Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
1.
Data Brief ; 53: 110186, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38406253

RESUMO

A dataset about three topics is provided, as a follow-up to the article "Mexico's forest diversity: common tree species and proposed forest-vegetation provinces" by Ricker et al. [1]. Firstly, 6927 site locations are provided for 22,532 trees of 1452 species. Secondly, measurements of basic wood-densities are reported for 779 tree species, obtained from 5256 trunk-core samples from Mexico's national forest inventory, and ranging from 0.05 to 0.93 g/cm3. Third, the data and maps of the forest-vegetation provinces from [1] were updated with the new cartography of Mexico's vegetation and land use (base year 2018). The maps are available now in an adjusted presentation as a shapefile-set for ArcGIS, as well as map-package and image files.

2.
Genome Biol Evol ; 15(1)2023 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-36582124

RESUMO

Mycoheterotrophy is an alternative nutritional strategy whereby plants obtain sugars and other nutrients from soil fungi. Mycoheterotrophy and associated loss of photosynthesis have evolved repeatedly in plants, particularly in monocots. Although reductive evolution of plastomes in mycoheterotrophs is well documented, the dynamics of nuclear genome evolution remains largely unknown. Transcriptome datasets were generated from four mycoheterotrophs in three families (Orchidaceae, Burmanniaceae, Triuridaceae) and related green plants and used for phylogenomic analyses to resolve relationships among the mycoheterotrophs, their relatives, and representatives across the monocots. Phylogenetic trees based on 602 genes were mostly congruent with plastome phylogenies, except for an Asparagales + Liliales clade inferred in the nuclear trees. Reduction and loss of chlorophyll synthesis and photosynthetic gene expression and relaxation of purifying selection on retained genes were progressive, with greater loss in older nonphotosynthetic lineages. One hundred seventy-four of 1375 plant benchmark universally conserved orthologous genes were undetected in any mycoheterotroph transcriptome or the genome of the mycoheterotrophic orchid Gastrodia but were expressed in green relatives, providing evidence for massively convergent gene loss in nonphotosynthetic lineages. We designate this set of deleted or undetected genes Missing in Mycoheterotrophs (MIM). MIM genes encode not only mainly photosynthetic or plastid membrane proteins but also a diverse set of plastid processes, genes of unknown function, mitochondrial, and cellular processes. Transcription of a photosystem II gene (psb29) in all lineages implies a nonphotosynthetic function for this and other genes retained in mycoheterotrophs. Nonphotosynthetic plants enable novel insights into gene function as well as gene expression shifts, gene loss, and convergence in nuclear genomes.


Assuntos
Genomas de Plastídeos , Orchidaceae , Humanos , Idoso , Filogenia , Genes de Plantas , Proteínas de Plantas/genética , Orchidaceae/genética
3.
Semin Arthritis Rheum ; 52: 151946, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35033377

RESUMO

BACKGROUND/OBJECTIVES: Factors associated with chronic heart failure (CHF) in patients with systemic lupus erythematosus (SLE) have received little attention. Recent data on the use of hydroxychloroquine in the treatment of SARS-CoV-2 infection have cast doubt on its cardiac safety. The factors associated with CHF, including therapy with antimalarials, were analyzed in a large multicenter SLE cohort. METHODS: Cross-sectional study including all patients with SLE (ACR-1997 criteria) included in the Spanish Society of Rheumatology Lupus Register (RELESSER), based on historically gathered data. Patients with CHF prior to diagnosis of SLE were excluded. A multivariable analysis exploring factors associated with CHF was conducted. RESULTS: The study population comprised 117 patients with SLE (ACR-97 criteria) and CHF and 3,506 SLE controls. Ninety percent were women. Patients with CHF were older and presented greater SLE severity, organ damage, and mortality than those without CHF. The multivariable model revealed the factors associated with CHF to be ischemic heart disease (7.96 [4.01-15.48], p < 0.0001), cardiac arrhythmia (7.38 [4.00-13.42], p < 0.0001), pulmonary hypertension (3.71 [1.84-7.25], p < 0.0002), valvulopathy (6.33 [3.41-11.62], p < 0.0001), non-cardiovascular damage (1.29 [1.16-1.44], p < 0.000) and calcium/vitamin D treatment (5.29 [2.07-16.86], p = 0.0015). Female sex (0.46 [0.25-0.88], p = 0.0147) and antimalarials (0.28 [0.17-0.45], p < 0.000) proved to be protective factors. CONCLUSIONS: Patients with SLE and CHF experience more severe SLE. Treatment with antimalarials appears to confer a cardioprotective effect.


