSE148 (GSE148 GSE14 (GSE14 GSE1 (GSE1 (GSE

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 The incidences of periodontitis and osteoporosis are rising worldwide. Observational studies have shown that periodontitis is associated with increased risk of osteoporosis. We performed a Mendelian randomization (MR) study to genetically investigate the causality of periodontitis on osteoporosis. We explored the causal effect of periodontitis on osteoporosis by MR analysis. A total of 9 single nucleotide polymorphisms (SNP) were related to periodontitis. The primary approach in this MR analysis was the inverse variance-weighted (IVW) method. Simple median, weighted median, and penalized weighted median were used to analyze sensitivity. The fixed-effect IVW model and random-effect IVW model showed no significant causal effect of genetically predicted periodontitis on the risk of osteoporosis (OR=1.032; 95%CI: 0.923-1.153; P=0.574; OR=1.032; 95%CI: 0.920-1.158; P=0.588, respectively). Similar results were observed in simple mode (OR=1.031; 95%CI: 0.780-1.361, P=0.835), weighted mode (OR=1.120; 95%CI: 0.944-1.328, P=0.229), simple median (OR=1.003; 95%CI: 0.839-1.197, P=0.977), weighted median (OR=1.078; 95%CI: 0.921-1.262, P=0.346), penalized weight median (OR 1.078; 95%CI: 0.919-1.264, P=0.351), and MR-Egger method (OR=1.360; 95%CI: 0.998-1.853, P=0.092). There was no heterogeneity in the IVW and MR-Egger analyses (Q=7.454, P=0.489 and Q=3.901, P=0.791, respectively). MR-Egger regression revealed no evidence of a pleiotropic influence through genetic variants (intercept: -0.004; P=0.101). The leave-one-out sensitivity analysis indicated no driven influence of any individual SNP on the association between periodontitis and osteoporosis. The Mendelian randomization analysis did not show a significant detrimental effect of periodontitis on the risk of osteoporosis. worldwide (MR (SNP varianceweighted variance (IVW fixedeffect fixed randomeffect random OR=1.032 OR1032 OR 1 032 (OR=1.032 95%CI 95CI CI 95 0.9231.153 09231153 0.923 1.153 0 923 153 0.923-1.153 P=0.574 P0574 P 574 0.9201.158 09201158 0.920 1.158 920 158 0.920-1.158 P0588 588 P=0.588 respectively. respectively . respectively) OR=1.031 OR1031 031 (OR=1.031 0.7801.361, 07801361 0.780 1.361, 780 361 0.780-1.361 P=0.835, P0835 P=0.835 , 835 P=0.835) OR=1.120 OR1120 120 (OR=1.120 0.9441.328, 09441328 0.944 1.328, 944 328 0.944-1.328 P=0.229, P0229 P=0.229 229 P=0.229) OR=1.003 OR1003 003 (OR=1.003 0.8391.197, 08391197 0.839 1.197, 839 197 0.839-1.197 P=0.977, P0977 P=0.977 977 P=0.977) OR=1.078 OR1078 078 (OR=1.078 0.9211.262, 09211262 0.921 1.262, 921 262 0.921-1.262 P=0.346, P0346 P=0.346 346 P=0.346) 1.078 1078 0.9191.264, 09191264 0.919 1.264, 919 264 0.919-1.264 P=0.351, P0351 P=0.351 351 P=0.351) MREgger Egger OR=1.360 OR1360 360 (OR=1.360 0.9981.853, 09981853 0.998 1.853, 998 853 0.998-1.853 P=0.092. P0092 P=0.092 092 P=0.092) Q=7.454, Q7454 Q 7 454 (Q=7.454 P0489 489 P=0.48 Q3901 3 901 Q=3.901 P0791 791 P=0.791 intercept (intercept 0.004 0004 004 -0.004 P=0.101. P0101 P=0.101 101 P=0.101) leaveoneout leave one out OR=1.03 OR103 03 (OR=1.03 9231 0.9231.15 0923115 0923 0.92 1153 1.15 92 15 0.923-1.15 P=0.57 P057 57 9201 0.9201.15 0920115 0920 1158 0.920-1.15 P058 58 P=0.58 7801 0.7801.361 0780136 0780 0.78 1361 1.361 78 36 0.780-1.36 P083 P=0.83 83 OR=1.12 OR112 12 (OR=1.12 9441 0.9441.328 0944132 0944 0.94 1328 1.328 94 32 0.944-1.32 P022 P=0.22 22 OR=1.00 OR100 00 (OR=1.00 8391 0.8391.197 0839119 0839 0.83 1197 1.197 19 0.839-1.19 P097 P=0.97 97 OR=1.07 OR107 07 (OR=1.07 9211 0.9211.262 0921126 0921 1262 1.262 26 0.921-1.26 P034 P=0.34 34 1.07 107 9191 0.9191.264 0919126 0919 0.91 1264 1.264 91 0.919-1.26 P035 P=0.35 35 OR=1.36 OR136 (OR=1.36 9981 0.9981.853 0998185 0998 0.99 1853 1.853 99 85 0.998-1.85 P009 P=0.09 09 Q=7.454 Q745 45 (Q=7.45 P048 48 P=0.4 Q390 90 Q=3.90 P079 79 P=0.79 0.00 000 -0.00 P010 P=0.10 10 OR=1.0 OR10 (OR=1.0 0.9231.1 092311 0.9 115 1.1 0.923-1.1 P=0.5 P05 5 0.9201.1 092011 0.920-1.1 0.7801.36 078013 0.7 136 1.36 0.780-1.3 P08 P=0.8 8 OR=1.1 OR11 (OR=1.1 0.9441.32 094413 094 132 1.32 0.944-1.3 P02 P=0.2 2 0.8391.19 083911 083 0.8 119 1.19 0.839-1.1 P09 P=0.9 0.9211.26 092112 126 1.26 0.921-1.2 P03 P=0.3 1.0 0.9191.26 091912 091 0.919-1.2 OR=1.3 OR13 (OR=1.3 0.9981.85 099818 099 185 1.85 0.998-1.8 P00 P=0.0 Q=7.45 Q74 4 (Q=7.4 P04 P=0. Q39 Q=3.9 P07 P=0.7 0.0 -0.0 P01 P=0.1 OR=1. OR1 (OR=1. 0.9231. 09231 0. 11 1. 0.923-1. P0 0.9201. 09201 0.920-1. 0.7801.3 07801 13 1.3 0.780-1. 0.9441.3 09441 0.944-1. 0.8391.1 08391 08 0.839-1. 0.9211.2 09211 1.2 0.921-1. 0.9191.2 09191 0.919-1. 0.9981.8 09981 18 1.8 0.998-1. Q=7.4 Q7 (Q=7. P=0 Q3 Q=3. -0. OR=1 (OR=1 0.9231 0.923-1 0.9201 0.920-1 0.7801. 0.780-1 0.9441. 0.944-1 0.8391. 0.839-1 0.9211. 0.921-1 0.9191. 0.919-1 0.9981. 0.998-1 Q=7. (Q=7 P= Q=3 -0 OR= (OR= 0.923- 0.920- 0.7801 0.780- 0.9441 0.944- 0.8391 0.839- 0.9211 0.921- 0.9191 0.919- 0.9981 0.998- Q=7 (Q= Q= - (Q

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.