[A search for secondary causes of osteoporosis or low mineral density in postmenopausal women]. / Osteoporosis postmenopáusica: relevancia de la búsqueda estructurada de causas secundarias.

BACKGROUND: A secondary cause can be found in up to one third of women with osteoporosis, potentially modifying their therapeutic approach. AIM: To determine the prevalence of secondary causes and risk factors for decreased bone mineral density (BMD) and osteoporosis. MATERIAL AND METHODS: We included postmenopausal women with a diagnosis of osteoporosis or low BMD who consulted for the first time in an endocrinology clinic between October 2018 and March 2020. A complete medical history, physical examination and a standardized laboratory assessment to identify secondary causes were performed. RESULTS: During the study period, 114 women were evaluated, 30 of them with low BMD and 84 with osteoporosis. After obtaining a medical history and a structured laboratory screening, at least one secondary cause was found in 50% of patients with osteoporosis and in 67% of those with low BMD. Most patients with no identified secondary cause had at least one risk factor for fragility fractures. CONCLUSIONS: A structured evaluation that includes medical history and standardized laboratory study in postmenopausal women with osteoporosis or low BMD, is a valuable tool to identify secondary causes of osteoporosis.

[Profile of glucose lowering drug use in outpatients with type 2 diabetes mellitus]. / Perfiles de hipoglicemiantes e insulinas en pacientes con diabetes mellitus tipo 2 y su efecto en control metabólico, hipoglicemia y otros efectos adversos.

BACKGROUND: The use of glucose lowering agents with favorable weight profile is a growing practice in Diabetology. AIM: To characterize medication combinations in patients with type 2 Diabetes (T2D) and their effect on metabolic control. MATERIAL AND METHODS: Review of medical records of 249 outpatients with T2D with a median age of 66 years, cared for at a medical network. Clinical characteristics, glycated hemoglobin (HbA1c), details of Diabetes treatment (types of drugs or insulin), renal function, lipids and B12 vitamin levels were registered. RESULTS: The median disease duration was 16 years. The most recent HbA1c was 7.4%. No patient was using sulfonylureas, 45 were using Dipeptidyl peptidase 4 inhibitors, 113 were using Sodium-glucose Cotransporter-2 (SGLT2i) Inhibitors, 21 used Glucagon-like Peptide-1 Receptor Agonists (GLP1ra), 158 used basal insulin and 61 on basal plus bolus insulin. The use of SGLT2i or GLP1ra was associated with a metabolic control similar to those patients not using them, while patients on rapid insulin had a significantly worse metabolic control and a tendency to greater body mass index. The use of basal insulin and rapid insulin was significantly associated with more hypoglycemia events. CONCLUSIONS: The use of SGLT2i and GLP1ra in patients with T2D is associated with better metabolic control than rapid insulin with less risk of hypoglycemia. The use of these therapies should be prioritized in the future.

Aplicaciones de perfiles sensoriales en adolescentes y adultos en el ámbito de salud: una revisión narrativa de la literatura / Aplicações de perfis sensoriais em adolescentes e adultos em ambientes de saúde: uma revisão narrativa da literatura / Sensory profile applications in adolescents and adults in the health care: a narrative review of the literature

Resumen Introducción Conocer qué tipo de información sensorial se procesa y la reacción a los diferentes estímulos sensoriales es relevante para el abordaje de los trastornos psiquiátricos y del neurodesarrollo en adolescentes y adultos. Este estudio corresponde a una revisión de la literatura sobre las diferentes aplicaciones de tres de los instrumentos más utilizados que evalúan la modulación sensorial desde la adolescencia. Objetivos Identificar y sintetizar la información disponible sobre las aplicaciones del perfil sensorial para adolescentes y adultos y el cuestionario del procesamiento sensorial. Método Revisión narrativa de la literatura, donde se realizó una prueba de sensibilidad para definir palabras clave y fuentes de datos. Las investigaciones se realizaron en las bases de datos Web of Science, Scopus, SciELO, LILACS y la Revista Chilena de Terapia Ocupacional, desde el año 2002 a enero del año 2023. Resultados Se analizaron 64 artículos en total donde los hallazgos fueron que el uso del instrumento del perfil sensorial para adolescentes y adultos se utiliza en más de 20 patologías y también en población sana. Los dos cuestionarios de procesamiento sensorial está en la etapa inicial de aplicación y validación del instrumento en varios países. Conclusión Esta es la primera revisión narrativa de la literatura que se realiza sobre los tres instrumentos de evaluación del procesamiento sensorial disponibles para adolescentes y adultos. Estos tres instrumentos clínicos son complementarios y proporcionan información relevante al clínico para el diagnóstico del procesamiento sensorial y la orientación de la intervención de terapia ocupacional.