Assuntos
Antimaláricos , COVID-19 , Insuficiência Cardíaca , Lúpus Eritematoso Sistêmico , Reumatologia , Antimaláricos/uso terapêutico , Estudos Transversais , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/epidemiologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Sistema de Registros , SARS-CoV-2
4.
Front Plant Sci ; 12: 661522, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34267769

RESUMO

Background: Hydrangea section Cornidia consists of 26 currently accepted species and a yet undefined number of new species and erroneously synonymized taxa. This clade consists of (sub)tropical lianas occurring from northern Mexico to southern Chile and Argentina, and one species from Southeast Asia. Currently, no molecular phylogenetic hypothesis is available that includes more than a few species of this section. Hence, a resolved and well-sampled molecular phylogenetic hypothesis may help to enforce taxonomic decisions. In this study, we present a phylogenetic framework based on sequences from two low copy nuclear genes from a comprehensive taxon sampling of H. section Cornidia and a selection of outgroups. Our phylogenetic reconstructions prove the non-monophyly of the traditionally recognized subsections Monosegia and Polysegia and their corresponding series, Speciosae and Aphananthae, and Synstyleae and Chorystyleae, respectively. Three morphologically defined species were recovered with high support as monophyletic, namely, Hydrangea panamensis, Hydrangea serratifolia, and Hydrangea tarapotensis. However, statistical support for some shallow nodes did not allow to refute, with high support, the monophyly of several of the herein recognized species for which more than one individual could be analyzed. Based on the obtained phylogenetic framework, we reconstructed the evolution of selected reproductive characters. Hydrangea section Cornidia is the only genus section for which dioecism has been extensively documented. Our character reconstruction of sexual dimorphism shows that dioecism is the ancestral state in this section and that this was reversed to monoecy in Hydrangea seemannii and Hydrangea integrifolia. Character reconstruction for the enlarged marginal flowers recovered their presence as the ancestral character state in H. section Cornidia, although at least three internal lineages independently lost them; thus, losses were reconstructed to be more likely than gain. With respect to the flower color, more species exhibit white than red flowers, and white is reconstructed as the ancestral state. Cornidia also shows an unusual disjunct geographic distribution between Asia and Central Mesoamerica-South America, as it is not present in the USA and Canada. The origin of Cornidia is reconstructed to be the New World with higher probability, and the presence of one species in Asia is likely due to long-distance dispersal.

5.
Plants (Basel) ; 10(4)2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33807445

RESUMO

The Mexican state of Veracruz has suffered very high deforestation rates in the last few decades, and despite the establishment of protected areas and conservation projects, primary forest is now mainly persisting in mostly small, scattered, fragmented remnants. New species of Magnolia section Talauma in this state have been described with little to no reference to the already existing ones, potentially resulting in over-splitting, obscuring their taxonomic delineation and conservation status, and consequently conservation programs. To study the conservation units and their genetic diversity, we here employ 15 microsatellite markers on a highly representative sampling of 254 individuals of what are presumed to be five Magnolia species. The results support at least three species and maximum five main conservation units. We propose downgrading the latter to four, given morphological, ecological, demographical, and geographical considerations. Two out of the three sympatrically occurring species in the rainforest in the Los Tuxtlas volcanic area have weak genetic evidence to be considered separate species. Similarly, the individuals in the Sierra de Zongolica in central Veracruz, who bear a very high morphological and genetic similarity to Magnolia mexicana, have weak genetic evidence to be recognised as a separate species. Nonetheless, the individuals could be identified as Magnolia decastroi based on morphology, and further research including the full range of this species is recommended.

6.
Plants (Basel) ; 10(3)2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33809003

RESUMO

Mexico is floristically the fourth most species-rich country in the world, and Asteraceae is the most diverse vascular plant family in this country. The species exhibits a wide range of growth forms, but the tree-like habit, appropriately named daisy trees, is heavily underestimated, even though slightly different tree definitions are handled. Very little is known about their precise species number or conservation status in Mexico, so we update here the list of known Mexican daisy tree species, summarize their very diverse uses, present a general panorama of their present and future distribution, and discuss their conservation status. A bibliographic review and herbarium study were carried out, carefully curated taxonomical ocurrence maps were prepared for each species, and a climatic suitability modelling approach was used to characterise the spatial patterns of Mexican Asteraceae trees. With 149 daisy tree species, the country ranks second at a global level; within the country, their greatest diversity is found in central and western Mexico. A decrease in diversity is estimated in areas that currently host the highest species richness, whereas the hotspot regions are estimated to show an increase in species diversity, so climate change is not a threat to all Mexican daisy tree species.

