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Recommendations for the prevention of fragility fractures: a consensus from international experts and Ibero-American scientific societies
No full textPurpose
To develop a multidisciplinary consensus outlining key recommendations to prevent fragility fractures and improve care through coordinated efforts across healthcare sectors.
Methods
An international group of experts, coordinated by the Spanish National Hip Fracture Registry (RNFC), engaged over 300 professionals and 31 scientific societies. Using a nominal group technique, the committee reviewed scientific evidence and collaboratively developed ten core recommendations. The consensus was refined through multiple telematic reviews and finalized at the 7th RNFC Annual Meeting in March 2024.
Results
The consensus presents ten actionable recommendations: (1) inclusion of osteoporosis and fragility fractures in health policies, (2) early detection and management of frailty and falls, (3) implementation of clinical practice guidelines, (4) promotion of fracture registries and audits, (5) support for Orthogeriatric Units and Fracture Liaison Services (FLS), (6) adoption of a “Fragility Fracture Code,” (7) empowerment of Primary Care in fracture prevention, (8) increased patient association involvement, (9) public awareness campaigns, and (10) promotion of research including patient-reported outcomes.
Conclusions
Fragility fractures are a major public health issue with rising incidence, disability, and healthcare costs. This consensus offers unified, evidence-based guidance for policy makers, healthcare professionals, and patient organizations. Broad dissemination and implementation of these recommendations aim to reduce fracture rates and enhance patient outcomes through coordinated, multidisciplinary care.Depto. de CirugíaFac. de MedicinaTRUEpu
World Association for Veterinary Dermatology Consensus Statement for Diagnosis, and Evidence‐Based Clinical Practice Guidelines for Treatment and Prevention of Canine Leishmaniosis
No full textAuthor Contributions:
Manolis N. Saridomichelakis: data curation (lead), formal analysis(lead), investigation (lead), methodology (lead), writing – original draft(lead), writing – review and editing (lead). Gad Baneth: writing – origi-nal draft (equal), writing – review and editing (equal). Silvia Colombo:writing – original draft (equal), writing – review and editing (equal). Filipe Dantas-Torres: writing – original draft (equal), writing – re-view and editing (equal). Lluís Ferrer: writing – original draft (equal),writing – review and editing (equal). Alessandra Fondati: writing –original draft (equal), writing – review and editing (equal). GuadalupeMiró: writing – original draft (equal), writing – review and editing(equal). Laura Ordeix: investigation (supporting), writing – originaldraft (equal), writing – review and editing (equal). Domenico Otranto:writing – original draft (equal), writing – review and editing (equal).Chiara Noli: conceptualization, data curation, formal analysis, fund-ing acquisition, investigation, methodology, project administration, su-pervision, validation, writing – original draft (equal), writing – reviewand editing (equal)Background: Canine leishmaniosis (CanL) due to Leishmania infantum remains common, and veterinarians do not always follow scientifically sound approaches for diagnosis, treatment and prevention.
Objectives: To provide consensus guidelines for diagnosis and evidence-based guidelines for treatment and prevention of CanL.
Methods and material: Clinical consensus guidelines for the diagnosis were structured based on literature and authors' experience. Three electronic databases were searched for randomised controlled trials, systematic reviews and meta-analyses on treatment and prevention.