Resumo Introdução Conhecer que tipo de informação sensorial é processada e a reação a diferentes estímulos sensoriais é relevante para a abordagem de transtornos psiquiátricos e de neurodesenvolvimento em adolescentes e adultos. Este estudo corresponde a uma revisão da literatura sobre as diferentes aplicações de três dos instrumentos extensivamente utilizados para avaliar a modulação sensorial a partir da adolescência. Objetivos Identificar e sintetizar as informações disponíveis sobre as aplicações do questionário de processamento sensorial e do perfil sensorial para adolescentes e adultos. Método Revisão narrativa da literatura, a partir de um teste de sensibilidade para definir palavras-chave e fontes de dados. A pesquisa foi realizada nos bancos de dados Web of Science, Scopus, SciELO, LILACS e na Revista Chilena de Terapia Ocupacional, de 2002 a janeiro de 2023. Resultados Um total de 64 artigos foi analisado e os achados foram que o uso do instrumento de perfil sensorial para adolescentes e adultos é usado em mais de 20 patologias e também na população saudável. Os dois questionários de processamento sensorial está em fase inicial de implementação e validação do instrumento em vários países. Conclusão Esta é a primeira revisão narrativa da literatura sobre os três instrumentos de avaliação do processamento sensorial disponíveis para adolescentes e adultos. Esses três instrumentos clínicos são complementares e fornecem informações relevantes ao clínico para diagnosticar o processamento sensorial e orientar a intervenção da terapia ocupacional.

Abstract Introduction Understanding the type of sensory information processed and the reactions to various sensory stimuli is critical for neurodevelopmental and psychiatric disorders in adolescents and adults. This literature review explores the different applications of three of the most commonly used instruments for assessing sensory modulation from adolescence. Objective To identify and synthesize the existing information about the applications of the sensory profile for adolescents and adults, as well as the sensory processing questionnaire. Method Narrative review of the literature in which was conducted a sensitivity test to establish keywords and identify relevant data sources. The research was carried out using databases such as WOS, Scopus, SciELO, LILACS, and the Chilean Journal of Occupational Therapy, covering the period from 2002 to January 2023, following predefined inclusion/exclusion criteria. Results A total of 64 articles were analyzed where the findings were that the use of the sensory profile instrument for adolescents and adults is used in more than 20 pathologies and also in healthy population. The sensory processing questionnaire is in the initial stage of application and validation of the instrument in several countries. Conclusion This is the first narrative literature review of the three sensory processing assessment instruments available for adolescents and adults. These three clinical instruments are complementary and provide relevant information to the clinician for diagnosing sensory processing and guiding occupational therapy intervention.

Osteoporosis postmenopáusica: relevancia de la búsqueda estructurada de causas secundarias / A search for secondary causes of osteoporosis or low mineral density in postmenopausal women

BACKGROUND: A secondary cause can be found in up to one third of women with osteoporosis, potentially modifying their therapeutic approach. AIM: To determine the prevalence of secondary causes and risk factors for decreased bone mineral density (BMD) and osteoporosis. Material and Methods: We included postmenopausal women with a diagnosis of osteoporosis or low BMD who consulted for the first time in an endocrinology clinic between October 2018 and March 2020. A complete medical history, physical examination and a standardized laboratory assessment to identify secondary causes were performed. RESULTS: During the study period, 114 women were evaluated, 30 of them with low BMD and 84 with osteoporosis. After obtaining a medical history and a structured laboratory screening, at least one secondary cause was found in 50% of patients with osteoporosis and in 67% of those with low BMD. Most patients with no identified secondary cause had at least one risk factor for fragility fractures. Conclusions: A structured evaluation that includes medical history and standardized laboratory study in postmenopausal women with osteoporosis or low BMD, is a valuable tool to identify secondary causes of osteoporosis.