7.
PhytoKeys ; 171: 91-153, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33584112

RESUMO

Hydrangea section Cornidia, currently consisting of 19 accepted taxa, occurs from Mexico to Chile and Argentina, with one species in southeast Asia. Its representatives are root-climbing lianas which may grow up to 60 m high in the tree canopy of temperate to (sub)tropical forests. Our extensive field work throughout its distribution area, study of herbarium specimens and ongoing molecular studies have resulted in the discovery of species new to science, as well as new insights into the circumscription of many taxa. We here present amended descriptions for seven Hydrangea species of Central and South America and discuss the taxonomical situation of two Colombian Hydrangeas, including an identification key, illustrations, and distribution maps. Field work was carried out in Costa Rica, Panama, Ecuador and Peru, including exploration in areas where the genus had not been collected before. These specimens and observations were complemented with the study of specimens of 41 herbaria of North, Central and South America, as well as Europe. Detailed morphological studies of all species were carried out, based on living plants in their natural habitat, as well as on dried specimens from our own collections and all available herbarium material. Type material was studied in detail for all species concerned. Based on an extensive number of morphological characters, combined with distribution patterns, phenological differences and ecological preferences, including molecular data in most cases, Hydrangea peruviana and H. oerstedii are clearly distinct taxa, as well as the other seven species mentioned here, which had been synonymized with either of these two species. The present study results in the recognition of 26 species in section Cornidia and exemplifies the urgent need for profound taxonomic studies in plants, as in many families we do not dispose of well-circumscribed units for conservation to mitigate the already occurring unprecedented loss of biodiversity.


ResumenHydrangea sección Cornidia, que actualmente consiste en 19 taxones aceptados, se distribuye desde México hasta Chile y Argentina, con una especie en el sureste asiático. Sus representantes son lianas trepadoras que pueden crecer hasta 60 m de altura en la copa de los árboles de los bosques templados a (sub)tropicales. Nuestro extenso trabajo de campo en toda su área de distribución, la revisión de especímenes de herbario y los estudios moleculares en curso han dado como resultado el descubrimiento de especies nuevas para la ciencia, así como conocimiento nuevo sobre la circunscripción de muchos taxones. Aquí presentamos descripciones enmendadas para siete especies de Hydrangea de Centro y Suramérica y discutimos la situación taxonómica de dos Hydrangeas colombianas, incluyendo una clave de identificación, ilustraciones y mapas de distribución. El trabajo de campo se llevó a cabo en Costa Rica, Panamá, Ecuador y Perú, incluída la exploración en áreas donde el género no había sido recolectado antes. Estos especímenes y observaciones se complementaron con el estudio de especímenes de 41 herbarios de Norte, Centro y Suramérica, así como de Europa. Se llevaron a cabo estudios morfológicos detallados de todas las especies, basados ​​en plantas vivas en su hábitat natural, así como en muestras secas de nuestras propias colecciones y todo el material de herbario disponible. El material tipo se estudió en detalle para todas las especies en cuestión. En base a una gran cantidad de caracteres morfológicos, combinados con patrones de distribución, diferencias fenológicas y preferencias ecológicas, incluyendo datos moleculares en la mayoría de los casos, Hydrangea peruviana y H. oerstedii son taxones claramente distintos, así como las otras siete especies mencionadas aquí, que habían sido sinonimizadas con cualquiera de estas dos especies. El presente estudio resulta en el reconocimiento de 26 especies en la sección Cornidia y ejemplifica la necesidad urgente de estudios taxonómicos profundos en plantas, ya que en muchas familias no disponemos de unidades de conservación bien circunscritas para mitigar la pérdida de biodiversidad sin precedentes.