Results, conclusions and clinical importance: Diagnosis should be based on compatible clinical signs and/or clinicopathologic abnormalities, exclusion of differentials, demonstration of infection and increased concentration of anti-Leishmania IgG (quantitative serology). Euthanasia for public health purposes is not recommended and drugs with anti-Leishmania activity should be avoided in subclinically infected dogs. Recommended treatments include meglumine antimoniate-allopurinol (first-line treatment), miltefosine-allopurinol (first-line treatment) and aminosidine-allopurinol (second-line treatment); marbofloxacin may be considered in dogs with advanced chronic kidney disease. In endemic areas, recommended measures for prevention include deltamethrin 4% collar, flumethrin 4.5%-imidacloprid 10% collar or permethrin 50%-imidacloprid 10% spot-on, not using infected blood products for transfusion, not breeding seropositive bitches or dogs with CanL, administration of domperidone (seronegative dogs) and dietary nucleotides-active hexose correlated compound (subclinically infected, seropositive dogs). Vaccination with LiESP with MDP may be considered, whereas protein Q vaccine is recommended in areas with very high rates of seroconversion. In non-endemic areas, recommended measures include not using infected blood products for transfusion and removal of infected female dogs from reproductioDepto. de Sanidad AnimalFac. de VeterinariaTRUEpu
Lactic Microbiota and Metabolites in Raw Cow’s Milk: Implications for Consumer Health
No full textThis study explores the microbiota and metabolite profile of raw cow’s milk, analyzing the correlation between them and their potential impact on consumer health, focusing on factors like cow’s feeding regimen (conventional vs. grazing), the herd’s geographical location (coastal vs. inland), and the thermal stability of raw milk samples. To achieve this, raw milk quality was assessed through mesophilic bacterial count and thermal stability using the 70° and 80° ethanol test. Metataxonomic analysis was performed using Illumina 16S rRNA hypervariable region sequencing, and untargeted metabolomics was conducted using UHPLC-Q/TOF MS/MS, followed by multivariate correlation analysis. All samples met quality standards. A total of 1258 prokaryotic ASVs were identified, spanning 48 bacterial phyla and one archaeal phylum, with 909 genera and 349 unidentified ASVs. Additionally, 70 metabolites were identified, including essential amino acids, vitamins, and bioactive compounds with antimicrobial, anti-inflammatory, and prebiotic properties. Significant correlations between bacterial diversity and metabolite profiles were observed. Feeding regimen and geographical location influence microbial composition and metabolite abundance, while thermal stability was linked to specific metabolites like oleamide and pyridoxal. These findings suggest that microbiota-derived metabolites can enhance the nutritional and functional value of milk. Further research is needed to understand how environmental and processing factors influence these dynamics.Central Lechera AsturianaUniversidad Complutense de MadridDepto. de MedicinaFac. de MedicinaTRUEpu
Moderate increase of MET in hepatocytes protects against cholestatic liver injury by promoting an effective antioxidant response
No full textHepatocyte growth factor (HGF)/hepatocyte growth factor receptor (MET) signaling plays a critical role during liver regeneration upon acute and chronic damage, and is therefore an interesting target for therapeutic intervention. Nevertheless, the molecular mechanisms underlying the proregenerative effects of HGF/MET signaling are not fully elucidated, particularly during cholestatic injury. Our aim was to analyze the impact of moderately enhanced MET on the hepatic response to cholestatic injury, and uncover the mechanisms behind it. For that, Alb-R26Met mice expressing a wild-type Met transgene in albumin-positive liver cells were fed with a 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-supplemented diet, used as a model simulating human primary sclerosing cholangitis. Results indicate that increased MET expression diminished liver damage in DDC-fed mice, evidenced by lower serum levels of bilirubin and alkaline phosphatase, and decreased cell apoptosis. However, decreased ductular expansion was observed, which together with enhanced hepatocyte proliferation suggests that hepatocytes act as the main cellular defense. Both in vivo and in vitro studies using Alb-R26 Met liver-derived hepatocytes under