Perfiles de hipoglicemiantes e insulinas en pacientes con diabetes mellitus tipo 2 y su efecto en control metabólico, hipoglicemia y otros efectos adversos / Profile of glucose lowering drug use in outpatients with type 2 diabetes mellitus

BACKGROUND: The use of glucose lowering agents with favorable weight profile is a growing practice in Diabetology. AIM: To characterize medication combinations in patients with type 2 Diabetes (T2D) and their effect on metabolic control. MATERIAL AND METHODS: Review of medical records of 249 outpatients with T2D with a median age of 66 years, cared for at a medical network. Clinical characteristics, glycated hemoglobin (HbA1c), details of Diabetes treatment (types of drugs or insulin), renal function, lipids and B12 vitamin levels were registered. RESULTS: The median disease duration was 16 years. The most recent HbA1c was 7.4%. No patient was using sulfonylureas, 45 were using Dipeptidyl peptidase 4 inhibitors, 113 were using Sodium-glucose Cotransporter-2 (SGLT2i) Inhibitors, 21 used Glucagon-like Peptide-1 Receptor Agonists (GLP1ra), 158 used basal insulin and 61 on basal plus bolus insulin. The use of SGLT2i or GLP1ra was associated with a metabolic control similar to those patients not using them, while patients on rapid insulin had a significantly worse metabolic control and a tendency to greater body mass index. The use of basal insulin and rapid insulin was significantly associated with more hypoglycemia events. CONCLUSIONS: The use of SGLT2i and GLP1ra in patients with T2D is associated with better metabolic control than rapid insulin with less risk of hypoglycemia. The use of these therapies should be prioritized in the future.

Consecuencias psicosociales de la privación de la libertad en imputados inocentes / Psychosocial consequences of innocent persons being deprived of their liberty / Consequências psicossociais da privação da liberdade em imputados inocentes

El objetivo de este estudio fue describir las consecuencias psicosociales en sujetos privados de la libertad que resultaron inocentes. El marco teórico incluyó los conceptos de psicología jurídica, presunción de inocencia, verdad jurídica, privación de la libertad, efectos de la prisionización y estigmatización social. El instrumento empleado para la recolección de información fue una entrevista semiestructurada, que logró dar cuenta de los efectos psicológicos y sociales de la privación de la libertad en personas que fueron imputadas y que resultaron finalmente inocentes, según la verdad jurídica. Se concluye con la ratificación de las consecuencias psicosociales del hecho de estar privados de la libertad, y con una reflexión acerca de la actuación de los operadores del sistema judicial y la dificultad para detectar los errores.

O objetivo deste estudo é descrever as consequências psicossociais nos sujeitos privados da liberdade que ficaram inocentes. O quadro teórico incluiu os conceitos da psicologia legal, da presunção do inocência, da verdade legal, da privação da liberdade, dos efeitos do encarceramento e da estigmatização social. O instrumento usado para a coleta das informações foi uma entrevista semiestruturada, e evidenciou os efeitos psicológicos e sociais da privação da liberdade nas pessoas que foram imputadas e ficaram inocentes, de acordo com a verdade legal. O artigo conclui com o ratificação das consequências psicossociais do fato de estar privados da liberdade, e com uma reflexão sobre o desempenho dos operadores do sistema judicial e da dificuldade para detectar os erros.

This study was aimed at describing the psychosocial consequences affecting individuals who after having been deprived from their liberty were found innocent. The theoretical frame included concepts such as legal psychology, the presumption of innocence and the in dubio pro-reo, i. e. “when in doubt, for the accused” principles, judicial truth, deprivation of liberty, and the effects of prisonization and social stigmatization. The instrument used in the gathering of information was a semi-structured interview which succeeded in accounting for the psychological and social consequences of deprivation of liberty for innocent people wrongfully convicted, according to the juridical truth. The study concludes with the ratification of such effects and consequences and the usual difficulty in error detecting and correcting.