8.
Photochem Photobiol ; 97(1): 22-31, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32762117

RESUMO

A set of opaque films were prepared with Degussa P25® or Hombikat UV100® TiO2 powders by the doctor blade method on glass slides with different compositions of polyethylene glycol of 20 kDa (PEG20), and they were characterized by spectroscopy, microscopy and photochemical kinetics measurements. After annealing treatment at 450 °C, about 5-7% C atom was incorporated into the films, as a consequence of the degradation of the organic complexing agents, inducing a small reduction of the energy band gap of TiO2 (i.e. 3.02 ≤ Eg (eV) ≤ 3.08). All films were about 15 ± 2 µm thick but their micro-morphological characteristics depended on the content of PEG20, showing different patterns of cracks and aggregates that produce intense light scattering and retransmission phenomena with the result of a three-dimensional excitation of the TiO2 particles in the thick film. Back-face excitation with UVA light (365 ± 42 nm) of the opaque films in contact with an aqueous solution produced both surface-bound and free hydroxyl radicals (HO• ), as detected using a coumarin solution as a radical dosimeter. The photogeneration efficiency of HO• decreased with the surface roughness of the films, which varied between 135 and 439 nm depending on the film's composition.

9.
Reumatol. clín. (Barc.) ; 9(5): 269-273, sept.-oct. 2013. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-115097

RESUMO

Objetivos: Analizar las prescripciones de tratamiento para la osteoporosis (OP) de los médicos de atención primaria (AP), antes y después de conocer el resultado de la densitometría ósea (DXA). Material y métodos: Se estudió a mujeres mayores de 50 años procedentes de 2 áreas sanitarias espa˜nolas (Islas Canarias y Alicante). Se recogieron los factores de riesgo del FRAX® y se revisaron las prescripciones de tratamiento para OP antes de la DXA y en los meses posteriores (bisfosfonatos, estroncio, raloxifeno/bazedoxifeno, estrógenos, parathormona). Para evaluar lo apropiado del tratamiento, se utilizaron guías publicadas. Se consideró riesgo elevado de fractura si FRAX® para cadera >= 3% o historia de fractura por fragilidad. Resultados: Se incluyó a 339 mujeres (edad media: 63 años). Antes de la DXA, recibían tratamiento el 14% de Canarias y el 58% de Alicante. Un 37% de las pacientes tratadas y un 26% de las no tratadas antes de la DXA tenían un riesgo de fractura elevado. El FRAX® promedio para fractura mayor y para fractura de cadera fue 5,6% y 2%, respectivamente. Tras la DXA, el porcentaje de pacientes tratadas pasó del 35 al 39%: aumentó del 14 al 28% en Canarias y se redujo del 58 al 51% en Alicante. En conjunto, recibía tratamiento: el 64% de los casos de OP, el 38% de las osteopenias y el 15% con DXA normal. Cuando se aplicaron las guías de tratamiento de OP, se obtuvo desde un 7% a tratar con la guía más restrictiva hasta un 43% con la más flexible. Conclusiones: Existe gran variabilidad en la prescripción de tratamiento para la OP antes y después de la DXA entre los médicos de AP. Se precisa de una guía de consenso amplia entre las diferentes especialidades para optimizar la práctica clínica(AU)


Objectives: To analyze the requirements for osteoporosis (OP) treatment of primary care physicians (PCP), before and after knowing the result of a bone densitometry (DXA). Material and methods: We studied 50 years older women from two Spanish health areas (Canary Islands and Alicante). The FRAX® risk factors were collected and we reviewed the requirements for OP treatment before DXA and in the subsequent months (bisphosphonates, strontium, raloxifene/bazedoxifene, estrogens, parathyroid hormone). To evaluate the appropriateness of treatment we used published guidelines. A high risk for hip fracture was considered if FRAX® >= 3% or the patient had a history of fragility fracture Results: We included 339 women (mean age: 63 years). Before DXA, 14% of Canarias and 58% of Alicante were receiving treatment. Thirty seven percent of treated patients and 26% of the untreated patients had a high fracture risk before DXA. The average FRAX® for a high risk of fracture and hip fracture was 5.6% and 2%, respectively. After DXA, the percentage of treated patients rose from 35 to 39%: increasing from 14 to 28% in the Canary Islands and decreasing from 58 to 51% in Alicante. Overall, treatment was received by 64% of patients with OP, 38% of patients with osteopenia and 15% of those with normal DXA. When the OP treatment guidelines were applied, we found that 7% needed treatment according to the most restrictive guidelines and 43% according to the most flexible guidelines. Conclusions: There is great variability in treatment for OP prescribed before after DXA between GP. A broad consensus guideline between different specialties is required to optimize clinical practice(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Osteoporose/diagnóstico , Densitometria/instrumentação , Densitometria/métodos , Densitometria , Glucocorticoides/uso terapêutico , Receptores de Glucocorticoides/uso terapêutico , Osteoporose , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Atenção Primária à Saúde , Densidade Óssea , Densidade Óssea/fisiologia , Densidade Óssea/efeitos da radiação
10.
Reumatol Clin ; 9(5): 269-73, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23735224

