Preventing the next fragility fracture: a cross-sectional survey of secondary fragility fracture prevention services worldwide.

BACKGROUND: There has been an increasing awareness of the public health impact of fragility fractures due to osteoporosis and the imperative of addressing this health burden with well-designed secondary fragility fracture prevention services (SFFPS). The objectives of this survey, conducted within the international membership of the Fragility Fracture Network (FFN), were to identify gaps in services and identify the needs for further training and mentorship to improve the quality of SFFPS provided to patients who sustain fragility fractures. METHODS: We conducted an electronic cross-sectional survey of FFN Secondary Fracture Prevention Special Interest Group (SIG) members from April 2021 to June 2021 using SurveyMonkey. The survey questions were developed by four SIG members from New Zealand, Australia, Canada and the Netherlands, who have experience in developing, implementing and evaluating SFFPS. The sampling framework was convenience sampling of all 1162 registered FFN Secondary Fracture Prevention SIG members. Descriptive analyses were performed for all variables and presented as frequencies and percentages. RESULTS: 69 individuals participated in the survey, from 34 different countries over six continents, with a response rate of 6% (69/1162). Almost one-third of respondents (22/69) were from 15 countries within the European continent. Key findings included: (1) 25% of SFFPS only included patients with hip fracture; (2) less than 5% of SFFPS had any mandatory core competencies for training; (3) 38.7% of SFFPS were required to collect key performance indicators; and (4) 9% were collecting patient-reported outcome measures. CONCLUSIONS: This survey identified key areas for improving SFFPS, including: expanding the reach of SFFPS to more patients with fragility fracture, developing international core competencies for health provider training, using key performance indicators to improve SFFPS and including the patient voice in SFFPS development. These findings will be used by the FFN to support SFFPS development internationally.

Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study.

BACKGROUND: It is known that sexual problems increase with age but little is known about the predictors of female sexual dysfunction (FSD) in Brazilian climacteric women. AIM: To identify predictive factors for FSD in climacteric women. METHODS: This is a cross-sectional population-based study carried out through a household survey. OUTCOMES: The measures investigated were sociodemographic characteristics, depressive symptoms, level of physical activity, presence of FSD, self-rated health and sleep satisfaction. RESULT: A total of 381 climacteric, sexually active women were included, with a mean age of 55.04 (±7.21) years. The prevalence of FSD was 38.3%. All variables investigated were associated with FSD (P < .05). In the final model, the predictors for FSD were low satisfaction with sleep (OR 4.20; 95% CI 2.32-7.62), advanced age (OR 1.04; 95% CI 1.00-1.08), low education level (OR 0.90; 95% CI 0.85-0.97) and having a partner (OR 0.35; 95% CI 0.16-0.76). CLINICAL IMPLICATION: These aspects deserve attention from the health team to prevent and identify FSD early in life in climacteric women. STRENGTHS & LIMITATIONS: This study support existing data about risk factors for FSD in climacteric women. However, it is not possible to attribute causality to any of the correlates identified, which is a limitation of cross-sectional studies. CONCLUSION: Dissatisfaction with sleep, senility, insufficient income, low education, not having a partner, complaints of depression, and the worse perception of global health are predictive factors for FSD in climacteric women. Romano Marquez Reis SC, Martins Pinto J, Aparecida Porcatti de Walsh I, et al. Predictive Factors for the Risk of Sexual Dysfunction in Climacteric Women: Population-based Study. J Sex Med 2022;19:1546-1552.

Effects of radiofrequency on adipose tissue: A systematic review with meta-analysis.

BACKGROUND: Equipment that acts in the reduction in adipose tissue are becoming widely investigated. One of the resources that begin to gain recognition is radiofrequency. PURPOSE: To verify the existence of scientific evidence and the methodological quality of the articles on the effects of radiofrequency in the reduction in adipose tissue. METHODOLOGY: Systematic review with meta-analysis on the effects of radiofrequency on adipose tissue. The research was carried out using several databases and including experimental studies only in humans. The evaluation of the methodological quality of the articles was done based on the PEDro Scale. RESULTS: Twelve articles related with adipose tissue and cellulitis were included. There was a great variability of protocols, and the methodological quality was generally low and the methods most used for the evaluation of results were anthropometry, photography, and histopathology. Clinical results suggest a positive effect of radiofrequency on the reduction in adipose tissue, proving an increase in adipocyte lipolysis. After statistical analysis, it was verified that the anthropometry presented questionable results. CONCLUSION: The clinical results of the studies point to the positive effects of radiofrequency on the reduction in adipose tissue; however, the low methodological make this topic still debatable, requiring more controlled studies.