cholestasis-simulated in vitro conditions demonstrated an enhanced upregulation of nuclear factor erythroid 2-related factor 2 (NRF2; encoded by the Nfe2l2 gene), parallel to an upregulation of glutathione biosynthesis enzymes, increased levels of glutathione, and decreased reactive oxygen species, along with decreased activation of transforming growth factor beta (TGF-β)-induced signaling. Consistently, MET transgenic hepatocytes were protected against TGF-β-induced oxidative stress and apoptosis in vitro. In conclusion, our work evidences that moderate upregulation of wild-type MET in hepatocytes is sufficient to promote a strong antioxidant response in the liver that efficiently protects against chronic cholestasis, thus allowing optimal liver regeneration.Ministerio de Ciencia, Innovación y Universidades (España)European Regional Development FundInstituto de Salud Carlos III (España)Universidad Complutense de MadridComunidad de MadridEuropean CommissionDepto. de Bioquímica y Biología MolecularFac. de FarmaciaTRUEpu
Osteogenic-Inducing Apatite/Agarose/Gelatin Hybrid Scaffolds Embedding Gold Nanoparticles
No full textTo prepare porous scaffolds combining hydrogel and hydroxycarbonateapatite, enriched with a promising therapeutic agent, gold nanoparticles, to improve bone regeneration. The fabrication procedure is conducted under mild conditions, without toxic or aggressive chemicals, at physiological pH, and low temperatures; Methods: Gold nanoparticles (15–20 nm), were obtained by the Turkevith method. The scaffolds were fabricated by the GELPOR3D method, which has demonstrated its ability to integrate thermal labile molecules, during the scaffold fabrication process. The role of these nanoparticles in promoting cell adhesion, proliferation, and mineralization processes in vitro has been studied using osteoprogenitor MC3T3-E1 cells; Results: The scaffold fabrication conditions, combined with the surface functionalization of the gold nanoparticles with poly(ethylene glycol), ensure their uniform distribution throughout the scaffold and facilitate their gradual release over 48 h in a physiological medium. A significant increase in the mean cell area and a significant decrease in the circularity index during the early stages of osteoblast differentiation are observed. These pieces of evidence suggest that adequate cell spreading could lead to enhanced proliferation and matrix deposition activity; Conclusions: Scaffolds containing these gold nanoparticles exhibited a marked improvement in adhesion, proliferation, and mineralization of preosteoblasts (MC3T3 cells) at the concentrations studied. The functionalization of the nanoparticles, along with the shaping procedure employed, is critical for their homogeneous dispersion throughout the scaffold and their progressive release. The findings confirm the crucial role of gold nanoparticles in the early stages of osteoblast differentiation, which is essential for the transition from premature osteoblasts to mature osteoblasts.Instituto de Salud Carlos IIIEuropean Commission-ERCComunidad de MadridUniversidad Complutense de MadridDepto. de Química en Ciencias FarmacéuticasFac. de FarmaciaTRUEpu
Estimación
No full textDepto. de Estadística e Investigación OperativaEdiciones ComplutenseFac. de FarmaciaTRUEpu
Mulheres e vida diplomática. Balanço, possibilidades metodológicas e propostas
No full textEste ensayo fue publicado en inglés anteriormente con el siguiente título: “Women and Diplomatic Life: An Overview with Methodological Directions and Proposals”. In: CARBÓ, Elisabet; ROIG SANZ, Diana (eds.). Culture as Soft Power. Bridging Cultural Relations, Intellectual Cooperation, and Cultural Diplomacy. Berlim: De Gruyter, 2022, p. 43-64. ISBN: 9783110744552.Este capítulo tiene dos objetivos principales. Por un lado, presento una revisión sistemática de la producción académica sobre las trayectorias de mujeres que circularon en distintos circuitos diplomáticos a lo largo de un extenso período. La atención se centró en las publicaciones de las últimas dos décadas que trataron de la renovación de la historia diplomática y provienen de diversas áreas, entre las cuales se encuentran la Historia Cultural, la Historia Política, la Historia de las Mujeres y, en menor medida, el campo de las Relaciones Internacionales con una perspectiva de género. Se trata de una versión en portugués de un texto publicado originalmente en inglés.Ministerio de Ciencia e InnovaciónDepto. de Historia, Teorías y Geografías PolíticasFac. de Ciencias Políticas y SociologíaTRUEpu