RESUMO

OBJECTIVES: To analyze the requirements for osteoporosis (OP) treatment of primary care physicians (PCP), before and after knowing the result of a bone densitometry (DXA). MATERIAL AND METHODS: We studied 50 years older women from two Spanish health areas (Canary Islands and Alicante). The FRAX risk factors were collected and we reviewed the requirements for OP treatment before DXA and in the subsequent months (bisphosphonates, strontium, raloxifene/bazedoxifene, estrogens, parathyroid hormone). To evaluate the appropriateness of treatment we used published guidelines. A high risk for hip fracture was considered if FRAX ≥ 3% or the patient had a history of fragility fracture RESULTS: We included 339 women (mean age: 63 years). Before DXA, 14% of Canarias and 58% of Alicante were receiving treatment. Thirty seven percent of treated patients and 26% of the untreated patients had a high fracture risk before DXA. The average FRAX for a high risk of fracture and hip fracture was 5.6% and 2%, respectively. After DXA, the percentage of treated patients rose from 35 to 39%: increasing from 14 to 28% in the Canary Islands and decreasing from 58 to 51% in Alicante. Overall, treatment was received by 64% of patients with OP, 38% of patients with osteopenia and 15% of those with normal DXA. When the OP treatment guidelines were applied, we found that 7% needed treatment according to the most restrictive guidelines and 43% according to the most flexible guidelines. CONCLUSIONS: There is great variability in treatment for OP prescribed before after DXA between GP. A broad consensus guideline between different specialties is required to optimize clinical practice.


Assuntos
Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Atenção Primária à Saúde , Idoso , Idoso de 80 Anos ou mais , Densitometria , Feminino , Fraturas do Quadril , Humanos , Pessoa de Meia-Idade
11.
Reumatol. clín. (Barc.) ; 7(5): 305-313, sept.-oct. 2011. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-90948

RESUMO

Objetivo: Recoger información sobre cómo se realiza el diagnóstico, la clasificación y el tratamiento de los pacientes osteoporóticos con alto riesgo de fractura en las consultas de Reumatología. Material y métodos: Se realizó una encuesta a reumatólogos españoles que atienden de forma habitual a pacientes con osteoporosis (OP), donde se recogieron datos demográficos, clínicos y sobre los factores de riesgo de OP y de fractura considerados más importantes, así como pruebas diagnósticas y tratamiento según el riesgo de fractura de los pacientes. Resultados: El 99,5% de los reumatólogos encuestados consideraba que existe un grupo de pacientes con OP con alto riesgo de fractura, siendo la fractura previa el factor de riesgo más importante, riesgo que se incrementaba en caso de fracturas múltiples, severas, de cadera, o si se presentaban en pacientes tratados. Le siguieron en orden decreciente el tratamiento con glucocorticoides, la edad avanzada y la densidad mineral ósea (DMO) baja. El número de fracturas vertebrales fue considerado el dato radiológico más importante, seguido de la cronología y la severidad de las fracturas. En pacientes calificados de alto riesgo, la mayoría de los encuestados seleccionó teriparatida como primera opción de tratamiento. Conclusiones: La definición de paciente con OP con alto riesgo de fractura en la práctica diaria no es homogénea, aunque la mayoría de reumatólogos consideró que el factor más importante es tener fractura previa, seguido del tratamiento con glucocorticoides, edad avanzada y DMO baja. El tratamiento osteoformador es el más utilizado en pacientes con OP con alto riesgo de fractura (AU)


Objective: To collect information about diagnosis, classification and treatment of patients at high risk of fracture in the rheumatologist’s practice. Material and Methods: A survey was conducted among Spanish rheumatologists. The survey was aimed at gathering data on the physician’s healthcare activity, the osteoporosis (OP) and fracture risk factors considered as most relevant, the diagnostic used tests and the treatment indication according to the presence of different risk factors. Results: 99.5% of rheumatologists felt that there is a group of patients with OP at high risk of fracture. Previous fracture was considered the most important risk factor, particularly in case of multiple fractures, severe fractures, hip fracture, or that occurred during treatment. Glucocorticoid treatment, older age and low bone mineral density were considered, in this order, other important risk factors. The number of vertebral fractures was considered the most relevant radiological data, followed by the fracture’s chronology and severity. Most of the respondents selected teriparatide as the first treatment option in high-risk patients. Conclusions: The definition of OP patient with high risk of fracture is not uniform in daily practice, although the majority of rheumatologists considered that having a previous fracture is the most important risk factor, followed by glucocorticoid treatment, older age and low BMD. Anabolic treatment was the approach most commonly used in OP patients with high risk of fracture (AU)


