Mind the osteoporosis care gap with timely diagnosis: an executive summary of nationwide osteoporosis Campaigns 2019-2021.

Background: The World Osteoporosis Day inaugurate on October 20 every year by the International Osteoporosis Foundation to initiate bone health and osteoporosis as a global health agenda for policymakers, health care providers, and the public. The reported the campaigns activities in three years 2019, 2020, and 2021. The aim of this campaigns was to promote the osteoporosis awareness to close osteoporosis care and data gaps. Methods: World Osteoporosis Day campaigns were held during three consecutive years 2019-2021 through "structuring" and "implantation" phases. The slogan of "early detection and timely diagnosis of osteoporosis" was followed in different public awareness and healthcare professional educational events. Also, a short survey regarding the knowledge of women aged ≥ 50 years of osteoporosis was used in campaigns to gather data for future planning. These nationwide campaigns was supported by the Osteoporosis Research Center in collaboration with the non-communicable diseases management office of Iran's Ministry of Health. Results: All activities stablished to close the "data" and "awareness" gap in osteoporosis care. 1972, 1881, and 2538 women aged ≥ 50 were participated in the world osteoporosis campaigns and educated in 2019, 2020, and 2021, respectively. More than thousands of online and published educational materials were provided and disseminated in group and face-to-face and virtual education via celebration meetings in primary healthcare facilities, parks and shopping malls. The wide-ranging health slogans and massages was distributed by way of SMS, press conferences on television, radio, and other social media platforms. In addition, the in-person and virtual events such as up-date osteoporosis symposiums, national osteoporosis research network meetings, osteoporosis essential courses, and subspecialty one-day seminars provided knowledge for health care teams and policy makers. Conclusion: Closing the osteoporosis treatment gap was approached by nationwide campaigns to make an appropriate intervention to emphasize early diagnosis and awareness of osteoporosis to close the care gap. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01257-7.

The critical role of gut microbiota dysbiosis in skeletal muscle wasting: a systematic review.

AIMS: Skeletal muscle wasting is affected by the gut microbiota dysbiosis through multiple pathways, including inflammatory process, defected immune system, and anabolic resistance. We aimed to systematically review the studies investigating the gut microbiota composition in sarcopenic and cachexic humans and animals. METHODS: We carried out a comprehensively systematic search using relevant keywords on PubMed, Web of Science, and Scopus databases until July 2021. Original human observational research and animal studies related to our research topics published in English were selected. RESULTS: Seven human studies and five animal studies were included. Three human studies were case-control, whereas the other four were cross-sectional studies that investigated three different conditions, including age-related sarcopenia, as well as liver cirrhosis and cancer cachexia. The principal alteration in age-related sarcopenia and liver cirrhosis-induced sarcopenia was a reduction in short-chain fatty acids (SCFAs) -producing bacteria. Lachnospiraceae family, consisting of Lachnospira, Fusicatenibacter, Roseburia, and Lachnoclostridium, significantly decreased in age-related sarcopenia, while in liver cirrhosis-induced sarcopenia, the alpha diversity of gut microbiota decreased compared with the control group. Moreover, Enterobacteriaceae, which has a pro-inflammatory effect increased in muscle-wasted animals. CONCLUSION: This systematic review presents associations between the gut microbiota alterations and skeletal muscle wasting as a consequence of various pathologies, including aging sarcopenia, renal failure, and cancer cachexia in both human and animal studies.

Bone characteristics and metabolic phenotypes of obesity in an Iranian Elderly population: Bushehr Elderly Health Program (BEHP).

INTRODUCTION: Obesity and osteoporosis are health problems with high impact on the morbidity and mortality rate. While the association between BMI and bone density is known, the combined effects of obesity and metabolic components on bone health have not yet been revealed. The objectives of this study were to determine the association between bone health and different phenotypes of obesity in an elderly population. METHODS: This cross-sectional study was conducted on the data collected in the Bushehr Elderly Health Program (BEHP). The participants were classified in four groups based on the metabolic phenotypes of obesity (metabolic healthy obese (MHO), metabolic non-healthy non-obese (MNHNO), metabolic non-healthy obese (MNHO), and metabolic healthy non-obese (MHNO)). The association between osteoporosis and TBS and the metabolic phenotypes of obesity were assessed using multiple variable logistic regression models. RESULTS: Totally, 2378 people (1227 women) were considered for analyses. The prevalence of MHNO, MHO, MNHNO, and MNHO were 902 (39.9%), 138 (6.1%), 758 (33.5%), and 464 (20.5%), respectively. In the multivariate logistic regression models, those with MHO (OR 0.22; 95% CI 0.12-0.36), MNHNO (OR 0.52; 95% CI 0.4-0.66), and MNHO phenotypes (OR 0.22; 95% CI 0.16-0.3) had a significantly lower risk of osteoporosis. Likewise, those having MHO (OR 2.38; 95% CI 1.51-3.76), MNHNO (OR 1.49; 95% CI 1.11-2), and MNHO (OR 2.50; 95% CI 1.82-3.42) phenotypes were found to had higher risk of low bone quality as confirmed by TBS. CONCLUSIONS: The obese subjects have lower bone quality, regardless of their obesity phenotype.

Internationalization of medical education in Iran: A way towards implementation of the plans of development and innovation in medical education.

INTRODUCTION: Academic institutions are the most important organizations for implementation of internationalization policies and practices for integrating an international, intercultural and global dimension in higher education system. Also, a globally increasing demand for higher education has been seen in the past two decades so that the number of students enrolled in higher education institutions in the worldwide nation-states has increased dramatically. The National Plan of International Development of Medical Education was designed with the aim of identifying available potentials in all the universities of medical sciences, encouraging the development of international standards of medical education, and planning for the utilization of the existing capacity in Islamic republic of Iran. METHODS: Authors have tried to review the several aspects of international activities in higher education in the world and describe national experiences and main policies in globalization of medical education in Iran within implementation of the National Plan for Development and Innovation in Medical Education. RESULTS: The findings of some global experiences provide the policy makers with clear directions in order to develop internationalization of higher education. CONCLUSION: The Program for International Development of Medical Education was designed by the Deputy of Education in the Ministry of Health and the effective implementation of this Program was so important for promotion of Iranian medical education. But there were some challenges in this regard; addressing them through inter-sectoral collaboration is one of the most important strategies for the development of internationalization of education in the field of medical sciences.