Volume 14 · Number 2 · July 2022
- Joint recommendations on the management of patients with osteoporosis and/or fragility fractures during and after the pandemic due to COVID-19 of SEIOMM, SEFRAOS, SER, SEMI, SEGG, SEMG, SEMERGEN and SEEN
- Clinical efficacy of FRAX®-based hybrid and age-dependent intervention thresholds in the Ecuadorian population
- Changes in bone mass in a child population with type 1 diabetes mellitus. Longitudinal study [82-87]
- Effect of treatment with denosumab for 24 months in individuals with recent spinal cord injury with osteoporosis [88-92]
- Description of the patients treated at the Fracture and Fall Prevention Unit in the context of a Fracture Liaison Service. FLS Anoia [93-97]
Familial hypocalciuric hypercalcemia (FHH) is a syndrome characterized by the association of mild or asymptomatic hereditary hypercalcemia and hypocalciuria. 3 subtypes have been described (FHH1, FHH2 and FHH3). FHH1, the most common, is due to inactivating mutations in the calcium-sensitive receptor (CaSR) gene [1-3]. Its prevalence is low, the inheritance is autosomal dominant, and it is often diagnosed by chance, because it is rarely symptomatic. Due to its clinical benignity, it is essential to establish a differential diagnosis (DD) with primary hyperparathyroidism (PHPT) to avoid unnecessary examinations and treatments. Routine genetic testing is not accurate because biochemical tests usually establish the diagnosis .
Joint recommendations on the management of patients with osteoporosis and/or fragility fractures during and after the pandemic due to COVID-19 of SEIOMM, SEFRAOS, SER, SEMI, SEGG, SEMG, SEMERGEN and SEEN
The COVID-19 pandemic has impacted the healthcare of patients with osteoporosis and fragility fractures .
Some strategies aimed at protecting against the spread of the virus, such as social distancing, have brought about changes in care models that are been homogeneous in all areas.
The need to limit access to health centers and infections has imposed a system of telemedicine  which offers many advantages to professionals and users and has become a key assistance tool to ensure social distancing. Likewise, telematic consultation can have additional applications in routine clinical practice, as it allows medical professionals to attend to patients with displacement problems and efficiently solve doubts and/or problems related to treatment, so it could be especially useful to control therapeutic compliance. However, in order to advance more effectively and secure telematic attention, always seeking the greatest agility in the responses, it should be protocolized.
Type 1 diabetes mellitus (DM1) has been associated with lower bone mass for more than 30 years [1,2], although existing data in children and adolescents are contradictory [3-8]. Published results on bone mass development in the adult diabetic population show a lower BMD in type 1 diabetics that persists over time and a higher risk of fractures [9-11]. However, in the pediatric population with DM1, longitudinal studies are very limited and with discrepant results. Some authors report a reduction in BMD during follow-up [6,12,13], while others do not observe long-term changes [14,15]. These discrepant results may be due to multiple variables such as the length of follow-up, which is almost always too short; the different ages and anthropometric variables, or the different pubertal stages of the diabetic population included in the studies [11-14].
Effect of treatment with denosumab for 24 months in individuals with recent spinal cord injury with osteoporosis
After a spinal cord injury (SCI) there is a marked loss of bone mass and an increase in remodeling that leads to the development of osteoporosis and skeletal fractures, especially below the level of the injury [1-3]. Thus, more than 50% of patients with complete SCI develop densitometric osteoporosis one year after SCI1, which can reach 81% of patients after more than 5 years of SCI . However, despite the high incidence of osteoporosis and fractures, the therapeutic approach to these patients is clearly deficient, since less than 10-20% of them receive anti-osteoporotic treatment [2,5].
Description of the patients treated at the Fracture and Fall Prevention Unit in the context of a Fracture Liaison Service. FLS Anoia
Worldwide, 1 in 3 women and 1 in 5 men will experience a fragility fracture in their lifetime. Every 3 seconds there is 1 fragility fracture in the world. The most frequent fractures associated with osteoporosis are located in the hip, spine and wrist [1,2].
Hip fracture has become an international barometer of osteoporosis, associated with low bone mineral density, high health care costs, and greater disability than other types of osteoporotic fracture . Only 30% of people with a hip fracture regain their pre-fracture level of physical function, and many are left with reduced mobility, loss of functional independence, and requiring long-term care. For this reason, among other reasons, the International Osteoporosis Foundation (IOF) has developed the Capture the Fracture program, aimed at reducing secondary and posterior fractures by facilitating the implementation of Fracture Liaison Services (FLS) [1,2].