Assuntos
Humanos , Masculino , Feminino , Ferimentos e Lesões/epidemiologia , Osteoporose/classificação , Osteoporose/diagnóstico , Osteoporose/terapia , Fatores de Risco , Conhecimentos, Atitudes e Prática em Saúde , Guias de Prática Clínica como Assunto , Glucocorticoides/uso terapêutico , Projetos , Administração da Prática Médica/organização & administração
12.
Reumatol Clin ; 7(5): 305-13, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-21925446

RESUMO

OBJECTIVE: To collect information about diagnosis, classification and treatment of patients at high risk of fracture in the rheumatologist's practice. MATERIAL AND METHODS: A survey was conducted among Spanish rheumatologists. The survey was aimed at gathering data on the physician's healthcare activity, the osteoporosis (OP) and fracture risk factors considered as most relevant, the diagnostic used tests and the treatment indication according to the presence of different risk factors. RESULTS: 99.5% of rheumatologists felt that there is a group of patients with OP at high risk of fracture. Previous fracture was considered the most important risk factor, particularly in case of multiple fractures, severe fractures, hip fracture, or that occurred during treatment. Glucocorticoid treatment, older age and low bone mineral density were considered, in this order, other important risk factors. The number of vertebral fractures was considered the most relevant radiological data, followed by the fracture's chronology and severity. Most of the respondents selected teriparatide as the first treatment option in high-risk patients. CONCLUSIONS: The definition of OP patient with high risk of fracture is not uniform in daily practice, although the majority of rheumatologists considered that having a previous fracture is the most important risk factor, followed by glucocorticoid treatment, older age and low BMD. Anabolic treatment was the approach most commonly used in OP patients with high risk of fracture.


Assuntos
Atitude do Pessoal de Saúde , Conservadores da Densidade Óssea/uso terapêutico , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Pesquisas sobre Atenção à Saúde , Humanos , Osteoporose/complicações , Osteoporose/diagnóstico , Fraturas por Osteoporose/etiologia , Reumatologia , Medição de Risco , Fatores de Risco , Prevenção Secundária , Espanha , Inquéritos e Questionários , Teriparatida/uso terapêutico
13.
J Clin Rheumatol ; 17(5 Suppl 3): S59-66, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23640502

RESUMO

BACKGROUND: : There is no universally accepted definition for patients at high risk of osteoporotic fracture. OBJECTIVES: : This study aimed to survey Spanish rheumatologists; to obtain opinions about risk factors, and an acceptable definition for patients at high risk of osteoporotic fracture; and to compare daily practice patterns with current osteoporosis guidelines. METHODS: : A total of 174 rheumatologists from throughout Spain completed an online survey about various risk factors for fragility fracture and about the management of patients with osteoporosis in clinical practice. Results were reviewed by a coordinating committee of osteoporosis experts and were compared with published national and international guideline recommendations. RESULTS: : Almost all rheumatologists who completed the survey (99%) consider that a group of patients exists with a high risk of osteoporotic fracture and that this group should be managed appropriately. Previous fracture is considered the most important risk factor, particularly in cases of multiple fracture, severe vertebral fracture, hip fracture, or fracture despite osteoporosis treatment. However, in osteoporosis guidelines, age, bone mineral density, and previous fragility fracture are the most important risk factors for new fracture. Furthermore, Spanish rheumatologists tend to treat patients at high risk of fracture with anabolic therapy (e.g., teriparatide), whereas guidelines make no such recommendation. CONCLUSIONS: : In osteoporosis, a large gap exists between implementation of guideline recommendations and actual clinical practice; this may be due, in part, to heterogeneity among existing guidelines. Thus, inclusion in guidelines of a practical definition of high risk of osteoporotic fracture may provide significant opportunities to improve patient care and prevent future fragility fractures. KEY POINTS: :


Assuntos
Competência Clínica/normas , Fidelidade a Diretrizes/normas , Osteoporose/complicações , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/epidemiologia , Guias de Prática Clínica como Assunto/normas , Fatores Etários , Índice de Massa Corporal , Coleta de Dados , Tomada de Decisões , Gerenciamento Clínico , Humanos , Fatores de Risco , Fumar/efeitos adversos , Espanha
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...