Baseline characteristics of postmenopausal women with osteoporosis treated with teriparatide in a real-world setting in Latin America: a subregional analysis from the Asia and Latin America Fracture Observational Study (ALAFOS)

Abstract Background: Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America. Methods: We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico. Results: The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40-94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were - 3.02 (1.23) at the lumbar spine and - 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline. Conclusions: This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.

La pesquería de tiburones oceánicos-costeros en los litorales de Colima, Jalisco y Michoacán

Fishery of oceanic and coastal sharks in Colima, Jalisco and Michoacán. Shark fishery is one of the most important activities in the Mexican Pacific coast, nevertheless, there is few data available about the specific captures done by the fleet along the coast. This study describes fishery biology aspects of the shark species catched by the semi-industrial long-line fleet of Manzanillo. Monthly samplings were made on board of these vessels during an annual period from April 2006 to April 2007. Captured species composition (n=1 962 organisms) was represented by nine species. The one that sustains this fishery was Carcharhinus falciformis (88.12%), followed by Prionace glauca (8.21%). Low frequency species were represented by Sphyrna zygaena (1.78%), Alopias pelagicus (0.82%), Carcharhinus longimanus (0.45%). Furthermore, rare species were Alopias superciliosus (0.35%), Carcharhinus leucas (0.1%), Carcharhinus limbatus (0.1%) and Isurus oxyrinchus (0.05%). Fishery activity affected principally (60-92.70%) young males of C. falciformis, S. zygaena, C. longimanus and I. oxyrinchus; adult males (56-75%) of A. pelagicus, A. superciliosus, and C. limbatus; for P. glauca there were primarily female adults. For all the species found, females showed the bigger sizes when compared to males (with the exception of S. zygaena, that showed sexual dimorphism). Considering the lineal regressions made between precaudal length and total length, and, fork length and total length for C. falciformis, P. glauca, S. zygaena and A. pelagicus, the determination coefficients (r²) showed that both lengths can be useful to obtain the total length of fish with some damage or absence of its caudal fin. The estimated fecundity for C. falciformis was of 3-7 offspring/female of 30-45cm LT (average of 40.57+2.03cm LT); and for P. glauca 5-52offspring/female of 5-18.6cm LT (average of 11.61±0.21cm LT). In the case of C. longimanus only one female was captured with a total of eight embryos, with an average of 45cm LT each; for this reason we assumed that the fishery areas do not coincide with the nursery oness for this species. According to the information obtained, we concluded that C. falciformis has a concurrent cycle and P. glauca a consecutive biannual one. Rev. Biol. Trop. 59 (2): 655-667. Epub 2011 June 01.

La pesquería de tiburón es una de las más importantes en el Pacífico mexicano, en la actualidad no se cuentan con los datos de la composición específica de las capturas de las diferentes flotas. En el presente trabajo se describen aspectos biológicos-pesqueros de las especies de tiburón, capturadas por la flota palangrera de mediana altura del puerto de Manzanillo, en un periodo anual de abril 2006-abril 2007, los muestreos se realizaron mensualmente a bordo de estas embarcaciones. La composición de las capturas estuvo representada por nueve especies (n=1 962), de las cuales Carcharhinus falciformis (Bibron, 1839) (88.12%) sostiene esta pesquería y en segundo lugar Prionace glauca (Linnaeus, 1758) (8.21%). Las especies poco frecuentes fueron Sphyrna zygaena (Linnaeus, 1758) con (1.78%), Alopias pelagicus (Nakamura, 1935) (0.82%), Carcharhinus longimanus (Poey, 1861) (0.45%), Alopias superciliosus (Lowe, 1839) (0.35%), Carcharhinus leucas (Valenciennes, 1839) (0.1%), Carcharhinus limbatus (Valenciennes, 1839) (0.1%) é Isurus oxyrinchus (Rafinesque, 1810) (0.05%). La fecundidad estimada para C. falciformis fue de 3-7 crías/hembra con tallas de 30-45cm LT; 40.57+2.03cm LT y P. glauca con 5-52 crías/hembra, con tallas de 5-18.6cm LT; 11.61±0.21cm LT. Por lo tanto se asume que C. falciformis presenta un ciclo concurrente y P. glauca probablemente un ciclo bianual consecutivo.

Un programa de educación diabetológica centrado en el aprendiz y en principios andragógicos dirigido al desarrollo de habilidades de autocontrol de la diabetes mellitus / Diabetological program based on educational andragogic principles aimed at the development of abilities for diabetes mellitus selfassessment

Este estudio evaluativo cuyo objetivo fue diseñar, aplicar y evaluar un programa de educación diabetológica, constó, metodológicamente, de dos fases: la primera fue el diseño del programa, el cual quedó constituido por 10 unidades programáticas fundamentadas en : a) necesidades del aprendiz, b) principios andragógicos de horizontalidad y participación y c) objetivos educacionales dirigidos al desarrollo de habilidades de autocontrol. La segunda fase de aplicación y evaluación, se realizó en dos ambulatorios de Barquisimeto. Se seleccionaron 30 diabéticos tipo 2, con edades entre 41 y 65 años, alfabetas, sin alteraciones absolutas de sus capacidades sensoriales como ceguera y sordera y que no hubieran asistido a talleres de educación diabetológica. De ellos sólo 24 terminaron el estudio. El 75 por ciento eran mujeres, el 91,66 por ciento tenían una instrucción básica incompleta. Cada grupo tuvo distintas necesidades de conocimientos y habilidades, lo cual determinó la selección de las unidades a desarrollar. El 62,5 por ciento de los pacientes aumentó su nivel de comprensión; con estó el porcentaje de pacientes con elevado nivel de comprensión aumentó de 33,33 por ciento a 91,66 por ciento. El nivel de motivación para autocontrolar la diabetes aumentó en el 75 por ciento de los pacientes. El resto de los pacientes por razones socioeconómicas, no varió su motivación. El porcentaje de pacientes en fase de acción, aumentó de 4,17 por ciento a 66,67 por ciento. El 95,83 por ciento alcanzó un nivel elevado de habilidad para automedir la glicemia copilar y 100 por ciento alcanzó igual nivel de habilidad para autocuidar sus pies. Se demostró que el programa fue eficaz para alcanzar los objetivos propuestos